No description available.

No description available.

No description available.

No description available.

No description available.

Research report: Faculty of Health Sciences / ABSTRACT Labour induction in an underresourced environment poses a tremendous challenge. While labour induction is a common obstetric procedure, it poses potential hazards for mother and fetus. This is largely dependent on method and agent used and can be expensive on limited resources because of high purchase prices, refrigerated storage, monitoring equipment and manpower. Misoprostol is a unique anti-ulcer agent that has good properties as an induction agent, but as yet not fully evaluated. It is relatively cheap, easily available, simple to store and has a long shelf life, and would amount to considerable cost saving in an underresourced setting if it were proven to be effective and safe for induction of labour. A simple reliable method of administration and appropriate dosage regimen of misoprostol for the purposes of induction of labour is needed. This study was undertaken in two phases; Part A. The clinical trial where an oral misoprostol suspension was given in a stepwise manner for the induction of labour alone or in combination with an inexpensive mechanical method (Foley catheter bulb) is compared with the “standard” method of induction i.e. dinoprostone 2 mg gel in a randomized controlled trial. Altogether 750 patients (250 in each arm) were recruited. Part B. (a) In vitro study to verify if misoprostol has a direct stimulatory effect on gut smooth muscle similar to sihlambezo.1 There is an increase in the incidence of meconium stained liquor in women who have taken sihlambezo or castor oil and misoprostol.2 It is postulated that misoprostol crosses the placenta and stimulates foetal bowel activity directly rather than as a result of asphyxia caused by excessive uterine contractions due to misoprostol. Strips of rat uterine and intestinal smooth muscle were mounted on a strain gauge with a chart recorder in a physiological bath as was done in the Pharmacology department for the original sihlambezo studies. The model was perfused with doubling concentrations of each test substance, and the concentration noted at which the first uterine muscle and the first bowel muscle activity was detected. The test substances were: #1; prostaglandin E2 (Dinoprostone) #1; oxytocin (Syntocinon) #1; misoprostol freshly dissolved in water #1; misoprostol freshly dissolved in a weak hydrochloric acid solution to approximate stomach content pH #1; misoprostol dissolved in water and stored for 2 hours, 6 hours, 24 hours and 1 year. For each substance, the ratio between the minimum stimulatory concentration for uterine to bowel smooth muscle was calculated, and these ratios compared between substances. The absolute minimum stimulatory concentrations were compared between the different misoprostol preparations to determine the effects of storage and acidification. (b) In vitro study to find out if misoprostol dissolved in water is stable and over what duration of time. This has practical importance, because if it is unstable, it may imply that a fresh sample has to be prepared each time the induction agent is given, and this may be several times per patient per induction. This would escalate the cost of the drug, especially in an underresourced setting such as ours, and would mean more manpower i.e. nursing staff, would be required for each case of induction. We also wanted to establish if acidification of the preparation would affect misoprostol stability as was implied to happen when misoprostol is given vaginally3. References 1 Mitri F, Hofmeyr GJ, van Gelderen CJ. Meconium during labor, self medication and other associations. S Afr Med J 1987: 71: 431-433. 2 Hofmeyr GJ, Gulmezoglu AM. Vaginal misoprostol for cervical ripening and labor induction in late pregnancy (Cochrane Review). In: The Cochrane Library, Issue 3, 1999. Oxford: Update Software. 3 Gunalp S, Bildirici I. The effect of vaginal pH on the efficacy of vaginal misoprostol for induction of labour. Acta Obstet Gynaecol Scand 2000; 79(4): 283-5.

Chronic tissue injuries present an enormous problem to both patients and healthcare professionals, and yet little is definitively known as to the underlying pathophysiology. While there are numerous comorbidities associated with these wounds, a unifying theme has been proposed to be the repetitive incidence of ischemia reperfusion injury.A mouse model of cyclic ischemia reperfusion was employed to examine the initiation events in the pathology of chronic wounds. Mice were subjected to eight hours of magnetic skin compression via four cycles of two-hours ischemia and thirty minutes of reperfusion. The presence of neutrophil markers of oxidative stress and inflammation such as myeloperoxidase and matrix metalloproteinases were measured at time points 1, 3, & 5 days post-injury. A sharp increase in MPO and MMP-9 was witnessed throughout, with the highest concentrations found at day 1. Simultaneously, immunodetection of heme oxygenase was performed, revealing high levels of inducible HO-I throughout the time course, with no change in HO-2 expression. Tissue damage was confirmed through histological examination.

Diabetic foot ulcers (DFUs) are a common and severe adverse event associated with diabetes, as 25% of diabetic patients will experience DFUs. The lack of effective DFU therapies results in 20% of diabetic patients requiring amputation. We first developed an algorithm to account for polydispersity when calculating nanoparticle concentration, which will reduce variability between batches and treatments. We also developed a novel 2-layer biomaterial, which combines anti-microbial properties of CLKRS peptide coated silver nanoparticles (CLKRS- AgNPs) with a pro-regenerative collagen matrix embedded with microscopic skin tissue columns (MSTC), to promote DFU wound healing. The collagen hydrogel formulation was optimized, and the physical properties, biocompatibility, and wound healing properties were assessed. Our results indicate that the CLKRS-AgNPs prevent bacterial growth and the collagen matrix provides a regenerative environment. Last, we developed and tested antimicrobial fabrics which can also be applied to chronic wounds, such as DFUs, to prevent and treat infections.

With the prolonged lifespan of the average person, the number of hospital stays have increased. Currently, pressure ulcers are one of the most severe complications associated with prolonged hospital stay. The protocol in today€™s hospital is to rotate bedridden patients once every two hours to prevent pressure ulcers. This puts a strain on attending nurses as the risk of a pressure ulcer for a patient is not universal and therefore, a universal preventative protocol is not the most effective solution. This thesis describes the circuit design and physical implementation of a device to address the issue of pressure ulcers. The device has the form factor of a patch to be placed on specific, at risk areas of the human body. The device was designed and prototyped first on a rigid structure and then on a flexible printed circuit board substrate. A calibration procedure was developed to reduce part to part variability inherent to the pressure sensor. The resistance measurement was achieved through a novel approach including the use of a timer removing the need for an analog-to-digital converter. A seven hour experiment was conducted with live, animal subjects to measure the pressure and temperature of at risk areas of the body. The results of the experiment successfully prove the fundamental approach outlined in this thesis and justify continued research and refinement into the product design.

by Enders Kwok Wai Ng. / Thesis (M.D.)--Chinese University of Hong Kong, [1999]. / Includes bibliographical references (p. 178-203). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.