Quality control testing of different brands of conventional tablets of ibuprofen available in Trinidad & Tobago, West Indies: An in-vitro testing

Objective: To perform in-vitro quality control testing of different brands of 400 mg Ibuprofen conventional tablet as per the pharmacopoeia standard and compare them to those are available in hospitals and pharmacies in Trinidad. Design and Methodology: The four popular brands (A, B, C, D) of Ibuprofen conventional tablet of 400 mg strength were chosen. The Ibuprofen tablets were obtained from government hospital pharmacies as well as from local private pharmacies. The in-vitro evaluation tests-friability, weight variation, disintegration time, dissolution and drug assay tests were performed as per the United States Pharmacopoeia. Results: The results showed that all the tablets passed the uniformity of weight (<± 5%), friability (<1%), disintegrated in less than 30 minutes (Ibuprofen coated tablets) and drug assays showed that the amount of drugs varied between 90-100%. The Invitro dissolution study in phosphate buffer pH 7.2 showed that about 95% drug release in 30 minutes. Conclusion: The results of all these parameters of different brands Ibuprofen of tablets were in the pharmacopoeia limits so it could be concluded that marketed pharmaceutical tablets of Ibuprofen of these brands satisfy quality control limits of pharmacopoeia.

Comparative In-Vitro Quality Control Testing of Different Brands of Paracetamol Tablets Available In The Trinidad & Tobago, West Indies

Paracetamol tablets are popular over the counter (OTC products among the patients as a good analgesics and antipyretics. The objective of this study was to compare the quality of the paracetamol tablet formulations those are locally available in Trinidad & Tobago pharmaceutical market manufactured by various pharmaceutical companies with pharmacopoeia standards. The four popular brands (A, B, C, D) of paracetamol conventional tablet of 500 mg strength were chosen. The paracetamol tablets were obtained from government hospital pharmacies as well as from local private pharmacies. To compare the quality of tablet formulations of different brands various official parameters like friability, weight variation, disintegration time, dissolution and drug assay tests were performed as per the pharmacopoeia. The result of all these parameters of different brands were in the pharmacopoeial limits so it could be concluded that marketed pharmaceutical tablets of paracetamol of these brands are safe, effective and efficacious as well as satisfy quality control limits of pharmacopoeia.

Postal dose audits for radiotherapy centers in Latin America and the Caribbean: trends in 1969-2003

Since 1969 the International Atomic Energy Agency and the World Health Organisation (along with the Pan American Health Organization, working with countries in Latin America and the Caribbean) have operated postal dosimetry audits based on thermoluminescent dosimetry (TLD) for radiotherapy centres. The purpose of these audits is to provide and independent dosimetry check of radiation beams used to treat cancer patients. The success of radiotherapy treatment depends on accurate dosimetry. Over the period of 1969 through 2003 the calibration of approximately 5200 photon beams in over 1300 radiotherapy centres in 115 countries worldwide was checked. Of these audits, 36 percent were performed in Latin America and the Caribbean, with results improving grealtly over the years. Unfortunately, in several instances large TLD deviations have confirmed clinical observations of inadequate dosimetry practices in hospitals in various parts of the world or even accidents in radiotherapy, such as the one that occurred in Costa Rica in 1996. Hospitals or centres that operate radiotherapy services without qualified medical physicists or without dosimetry equipment have poorer results than do hospitals or centres that are properly staffed and equipped. When centres have poor TLD results, a follow-up program can help them improve their dosimetry status. However, to achieve audit results that are comparable to those for centers in industrialized countries, additional strengthening of the radiotherapy infrastructure in Latin America and the Caribbean is needed (AU)

Control externo de la calidad del diagnostico serologico del dengue en laboratorios de paises de las Americas, 1996-2001 / Quality control of the serological diagnosis of dengue in laboratories throughout the Americas, 1996-2001

