Focused antenatal care acceptance in northeastern region of Nigeria: clients' perspective.

Antenatal care is the medical care of the woman during pregnancy to ensure healthy outcomes for both mother and the baby. World Health Organization (WHO) recommended adoption of a new model of ANC known as Focused Ante-Natal Care (FANC), with four clinic visits during pregnancy for all the women in low risk category. Pregnant women who are at low risk of complication form about 75% of all pregnant women Objectives: The objective of the study was to determine acceptance of Focused Antenatal Care among antenatal clinic attendees in health institutions in northeastern Nigeria. Materials And Method: Focused group discussion was used as a qualitative method of data collection in 6 different health facilities. Results: Majority of the clients preferred the FANC to the old method of ANC. Some clients had already started cutting the number of ANC visits in their own way by late presentation during pregnancy. Such practices may contribute negatively to early detection and prevention of diseases during pregnancies. Conclusion: It is therefore highly recommended to fast track governments efforts towards commencement of FANC as recommended by the WHO in all the health facilities in the region in particular and the whole Nigerian nation in general

Development and in-vitro Evaluation of Once Daily Tablet Dosage Form of Loxoprofen Sodium

Purpose: To formulate and characterize once daily controlled release tablet of loxoprofen sodium.Methods: Eudragit RS-100, hydroxylpropyl methylcellulose (HPMC) and pectin were used as release retarding polymers. All the formulations were prepared by direct compression method. Various precompression studies were carried out to determine Hausner’s ratio, Carr’s index, angle of repose, bulk density and tapped density Differential scanning calorimetry (DSC) studies and also post-compression studies to evaluate hardness, friability, weight variation, drug content, in-vitro drug release were conducted on the tablets. The drug release data were subjected to kinetic models, including zero order, first order, Hixon Crowell, Higuchi and Korsmeyer-Peppas.Results: Compressibility index (7.6 ± 1.32 - 12.5 ± 1.43%), Hausner’s ratio (1.08 ± 0.04 - 1.14 ± 0.03), angle of repose (27.78 ± 0.47 - 30.49 ± 0.46°), hardness (6.25 ± 0.27 - 7.21±0.21 kg/cm2), friability (0.14 ± 0.06 - 0.28 ± 0.0 %), weight variation (249.5 ± 2.09 - 251.35 ± 2.41 mg) and drug content  (97.30 ± 0.28 - 103.70 ± 0.31 %) were within generally accepted limits for the pre-and post-compression formulations, respectively. The tablets having the maximum amount of among the three polymers tested as matrix materials, HPMC, represented by F3 tablets, exerted better sustained release properties after 12 h. Release pattern was more of Fickian diffusion followed by Higuchi mechanism.Conclusion: The release of the loxoprofen sodium was optimized up to 12 h.Keywords: Loxoprofen, Sustained release, hydroxypropyl methylcelluose, Pectin, Eudragit, Matrix tablet

A thermally-driven seawater desalination system: Proof of concept and vision for future sustainability

Since the 1970s, commercial-scale thermally-driven seawater desalination plants have been powered by low-grade energy sources, drawn either with low-pressure bled-steam from steam turbines or the solar renewable energy harvested that are supplied at relatively low temperatures. Despite the increasing trend of seawater reverse osmosis plants, the role of thermal desalination methods (such as multi-stage flashing and multi-effect distillation) in GCC countries is still relevant in the Arabian Gulf, arising from higher salinity, the frequent algae blooms of seawater and their ability to utilize low temperature heat sources. Given the urgent need for lowering both the capital and operating costs of all processes within the desalination industry and better ther- modynamic adaptation of low-grade heat input from renewable sources, the present paper ad- dresses the abovementioned issues by investigating the direct contact spray evaporation and condensation (DCSEC) method. A DCSEC system comprises only hollow chambers (devoid of membranes or tubes, minimal use of chemical and maintenance) where vapor generation (flashing) utilizes the enthalpy difference between the sprayed feed seawater and the saturated vapor enthalpy of the vessels. Concomitantly, vapor is condensed with spray droplets of cooler water (potable) in adjacent condenser vessels, employing a simple design concept. We present detailed design and real seawater experiments data of a DCSEC system for the first time. The water production cost is calculated as $0.52/m3, which is one of the lowest figures reported compared to commercial processes presented by Global Water Intelligence

A thermally-driven seawater desalination system: Proof of concept and vision for future sustainability

