Treatment outcome of children with severe acute malnutrition admitted to therapeutic feeding centers in Southern Region of Ethiopia

Background: Inadequate intake of carbohydrates, proteins, vitamins and minerals is one of the causes for malnutrition. It often affects young children and contributes to more than 60% of deaths in children in developing countries. One in four of malnourished children receiving traditional treatment die during or soon after treatment. The study aimed to assess the treatment outcome of children treated in therapeutic feeding centers (TFC) in southern Ethiopia.Methods: A retrospective review of reports submitted by the TFCs was done during 2003-2004. Data was collected from the monthly reports using standardized formats. The variables included age, treatment centers, type of malnutrition and treatment outcome which were analyzed using descriptive statistics.Results: Of 11,335 cases of malnutrition, 47% (5447) had severe wasting and 53% (6103) had edematous malnutrition. Of the total, 87% (11,191) were cured while 3.6% (468) had died. The average length of stay was 25 and 21 days with an average weight gain of 14 and 13.4 g/kg/d for children with severe wasting and edematous malnutrition, respectively. With increasing age, the death rate decrease  and cure rate increased (p < 0.05 for both).Discussion: Our results show that the new management approach  implemented in the TFC improved the treatment outcome of malnourished children compared to the minimum international standard set for  management of severe acute malnutrition which is cure rate of at least 75% and death rate less than 10%, average length of stay of less than30 days and average weight gain of 8g/kg/day

Fed batch production of hydrogen from palm oil mill effluent using anaerobic microflora

Anaerobic production of hydrogen from palm oil mill effluent (POME) by microflora was investigated in 5-l bioreactor at 60 °C and pH 5.5. POME sludge was collected from the anaerobic pond of a POME treatment plant at a palm oil mill and used as a source of inocula. A batch reactor was found to yield a total of 4708 ml H2H2/(l POME) and the maximum evolution rate was 454 ml-H2H2/(l POME h). A fed batch process was conducted after 50 h. Two liters of reaction medium was removed and 2 l of fresh POME was added to the reactor every 24 h (15 times). The reproducibility of the fed batch process checked by changing the feeding time every 8 h (10 times). A yield of 2382 ml H2H2/(l POME) and 2419 ml H2H2/(l POME) at maximum evolution rate of 313 ml H2H2/(l POME h) and 436 ml H2H2/(l POME h) were obtained, respectively. Throughout the study, methane gas was not observed in the evolved gas mixture

Is Adherence to Imatinib Mesylate Treatment Among Patients with Chronic Myeloid Leukemia Associated with Better Clinical Outcomes in Qatar?

Background: Despite the revolutionary success of introducing tyrosine kinase inhibitors (TKIs), such as imatinib mesylate (IM), for treating chronic myeloid leukemia (CML), a substantial proportion of patients' treatments fail. Aim: This study investigates the correlation between patient adherence and failure of TKIs' treatment in a follow-up study. Methods: This is a follow-up study of a new cohort of CML patients. Adherence to IM is assessed using the Medication Event Monitoring System (MEMS 6 TrackCap, AARDEX Ltd). The 9-item Morisky Medication Adherence Scale, medication possession ratio (MPR) calculation, and the electronic medical records are used for identifying potential factors that influence adherence. Clinical outcomes are assessed according to the European LeukemiaNet 2013 guidelines via reverse transcriptase quantitative polymerase chain reaction measurement of the level of BCR-ABL1 transcripts in peripheral blood. Response is classified at the hematological, cytogenetic, and molecular levels into optimal, suboptimal, or failure. Results: A total of 36 CML patients (5 citizens and 31 noncitizen residents) consented to participate in the study. The overall mean MEMS score was 89. Of the 36 patients, 22 (61%) were classified as adherent (mean: 95) and 14 (39%) were classified as nonadherent (mean: 80.2). Adherent patients were significantly more likely to obtain optimal response (95%) compared to the nonadherent group (14.3%; P < 0.0001). The rate of poor adherence was as high as 39% using MEMS, which correlates with 37% treatment failure rate. The survey results show that 97% of patients increased the IM dose by themselves when they felt unwell and 31% of them took the missing IM dose when they remembered. Other factors known to influence adherence show that half of patients developed one or more side effects, 65% of patients experienced lack of funds, 13% of patients declared unavailability of the drug in the NCCCR pharmacy, and 72% of patients believed that IM would cure the disease. The MPR results reveal that 16% of patients had poor access to treatment through the hospital pharmacy. Discussion and conclusion: This is the first prospective study to evaluate CML patients' adherence and response to IM in Qatar. The high rate of treatment failure observed in Qatar is explained by poor adherence. An economic factor (unaffordable drug prices) is one of the main causes of nonadherence and efforts should be made locally to improve access to medication for cancer diseases. Other risk factors associated with poor adherence could be improved by close monitoring and dose adjustment. Monitoring risk factors for poor adherence and patient education that include direct communication between the health-care teams, doctors, nurses, pharmacists, and patients are essential components for maximizing the benefits of TKI therapy and could rectify this problem. The preliminary results show that patients' response to treatment may be directly linked to patients' adherence to treatment. However, further in-depth and specific analysis may be necessary in a larger cohort

