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Diving and Hyperbaric Medicine Jun 2018It has been our institution's policy to not place glass medication ampoules inside our hyperbaric chamber for fear of rupture. There is only a small and conflicting...
INTRODUCTION
It has been our institution's policy to not place glass medication ampoules inside our hyperbaric chamber for fear of rupture. There is only a small and conflicting amount of data as to whether glass ampoules are safe for use under hyperbaric conditions.
OBJECTIVES
The primary objective of this study was to test the safety and usability of glass medication ampoules inside a hyperbaric chamber.
METHODS
Repetitive, rapidly staged compressions and decompressions were performed on multiple different glass medications ampoules inside the medical lock of a medical hyperbaric chamber. Medication ampoules of varying sizes (1 ml to 10 ml) of medication that may be required in a hyperbaric emergency were assessed. The ampoules were rapidly compressed 100 times to pressures of 142 kPa, 183 kPa, 300 kPa, 405 kPa and 507 kPa. They were then dropped from a height of 30 cm while compressed at 507 kPa and then half the ampoules were opened while pressurized at 507 kPa.
RESULTS
No ampoules were broken during compression or decompression. No ampoules broke when dropped from 30 cm onto the chamber floor. All ampoules opened at a pressure of 507 kPa functioned normally. No lids/ampoules shattered upon opening.
CONCLUSION
This study suggests that glass medication ampoules appear to be safe for use inside a medical hyperbaric chamber at routine treatment pressures.
Topics: Drug Packaging; Emergencies; Glass; Humans; Hyperbaric Oxygenation; Pressure
PubMed: 29888383
DOI: 10.28920/dhm48.2.107-109 -
Revista Brasileira de Anestesiologia 2011Glass ampoules have been widely used in packaging injection drugs. Glass has important characteristics that allow it to be widely used in fabrication of recipients for...
BACKGROUND AND OBJECTIVES
Glass ampoules have been widely used in packaging injection drugs. Glass has important characteristics that allow it to be widely used in fabrication of recipients for drugs and other sterile substances. However, contamination of solutions with glass microparticles on breaking open glass ampoules, the presence of metals, percutaneous injury, and biological contamination justify the need of educational materials to orient the manipulation of ampoules.
CONTENTS
Glass microparticles generated in the snap-opening of ampoules, as well as metals that contaminate their contents can be aspirated and injected through several routes. Exogenous contaminations by glass and metals can reach several sites in the organism. They trigger organic reactions that may give rise to injuries. Opening ampoules can expose professionals to the risk of percutaneous injuries. These lesions increase the biological risk as they are the gateway for viruses and bacteria. Ampoules opening systems (VIBRAC and OPC) have been developed to reduce the incidence of such accidents. Alternative materials to glass may represent an interesting strategy to increase safety. The use of prefilled syringes may represent an evolution regarding safety.
CONCLUSIONS
Team training and information provided by the pharmaceutical industry on the use of ampoules are fundamental in the prophylaxis of accidents and contaminations. The search for safer materials to replace glass is also important.
Topics: Drug Contamination; Drug Packaging; Glass; Health Personnel; Occupational Injuries; Risk Factors; Risk Management
PubMed: 21724014
DOI: 10.1016/S0034-7094(11)70059-9 -
Asian Journal of Surgery Apr 2024
PubMed: 38212223
DOI: 10.1016/j.asjsur.2023.12.084 -
European Addiction Research 2022Injectable naloxone is already provided as take-home naloxone (THN), and new concentrated intranasal naloxone is now being introduced in Europe. Despite evidence of the...
BACKGROUND
Injectable naloxone is already provided as take-home naloxone (THN), and new concentrated intranasal naloxone is now being introduced in Europe. Despite evidence of the effectiveness and cost-effectiveness of THN, little is known about the attitudes of key target populations: people who use opioids (PWUO), family/friends, and staff. We examined the acceptability of different naloxone devices (ampoule, prefilled syringe, and concentrated nasal spray) across 5 European countries.
OBJECTIVES
The aim of this study was to compare THN target groups (PWUO vs. family/friends vs. staff) in their past rates of witnessed overdose and THN administration (as indicators of future use), current THN device preference, and THN carriage on the day of survey.
METHOD
Cross-sectional survey of respondents (age ≥18) in addiction treatment, harm reduction, and recovery services in Denmark, England, Estonia, Norway, and Scotland. A purpose-developed questionnaire (59 items) was administered in the local language electronically or in a pen-and-paper format.
RESULTS
Among n = 725 participants, 458 were PWUO (63.2%), 214 staff (29.5%), and 53 (7.3%) family members. The groups differed significantly in their likelihood-of-future THN use (p < 0.001): PWUO had the highest rate of previously witnessing overdoses (352; 77.7%), and staff members reported the highest past naloxone use (62; 30.1%). Across all groups, most respondents (503; 72.4%) perceived the nasal spray device to be the easiest to use. Most reported willingness to use the spray in an overdose emergency (508; 73.5%), followed by the prefilled syringe (457; 66.2%) and ampoules (64; 38.2%). Average THN carriage was 18.6%, ranging from 17.4% (PWUO) to 29.6% (family members).