Since the 1970s, commercial-scale thermally-driven seawater desalination plants have been powered by low-grade energy sources, drawn either with low-pressure bled-steam from steam turbines or the solar renewable energy harvested that are supplied at relatively low temperatures. Despite the increasing trend of seawater reverse osmosis plants, the role of thermal desalination methods (such as multi-stage flashing and multi-effect distillation) in GCC countries is still relevant in the Arabian Gulf, arising from higher salinity, the frequent algae blooms of seawater and their ability to utilize low temperature heat sources. Given the urgent need for lowering both the capital and operating costs of all processes within the desalination industry and better thermodynamic adaptation of low-grade heat input from renewable sources, the present paper addresses the abovementioned issues by investigating the direct contact spray evaporation and condensation (DCSEC) method. A DCSEC system comprises only hollow chambers (devoid of membranes or tubes, minimal use of chemical and maintenance) where vapor generation (flashing) utilizes the enthalpy difference between the sprayed feed seawater and the saturated vapor enthalpy of the vessels. Concomitantly, vapor is condensed with spray droplets of cooler water (potable) in adjacent condenser vessels, employing a simple design concept. We present detailed design and real seawater experiments data of a DCSEC system for the first time. The water production cost is calculated as 0.52/m3, which is one of the lowest figures reported compared to commercial processes presented by Global Water Intelligence

Maternal health interventions in resource limited countries: a systematic review of packages, impacts and factors for change

The burden of maternal mortality in resource limited countries is still huge despite being at the top of the global public health agenda for over the last 20 years. We systematically reviewed the impacts of interventions on maternal health and factors for change in these countries. A systematic review was carried out using the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles published in the English language reporting on implementation of interventions, their impacts and underlying factors for maternal health in resource limited countries in the past 23 years were searched from PubMed, Popline, African Index Medicus, internet sources including reproductive health gateway and Google, hand-searching, reference lists and grey literature. Out of a total of 5084 articles resulting from the search only 58 qualified for systematic review. Programs integrating multiple interventions were more likely to have significant positive impacts on maternal outcomes. Training in emergency obstetric care (EmOC), placement of care providers, refurbishment of existing health facility infrastructure and improved supply of drugs, consumables and equipment for obstetric care were the most frequent interventions integrated in 52%-65% of all 54 reviewed programs. Statistically significant reduction of maternal mortality ratio and case fatality rate were reported in 55% and 40% of the programs respectively. Births in EmOC facilities and caesarean section rates increased significantly in 71%-75% of programs using these indicators. Insufficient implementation of evidence-based interventions in resources limited countries was closely linked to a lack of national resources, leadership skills and end-users factors. This article presents a list of evidenced-based packages of interventions for maternal health, their impacts and factors for change in resource limited countries. It indicates that no single magic bullet intervention exists for reduction of maternal mortality and that all interventional programs should be integrated in order to bring significant changes. State leaders and key actors in the health sectors in these countries and the international community are proposed to translate the lessons learnt into actions and intensify efforts in order to achieve the goals set for maternal health

MR imaging of osteochondral grafts and autologous chondrocyte implantation

Surgical articular cartilage repair therapies for cartilage defects such as osteochondral autograft transfer, autologous chondrocyte implantation (ACI) or matrix associated autologous chondrocyte transplantation (MACT) are becoming more common. MRI has become the method of choice for non-invasive follow-up of patients after cartilage repair surgery. It should be performed with cartilage sensitive sequences, including fat-suppressed proton density-weighted T2 fast spin-echo (PD/T2-FSE) and three-dimensional gradient-echo (3D GRE) sequences, which provide good signal-to-noise and contrast-to-noise ratios. A thorough magnetic resonance (MR)-based assessment of cartilage repair tissue includes evaluations of defect filling, the surface and structure of repair tissue, the signal intensity of repair tissue and the subchondral bone status. Furthermore, in osteochondral autografts surface congruity, osseous incorporation and the donor site should be assessed. High spatial resolution is mandatory and can be achieved either by using a surface coil with a 1.5-T scanner or with a knee coil at 3 T; it is particularly important for assessing graft morphology and integration. Moreover, MR imaging facilitates assessment of complications including periosteal hypertrophy, delamination, adhesions, surface incongruence and reactive changes such as effusions and synovitis. Ongoing developments include isotropic 3D sequences, for improved morphological analysis, and in vivo biochemical imaging such as dGEMRIC, T2 mapping and diffusion-weighted imaging, which make functional analysis of cartilage possible

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

BACKGROUND: Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. METHODS: We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. RESULTS: Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. CONCLUSION: This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field