Objective. To report the results from participating laboratories for four external quality control proficiency tests of dengue serological diagnosis that were carried out in the Region of the Americas in the period of 1996-2001. Methods. External quality control proficiency tests of dengue serological diagnosis were carried out in 1996-1997, 1998-1999, 2000-2001. Panels made up of 20 serum samples (12 of them positive for dengue IgM antibodies) were sent to participating laboratories in the Region. The sera were negative for HIV antibodies, hepatitis C virus antibodies, and hepatitis B surface antigen. The sera were stored at -20 degrees C until they were sent in refrigerated shipments to the participating laboratories. THe presence of IgM antibodies was determined through IgM-capture enzyme-linked immunosorbent assay (ELISA), while the IgG antibody titer was determined by hemagglutination inhibition or by IgG ELISA. The results of the IgM antibody testing that differed from those of the reference center were considered discordant. The IgG antibody titer was considered discordant when the results differed by two dilutions or more with respect to the reference center's results. Results. A total of 27 laboratories received a total of 59 serum panels over the 1996-2001 period, and the results from testing 54 of those panels (91.5 percent) were sent back in. Of the total of 1, 080 sera samples from those 54 panels, the results from 95.6 percent of the IgM antibody tests were concordant with the results from the reference center. With 47 of the 54 panels (87.0 percent) the participating laboratories' agreement with the reference center's results for the IgM antibody testing was 90.0 percent or higher. The laboratories sent back results from a total of 27 IgG antibody titer tests, and 22 of them (81.5 percent) coincided with those from the reference center. Considering the IgM antibody testing results from the four periods, the findings from 22 of the participating laboratories coincided with those from the reference center for at least 90 percent of the samples, and 13 of the laboratories were in complete concordance with the reference center. Conclusions. The majority of the participating laboratories showed an excellent level of performance in detecting dengue IgG and IgM antibodies. However, the deficiencies found in some instances confirm the need for continuing to improve laboratory diagnosis of dengue in the Region of the Americas (AU)

El control de la calidad de los analisis inmunohematologicos en la Region de las Americas / Quality control of immunologic testing of blood in the Region of the Americas

Assuring the best quality in transfusion medicine necessarily involves exercising exhaustive control over the entire system and developing protocols for procedures and techniques, the reagents and equipment used, personnel training and so on. Additional guarantees can come from adequately organizing the work and perhaps automating processes in order to avoid errors. Another way to avoid errors in the laboratory is to register and continuosly analyze the mistakes that do occur, since that makes it necessary to change procedures in order to avoid repeating them. External quality control programs (EQCP) make it possible to perform a periodic overall assessment of the suitability of techniques, reagents, and training of personnel in relation to the valdity of the results obtained. By voluntarily participating in an EQCP, the blood center shows its commitment to the quality of care. In the Region of the Americas, the Pan American Health Organization's Immunohematology Quality Control Program has made it possible to objectively quantify the improvement attained in the formative level reached by participating blood banks in the four years the Program has been in operation (AU)

Retrospective audit of blood donation at a Hospital-based blood centre: Implications for blood product supply and safety

An audit of blood donation at the University Hospital of the West Indies (UHWI) was performed between January 1995 and December 1998. During these four years, 21,733 persons attended the blood collection centre and 6,711 (30.8 percent) were rejected as donors. Females accounted for 3, 054 (45.6 percent) of rejected donors while 3,647 (54.4 percent) were males. Females were rejected primarily because of low haemoglobin levels, while rejection was most frequently attributed to symptoms of the common cold and recent drug use. One hunderd and two rejected donors (1.5 percent) admitted to recent treatment of a sexually transmitted disease, and 138 (2.0 percent) presented within 16 weeks of a prior donation. Of 15,022 units donated, altruistic voluntary donations accounted for 307 (2 percent) and 53 (0.3 percent) were autologous donations. Seven hundred and four units (4.6 percent) were discarded because of positivity on initial testing for a marker of transmissible infection. Overall prevalence for markers of infection was 2.5 eprcent for HTLV-1, 0.9 percent for Hepatitis B and 0.4 percent for HIV I/II. Donations at the University Hospital of the West Indies (UHWI) collection centre contributed 15.8 percent of the national blood supply for the period under study.(Au)

