Stability and compatibility of parenteral nutrition solutions; a review of influencing factors.

Both stability and compatibility of parenteral nutrition solutions (PNS) with drug products are major concerns for clinicians and clinical pharmacists, especially when concurrent administration of PNS with intravenous medications (IVM) is unavoidable. Since the same physicochemical principles apply to both adult's and paediatrics' PNS, concerns about stability and compatibility may still apply to both. However, these concerns are relatively more common in paediatrics and neonatal clinical settings, where limited vascular access can be problematic and the coadministration of PNS and drugs is more common. In neonatal and paediatric populations, there have been few experimental studies and comprehensive evaluations looking at medication compatibility with frequently used PNS. This work is part of a larger research project concerned for compatibility of PNS with commonly used intravenous medication in paediatric and neonates. This paper captures and reviews published data on factors influencing stability and compatibility of parenteral nutrition solutions. This information will help clinicians and clinical pharmacists to understand the principals of the stability and compatibility of PNS, furthermore, it will inform better design of future compatibility studies, as it highlights the complexity of PNS and the multiple factors influencing the stability of PNS, and hence its compatibility with IVM. When preparing, prescribing, and administering the PNS, especially when co-administration with IVM is unavoidable, it is important to take into account the physicochemical properties of the PNS components and IVM as well as administration conditions and environmental factors. These factors should also be considered in the design of the compatibility studies of the PNS with the IVM.

Seroprevalence of Toxoplasma gondii Infection in Children With Visual and/or Hearing Disability in Comparison With Healthy Children in Iraq

@#Introduction: Infection with Toxoplasma gondii is very prevalent in Iraq. The aim of this study was to determine the seroprevalence of T. gondii infection among children with visual, hearing or both disabilities (VHDC) and among healthy children (HC) living in Diyala and Baghdad provinces in Iraq. Methods: For this study, 100 VHDC children (attending the Al-Amal Centers for Blind, Dumb and Deaf Children) and 100 age-matched healthy children were recruited. Blood was obtained from all disabled and healthy children and the sera were examined for the presence of the specific antibodies (IgG and IgM) of T. gondii. Results: Among VHDC children, the seropositivity of IgG antibodies (24.0%) was significantly higher (OR= 7.6; 95% CI= 2.5-22.8; P= 0.0003) than that in HC children (4.0%). Disabled boys (OR= 5.7; P= 0.009) and disabled girls (OR= 12.7; P= 0.0183) showed significantly higher seropositivity than healthy children. The greatest risk was in disabled children who are their mothers had one or more abortion (OR= 6.89; P= 0.0005), followed by children who have brother or sister with visual and/or hearing disabilities (OR= 5.6; P= 0.0039), children whose their mothers got infection during pregnancy (OR= 2.9; P= 0.0256), and then children whose their mothers have taken treatment (OR= 2.9; P= 0.0256). The presence of stray cats in the houses was identified as a risk factor (OR= 4.05; P= 0.0186). Conclusion: In children with visual and/or hearing disabilities, the seropositivity of IgG antibodies was significantly higher than that in healthy children.