Menstrual hygiene management and its determinants among adolescent girls in low-income urban areas of Delhi,India: a community-based study

ObjectivesMenstrual hygiene management (MHM) in developing countries is linked to human rights, social justice, and the education and empowerment of young girls. The objective of this study was to assess menstrual hygiene practices and their determinants among adolescent girls, including school dropouts, and the effects of pad distribution programs in urban resettlement areas of Delhi, India.Methods A cross-sectional study was conducted from March 2019 to February 2020 in urban resettlement colonies and 2 villages of Delhi among 1,130 adolescent girls aged 10 to 19 years, who were interviewed face to face.Results In total, 954 participants (84.4%) used only disposable sanitary pads, 150 (13.3%) used both sanitary pads and cloths, and 26 (2.3%) used only cloths (n=1,130). Most school-going girls utilized the scheme for pad distribution, but only two-thirds of the girls who were out of school utilized the scheme. In the adjusted analysis, girls with lower educational status, those who had dropped out of school, and those from the Muslim religious community were more likely to use cloths for MHM.Conclusion More than 4 out of 5 adolescent girls in Delhi in low-income neighborhoods preferred sanitary pads for MHM. The government free pad scheme reached near-universal utilization among school-going girls (97%), but the subsidized pad scheme for girls who did not attend school was insufficiently utilized (75%).     

Constructing whole of population cohorts for health and social research using the New Zealand Integrated Data Infrastructure

Objectives: To construct and compare a 2013 New Zealand population derived from Statistics New Zealand’s Integrated Data Infrastructure (IDI) with the 2013 census population and a 2013 Health Service Utilisation population, and to ascertain the differences in cardiovascular disease prevalence estimates derived from the three cohorts. Methods: We constructed three national populations through multiple linked administrative data sources in the IDI and compared the three cohorts by age, gender, ethnicity, area‐level deprivation and District Health Board. We also estimated cardiovascular disease prevalence based on hospitalisations using each of the populations as denominators. Results: The IDI population was the largest and most informative cohort. The percentage differences between the IDI and the other two populations were largest for males and for those aged 15–34 years. The percentage differences between the IDI and Census cohorts were largest for people living in the most deprived areas. The ethnic distribution varied across the three cohorts. Using the IDI population as a reference, the Health Service Utilisation population generally overestimated cardiovascular disease prevalence, while the Census population generally underestimated it. Conclusions and implications: The New Zealand IDI population is the most comprehensive and appropriate national cohort for use in health and social research.     

Socio-demographic co-relates of psychiatric disorders

Objective: To find out the magnitude of probable psychopathology in children and study association of psychopathology with demographic, developmental and social factors.Methods: Childhood Psychopathology Measurement Schedule (CPMS) was used to measure the magnitude of probable psychopathology in 620 children from an urban slum of Miraj (Maharashtra). A second schedule recorded demographic, developmental and social factors.Results: CPMS score >10 was observed in 102 children (16.5%). It was significantly higher in children aged 7–10 years, in males, belonging to lower socioeconomic status, large families, being first born, having low birth weight (LBW); body mass index (BMI) less than 18.5. Low maternal education and alcohol abuse in father also had significant association with CPMS score >10.Conclusion: Findings suggest a need to educate the community about psychological implications of LBW, large family size and overcrowding in children. Improving maternal education and controlling alcoholism could help in reducing childhood psychopathology.     

Water vapor sorption of hot-melt extruded hydroxypropyl cellulose films: effect on physico-mechanical properties, release characteristics, and stability