La calidad y la reforma del sector de la salud en America Latina y el Caribe / Quality and health sector reform in Latin America and the Caribbean

Improving the quality of basic health services, together with the search for equity, efficiency, sustainability, and social participation, has been one of the guiding principles of health sector reform initiatives ever since thr I Summit of the Americas was held in 1994. This article addresses some basic concepts, examines the status of quality control within health systems and services in Latin America and the Caribbean, and analyzes the most important trends observed in the Region in the establishment of quality assurance programs. Finally, ways of improving and monitoring quality continuously and sustainably are recommended (AU)

External quality assessment of cervical vaginal cytology laboratory screening in the Caribbean - abstract

A model external quality assessment of cervical/vaginal cytology laboratory screening (PAP Smear) programme was piloted during 1996 to assess the proficiency of cytopathologists and cytotechnologists and to provide an opportunity for review/and reassessment of results as an integral component of continuous quality improvement of cytology services in the Caribbean. Eight pathologists and 22 cytotechnologists/technicians from seven Caribbean laboratories participated in this survey which consisted or reviewing eight reference slides provided by the Laboratory Proficiency Testing Program (LPTP, Ontario). The overall agreement with the LPTP results ranged from 5 percent to 63 percent in cytotechnologists as compared to cytopathologists (13 percent to 73 percent). The percentage agreement for severe dysplasia was between 22 percent (cytotechnologists) and 25 percent (cytopathologists), while better rates were observed for invasive carcinoma (60 - 63 percent). Inflammatory effects ere missed by both cytotechnologists (73 percent) and cytopathologists (49 percent). Moderate dysplasia was missed by both categories of laboratory professionals. There was a wide inter-laboratory variation of results as compared eith the LPTp (0 to 100 percent). Generally, laboratory professionals have placed greater emphasis on cervical biopsy, repeat smear, and provided guarded reports on PAP smears. The data show that there is a wide variation in the interpretation and reporting of cervico-vaginal cytology smears in Caribbean laboratories. Hence, there is an urgent need for continuous quality assessment and improvement of cervical cancer cytology screening services in the Caribbean (AU).

Cervical cytology quality control cytological and histological correlation at a private laboratory in Barbados - abstract

In this study, the cytological and histological diagnoses made during a six and a half-year period were compared with the aim of assessing the diagnostic accuracy of cervical cytology in a small private laboratory. There were 3486 cases biopsied, 40 (1.2 percent) cases with previous inadequate cervical smears, 195 (5.6 percent) cases with normal cytology and the remaining 3251 (93.2 percent) with abnormal cytological diagnoses. The overall concordance between the cytological and histological diagnoses was 63.9 percent. The greatest concordance was in cases with cytodiagnosis of CIN grade 3 (CIS) and invasive carcinoma combined 100/112 (89.3 percent), and the lowest with normal cytodiagnosis 75/195 (38.5 percent) cases. The significant histological diagnoses of the discordant cases were CIN 22.6 percent, condyloma 15.3 percent and carcinoma 1.1 percent. Fifty percent of the carcinomas diagnosed by cytology were of endometrial origin. Significant discordance occurred in cases with cytodiagnosis of HPV infection and CIN, in that 113 cases with cytodiagnosis of HPV infection/codyloma had histological diagnosis of CIN, and 156 cases with the cytodiagnosis of CIN had histological diagnosis of condyloma. The sensitivity rate for the diagnosis of HPV infection or condyloma by cytology was 632/1214 (52 percent). Most of the cases with inadequate smears had histodiagnosis of cervicitis with inflammatory atypia. This study has shown that the cytological evaluation of the severity of significant cervical abnormalities was a reliable guide for the clinician to the proper management of the patient (AU)

