Reversion of Ebolavirus Disease from a Single Intramuscular Injection of a pan-Ebolavirus Immunotherapeutic

Intravenous administration (IV) of antiviral monoclonal antibodies (mAbs) is challenging due to limited resources for performing infusions during an ongoing epidemic. An ebolavirus therapeutic administered via intramuscular (IM) injection would reduce these burdens and allow rapid treatment of exposed individuals during an outbreak. Here, we demonstrate how MBP134, a two mAb pan-ebolavirus cocktail, reverses the course of Sudan ebolavirus (SUDV/Gulu) disease with a single IV or IM dose in non-human primates (NHPs) as far as five days post-exposure. Furthermore, we investigated the utility of adding half-life extension mutations to the MBP134 mAbs, ultimately creating a half-life extended cocktail designated MBP431. MBP431 demonstrated an extended serum half-life in vivo and offered complete or significant protection with a single IM dose delivered as a post-exposure prophylactic (PEP) or therapeutic in NHPs challenged with EBOV. These results support the use of MBP431 as a rapidly deployable IM medical countermeasure against every known ebolavirus.

Acute localized exanthematous pustulosis: A novel side effect of piroxicam

Acute generalized exanthematous pustulosis (AGEP) is a rare yet well-known cutaneous reaction pattern, mostly caused by drugs. Acute localized exanthematous pustulosis (ALEP) is a localized variant of AGEP. A 42-year-old female presented with multiple erythematous pustules on the face, which appeared three days after the intramuscular injection of piroxicam. Histopathology revealed subcorneal pustules, epidermal spongiosis, and mixed inflammatory cell infiltration in the dermis. The pustules resolved within several days once the patient had discontinued the drug. Herein, we report the first case, as far as we know, of a female with a cutaneous drug reaction consistent with ALEP caused by piroxicam.

Sedative effect and physiological changes in horses treated with intramuscular injection of detomidine and morphine

ABSTRACT: This study aimed to elucidate the sedative effect and physiological changes associated with the intramuscular injection of detomidine combined with morphine in horses. Six healthy crossbred horses, aged 2 to 10 years, were included. A crossover experimental design was used to compare the effects of intramuscular injection of 30 µg/kg of detomidine alone (IMD) and intramuscular administration of 30 µg/kg of detomidine and 0.1 mg/kg of morphine (IMDM). The degree of sedation, height of head above ground, were assessed at the time points before and 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration, and heart rate, respiratory rate, systolic blood pressure, rectum temperature and intestinal motility were assessed at the time points before and 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration. The physiological parameters were analyzed using the Kruskal-Wallis test with Dunn’s post-hoc test and analysis of variance with t-test for independent samples and the sedation scores using the Friedman test and Mann Whitney U-test. P-values <0.05 indicated a statistically significant difference. IMDM promoted a higher sedative effect as compared to IMD, but the sedation occurred inconsistently. Additionally, a reduction in intestinal motility was observed with IMDM at 60, 75, 90, and 105 minutes after administration. IMDM promoted more variable sedation and prolonged reduction in the intestinal motility in the horses as compared to IMD.

