Doctor of Pharmacy

dissertationCeftazidime is an investigational cephalosporin antibiotic with a broad spectrum of activity. In early in vitro studies, antibacterial activity has been demonstrated against most aeorbic gram-negative organism, including Pseudomonas aeriginosa. Before the pharmacokinetics of a new antibiotic such as ceftazidime can be adequately described, an accurate and reliable drug assay must be developed. Two methods currently available for ceftazidime determination include microbiological and high-pressure liquid chromatographic assays. The objective of this study was to compare the accuracy of an HPLC assay with a microbiological assay in the determination of a serum ceftazidime concentrations

Proyecto de inversión pública : instalación del servicio de estimulación temprana del puesto de salud Pativilca - distrito Pítipo, provincia de Ferreñafe, departamento Lambayeque

La carencia de mantener un adecuado servicio de atención integral de salud se percibe en todos los ámbitos del Perú es por ello que el presente proyecto “Instalación del servicio de estimulación temprana del puesto de salud Pativilca- distrito Pítipo, provincia de Ferreñafe, departamento Lambayeque”, tiene como objetivo mejorar el insuficiente acceso de los niños menores de 36 meses en la atención del servicio de estimulación temprana. Puesto que la estimulación temprana constituye un reto del próximo milenio, acometerla es responsabilidad no solo del profesional de enfermería, sino también se rescata la participación activa de los padres en esta labor. Así mismo al finalizar el proyecto se habrá logrado fortalecer las competencias del personal de salud para una adecuada atención integral; se habrá dotado de equipamiento suficiente en los servicios de salud y se habrá desarrollado conocimientos apropiados a las familias para el cuidado integral del niño menor de 3 años, además se contará con una apropiada información para el cuidado integral de los niños menores de 3 años; también se habrá fortalecido las capacidades de los agentes comunitarios en los sistemas de vigilancia comunitaria, para una adecuada atención integral del niño menor de 3 años. El presupuesto de inversión es de 357,586 nuevos soles.Trabajo académic

Effects of nebulised magnesium sulphate on inflammation and function of the guinea-pig airway

Magnesium sulphate is a potential treatment for acute severe asthma. However, the mechanisms and dose-response relationships are poorly understood. The first objective of this study was to examine whether inhaled magnesium sulphate exerts bronchodilator activity measured as bronchoprotection against histamine-induced bronchoconstriction in conscious guinea-pigs alone and combined with salbutamol. Secondly, we examined whether inhaled magnesium sulphate inhibits airways inflammation and function in models of neutrophilic and eosinophilic lung inflammation induced, respectively, by inhaled lipopolysaccharide or the inhaled antigen, ovalbumin (OVA). Airway function was measured in conscious guinea-pigs as specific airway conductance (sGaw) by whole-body plethysmography. Anti-inflammatory activity was measured against lung inflammatory cell influx induced by OVA inhalation in OVA-sensitised animals or by lipopolysaccharide (LPS) exposure of non-sensitised animals. Airway function (sGaw) was measured over 24 h after OVA exposure. Airway hyperresponsiveness to inhaled histamine and inflammatory cells in bronchoalveolar lavage fluid were recorded 24 h after OVA or LPS challenge. Histamine-induced bronchoconstriction was inhibited by inhaled magnesium sulphate or salbutamol alone and in combination, they produced synergistic bronchoprotection. LPS-induced neutrophil influx was inhibited by 6 days pretreatment with magnesium sulphate. Early and late asthmatic responses in OVA sensitised and challenged animals were attenuated by magnesium sulphate. Lung inflammatory cells were increased by OVA, macrophages being significantly reduced by magnesium sulphate. Nebulised magnesium sulphate protects against histamine-induced bronchoconstriction in conscious guinea-pigs and exerts anti-inflammatory activity against pulmonary inflammation induced by allergen (OVA) or LPS. These properties of magnesium sulphate explain its beneficial actions in acute asthma

