Quality medicines in maternal health: results of oxytocin, misoprostol, magnesium sulfate and calcium gluconate quality audits.

BACKGROUND: The high level of maternal mortality and morbidity as a result of complications due to childbirth is unacceptable. The impact of quality medicines in the management of these complications cannot be overemphasized. Most of those medicines are sensitive to environmental conditions and must be handled properly. In this study, the quality of oxytocin injection, misoprostol tablets, magnesium sulfate, and calcium gluconate injections was assessed across the six geopolitical zones of Nigeria. METHOD: Simple, stratified random sampling of health facilities in each of the political zones of Nigeria. Analysis for identification and content of active pharmaceutical ingredient was performed using high-performance liquid chromatography procedures of 159 samples of oxytocin injection and 166 samples of misoprostol tablets. Titrimetric methods were used to analyze 164 samples of magnesium sulfate and 148 samples of calcium gluconate injection. Other tests included sterility, pH measurement, and fill volume. RESULTS: Samples of these commodities were procured mainly from wholesale and retail pharmacies, where these were readily available, while the federal medical centers reported low availability. Approximately, 74.2% of oxytocin injection samples failed the assay test, with the northeast and southeast zones registering the highest failure rates. Misoprostol tablets recorded a percentage failure of 33.7%. Magnesium sulfate and Calcium gluconate injection samples recorded a failure rate of 6.8% and 2.4%, respectively. CONCLUSION: The prevalence of particularly of oxytocin and misoprostol commodities was of substandard quality. Strengthening the supply chain of these important medicines is paramount to ensuring their effectiveness in reducing maternal deaths in Nigeria.

BOP: biocompatible osteoconductive polymer: an experimental approach.

BOP (biocompatible osteoconductive polymer) is a material proposed for osteosyntheses and for filling of bone defects in orthopaedics, neurosurgery and stomatology. It is a composite made of a copolymer of N-vinylpyrrolidone and methylmethacrylate, of polyamide-6 fibers and of calcium gluconate. The histological investigation includes the study of 30 intact rabbit femurs instrumented with a BOP rod, as well as the study of organs of the reticuloendothelial system. The currently available results show the absence of toxicity on hematopoietic tissue. Zones of osteoblastic activity surround the rods, coupled with an osteoclastic reaction which may result in the partial fragmentation of the polyamide fibers and its incorporation in the newly formed bone. We also observed the encapsulation of the material. The biomechanical approach investigated the mechanical properties of the material in bending and in shear. The radiological aspects of the investigation consisted of computerized axial tomography of the implanted femurs to measure density at the bone-implant interface.