Bacteriological aspects of chicken processed in Jamaica

Bacteriological aspects of chicken processed in Jamaica were studied. The effect of processing on the number of bacteria on chicken from the largest processing plant (Jamaican Broilers) was investigated with reference to international standards. Microbial numbers, temperature and total organic matter content of selected washing tanks were examined. The number of bacteria on the hands of the workers and the final temperature of the carcasses after packaging and before freezing were also determined. Bacterial counts on the Jamaica Broilers chickens were compared with those of chickens from a smaller processing plant. Bacterial numbers on chickens sampled at retail outlets were also investigated and found to differ significantly from those on chicken sampled at the processing plant. Microbial examination of the delivery trucks, and observation of the hygienic condition of the outlets were conducted. The question of whether the transport system or condition of the retail outlets was the major factor responsible for the increase, was discussed. A correlation was found between the level of hygiene of the outlets and the number of bacteria on retail chickens. The shelf life and dynamics of the microbial population of chicken during storage at 4§C was examined. Chicken purchased at a retail outlet was stored at 4§C and rinsed in 0.1 percent peptone every 48 hours. The number of bacteria per ml of rinse water was determined. A total of 50 to 100 organisms were isolated and purified from total count plates of each sample day. Preliminary identification was by the method of Shewan et al. (1960) with confirmation by further biochemical tests. Pseudomonas species were found to be the major group of spoilage bacteria. Pseudomonas isolates were classified into different biochemical groups which were shown to undergo changes in distribution during storage. They were also characterised by their intrinsic antibiotic resistance patterns. While all the isolates were found to be resistant to penicillin and ampicillin, only 28 percent displayed high resistance to one or more of six other antibiotics tested. This investigation of bacteriological conditions of chicken processed in Jamaica is a pioneer effort. Nevertheless, it has provided sufficient information for the compilation of recommendations which may help to improve the microbial quality of chickens, with consequent increase in the shelf life. This study may also be useful to other Caribbean islands in which the conditions of processing, transportation and retail handling of chickens are similar (AU)

Quality control in laboratory investigations on Schistosoma mansoni in St Lucia, West Indies. Maintenance of artificial prevalence as a laboratory aid

A method is described of maintaining an apparent S mansoni prevalence rate of 10 percent in an area estimated to have a natural rate of below 5 percent following two chemotherapy campaigns. To sustain interest and therefore accuracy among microscopists engaged on screening, known S. mansoni-positive stools were seeded without their knowledge, among those collected in the field. The problems of achieving a desired level of seeding, and of a possible further dimension of the scheme are discussed (AU)

Quality control in laboratory investigations on Schistosoma mansoni on St. Lucia, West Indies: a staff assesment scheme

A method is described for the supervision of technicians engaged in microscopical screening of large numbers of stools for Schistosoma mansoni ova. The scheme presents graphically a regular updated longitudinal evaluation of both individual and group standards of technical competence (AU)

The meat trade in Portland with special emphasis on the public health aspect

Some of the features stated which make a private slaughter place unsatisfactory are :- 1) Broken up concrete slab 2) Overgrown vegetation 3) Stagnant water in drains 4) Dirty concrete surface 5) Inadequate water supply 6) Dirty and unsightly surroundings 7) Insanitary toilet facilities . In respect of the survey carried out to determine the extent to which the public is exposed to disease through the meat trade, from the purchasing of the animals through to the consumption of the meat, the researcher has decided to make the following recommendations for further improvements. (AU)

Some aspects of the development of the water quality control programme in Jamaica 1956 - 1975

Due to the high incidence of water-borne diseases in the island in the early 1950s, the Government took the decision to institute an islandwide programme of "water quality control". On the advice of an international sanitary engineer the services of a Jamaican sanitary engineer were secured. He was employed to the Ministry of Health. Training programmes were instituted and training of related personnel has been ongoing. Sixty per cent of those trained found the programme inadequate for the job of water quality control. It is thought that more sophisticated instrumentation is needed to deal with the more complex type of water pollution as well as a higher level of training for personnel (AU)