Quality of antiepileptic drugs in Vietnam

The purpose of this research was to evaluate the quality of anti-epileptic drugs (AEDs) in a central city of South Vietnam. A cross-sectional study was conducted in all the outlets for AEDs. Out of 33 pharmacies 54% had AEDs. Where the drugs were available, 89% of the pharmacies, 10 units were purchased, choosing the cheapest ones. The information on the packaging, the galenic form and the aspect of the drug were studied. Each sample's tablet was weighted and was considered satisfactory if it was within +/-10% of the average. A HPLC method was used for dosing the active ingredient (AI), which was considered satisfactory within +/-10% of the theoretical value. Eight samples were based on carbamazepin and eight on phenytoin. None of the 16 samples collected were past their expiring date. Tablets were homogeneous in shape, dimension and color. The uniformity of weight was satisfactory but the AI results were alarming for Carbamazepin and more often for Phenytoin. Only 35% of the tablets were correctly dosed. Because of differences of sensitivities of AEDs to storage conditions, environmental factors (heat, light and humidity) could be responsible for this result. Best results were achieved in structures where storage seemed to be better. The influence of storage conditions must be further studied to confirm this conclusion.     

AEDs availability and professional practices in delivery outlets in a city center in southern Vietnam

In developing countries, from 80 to 90% of the people with active epilepsy do not have access to treatment. A multitude of factors such as nonavailability of antiepileptic drugs (AEDs) contributes to the treatment gap in epilepsy. Our study carried out in 2003 in southern Vietnam showed that 57% of pharmacies had AEDs. A majority of these pharmacies were located in specific areas like market area or hospital area. The pharmacist in charge was present in only 24% of the pharmacies. The different kinds of AEDs available were carbamazepine (94%), phenytoin (61%), valproate (56%) and diazepam (16%). The maximum stock of a drug was two box. The availability of AEDs in southern Vietnam can be regarded as sufficient but does not allow an adequate treatment for a long time. An effort must be made to sensitize professional health workers to decrease the treatment gap in epilepsy.     

Méthodologie des études neuroépidémiologiques dans les pays tropicaux : un challenge ?

The purpose of this paper is to highlight the difficulties of applying neuroepidemiological methods in low income countries or developing countries, which are mostly tropical countries, taking advantage of the experience of the Institute of Neuroepidemiology and Tropical Neurology, which was created in Limoges in 1982. These difficulties could be related to several aspects: methodological, logistical, political or economical, linked to ethical issues, even difficulties to publish the studies. However, concept and neuroepidemiological methods should stay the same worldwide, even if their translation into practice could sometimes raise some problems in developing countries. Study protocol should be more detailed. Some specific epidemiological methods could be useful. Collection of data should be standardized. True cooperation at every level is needed for these researches to be valid.     

Optimization of liberation of theophylline derivatives from Gelucire matrix tablets]

Matrix tablets containing theophylline, etofylline, dyphylline and proxyphylline were prepared with saturated polyglycolysed glycerides whose melting point was 50 degrees C and HLB were 2 and 13 (Gelucires 50/02 and 50/13), in order to eliminate the melting point influence and to have extreme values of HLB. The influence of two parameters was studied: HLB of the mixtures of Gelucires and drug solubility. Drug release was found to increase as these two parameters rose, the main factor being HLB value. Multiple linear regression was used to evaluate their influence. The mathematical model obtained was employed to optimize the release of each active ingredient from the tablets made of mixtures of the two Gelucires with HLB ranging from 3 to 4 depending on drug solubility.     

La réhydratation orale par sonde gastrique est-elle plus efficace que la réhydratation orale par cuillère ? Étude préliminaire chez l’enfant atteint de déshydratation non sévère à l’hôpital Joseph-Raseta-Befelatanana,Madagascar

Bulletin de la Société de pathologie exotique - Depuis sa recommandation par l’OMS, la solution de réhydratation orale (SRO) a contribué à la réduction de la...