Well as its Microcapsules in Rats

ABSTRACT Ketorolac is a potent non-steroidal analgesic drug. It is 36 times more potent than phenyl butazone, and twice as that of indomethacin. The oral administration of ketorolac is associated with high risk of adverse effects such as irritation, ulceration, bleeding of gastrointestinal tract, edema as well as peptic ulceration. These attributes make ketorolac a good candidate for controlled release dosage forms, so as to ensure slow release of the drug in the stomach. The present study reports on the formulation of ketorolac loaded Eudragit RS100, Eudragit RL100 as well as Ethyl cellulose as a controlled release drug delivery system. Solid dispersion and microencapsulation by air suspension method were the techniques of choice in order to coat the drug so as to improve bioavailability and stability and also target a drug at specific sites. The ratio of (1:3) drug to polymer from all polymers used was selected from solid dispersions systems as well as microcapsules to conduct further in vivo evaluation, since it was the best ratio which achieved significant reduction in the release of ketorolac at acidic pH of the stomach and maximal release at alkaline pH of the intestine. The effects of various formulations on ulcer index as well as ulcer incidence were studied. The obtained results indicate that microencapsulation technique was able to protect the stomach from ulcerogenic effect ketorolac compared to solid dispersion technique

Insulin autoantibodies as determined by competitive radiobinding assay are positively correlated with impaired beta-cell function — The Ulm-Frankfurt population study

Out of a random population of 4208 non-diabetic pupils without a family history of Type I diabetes 44 (1.05%) individuals had islet cell antibody (ICA) levels greater or equal to 5 Juvenile Diabetes Foundation (JDF) units. 39 of these ICA-positives could be repeatedly tested for circulating insulin autoantibodies (CIAA) using a competitive radiobinding assay. The results were compared with the insulin responses in the intravenous glucose tolerance tests (IVGTT) and with HLA types. Six pupils were positive for CIAA. All of them had complement-fixing ICA, and 5 of them were HLA-DR4 positive. Three of the 6 showed a first-phase insulin response below the first percentile of normal controls. Our data indicate that in population-based studies CIAA can be considered as a high risk marker for impaired beta-cell function in non-diabetic ICA-positive individuals

Surgical treatment of aortobronchial fistula after thoracic endograft failure

Endovascular stent grafting has been recently considered as a less invasive alternative to either medical therapy or open surgical treatment for many patients with descending thoracic aortic disease. Late complications are rarely described in literature. Herein, we described the occurrence of an aorto-bronchial fistula and a retro-A dissection in a 73-year-old man after stent-grafting for a penetrating atherosclerotic ulcer (PAU) of the descending thoracic aorta and the successful surgical technique adopted in order to remove the stent-graft

Nurses' experiences of delirium and how to identify delirium - A qualitative study

Aim: Delirium is a serious, acute medical condition which places a heavy burden on the patient, his or her family and healthcare professionals. There have been only a limited number of studies to explore nurses' experiences of delirium and how delirium is identified in community care. The research questions of the study are as follows: “How do community care nurses' experience delirium?” and “How is delirium identified?”. Design: This study has been designed as an explorative and descriptive study. Methods: A topic-based interview guide was developed containing questions associated with the Registered Nurses' experiences of their meetings with people with delirium and their identification of delirium. Results: Nurses working in the community care need to know more about delirium as they play a key role in treatment. Our results also show that the participants have difficulty in establishing whether a patient is suffering from acute confusion/delirium, depression or dementia.publishedVersio

Physicochemical characteristics of Bt (Seeni-1) Vs. local hamid cultivar cotton seed oils

n investigation on physicochemical characteristics of Bt (Seeni-1) vs local Hamid cultivar (cv) cottonseed oils (CSO) was conducted. Protein in Seeni-1 seed was relatively higher than Hamid cv seed. Oil content, ash and fibre of Hamid cv were relatively higher. Ash and oil content in black (chemical delinting) and white (mechanical delinting) seed were relatively higher in Hamid cv. There were no differences between the specific gravity (sp.gr.), refractive index (R.I.) and moisture content of both oils. Free fatty acids (FFA) and iodine value (IV) in Seeni-1 were relatively higher. Saturated fatty acids (SFAs) in Hamid cv oil proved to be more than Seeni-1 oil [automatically the USFA should be higher in Seeni-1]. Phosphorus content in Seeni-1 oil was lower than that of Hamid cv, whereas there was no significant difference in the peroxide value (PV)