Essential medicines management during emergencies in Pakistan

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan\u27s 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level care facilities of calamity-hit areas helped to ascertain the average consumption and cost of essential medicines and supplies for the catchment population. Tools for quantification and forecasting of medicines and supplies were developed and shared. Medicines and medical supplies were efficiently used resulting in minimum wastage

The economic burden of bronchiectasis - known and unknown:a systematic review

Abstract Background The increasing prevalence and recognition of bronchiectasis in clinical practice necessitates a better understanding of the economic disease burden to improve the management and achieve better clinical and economic outcomes. This study aimed to assess the economic burden of bronchiectasis based on a review of published literature. Methods A systematic literature review was conducted using MEDLINE, Embase, EconLit and Cochrane databases to identify publications (1 January 2001 to 31 December 2016) on the economic burden of bronchiectasis in adults. Results A total of 26 publications were identified that reported resource use and costs associated with management of bronchiectasis. Two US studies reported annual incremental costs of bronchiectasis versus matched controls of US$5681 and US$2319 per patient. Twenty-four studies reported on hospitalization rates or duration of hospitalization for patients with bronchiectasis. Mean annual hospitalization rates per patient, reported in six studies, ranged from 0.3–1.3, while mean annual age-adjusted hospitalization rates, reported in four studies, ranged from 1.8–25.7 per 100,000 population. The average duration of hospitalization, reported in 12 studies, ranged from 2 to 17 days. Eight publications reported management costs of bronchiectasis. Total annual management costs of €3515 and €4672 per patient were reported in two Spanish studies. Two US studies reported total costs of approximately US$26,000 in patients without exacerbations, increasing to US$36,00–37,000 in patients with exacerbations. Similarly, a Spanish study reported higher total annual costs for patients with > 2 exacerbations per year (€7520) compared with those without exacerbations (€3892). P. aeruginosa infection increased management costs by US$31,551 to US$56,499, as reported in two US studies, with hospitalization being the main cost driver. Conclusions The current literature suggests that the economic burden of bronchiectasis in society is significant. Hospitalization costs are the major driver behind these costs, especially in patients with frequent exacerbations. However, the true economic burden of bronchiectasis is likely to be underestimated because most studies were retrospective, used ICD-9-CM coding to identify patients, and often ignored outpatient burden and cost. We present a conceptual framework to facilitate a more comprehensive assessment of the true burden of bronchiectasis for individuals, healthcare systems and society

Gut-central nervous system axis is a target for nutritional therapies

Historically, in the 1950s, the chemist Linus Pauling established a relationship between decreased longevity and obesity. At this time, with the advent of studies involving the mechanisms that modulate appetite control, some researchers observed that the hypothalamus is the "appetite centre" and that peripheral tissues have important roles in the modulation of gut inflammatory processes and levels of hormones that control food intake. Likewise, the advances of physiological and molecular mechanisms for patients with obesity, type 2 diabetes mellitus, inflammatory bowel diseases, bariatric surgery and anorexia-associated diseases has been greatly appreciated by nutritionists. Therefore, this review highlights the relationship between the gut-central nervous system axis and targets for nutritional therapies

Recurrent iliac hydatidosis: A case report

INTRODUCTION: Hydatid cysts may occur in any area of the body, but they usually localize to the liver and the lungs. Primary localization in bone is not common. PRESENTATION OF CASE: The authors report the case of multifocal hydatid disease appeared 3 years after the surgical treatment of a cyst of the hip. The patient presented with cough and chest pain of 2 months duration. Only the lung localization was symptomatic. The thoracic echography, the abdominal and chest scan allowed the diagnosis. DISCUSSION: Hydatid recurrence remain frequent, whatever is the nature of the treatment, surgical or chemical. CONCLUSION: The premature detection of recurrence is of great importance

Copper hexacyanoferrate functionalized singlewalled carbon nanotubes for selective cesium extraction

