Muhammad Irshad, Muhammad Azhar Saeed, Rao Sohail Yasin.
Rising Tendency of Intramuscular Injection Induced Peripheral Nerve Injury: Time to Act.
Ann Pak Inst Med Sci Jan ;10(2):63-6.

Objective: This study is conducted to look for the rising tendency of intramuscular (IM) injection induced nerve palsy. It is thus hoped that the research will influence the policy makers to institute policies for the prevention of this problem. Study Design: Cross Sectional Study. Place and Duration of Study: This study was carried out in the Neurology Department of Pakistan Institute of Medical Science, Islamabad, Pakistan from Jan 2005 to Aug 2010. Materials and Methods: A total of 206 cases of IM injection induced nerve palsy, referred to EMG lab of PIMS for nerve conduction study (NCS), were included in the study. Patients having root or plexus lesion and if NCS located lesion at site of entrapments were excluded. Nerve palsy confirmed and severity of lesion classified using standard electrodiagnostic test. Results: Out of 206 cases, 55.83% were males. Mean age was 34.6 years (range 2- 85 years). Children less than 15 years were 14.6%. There was wrist drop in 62.62% and foot drop in 25.24%. Among all, 67% had radial and 30.1% had sciatic nerve palsy. Eighteen percent each had complete and severe partial and 57.77% had partial nerve damage. Two patients had mild nerve damage while 8 patients had only neuralgia with normal NCS. Rising trend of IM injection related nerve palsy was noted as 79 cases were recorded from 2005 to 2007, while from 2008 to 2010 (Aug) the recorded cases were 127. Injections administered were 52% by dispensers at private hospitals, 36% by quacks while 12% were given by nurses. Conclusion: There was a rising trend of IM injection related nerve palsy, which is a serious health hazard that can be avoided by safe injection practices. The dispensers of private clinics and quacks are responsible for majority of these cases. There is a need to enforce policies that only qualified and trained nurses are employed by private clinics and adopt effective strategies to end quackery in our country.

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