Studi Kasus: Diagnosis dan Pengobatan Stomatitis pada Kucing Domestik

Stomatitis is an inflammation that occurs in the oral mucosal tissue, characterized by ulcers. This case study aims to diagnose and treat stomatitis in a cat. A 7-month-old female domestic cat weighing 2.7 kg with lethargy, lost of appetite, decreased thirst, and was having sores for 2 days was examined. The cat was examined physically include anamnesis, an inspection of body condition and eating behavior, palpation of the skin, hair, and parts of the body that can be palpated, and auscultation of the thorax and abdomen. The blood sample that was examined includes the erythrocyte count, hemoglobin value, leukocytes count, and their differentials. Physical examination results showed hyperemic gingival, swollen submandibular and retropharyngeal lymphoglandula, and there were multiple ulcers on the lips and tongue. Hematological examination showed thrombocytopenia and monocytosis. The stomatitis was diagnosed to the cat with a good prognosis. Therapy was given for 5 consecutive days in the form of intramuscular injection of Amoxycillin 10 mg/kg BW twice daily, intramuscular injection of diphenhydramine HCl 1 mg/kg BW once daily, subcutaneous injection of 0.5 ml vitamin C once daily, oral administration of 0.5 ml multivitamin twice daily, and povidone-iodine for gargle twice a day applied lightly to the lesion area. Stomatitis in this case study was cured within 5 days by treating with amoxicillin, diphenhydramine HCl, vitamin C, multivitamins, and topical povidone-iodine. Keywords: Amoxicillin; Cat; Stomatitis; Vitamin C. Abstrak Stomatitis merupakan radang yang terjadi pada jaringan mukosa mulut yang ditandai adanya ulser. Studi kasus ini bertujuan melakukan diagnosis dan pengobatan stomatitis pada kucing. Studi kasus ini melaporkan seekor kucing domestik betina umur 7 bulan dengan berat badan 2,7 kg dengan keluhan lesu, tidak ada nafsu makan dan minum, serta menderita sariawan sejak 2 hari sebelum diperiksa. Kucing diperiksa secara fisik meliputi anamnesa, inspeksi terhadap kondisi tubuh dan perilaku makan, palpasi terhadap kulit, rambut, dan permukaan tubuh lainnya, serta auskultasi pada daerah thorax dan abdomen. Sampel darah kucing diperiksa terhadap jumlah eritrosit kadar hemoglobin, jumlah leukosit dan diferensialnya. Hasil pemeriksaan fisik menunjukkan limfoglandula submandibula dan retropharingeal bengkak, gingiva hiperemi serta adanya ulser multiple pada bibir dan lidah. Hasil pemeriksaan darah menunjukkan trombositopenia dan monositosis. Berdasarkan hasil pemeriksaan kucing didiagnosis stomatitis dengan prognosis fausta. Kucing diberi terapi selama 5 hari berupa amoxicilin dosis 10 mg/kg BB dua kali sehari secara intramuskuler, dyphenhidramin HCl 1 mg/kg BB satu kali sehari secara intramuskuler, vitamin C sebanyak 0,5 ml satu kali sehari secara subkutan, multivitamin sebanyak 0,5 ml dua kali sehari secara per oral, dan povidone iodine dua kali sehari dioleskan pada lesi stomatitis. Stomatitis pada kasus ini dapat disembuhkan dalam waktu 5 hari dengan pemberian amoxicilin, dipenhidramin HCl, vitamin C, multivitamin secara sistemik dan povidone iodine secara topikal. Kata kunci: Amoksisilin; Kucing; Stomatitis; Vitamin c

A STUDY TO ASSESS THE EFFECTIVENESS OF HELFER SKIN TAP TECHNIQUE ON THE LEVEL OF PAIN REDUCTION DURING INTRA MUSCULAR INJECTION AMONG ORTHOPAEDIC PATIENT OF PANDIT DEEN DAYAL UPADHYAYA (CORONATION) GOVERNMENT HOSPITAL DEHRADUN UTTARAKHAND

Pain is an unpleasant sensory and emotional feeling accompanying existing or impending tissue damages or reference to such damage.According to WHO annual report more than 16 billion IM injections are administered throughout the word. Aim: This study is intended to determine the effectiveness of Helfer skin tap technique on the level of pain reduction during IM injection among orthopedic patient of PanditDeenDayalUpadhaya (Coronation)Government Hospital, Dehradun Uttarakhand. Methodology: An experimental approach with cross-over design was adopted for the study. The study samples were orthopedic patients who receiving IM diclofenac injection. There were 50 subjects that fulfill the inclusion and exclusion criteria are divided into two experimental groups (25 samples in each groups) by simple random sampling technique. The pain level was assessed by universal numerical pain rating scale .The pain level with the administration of intramuscular injection by Helfer skin tap technique was compared with a pain level with conventional Technique. Result:The result shows that in experimental group I majority of sample 52%perceived mild pain with Helfer skin tap technique whereas with majority of samples 64% perceived moderate pain with conventional technique. The mean pain score with Helfer skin tap technique was 3.88 was less than conventional technique 5.32.The obtained t value was 3.80 was significant at p<0.05 level of significance.Inexperimental group II majority of sample 64% perceived mild pain with Helfer skin tap technique whereas with majority of samples 68% perceived moderate pain with conventional technique. The mean pain score with Helfer skin tap technique was 3.52 was less than conventional technique 5.16.The obtained t value was 5.479 was significant at p<0.05 level of significance In period I the mean pain score using Helfer skin tap technique in experimental group I 3.88 was less than mean pain score of conventional technique in experimental group II 5.15.the obtained t value was found statistically significant at p<0.05 level. In period II the mean pain score using Helfer skin tap technique 3.52 was less than the mean pain scores of conventional technique 5.32.the obtained t value 4.5 was statistically significant at p<0.05 level of significance. There was no significant association found between level of pain during intramuscular injection with selected demographic variables. The overall result shows that Helfer skin tap technique was helpful in reducing the level of pain during intramuscular injection among orthopedic patients.

