BackgroundNasal septal deviation may affect nasal bone growth and facial morphology. Knowledge of nasal morphologic parameters may plays an important role in planning successful rhinoplasty and septoplasty operation. The aim of our study was to evaluate the relationship between the direction and degree of nasal septal deviation with nasal bone morphology, along with factors such as age and gender.MethodsMaxillofacial computed tomography (CT) of 250 patients with nasal septal deviation was analyzed retrospectively in this study. We excluded patients with factors that could affect their nasal bone morphology, and a total of 203 patients (111 males, 92 females; mean age, 36.23 years; age range, 18–79 years) were evaluated. The nasal deviation angle was measured on coronal CT images as the angle between the most deviated point of the septum, and the midline nasal morphology was determined by measuring nasal length, internasal angle and lateral and intermediate nasal thickness on both sides.ResultsThe deviation of nasal septum has been detected as to the right in 107 patients (52.7%) and to the left in 96 patients (47.3%). Lateral and intermediate nasal bone thickness and nasal bone length were significantly greater on the ipsilateral deviation side (Table 3). No significant correlation was found between the variation of the nasal deviation angle and nasal bone morphology (Table 4). There were significant differences between the sexes for all investigated parameters except for the nasal deviation angle (p = 0.660). We found that the only internasal angle increases with aging (p = 0.002).ConclusionThe study shows that the direction of nasal septal deviation may be a factor that affects nasal bone morphology.

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A 14-year-old girl applied to our pediatric emergency department with loss of consciousness and a generalized tonic-clonic seizure. Her seizure was treated with midazolam (0.1 mg/kg, a total of 5 mg). The seizures ceased right after the midazolam injection. To exclude possible intracranial abnormality as a cause of the seizure, cranial computed tomography was performed, and she was hospitalized for further evaluation. Cranial computed tomography scan showed no signs of intracranial abnormality. Twenty minutes after the cessation of seizures, she regained consciousness. Two hours later, she noticed sensory loss in her lower limbs and progressive back pain. Neurologic evaluation revealed paresis of the upper limbs, diplegia of the lower limbs, and urinary retention. Her body temperature, pulse, respiration, and blood pressure were 36.2°C (97.2°F), 78 beats/min, 22 breaths/min, and 150/90 mm Hg, respectively. Cranial nerves were intact. Deep-tendon reflexes were hyperactive on both upper extremities and absent on both lower extremities, and there were no pathologic reflexes. She had no sensation below the level of T6. Other clinical findings were tenderness in the upper thoracic region and absence of sphincter tone. There were no other pathologic physical examination findings. The medical history was negative for anticoagulant therapy, vascular abnormality, trauma, and bleeding disorders.Initial investigations including a complete blood cell count, serum electrolytes, liver function tests,

Objective: Medications are generally administered by either the enteric or parenteral route. With parenteral administration, intramuscular (IM) is the preferred approach because it increases the bioavailability of the drug, acts more quickly than the enteric route. The aim of this study was to determine the rate of true dorsogluteal intramuscular drug injection and to determine the causes for application failures in practice by ultrasonography (US). Methods: The study was conducted from May 1 to May 30, 2017 in Giresun University Education and Research Hospital, Giresun, Turkey. We examined 60 patients who were administered dorsogluteal IM injection with a 38.1mm length needle. After the injection, localization of medications (whether intramuscular or subcutaneous adipose tissue [SAT]) was evaluated by Ultrasound. Results: Female/male ratio of the patients was 27/33, with a mean age of 39.78±2.16 years. Obese/normal weight ratio was 20/40. The mean dorsogluteal area SAT thickness of obese and normal weight patients were 32.34±2.17 mm and 20.85±1.20 mm, respectively. In 23 of the patients, IM injected drug was observed in the SAT, while it was observed in the IM area in 37 patients. Medication was observed in IM area in 37 of 50 patients who dorsogluteal region SAT thickness was appropriate (SAT thickness lower than 33.1mm) for IM injection while it was seen in SAT area in 13 patients. Conclusions: SAT thickness values are important if IM drug injection is to be administered correctly. Unsuccessful IM injections may be seen even in patients with appropriate SAT thicknesses. doi: https://doi.org/10.12669/pjms.35.4.313 How to cite this:Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.313 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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