A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry

There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.

Investigation of oxidative potential of fresh and O_(3)-aging PM_(2.5)from various emission sources across urban and rural regions

Inhalation of atmospheric PM_(2.5)can induce the generation of excessive reactive oxygen species(ROS)in human alveoli,triggering local and systemic inflammation,which can directly or indirectly result in respiratory and cardiovascular diseases.In this study,we assessed the oxidative potential(OP)of fresh and O_(3)-aged PM_(2.5)particles from various urban and rural emission sources using the dithiothreitol(DTT)method.Our results revealed variations in the OP of fresh PM_(2.5)among different emission sources,with biomass burning sources exhibiting the highest OP,followed by industrial areas,vehicular emissions,cooking emissions,and suburban areas,respectively.Water-soluble organics and transition metals might potentially exert significant influence on particle OP.O_(3)aging notably decreased the OP of PM_(2.5)particles,possibly due to the oxidation of highly DTT-active components into low redox-active small molecules.Moreover,the evolution of OP in different PM_(2.5)components,including methanol-soluble and insoluble fractions,exhibited distinct responses to O_(3)aging for source-oriented PM_(2.5).Additionally,differences in chemical composition between fresh and aged PM_(2.5)were further elucidated through measurements of component-dependent hygroscopic behaviors and phase transitions.This study systematically delineates variances in the toxic potential of fresh and O_(3)-aged PM_(2.5)from various anthropogenic sources.The findings highlight the intrinsic compositional dependence of particle OP and provide essential insights for assessing the health effects of source-oriented PM_(2.5),as well as for formulating human health protection policies.