Pain in Patients with Post Paralytic Hemifacial Spasm: Before, during and after Botulinum Toxin Injections

It is well-established that botulinum toxin (BT) injections improve quality of life in patients with postparalytic hemifacial spasm. Nevertheless, injection-related pain and contracture-related pain have not yet been studied. The primary objective of our study was to evaluate injection-related pain in patients with facial palsy sequelae, and to compare the standard technique (syringe) with the Juvapen device. The secondary objective was to evaluate the improvement of contracture-related pain one month after BT injection. Methods: We conducted an observational, prospective, monocentric study based on 60 patients with facial palsy sequelae who received BT injections in our university ENT (ear, nose throat) department. There were 30 patients in the Juvapen group (J) and 30 in the standard technique group (ST). All patients completed Numerical Rating Scale (NRS) questionnaires immediately after the injections and one month later. Results: The average NRS score was 1.33/10 with Juvapen and 2.24/10 with the standard technique (p = 0.0058; Z = 2.75). In patients with contracture-related pain, the average NRS score was 3.53 before BT injection, and 0.41 one month after BT injection (p = 0.0001). Conclusions: Juvapen is a less-painful injection technique than the standard one. BT reduces contracture-related pain one month after injection.

Optimization of Additional Composition Variations ZnO Nanoparticles on The Characteristics of Porous Hydroxypatite as Bone Filler

Research on the synthesis and characterization of porous hydroxyapatite with the addition of ZnO nanoparticles has been carried out through a combination of foam immersion and injection methods. This research was conducted to optimize the previous research by increasing the variation of ZnO composition and adding the injection method to the research process. The materials used in this research include hydroxyapatite nanoparticles, ZnO nanoparticles, Aquades, PVA and polyurethane foam. Manufacturing is done by immersing polyurethane foam into a slurry. Slurry is a mixture of PVA and hydroxyapatite solutions with variations in the addition of ZnO nanoparticles (8 wt%, 10 wt%, 12 wt%, and 14 wt%). Then inject the remaining slurry into the foam. After that the sample was dried and heated at a temperature of 650ºC to remove foam and PVA, then the sample was sintered at a temperature of 1200ºC for 3 hours. Based on SEM analysis, porosity test, and compressive strength test, the best results were shown by sample IV because it had a pore diameter of 142.9 – 371.4 m with a porosity of 69.983%, a compressive strength value of 1.8653 MPa and non-toxic. The best results have not met the standard for bone filler application. In further research, improvements need to be made by using other additives such as ZrO2, so that it can improve the mechanical properties of porous hydroxyapatite to meet standard bone filler applications.

Steroid Injection Using Tendon Excursion for Trigger Finger: Introduction to Injection Methods and Analysis of Treatment Results

Purpose: Local corticosteroid injections are routinely used as first-line treatment for trigger finger. However, accurate delivery of steroids into the tendon sheath is important for the effectiveness of the treatment and the prevention of complications. This study aimed to introduce our steroid injection technique for trigger finger, which uses tendon excursion of the flexor tendon, and evaluate the clinical outcomes in patients who were treated with this technique.Methods: A total of 171 patients with trigger finger who were treated with steroid injections were retrospectively reviewed. The efficacy of injection and complications were investigated. The evaluation of the efficacy was classified into “good,” “fair,” and “poor.” The results were analyzed according to the type of finger and the Quinnell grading system.Results: The total efficacy was 83.6% (good/fair, 143 digits; poor, 28 digits). The treatment success rate for Quinnell grade IV was 43.8% (7 of 16), which was significantly lower than those of Quinnell grades II and III, which were 88.9% (88 of 99) and 87.5% (49 of 56), respectively (II vs. IV, p=0.004; III vs. IV, p=0.010). In four fingers (excluding the thumb), the success rate was significantly higher than that of the thumb (88.2% vs. 75.4%, p=0.048).Conclusion: The steroid injection technique using tendon excursion showed excellent results and low complication rates. In particular, the second to fourth fingers and low-grade fingers showed more effective results.

The Role of the Activator Additives Introduction Method in the Cold Sintering Process of ZnO Ceramics: CSP/SPS Approach

The great prospects for introducing the cold sintering process (CSP) into industry determine the importance of finding approaches to reduce the processing time and mechanical pressure required to obtain dense ceramics using CSP. The introducing zinc acetate into the initial ZnO powder of methods, such as impregnation, thermovapor autoclave treatment (TVT), and direct injection of an aqueous solution into a die followed by cold sintering process using a spark plasma sintering unit, was studied. The effect of the introduction methods on the density and grain size of sintered ceramics was analyzed using SEM, dynamic light scattering, IR spectroscopy, and XRD. The impregnation method provides sintered samples with high relative density (over 0.90) and significant grain growth when sintered at 250 °C with a high heating rate of 100 °C/min, under a uniaxial pressure of 80 MPa in a vacuum, and a short isothermic dwell time (5 min). The TVT and aqueous solution direct injection methods showed lower relative densities (0.87 and 0.76, respectively) of CSP ZnO samples. Finally, the development of ideas about the processes occurring in an aqueous medium with CSP and TVT, which are subject to mechanical pressure, is presented.

Testing Platform Invoke as a Tool for Shellcode Injection in Windows Applications

This paper investigates software attacks based on shellcode injection in Windows applications. The attack uses platform invoke to inject binary code by means of system calls. This creates a separate threat that carries the payload. The paper overviews protections against shellcode injection and thus analyzes the injection methods as well. Analysis models the injection of malicious code in a Windows app process. As a result, the paper proposes a step-by-step injection method. Experimental injection of user code in PowerShell is performed to test the method. The paper further shows the assembly code of the system call as an example of finding their IDs in the global system call table; it also shows part of the source code for the injection of binary executable code. Various counterattacks are proposed in the form of software control modules based on architecture drivers. The paper analyzes the feasibility of using dynamic invoke, which the authors plan to do later on.