Tehnični dejavniki aplikacije intramuskularne injekcije

Uvod: Aplikacija intramuskularne injekcije predstavlja najpogosteje uporabljen način aplikacije injekcij. Namen raziskave je bil preučiti najnovejše ugotovitve s področja priprave vbodnega mesta in aplikacije intramuskularne injekcije.Metode: Izveden je bil sistematični pregled znanstvene in strokovne literature v mednarodnih podatkovnih bazah CINAHL, PubMed, The Cochrane Library ter ScienceDirect. Uporabili smo naslednje ključne besede: intramuscular injection, instramuscular vaccination, injection site, skin disinfection, injection technique. Pri iskanju smo uporabili tudi Boolove operatorje AND (IN) in OR (ALI). Iskanje literature je potekalo marca in aprila 2021. Za oceno kakovosti posameznih raziskav smo uporabili orodje Critical Appraisal Skills Programme.Rezultati: Izmed 4.208 identificiranih zadetkov je bilo v končno analizo vključenih 13 člankov. Ugotovitve smo združili v štiri vsebinske kategorije: (1) izbira vbodnega mesta, (2) tehnike intramuskularne injekcije, (3) razkuževanje vbodnega mesta, (4) aspiracija.Diskusija in zaključek: Med zaključki raziskav ni enotnega mnenja glede varne in strokovne aplikacije intramuskularne injekcije. Kot kažejo raziskave, je najprimernejše mesto aplikacije ventroglutealno področje. Razkuževanje vbodnega mesta pred aplikacijo v izvenbolnišničnem okolju ni potrebno, medtem ko je aspiracija priporočljiva zgolj na dorzoglutelnem mestu. Priporoča se aplikacija s tehniko trakcija kože – pritisk – hitro sproščanje mišic, z izbiro igle ob upoštevanju debeline podkožnega maščevja, mesta za aplikacijo in gostote zdravila. Potrebna bi bila izvedba dodatnih raziskav, s katerimi bi lahko oblikovali priporočila za optimalno tehniko intramuskularne injekcije.

Intranasal HD-Ad vaccine protects the upper and lower respiratory tracts of hACE2 mice against SARS-CoV-2

Background The ongoing COVID-19 pandemic has resulted in 185 million recorded cases and over 4 million deaths worldwide. Several COVID-19 vaccines have been approved for emergency use in humans and are being used in many countries. However, all the approved vaccines are administered by intramuscular injection and this may not prevent upper airway infection or viral transmission. Results Here, we describe a novel, intranasally delivered COVID-19 vaccine based on a helper-dependent adenoviral (HD-Ad) vector. The vaccine (HD-Ad_RBD) produces a soluble secreted form of the receptor binding domain (RBD) of the SARS-CoV-2 spike protein and we show it induced robust mucosal and systemic immunity. Moreover, intranasal immunization of K18-hACE2 mice with HD-Ad_RBD using a prime-boost regimen, resulted in complete protection of the upper respiratory tract against SARS-CoV-2 infection. Conclusion Our approaches provide a powerful platform for constructing highly effective vaccines targeting SARS-CoV-2 and its emerging variants.