Comparison of Treatment Efficacy of Different Number of Botulinum Toxin Type A Injection Sites for Crow’s Feet Lines: A Single-Center Retrospective Clinical Study in Vietnam

Objective:Botulinum toxin type A is frequently used to treat crow’s feet lines.However,the optimal dose and injection sites are still controversial.The objective of this study was to compare the efficacy of different botulinum toxin type A injection patterns for the treatment of crow’s feet.Methods:This single-center,retrospective,clinical study was conducted at the National Hospital of Dermatology and Venereology from July 2020 to December 2020.Data on 60 patients with crow’s feet were collected and divided into 2 groups(3-or 4-point intramuscular injection)according to the intramuscular injection technique the patients received.The treatment efficacy was assessed based on the changes in the Crow’s Feet Grading Scale score at 1,4,and 16 weeks after treatment.Repeated measures analysis of variance was used for the assessment of changes in scores over time between the two groups.Results:After treatment,the average Crow’s Feet Grading Scale score was significantly decreased compared with the pretreatment score at all timepoints(1,4,and 16 weeks)in both states(dynamic:For 3-point intramuscular injection technique,1 week:1.90±0.71 vs.2.97±0.56;4 weeks:1.87±0.68 vs.2.97±0.56;16 weeks:2.60±0.67 vs.2.97±0.56.For 4-point intramuscular injection technique,1 week:1.73±0.83 vs.3.03±0.49;4 weeks:1.73±0.74 vs.3.03±0.49;16 weeks:2.57±0.68 vs.3.03±0.49,all P<0.001.and static:For 3-point intramuscular injection technique,1 week:1.20±0.89 vs.2.20±0.85;4 weeks:1.20±0.89 vs.2.20±0.85;16 weeks:1.87±0.97 vs.2.20±0.85;For 4-point intramuscular injection technique,1 week:1.50±0.86 vs.2.30±0.84;4 weeks:1.33±0.84 vs.2.30±0.84;16 weeks:1.87±0.97 vs.2.30±0.84.All P<0.001).The average subjective patient-rated satisfaction scores after treatment were significantly higher in the 4-point injection group than in the 3-point injection group(P=0.028).The adverse events were post-injection bruising in 3 patients and a feeling of eyelid tightness in 3 patients.Conclusion:Botulinum toxin type A injection is an effective treatment for crow’s feet.Adding a fourth injection maintains the same therapeutic effect and does not increase adverse effects.Patients with lower-fan crow’s feet patterns may benefit more from 4-point injection therapy.However,the present findings require confirmation in studies with larger sample sizes,longer follow-up times,and different botulinum toxin type A doses.

Intramuscular vaccine administrations including the adoption of"Zeta-track technique"&"without aspiration slow injection technique"(ZTT&WASiT):a prospective review

Objective:To review the current literature on the practice of intramuscular injections(IMIs),focusing on immunizations.Methods:The present study comprises 2 reviews,characterized by high-quality evidence,per taining to the deployment of the slow injection technique without aspiration(referred to in this paper as the without-aspiration slow injection technique[WASi T])and combined with the Zeta-track technique(ZTT).The literature review is oriented toward the analysis of 2 features associated with IMIs techniques:safety and pain,integrating new evidence on vaccinee positioning for each muscle site and general relaxation techniques in the multi-parametric analysis.Results:The rigorous and in-depth reviews in the current study reveal the usefulness of including,among the international guidelines for via intramuscular immunizations,the adoption of WASi T only for compliant vaccinees,and in combination with all validated techniques for IMIs,and the use of ZTT limitedly if specific well-developed muscles are indicated.All the technique's limitations are exposed.Conclusions:Future research directions are presented by including the author's study designs to provide indirect evidence for the validity of the rationale of the slow injection technique using scientific methods,and for the conduction of future randomized controlled trials(RCTs)focused on revisiting the adoption of ZTT in a dynamic and integrated immunizations protocol in anterolateral thigh(ALT),ventrogluteal(VG),and also in the deltoid muscle,in the specific cases analyzed.

Safety Observation Study on Haemophilus Influenza Type B Conjugate Vaccines Injected at Different Sites in Chinese Infants

In the present study, the safety of Hoemophilus influenza type b conjugate vaccines inoculated in the upper arm deltoid and vastus lateralis muscle was evaluated. 680 infants aged 2-5 months and 6-12 months were selected to be the research subjects in whom the Hib conjugate vaccines were inoculated by injection in the upper arm deltoid and vastus lateralis muscle, respectively. The safety analysis indicated that there were no statistic differences in the incidence rates of adverse reactions when the Hib conjugate vaccines were inoculated at different sites. So we concluded that the safety of inoculation injection of Hib conjugate vaccines in vastus lateralis muscle was the same as that inoculated in the upper arm deltoid.