ABSTRACT
Myrrh has long been used for its circulatory, disinfectant, analgesic, antirheumatic, antidiabetic, and schistosomicidal properties. Myrrh essential oil (MEO) was extracted from the oleo-gum resin of Commiphora molmol and formulated into emulsions and suppositories to mask/avoid its bitter taste. Three oil-in-water emulsions (E1-E3) were formulated and taste was evaluated by 10 volunteers. Particle size distribution was measured and correlated with excipients and the method of preparation. Physical and chemical stability testing was carried out for the optimum formulation (E2). Seven suppository formulations were investigated (F1-F7). Suppocire AML (F1) and Suppocire CM (F2) were chosen as fatty bases, and polyethylene glycol (PEG) 1500 (F3), PEG 4000 (F4), and a PEG blend (50% PEG 6000 + 30% PEG 1500 + 20% PEG 400) (F5) were chosen as water-soluble bases. A blend of PEG 1500 and Suppocire CM was also used (F7). Camphor (5%) was added to PEG 1500 (F6). Disintegration time, release rate, DSC, fracture points, and weight uniformity were evaluated. The overall average bitterness for formulations E1, E2, and E3 was 6.44, 4.15, and 3.45, respectively. Suppositories containing Suppocire AML had the fastest disintegration time (1.5 min) with dissolution efficiency (DE) of 56.8%. F3 containing PEG 1500 had a fast disintegration time of 2.5 min and maximum DE of 93.5%. The PEG blend had satisfactory release: (DE = 90.9%). A mixed fatty and water-soluble base (F7) had a disintegration time of 5 min and low DE (33.4%). A stable MEO emulsion with acceptable taste was formulated to improve patient acceptance and compliance. F3 suppositories yielded satisfactory results, while formulations containing fatsoluble bases exhibited poor release.
ABSTRACT
OBJECTIVES: To describe the implementation of the WHO(2006) growth standards in a therapeutic feeding programme. METHODS: Using programme monitoring data from 21,769 children 6-59 months admitted to the Médecins Sans Frontières therapeutic feeding programme during 2007, we compared characteristics at admission, type of care and outcomes for children admitted before and after the shift to the WHO(2006) standards. Admission criteria were bipedal oedema, MUAC <110 mm, or weight-for-height (WFH) of <-70% of the median (NCHS) before mid-May 2007, and WFH <-3 z score (WHO(2006)) after mid-May 2007. RESULTS: Children admitted with the WHO(2006) standards were more likely to be younger, with a higher proportion of males, and less malnourished (mean WFH -3.6 z score vs. mean WFH -4.6 z score). They were less likely to require hospitalization or intensive care (28.4%vs. 77%; 12.8%vs. 36.5%) and more likely to be treated exclusively on an outpatient basis (71.6%vs. 23%). Finally, they experienced better outcomes (cure rate: 89%vs. 71.7%, death rate: 2.7%vs. 6.4%, default rate: 6.7%vs. 12.3%). CONCLUSIONS: In this programme, the WHO(2006) standards identify a larger number of malnourished children at an earlier stage of disease facilitating their treatment success.