The Exoplanet Eccentricity Distribution from Kepler Planet Candidates

The eccentricity distribution of exoplanets is known from radial velocity surveys to be divergent from circular orbits beyond 0.1 AU. This is particularly the case for large planets where the radial velocity technique is most sensitive. The eccentricity of planetary orbits can have a large effect on the transit probability and subsequently the planet yield of transit surveys. The Kepler mission is the first transit survey that probes deep enough into period-space to allow this effect to be seen via the variation in transit durations. We use the Kepler planet candidates to show that the eccentricity distribution is consistent with that found from radial velocity surveys to a high degree of confidence. We further show that the mean eccentricity of the Kepler candidates decreases with decreasing planet size indicating that smaller planets are preferentially found in low-eccentricity orbits.Comment: 6 pages, 4 figures, accepted for publication in MNRA

Prevalence, treatment and correlates of depression in multiple sclerosis

BackgroundThe prevalence of depression in Multiple Sclerosis (MS) is often assessed by administering patient reported outcome measures (PROMs) examining depressive symptomatology to population cohorts; a recent review summarised 12 such studies, eight of which used the Hospital Anxiety and Depression Scale-Depression (HADS-D). In clinical practice, depression is diagnosed by an individual structured clinical interview; diagnosis often leads to treatment options including antidepressant medication. It follows that an MS population will include those whose current depressive symptoms meet threshold for depression diagnosis, plus those who previously met diagnostic criteria for depression and have been treated such that depressive symptoms have improved below that threshold. We examined a large MS population to establish a multi-attribute estimate of depression, taking into account probable depression on HADS-D, as well as anti-depressant medication use and co-morbidity data reporting current treatment for depression. We then studied associations with demographic and health status measures and the trajectories of depressive symptoms over time.MethodsParticipants were recruited into the UK-wide Trajectories of Outcome in Neurological Conditions-MS (TONiC-MS) study, with demographic and disease data from clinical records, PROMs collected at intervals of at least 9 months, as well as co-morbidities and medication. Interval level conversions of PROM data followed Rasch analysis. Logistic regression examined associations of demographic characteristics and symptoms with depression. Finally, a group-based trajectory model was applied to those with depression.ResultsBaseline data in 5633 participants showed the prevalence of depression to be 25.3% (CI: 24.2-26.5). There were significant differences in prevalence by MS subtype: relapsing 23.2% (CI: 21.8- 24.5), primary progressive 25.8% (CI: 22.5-29.3), secondary progressive 31.5% (CI: 29.0-34.0); disability: EDSS 0-4 19.2% (CI: 17.8-20.6), EDSS ≥4.5 31.9% (CI: 30.2-33.6); and age: 42-57 years 27.7% (CI: 26.0-29.3), above or below this range 23.1% (CI: 21.6-24.7). Fatigue, disability, self-efficacy and self esteem correlated with depression with a large effect size (>.8) whereas sleep, spasticity pain, vision and bladder had an effect size >.5. The logistic regression model (N=4938) correctly classified 80% with 93% specificity: risk of depression was increased with disability, fatigue, anxiety, more comorbidities or current smoking. Higher self-efficacy or self esteem and marriage reduced depression. Trajectory analysis of depressive symptoms over 40 months in those with depression (N=1096) showed three groups: 19.1% with low symptoms, 49.2% with greater symptoms between the threshold of possible and probable depression, and 31.7% with high depressive symptoms. 29.9% (CI: 27.6-32.3) of depressed subjects were untreated, conversely of those treated, 26.1% still had a symptom level consistent with a probable case (CI: 23.5-28.9).ConclusionA multi-attribute estimate of depression in MS is essential because using only screening questionnaires, diagnoses or antidepressant medication all under-estimate the true prevalence. Depression affects 25.3% of those with MS, almost half of those with depression were either untreated or still had symptoms indicating probable depression despite treatment. Services for depression in MS must be pro-active and flexible, recognising the heterogeneity of outcomes and reaching out to those with ongoing symptoms