Stability of essential drugs in the field: results of a study conducted over a two-year period in Burkina Faso.

To evaluate the stability of essential drugs stored in realistic tropical conditions, we have carried out a two-year prospective study in western Burkina Faso. Twenty-seven essential drugs were stored in a rural site and a urban one where temperature and hygrometry were recorded daily. Samples of each drug were taken for further analysis to the World Health Organization Collaborative Center for the Study of Stability of Drugs in Nantes, France every three months. Quantitative analysis showed that the majority of samples suffered no significant loss of their active ingredient. In contrast, ampicillin, erythromycin, sulfaguanidine, injectable furosemide, penicillin G, trimethoprim, and chloroquine showed more than a 10% quantitative loss of their active ingredient. Thus, it is not recommended that these essential drugs be stored for more than one year in a tropical climate.

[Stability and antimicrobial effectiveness of Javel water in a tropical hospital environment]. / Stabilité et efficacité antimicrobienne de l'eau de Javel en milieu hospitalier tropical.

A sodium hypochlorite solution (NaClO) containing 0.5% w/v of available chlorine (0.5% Cl2 or 5000 ppm) is a good and cheap solution for disinfecting material used to medical care. It is effective against bacteria, fungi and viruses. It is easy to prepare. It can be a good solution for antisepsis and disinfection in dispensaries in developing countries. However, it is not always easy to keep it in adequate conditions. That's the reason why we have evaluated the durability of such a solution of NaClO exposed to disadvantageous factors, specially daylight and air, and its antibacterial effectiveness. In this study, after exposure of NaClO containing 4350 ppm of available chlorine to these adverse conditions, the final concentration of NaClO was 2300 ppm of available chlorine and was found effective for decontamination of medical material. A protocol for conservation and use of a sodium hypochlorite solution (0.5% Cl2) in dispensaries of developing countries is proposed.

[Natural immunity to Haemophilus influenzae type b. ELISA study of the distribution of IgG, IgG1 and IgG2 in France and Africa]. / Immunité naturelle vis-à-vis d'Haemophilus influenzae b étude par méthode ELISA de la distribution des IgG, IgG1 et IgG2 en France et en Afrique.

A Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugate vaccine will be released for use in infants in developing and industrialized countries in the near future. This prompted a comparative study of the natural immunity of mothers and passive immunity of their newborns in France and Africa. An ELISA method capable of discriminating immunoglobulin classes and subclasses was used. Monoclonal antibodies were used to determine titers of IgG1 and IgG2 antibodies. Because capsular polyribose ribitol phosphate does not bind readily to polystyrene, the plate was coated with streptavidine which bound to biotin linked to the antigen. Antibody titers were found to be identical in French and African study groups. Both IgG1 and IgG2 antibodies were found, often with higher titers for the latter. Both subclasses were found in cord blood of French and African children.

[Role of the hospital pharmacy in the preparation of an emergency plan. Experience of the central pharmacy of Angers Regional University Hospital Center]. / Rôle d'une pharmacie hospitalière dans l'élaboration d'un plan d'urgence. Expérience de la pharmacie centrale du CHRU d'Angers.

In case of disasters, an emergency plan has been set up in Angers hospital, to conform to the law. This plan concerns many partners including the hospital Pharmacist. The two principal roles of the Pharmacist are the elaboration of a checklist of drugs, medical and hospital supplies necessary for the care of the victims and the sep up of emergency containers. The computerization of this plan will facilitate its management. Thus the Hospital Pharmacist contributes to the rationalization of a health care necessity in a constrained economic context.

[Topical ophthalmic drugs]. / Actualités sur les formes médicamenteuses ophtalmiques locales.

Although satisfactory therapeutic results are obtained with usual topical opthalmic drugs, they present some inconveniences. Particularly, their biodisponibility is often poor, requiring the use of relatively important doses, and repeated applications. In order to avoid these difficulties, different systems more or less sophisticated, such as soluble inserts, impregnated lenses, liposomes or implantable pumps, have been conceived for topical application. However, although these systems seem to present certain advantages, none of them, commercialized or not, have been quite satisfactory.

[Comparative economic evaluation of nonwoven and traditional woven textiles in operating rooms]. / Evaluation économique comparative du linge non tissé et du linge traditionnel en bloc opératoire.

The nonwoven textiles do not let oneself unconcerned, but are often considered with reserve in the operating theatre, at least for the "noble" textiles, such as the surgical drapes or the surgeon's gowns. Their part is to set barriers to prevent against microbial contamination. Now, it is proved that these nonwoven textiles qualities rise above that of the woven materials. What are the reasons for this reserve? A survey carried out in 1986 at the Angers hospital, compared with other similar studies, have shown a cost decreased by 20 per cent on an average, when the nonwoven textiles are used for a surgical operation, except the gowns. On the other hand, the cost increases by 20 per cent when nonwoven textiles gowns are also used. The features of the traditional textiles versus nonwoven ones in an operating theatre are described and show the interest of the nonwoven textiles.