CONCLUSION
Respondents considered the concentrated naloxone nasal spray the easiest device to use. Still, most expressed willingness to use the nasal spray as well as the prefilled syringe in an overdose emergency. Carriage rates were generally low, with fewer than 1 in 5 respondents carrying their THN kit on the day of the survey.
Topics: Analgesics, Opioid; Attitude; Cross-Sectional Studies; Drug Overdose; Humans; Naloxone; Narcotic Antagonists; Nasal Sprays; Opioid-Related Disorders; Surveys and Questionnaires
PubMed: 35114666
DOI: 10.1159/000521197 -
Lancet (London, England) Jul 2021Pain management after caesarean delivery is important because acute pain in the postoperative period is associated with persistent pain, increased opioid use and...
BACKGROUND
Pain management after caesarean delivery is important because acute pain in the postoperative period is associated with persistent pain, increased opioid use and postpartum depression, and delayed functional recovery. We investigated the role of nurse-supported care in acute pain management after caesarean delivery, which as far as we know has not previously been investigated in Gaza.
METHODS
This was a comparative study done from March, 2018, to October, 2018, among women assigned to undergo caesarean delivery. Research nurses at the Al-Helal Al-Emirati Hospital, Rafah, Gaza Strip, occupied Palestinian territory, were trained to give supportive pain management care to women after caesarean delivery, including individualised care and educational sessions on pain, nutrition, exercise, and wound care. Women were randomly assigned to receive nurse-supported care or usual care. Pain assessment scales (range 1-5, where 1=no pain and 5=pain as bad as it could be) were used to record pain at 1, 6, 12, 18, and 24 h after caesarean delivery. The time from the end of the caesarean delivery to the first request for analgesia and the total amounts and types of analgesics (pethidine ampules, diclofenac ampules, or indometacin suppositories) used in the first 24 h were recorded as primary outcomes. Secondary outcomes were nausea and vomiting scores (0-3, where 0=no nausea or vomiting and 3=severe and unresponsive to antiemetic drugs), sedation scores (0-3, where 0=patient awake and 3=severe sedation and patient difficult to rouse), and pruritis scores (0-2, where 0=no pruritis and 2=severe pruritis needing treatment). Data were analysed with SPSS (version 22.0). Groups were compared by using the Student's t-test and χ. P values less than 0·05 were significant. The study was approved by the Ministry of Health and Helsinki Committee, Gaza Strip. Women provided verbal informed consent for inclusion in the study when they were assigned to the caesarean delivery.
FINDINGS
108 women participated, with a mean age of 29·2 years (SD 5·50). 49 women were randomly assigned to nurse-supported care and 59 to usual care. Pain was reduced in the nurse-supported care group compared with in the usual care group at 12 h (mean score 1·15 [SD 0·25] vs 1·60 [0·67], p=0·002) and at 18 h (1·08 [0·22] vs 1·26 [0·21], p=0·049) but did not differ significantly at other times. The time to first requesting analgesia was shorter in the nurse-supported care group than in the usual care group (mean 3·38 h [SD 1·01] vs 6·16 h [2·01], p=0·038). The proportions of women who asked for a first analgesic were similar in the two groups (30 [61%] and 36 [61%]), whereas seven (14%) women in the nurse-supported care group requested a second analgesic compared with 13 (22%) in the usual care group (p=0·045). There were no significant differences between the two groups for nausea and vomiting, sedation, or pruritis.
INTERPRETATION
Nurse-supported care provided better analgesia than usual care in women who had undergone caesarean delivery. A multicentre study is needed to explore the types, duration, and repeatability of the effects of nurse supportive care on pain perception and duration of hospital stay after caesarean delivery.
FUNDING
None.
PubMed: 34227956
DOI: 10.1016/S0140-6736(21)01510-5 -
Saudi Pharmaceutical Journal : SPJ :... Mar 2023The objectives of this study were to explore the wastage of narcotics and controlled medications and, their financial impact in a tertiary care setting over a one-year...
OBJECTIVE
The objectives of this study were to explore the wastage of narcotics and controlled medications and, their financial impact in a tertiary care setting over a one-year period.
METHODOLOGY
The study period was of one year, i.e., October 2020 - September 2021. The venue of study was a tertiary care hospital. The narcotic medications included Fentanyl, Tramadol, Morphine, and Meperidine. The controlled medications included Midazolam, Phenobarbital, Diazepam, Ketamine and Lorazepam. The annual consumption and wastage of the narcotic and controlled medications were documented using data report generated by narcotics and controlled medication in-charge pharmacist through the hospital's online system. Data was reported using average, minimum and maximum values. Quantities of wastage is expressed in terms of ampoules. Costs per ampoule were calculated and expressed in both Saudi Riyal (SAR) and United States Dollar (USD). The study was approved by an ethics committee.