Single-walled carbon nanotubes (SWCNTs) are functionalized with copper hexacyanoferrate (CuHCF) nanoparticles and therefore constitutes promising solid substrates for the sorption of Cs+ ions from liquid effluents. The high mechanical resistance and large electrical conductivity of SWCNTs are associated to the ability of CuHCF nanoparticles to selectively complex Cs+ ions in order to achieve membrane-like buckypapers presenting high loading capacity of cesium. The materials are thoroughly characterized using electron microscopy, Raman scattering, X-ray photoelectron spectroscopy and thermogravimetric analyses. Cs sorption isotherms are plotted after liquid phase ionic chromatography of the Cs solutions before and after exposure to the materials. It is found that the total sorption capacity of the material reaches 230 mg.g-1, and that one third of the sorbed Cs (80 mg.g-1) is selectively complexed in the CuHCF nanoparticles grafted on SWCNTs. These high values open interesting perspectives in the integration of such materials in electrically driven devices for the controlled sorption and desorption of these ions

Water level and atmospheric humidity history of Lake Ichkeul (northern Tunisia) during the last 3000 years

Changes in paleoecology and climate of northern Tunisia during the last 3000 years were reconstructed based on the flood history interpreted from a 172-cm sediment core of Lake Ichkeul (NW Tunisia). Seven wet/dry episodes were identified based on biological (ostracods, foraminifera and mollusks) and biotic indices (H and E index, species richness and abundance). These proxy-based environmental changes were supported by correspondence analyses (CAs) and ecophenotypic responses of the brackish taxon Cyprideis torosa in addition to a grain-size study. Two dry episodes were identified in the lower (EP1) and upper (EP7) parts of the core. These were marked by the dominance of the brackish ostracod C. torosa. High water salinity was indicated by the presence of the brackish ostracod Loxoconcha elliptica, the foraminifer Ammonia sp. and lagoonal mollusks. The occurrence of the freshwater ostracods Ilyocypris sp., Herpetocypris sp., Dawinula stevensoni and Limnocythere inopinata was associated with high species richness and ecophenotypic changes of C. torosa valves indicating lower salinity during three major wet episodes (EP2, EP4, and EP6). The ecological and environmental changes, occurring between 3050 and 50 cal. year BP, are most likely linked to an increase of fluvial inputs which are also recognized in several other Mediterranean lakes. The humid episodes were interrupted by two saline periods (EP3 and EP5) during which freshwater ostracod assemblages declined, diversity indices dropped to the lowest values, and fine-grained sediments became dominant. The top of the core is characterized by the remarkable dominance of L. elliptica coupled with C. torosa, the absence of freshwater ostracods, and the changes in grain-size sediment parameters which are most likely the result of anthropogenic activities. The changes in hydrochemistry and sedimentology were attributed to the deepening of the Bizerte navigation canal, main wadis damming, and Tinja sluice construction which mostly occurred in the XXth century

Effects of silicon porosity on physical properties of ZnO films

International audienceWe report on structural and optical properties of ZnO thin films deposited on different Si-based substrates presenting different porosities. ZnO layers were prepared by sol gel method and deposited on crystalline silicon (ZnO/Si), mesoporous silicon (ZnO/PS+) and nanoporous silicon (ZnO/PS-) by spin coating. Several techniques such as scanning electron microscope (SEM), X-ray diffraction (XRD), atomic force microscopy (AFM), photoluminescence spectroscopy (PL) and spectroscopic ellipsometry (SE) were used to study the influence of the pore size of porous silicon (PS) on physical properties of ZnO films. SEM images revealed the formation of ZnO granular nanoparticles on Si, PS- and PS+ substrates. We show by the XRD analysis that hexagonal crystallized (002) ZnO is mainly obtained for ZnO/PS- system causing by a strong absorption of the capillary effect and high adhesion to PS- surface. An intense PL related to ZnO and PS- was demonstrated for ZnO/PS- in UV and visible ranges. Optical properties of ZnO were determined and analyzed by SE using Tanguy dispersion model. For each sample, a specific optical model was carried out. SE confirms a good physical properties of ZnO/PS- comparing to ZnO/Si and ZnO/PS+. For example, the good crystallinity is characterized by low damping factor value (Gamma). This value was found by SE to be low (29 meV) for the ZnO/PS-, while the damping factors of ZnO/Si and ZnO/PS+ are 47 meV and 70 meV, respectively. The amplitude of dielectric function of ZnO/PS- around 3.4 eV reveals an increase of grain size and crystallinity of ZnO layer