Hot-melt extrusion technology was used to prepare thin polymer films containing hydroxypropyl cellulose and clotrimazole (CT). Films containing hydroxypropyl celluloses of different molecular weight and the drug were investigated for moisture-sorption, mechanical properties, and release characteristics. Stability of the films was also studied at 25 degrees C/60% relative humidity (RH) and 40 degrees C/75% RH for up to 3 months. To study the moisture-sorption of the hot-melt extruded films, a rapid dynamic vapor sorption technique was used. Mechanical properties were evaluated using the Texture Analyzer. The molecular weight of the polymer had a significant effect on the mechanical and release characteristics of the films but did not influence the equilibrium moisture content in the films stored at RHs ranging from 0 to 90%. However, the time to reach equilibrium was longer for the higher molecular weight polymers. The drug release rate was dependent on the rate of erosion, which in turn depended on the molecular weight of the polymer. The films were stable at 25 degrees C/60% RH for up to 3 months with no significant degradation or recrystallization of CT. However, recrystallization of the drug was observed within the films stored in accelerated stability conditions at the end of 3 months in which only 92.9% (+/-1.9) CT remained.     

Aggregation of BioGlue(®) presenting as a right atrial mass: a case report

Use of biological glue during cardiovascular surgery is a common practice, rarely associated with immediate or long-term complications. We present a patient with a right atrial mass as a long-term complication associated with the use of biological glue. Surgical exploration revealed the mass to be an unabsorbed and infected aggregate of biological glue used to stop bleeding from a friable right atrium during previous surgery.     

Reservoir Based Fentanyl Transdermal Drug Delivery Systems: Effect of Patch Age on Drug Release and Skin Permeation

Purpose  To understand and evaluate the stability and skin permeation profiles of fentanyl reservoir systems as a function of patch age. Methods  Drug release and skin permeation studies were performed using a modified USP apparatus 5 with a novel sample preparation technique. Results  The amount of fentanyl present in the EVA/adhesive layer (EAL) increased from about 17% of label claim (LC) at 5 months to 25% LC at 22 months. The increase in the drug concentration was mainly observed in the peripheral EAL. Simultaneously, the alcohol content of the patch decreased as a function of patch age. A significant effect of patch age on the drug content in the EAL and the drug release from the system was observed; however, skin permeation studies did not indicate an increase in drug delivery rate. Conclusions  Novel sample preparation technique with USP Apparatus 5 allowed determination of in vitro skin permeation rates for fentanyl transdermal patches with different designs. Permeation rates with cadaver skin as substrate were found not to change with patch age despite changing drug concentration in the EAL.     

Amelioration of hepatotoxicity by biocleavable aminothiol chimeras of isoniazid: Design,synthesis, kinetics and pharmacological evaluation

AIM To overcome the hazardous effects on liver caused by long-term use of antitubercular agent isoniazid(INH) by developing a novel hepatoprotective prodrug strategy by conjugating INH with aminothiols as antioxidant promoities for probable synergistic effect.METHODS INH was conjugated with N-acetyl cysteine(NAC) and N-(2)-mercaptopropionyl glycine using the SchottenBaumann reaction and with L-methionine using Boc-anhydride through a biocleavable amide linkage. Synthesized prodrugs were characterized by spectral analysis, and in vitro and in vivo release studies were carried out using HPLC. Their hepatoprotective potential was evaluated in male Wistar rats by performing liver function tests, measuring markers of oxidative stress and carrying out histopathology studies.RESULTS Prodrugs were found to be stable in acidic(pH 1.2) and basic(pH 7.4) buffers and in rat stomach homogenates, whereas they were hydrolysed significantly(59.43%-94.93%) in intestinal homogenates over a period of 6 h. Upon oral administration of prodrug NI to rats, 52.4%-61.3% INH and 47.4%-56.8% of NAC were recovered in blood in 8-10 h. Urine and faeces samples pooled over a period of 24 h exhibited 1.3%-2.5% and 0.94%-0.9% of NAC, respectively, without any presence of intact NI or INH. Prodrugs were biologically evaluated for hepatoprotective activity. All the prodrugs were effective in abating oxidative stress and re-establishing the normal hepatic physiology. The effect of prodrug of INH with NAC in restoring the levels of the enzymes superoxide dismutase and glutathione peroxidase and abrogating liver damage was noteworthy especially. CONCLUSION The findings of this investigation demonstrated that the reported prodrugs can add safety and efficacy to future clinical protocols of tuberculosis treatment.