Browsing by Author "Malkin, Robert"

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    A Foilized Polyethylene Pouch for the Prevention of Transmission of HIV from Mother to Child.
    (The open biomedical engineering journal, 2012-01) Malkin, Robert; Howard, Caroline
    Many children become HIV+ due to mother-to-child transmission, a risk that can be largely eliminated if infants ingest antiretroviral (ARV) medications immediately after birth. As most mothers in Africa deliver at home, the ARV must be provided at their last antenatal visit, sometimes months before birth. No current drug delivery system allows the mother to store the medication at home long enough to be effective. We propose a preserving, foilized, polyethylene pouch to be pre-dosed and sealed by a pharmacist for later delivery to the newborn.Pouches were filled with 0.6 ml of Nevirapine (NVP). Thirty-three pouches were immediately studied to measure the impact of medication handling (oxygen, light, filling and sealing the pouches). The remaining samples were stored for up to one year at three storage conditions (25°C/60%RH, 30°C/65%RH, and 40°C/75%RH). Every two months, moisture loss, preservative concentration, impurity concentrations and NVP concentration were measured. Flora and fauna challenges were conducted.THE POUCH NEARLY ELIMINATED MOISTURE LOSS: pouches lost less than 0.7% of their weight over twelve months. As expected, exposing the medication to light, oxygen, and handling significantly affected the sacrificial preservative concentrations (Propyl paraben dropped 38%, Methyl paraben dropped 12% at time point zero). However, after the initial time point, preservative levels were stable in the package over twelve months under all storage conditions (4.1% average concentration drop), leaving sufficient preservatives to protect the medication. The concentration of NVP changed an average of only 1.3% over all storage conditions and times points (maximum 1.4%).We conclude that the foilized polyethylene pouch can preserve NVP, and perhaps other ARV's, for up to one year.
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    Proposed Method to Evaluate the Impact on Health Outcomes of Capacity Building for Maintenance and Repair of Medical Equipment in Rwanda
    (2012) Penumetcha, Neeraja Raju

    It has been shown that training biomedical equipment technicians (BMETs) improves healthcare, but it is unclear if capacity building for repair and maintenance of medical equipment leads to improved patient health outcomes, and whether that relationship between equipment service and health can be measured.

    Health indicators are identified that may be used to measure an impact on patient health outcomes of Engineering World Health's biomedical equipment repair and maintenance training program in Rwanda.

    Fieldwork was conducted for 9 weeks in country to identify these indicators. Providers and administrators in twelve hospitals in Rwanda were interviewed about patient health outcomes, equipment use, and procedure preference based on equipment availability for selected clinical focus areas. Equipment availability and status were also surveyed. From the existing literature, expected health outcomes were compared between procedure preferences to estimate how patients would be affected by the availability of functional medical equipment.

    Neonatal jaundice treatment with phototherapy lamps, neonatal thermoregulation with incubators, and oxygen provision for acute respiratory management were identified as areas where the relationship between equipment service training and health could be measured. It is recommended that some of these areas be studied in the field to confirm and quantify the connection.