OBJECTIVE: To evaluate Korean physiatrists' practice of performing intramuscular botulinum toxin injection in anticoagulated patients and to assess their preference in controlling the bleeding risk before injection. METHODS: As part of an international collaboration survey study, a questionnaire survey was administered to 100 Korean physiatrists. Physiatrists were asked about their level of experience with botulinum toxin injection, the safe international normalized ratio range in anticoagulated patients undergoing injection, their tendency for injecting into deep muscles, and their experience of bleeding complications. RESULTS: International normalized ratio <2.0 was perceived as an ideal range for performing Botulinum toxin injection by 41% of the respondents. Thirty-six respondents replied that the international normalized ratio should be lowered to sub-therapeutic levels before injection, and 18% of the respondents reported that anticoagulants should be intentionally withheld and discontinued prior to injection. In addition, 20%-30% of the respondents answered that they were uncertain whether they should perform the injection regardless of the international normalized ratio values. About 69% of the respondents replied that they did have any standardized protocols for performing botulinum toxin injection in patients using anticoagulants. Only 1 physiatrist replied that he had encountered a case of compartment syndrome. CONCLUSION: In accordance with the lack of consensus in performing intramuscular botulinum toxin injection in anticoagulated patients, our survey shows a wide range of practices among many Korean physiatrists; they tend to avoid botulinum toxin injection in anticoagulated patients and are uncertain about how to approach these patients. The results of this study emphasize the need for formulating a proper international consensus on botulinum toxin injection management in anticoagulated patients.
Anticoagulants ; Botulinum Toxins* ; Compartment Syndromes ; Consensus ; Cooperative Behavior ; Surveys and Questionnaires ; Hemorrhage ; Humans ; Injections, Intramuscular* ; Intention ; International Normalized Ratio ; Muscles

We found that an error in wording in the abstract should be corrected.

We found that an error in wording in the abstract should be corrected.

Transgender people face many psychological problems due to not fitting into the binary categories (men and women) in Pakistani society. The current study aimed to explore the role of ostracism in subjective well-being (like life satisfaction, positive and negative affect) among transgender. The correlational research design was used in the present study. Through purposive and snowball sampling techniques, the 109 transgender sample was selected from Faisalabad and Lahore city. Urdu versions of the General Ostracism Scale, negative and positive affect scale and satisfaction with life scale were used as study measures. Data were analyzed through pearson product moment correlation, linear regression analysis and Multivariate Analyses of Variance (MANOVA). The results on correlation analysis show a significant positive relationship between ostracism and the subjective well-being component of negative affect. The findings on linear regression analysis revealed that ostracism was a significant positive predictor of negative affect in the transgender sample accounting for 11% of the variance in the model. The results on MANOVA showed substantial differences in life satisfaction and positive affect in terms of education levels. The current study findings can be utilized in various NGOs and mental health settings. They can teach the transgender community different coping strategies to deal with ostracism that will improve the levels of transgender's overall subjective well-being.