Leaching of pectin from mixed films containing pectin,chitosan and HPMC intended for biphasic drug delivery

Mixed films containing pectin, chitosan and HPMC, prepared by solvent casting from 0.1 M HCl (pH 1.5) and 0.1 M acetic acid (pH 2.9) were evaluated for their morphological and leaching properties. Films cast at pH 1.5 were uniform with smooth surfaces while films cast at pH 2.9 showed particle aggregation and had rough surfaces due to polyelectrolyte complex (PEC) formation between pectin and chitosan in the medium. The leaching of pectin was higher from films at cast pH 1.5 due to the absence of PEC formation. Pectin leaching was controlled in simulated upper gastrointestinal conditions but was accelerated in the presence of pectinolytic enzymes. The leaching of pectin from the mixed films was a function of the pH of the film casting solvent, pH of the incubation medium, PEC formation and HPMC content.     

Schistosomiasis control in Ghana: case management and means for diagnosis and treatment within the health system

An essential component of integrated schistosomiasis control as promoted by WHO is adequate clinical care for patients presenting at health care facilities. We evaluated the functioning of the Ghanaian health system for diagnosis and treatment of schistosomiasis by interviewing health workers from 70 health care facilities in 4 geographical areas in April and May 2000. Results from presentation of 4 hypothetical cases and a subsequent interview demonstrated that patients presenting with symptoms related to schistosomiasis have a small chance of receiving adequate treatment: often health workers do not recognize the symptoms, especially those of Schistosoma mansoni; patients are frequently referred for a diagnostic test or treatment with a large risk of non-compliance; and praziquantel was not available in 78% of the health care facilities with reported schistosomiasis in their coverage area. The overall cost of treatment is considerable: [symbol: see text] 2.13 for S. haematobium and [symbol: see text] 1.81 for S. mansoni patients, with drug costs contributing approximately 40% of the total cost. To better meet WHO recommendations for passive case detection as part of integrated schistosomiasis control, the Ghanaian health system needs to emphasize training of health workers in schistosomiasis case recognition and case management and increase the availability of praziquantel. Experience from other West African countries indicate that this is feasible.     

Chlamydia trachomatis infection as a risk factor for infertility among women in Ghana, West Africa

In developing countries, data about the prevalence of genital Chlamydia trachomatis infections and their sequelae, especially tubal infertility, is scarce. A prospective case-control study was performed enrolling 439 Ghanaian women. The case group included 191 patients with primary or secondary infertility. The control group consisted of 248 healthy pregnant women. First-void urine samples were investigated by PCR, and serum specimens were tested for C. trachomatis-specific IgG and IgA antibodies. Demographic and behavioral information were gathered for statistical analysis. The PCR prevalence of C. trachomatis was relatively low and did not differ significantly among both groups (2.4 versus 1.6%). In contrast, significantly higher prevalences of specific IgG (39% versus 19%) and IgA (14% versus 3%) antibodies were found among infertile women. The adjusted odds ratios were 2.1 and 2.8, respectively. Our data suggest that previous C. trachomatis infections may contribute to infertility in Ghanaian women.     

Applicability of a monoclonal antibody-based dipstick in diagnosis of urinary schistosomiasis in the Central Region of Ghana

Summary We tested a rapid visually read monoclonal antibody (MoAb) based dipstick assay for specific diagnosis of urinary schistosomiasis against microscopy and the use of haematuria and proteinuria in a schistosomiasis haematobia endemic area in the Central Region of Ghana. The study group consisted of 141 school children (83 males, 58 females) aged 8-19 years. A total of 129 of 141 (91.5%) submitted stool samples, and 7.8% had Schistosoma mansoni, 55% had hookworms and 6.2% had tapeworms. The presence of S. mansoni and intestinal parasites did not appear to influence the results of the MoAb-dipstick assay. The urinary schistosomiasis prevalence by MoAb-dipstick (78%) was higher (P < 0.05) than the estimate by microscopy (60.3%), microhaematuria (27%) and proteinuria (30.5%). The MoAb-dipstick correctly identified 98.8% of microscopically confirmed cases and missed one (1.3%). The dipstick was also positive for 26 of 56 (46.4%) egg-negative individuals, thereby giving a sensitivity of 98.8% and a specificity of 53.6%. On the other hand, microhaematuria and proteinuria were 38.8% and 30.6% sensitive, and 91.1% and 69.6% specific, respectively. Microhaematuria and proteinuria were less sensitive (P < 0.05) than both microscopy and MoAb-dipstick.     

Attitudes of doctors toward establishing safe abortion units in Ghana.

OBJECTIVES: To assess physician knowledge of the current legal status of abortion in Ghana and determine the proportion physicians in favor of establishing units where safe abortion would be provided, and the proportion of those willing to offer such services. METHODS: A survey conducted at Komfo Anokye Teaching Hospital, Ghana, in August 2003. Using a self-administered questionnaire, 74 randomly selected physicians expressed their views on whether abortion units should be established within national health facilities in Ghana, and what role they would play in them. RESULTS: Of the 59 physicians (80%) who favored the establishment of safe abortion units within national health facilities, 27 (36%) indicated a willingness to take part in counseling only, 33 (45%) were prepared to carry out abortions, and 14 (19%) said they would play no role in these units. CONCLUSION: Most physicians participating in this study conducted in Ghana were willing to play some role in the provision of safe abortion services.     

Differences in monosynaptic EPSPs elicited by masseter and temporalis spindle afferents in anaesthetised rats

We have used the intracellular variant of the spike triggered averaging method to examine the monosynaptic connexions of masseter and temporalis spindle afferents on jaw-elevator motoneurones. Temporalis spindle afferents elicited larger averaged EPSPs in motoneurones than masseter spindle afferents, in part because transmission at synapses of temporalis afferents was associated with lower incidences of failures. We conclude that EPSP amplitude in this motor system is governed, at least in part, by the presynaptic neurone rather than the identity of the postsynaptic neurone.     

Ceftriaxone in the treatment of acute and subacute human brucellosis

A total of 14 adults were diagnosed as having brucellosis by clinical means, serology and blood culture. The first patient to be treated failed to respond to 2 g/day intravenous ceftriaxone, therefore, subsequent patients were treated intravenously, twice daily with 2 g ceftriaxone. Immediate clinical response was seen in nine (69.2%) of the patients. Therapy was changed to tetracycline plus streptomycin in the remaining four (30.8%) patients because of lack of response after 5 days. It is concluded that ceftriaxone may be considered a second-line therapy for brucellosis in patients who cannot be given conventional therapy. Further evaluation of ceftriaxone, either alone or preferably in combination with streptomycin or rifampicin on a larger scale, is indicated.