RESULTS
The annual wastage of narcotics was 3.19 % while the same for controlled medications was 21.3 %. An annual wastage of 3.81 % was reported for narcotics and controlled medications combined. The total wastage cost of narcotics and controlled medications was 15,443.1 SAR that was equivalent to USD 4085.5. Fentanyl 500mcg formulations had the highest consumption, i.e., 28,580 ampoules followed by Morphine 10 mg formulations, i.e., 27,122 ampoules. The highest ampoule wastage was observed for Morphine 10 mg formulations, i.e., 1956 ampoules. The highest % wastage was observed for Midazolam formulations, i.e., 29.3 %.
CONCLUSION
The overall wastage was less than 5% of the total consumption, however, midazolam was observed to have the highest wastage. Shifting to prefilled syringes supplied by pharmacies, making protocols, and safely pooling costly drugs could result in significant savings.
PubMed: 37026053
DOI: 10.1016/j.jsps.2022.12.012 -
NPJ Microgravity 2019Directional solidification experiment was carried out with Al-Bi-Sn immiscible alloy under microgravity environment onboard the Tiangong 2 space laboratory of China....
Directional solidification experiment was carried out with Al-Bi-Sn immiscible alloy under microgravity environment onboard the Tiangong 2 space laboratory of China. Sample with a well-dispersed microstructure was obtained by properly designing the experimental scheme, the matrix shows equiaxed morphology, and there is no visible gas cavity or pinhole in the sample. In contrast, the reference samples solidified on earth show phase-segregated structure and contain some gas cavities or pinholes. The grain morphology of the terrestrial sample depends on the solidification direction, it is equiaxed when the sample ampoule was withdrawn against the gravity direction, while it is columnar when the sample ampoule was withdrawn along the gravity direction. The solidification process and affecting mechanisms of microgravity on the microstructure formation are discussed. The results indicate that the microgravity conditions can effectively diminish the convective flow of the melt and the Stokes motions of the minority phase droplets and gas bubbles, which are helpful for suppressing the occurrence of macro-segregation and preventing the formation of porosity. The results also demonstrate that the microgravity conditions favor the detachment between the melt and the wall of crucible, thus increasing the nucleation undercooling of α-Al nuclei and promoting the formation of equiaxed grain.
PubMed: 31754626
DOI: 10.1038/s41526-019-0086-z -
Beilstein Journal of Nanotechnology 2023This article describes an approach for synthesizing silicon phosphide nanoparticles with a defective zinc blende structure under mild conditions through thermal...
This article describes an approach for synthesizing silicon phosphide nanoparticles with a defective zinc blende structure under mild conditions through thermal annealing of hydrogenated silicon nanoparticles with red phosphorus. The synthesized SiP nanoparticles were analyzed using FTIR, XRD, electron diffraction, EDX, TEM, Raman spectroscopy, X-ray fluorescence spectrometry, and UV-vis spectrophotometry. For the isolated cubic SiP phase, a cell parameter of = 5.04 Å was determined, and the bandgap was estimated to be equal to 1.25 eV. Because of the nanoscale dimensions of the obtained SiP nanoparticles, the product may exhibit several exceptional properties as a precursor for diffusion doping of wafers and as anode material for Li-ion batteries. A similar method with a hydrogenation step offers the possibility to obtain other compounds, such as silicon selenides, arsenides, and sulfides.
PubMed: 37800121
DOI: 10.3762/bjnano.14.80 -
Annals of Medicine and Surgery (2012) Feb 2022In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of...
INTRODUCTION
In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case.
CASE PRESENTATION
A 17-year-old male patient was presented to the Hospital with a fever up to 39 °C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39 °C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli ( serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days.
DISCUSSION
Fever is a well-known sign of COVID-19 infection which has been observed in 83%-98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses.
CONCLUSION
Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19.
PubMed: 35096387
DOI: 10.1016/j.amsu.2022.103282 -
Journal of Korean Medical Science Nov 2014This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial,... (Randomized Controlled Trial)
Randomized Controlled Trial
This study aimed to examine the positive effects of polydeoxyribonucleotide (PDRN) on the wound-healing process in pressure ulcers. In this randomized controlled trial, the effects of PDRN were compared over time between an experimental group (n=11) and a control group (n=12). The former was administered the same dose of PDRN intramuscularly (1 ampule, 3 mL, 5.625 mg, for 5 days) for 2 weeks and perilesionally (1 ampule, 3 mL, 5.625 mg, twice a week) for 4 weeks. The primary endpoint for determining efficacy was wound healing in the pressure ulcers, which was reflected by the wound surface area determined using VISITRAK Digital (Smith & Nephew, Largo, FL). The secondary endpoint was the pressure ulcer scale for healing score, determined using pressure ulcer scale for healing (PUSH Tool 3.0 developed by the National Pressure Ulcer Advisory Panel). After the 4-week treatment period, PDRN therapy was found to significantly reduce the wound size and PUSH score, without adverse effect during the treatment. The findings indicate that PDRN can positively modify the wound healing process in pressure ulcers, and its use could improve the clinical outcomes of patients and lower the need for additional therapies or hospital stay.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Polydeoxyribonucleotides; Pressure Ulcer; Treatment Outcome; Wound Healing; Young Adult
PubMed: 25473213
DOI: 10.3346/jkms.2014.29.S3.S222