Continuous reactive crystallization of pharmaceuticals using impinging jet mixers

For reactive crystallization of pharmaceuticals that show a rapid reaction rate, low solubility of active pharmaceutical ingredient and hence a large supersaturation, it was found in a recent study that a process design which integrates an impinging jet mixer and batch stirred tank produces high quality crystals. The current investigation examines if the short processing time of reactive crystallization permits the impinging jet mixer—stirred tank design to be modified to operate in a continuous mode. The new design combines an impinging jet mixer for feed introduction and reaction with a continuous stirred tank reactor (CSTR) and tubular reactor for crystal growth. A study of reactive crystallization of sodium cefuroxime (an antibiotic), using first a 1L CSTR then scaling to a 50L CSTR, found that the new design produces crystals of higher crystallinity, narrower particle size, and improved product stability, than batch crystallizers

Mothers' education but not fathers' education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda

BACKGROUND: Health and nutrition inequality is a result of a complex web of factors that include socio-economic inequalities. Various socio-economic indicators exist however some do not accurately predict inequalities in children. Others are not intervention feasible. OBJECTIVE: To examine the association of four socio-economic indicators namely: mothers' education, fathers' education, household asset index, and land ownership with growth stunting, which is used as a proxy for health and nutrition inequalities among infants and young children. METHODS: This was a cross-sectional survey conducted in the rural district of Hoima, Uganda. Two-stage cluster sampling design was used to obtain 720 child/mother pairs. Information on indicators of household socio-economic status and child anthropometry was gathered by administering a structured questionnaire to mothers in their home settings. Regression modelling was used to determine the association of socio-economic indicators with stunting. RESULTS: One hundred seventy two (25%) of the studied children were stunted, of which 105 (61%) were boys (p < 0.001). Bivariate analysis indicated a higher prevalence of stunting among children of: non-educated mothers compared to mothers educated above primary school (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4–4.4); non-educated fathers compared to fathers educated above secondary school (OR 1.7, 95% CI 0.8–3.5); households belonging in the "poorest" quintile for the asset index compared to the "least poor" quintile (OR 2.1, 95% CI 1.2–3.7); Land ownership exhibited no differentials with stunting. Simultaneously adjusting all socio-economic indicators in conditional regression analysis left mothers' education as the only independent predictor of stunting with children of non-educated mothers significantly more likely to be stunted compared to those of mothers educated above primary school (OR 2.1, 95% CI 1.1–3.9). More boys than girls were significantly stunted in poorer than wealthier socio-economic strata. CONCLUSIONS: Of four socio-economic indicators, mothers' education is the best predictor for health and nutrition inequalities among infants and young children in rural Uganda. This suggests a need for appropriate formal education of the girl child aimed at promoting child health and nutrition. The finding that boys are adversely affected by poverty more than their female counterparts corroborates evidence from previous studies

Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya

Background: Chronic malnutrition or stunting among children under 5 years old is affected by several household environmental factors, such as food insecurity, disease burden, and poverty. However, not all children experience stunting even in food insecure conditions. To seek a solution at the local level for preventing stunting, a cross-sectional study was conducted in southeastern Kenya, an area with a high level of food insecurity. Methods: The study was based on a cohort organized to monitor the anthropometric status of children. A structured questionnaire collected information on the following: demographic characteristics, household food security based on the Household Food Insecurity Access Scale (HFIAS), household socioeconomic status (SES), and child health status. The associations between stunting and potential predictors were examined by bivariate and multivariate stepwise logistic regression analyses. Furthermore, analyses stratified by level of food security were conducted to specify factors associated with child stunting in different food insecure groups. Results: Among 404 children, the prevalence of stunting was 23.3%. The percentage of households with severe food insecurity was 62.5%. In multivariative analysis, there was no statistically significant association with child stunting. However, further analyses conducted separately according to level of food security showed the following significant associations: in the severely food insecure households, feeding tea/porridge with milk (adjusted Odds Ratio [aOR]: 3.22; 95% Confidence Interval [95% CI]: 1.43-7.25); age 2 to 3 years compared with 0 to 5 months old (aOR: 4.04; 95% CI: 1.01-16.14); in households without severe food insecurity, animal rearing (aOR: 3.24; 95% CI: 1.04-10.07); SES with lowest status as reference (aOR range: from 0.13 to 0.22). The number of siblings younger than school age was not significantly associated, but was marginally associated in the latter household group (aOR: 2.81; 95% CI: 0.92-8.58). Conclusions: Our results suggest that measures against childhood stunting should be optimized according to food security level observed in each community

The validity of estimated age in rural Pakistani children based on interviews with mothers and tooth counts of primary teeth.

Assessment of chronological age in children aged 6-30 months was made by obtaining information from uneducated rural Pakistani mothers and by means of counting the number of emerged primary teeth. There was found no statistically significant difference in the validity in age assessment between two methods. The average difference between true chronological age and perceived age was -0.8 months (SD 2.5 months) in boys, and 0.9 months (SD 3.9 months) in girls. The average difference between true chronological age and dental age was -0.4 months (SD 3.5 months) in boys, and 0.8 months (SD 4.8 months) in girls.link_to_subscribed_fulltex

Timing of emergence of individual primary teeth. A prospective longitudinal study of Pakistani children.

Primary tooth emergence in Pakistani children was investigated as a part of a prospective interdisciplinary study of growth and development. The average order of emergence of the primary teeth was in agreement with previous studies from other countries. There was no sex difference in emergence of individual primary teeth. The emergence of the primary incisors and mandibular first molars in both sexes, and the canines in boys were significantly delayed compared to Swedish standards (Hägg & Taranger 1986).link_to_subscribed_fulltex

Dental development, dental age and tooth counts: A prospective longitudinal study of Pakistani children

A sample of 443 Pakistani infants from four different socioeconomic areas was followed longitudinally study the emergence of the primary teeth. The mean ages of emergence of the primary teeth, without regard what kind of tooth and dental ages of the primary teeth were calculated. The subjects showed no sexual dimorphism in the emergence times of the primary teeth. The children from poor areas. were ahead by statistically significant differences from upper middle class, for emergence of the primary teeth 17-20. On comparison with Swedish standards (Hägg & Taranger, 1985) Pakistani children are delayed, by a statistically significant difference, in the emergence of primary teeth 1-16, however, they were at par in the emergence of 17-20 primary teeth.link_to_subscribed_fulltex

Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis

Background Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0–23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. Methods The sample included 24,529 children aged 0–59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz \u3c −2SD) and severe stunting (HFAz \u3c −3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. Results The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0–23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0–59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0–23 months and 0–59 months are: sex of child (male), mother’s perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0–23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0–59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0–23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0–59 months = 1.58 (95%Cl: 1.38, 1.82)]. Conclusions In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women’s nutrition, child feeding practices and household sanitation