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Losartan potassium is an angiotensin II receptor antagonist readily absorbed from the GIT, following oral administration. It has low bioavailability as it undergoes extensive first pass metabolism and low elimination half-life. The present study was aimed at studying sustained release behaviour of the drug using hydrophilic and hydrophobic polymers and to optimise using a 3[²] full factorial design. Eudragit and HPMC were used to evaluate the effect of hydrophilic and hydrophobic polymers on the release pattern of the drug. A full factorial was implemented at 20, 30 and 40% concentration of hydrophilic polymer and 2.5, 5 and 7.5% of hydrophobic polymer correlating with the release behaviour. Process variables were investigated and the results showed excellent adaptability in releasing drug over prolonged periods. Based on the results, it was found suitable to formulate a dosage form using optimum concentration of hydrophobic polymer along with hydrophilic polymer to vary the release behaviour for over 12 hours. [ABSTRACT FROM AUTHOR]

The U.S. Centers for Disease Control and Prevention (CDC) received surveillance data on how many people tested positive for SARS-CoV-2, but there was little information about what individuals did to mitigate transmission. To fill the information gap, we conducted an online, probability-based survey among a nationally representative panel of adults living in the United States to better understand the behaviors of individuals following a positive SARS-CoV-2 test result. Given the low response rates commonly associated with panel surveys, we assessed how well the survey data aligned with CDC surveillance data from March, 2020 to March, 2022. We used CDC surveillance data to calculate monthly aggregated COVID-19 case counts and compared these to monthly COVID-19 case counts captured by our survey during the same period. We found high correlation between our overall survey data estimates and monthly case counts reported to the CDC during the analytic period ( r : +0.94; p  < 0.05). When stratified according to demographic characteristics, correlations remained high. These correlations strengthened our confidence that the panel survey participants were reflective of the cases reported to CDC and demonstrated the potential value of panel surveys to inform decision making., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Matulewicz, Vohra, Crawford-Crudell, Oeltmann, Moonan, Taylor, Couzens and Weiss.)

Using a nationally representative panel survey, we examined isolation behaviors among persons in the United States who had positive SARS-CoV-2 test results during January 2021-March 2022. Compared with persons who received provider-administered results, persons with home-based results had 29% (95% CI 5%-47%) lower odds of following isolation recommendations.

Case investigation and contact tracing (CI/CT) is a critical part of the public health response to COVID-19. Individuals' experiences with CI/CT for COVID-19 varied based on geographic location, changes in knowledge and guidelines, access to testing and vaccination, as well as demographic characteristics including age, race, ethnicity, income, and political ideology. In this paper, we explore the experiences and behaviors of adults with positive SARS-CoV-2 test results, or who were exposed to a person with COVID-19, to understand their knowledge, motivations, and facilitators and barriers to their actions. We conducted focus groups and one-on-one interviews with 94 cases and 90 contacts from across the United States. We found that participants were concerned about infecting or exposing others, which motivated them to isolate or quarantine, notify contacts, and get tested. Although most cases and contacts were not contacted by CI/CT professionals, those who were reported a positive experience and received helpful information. Many cases and contacts reported seeking information from family, friends, health care providers, as well as television news and Internet sources. Although participants reported similar perspectives and experiences across demographic characteristics, some highlighted inequities in receiving COVID-19 information and resources., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Objective: To estimate the cost of maternal morbidity for all 2019 pregnancies and births in the United States., Methods: Using data from 2010 to 2020, we developed a cost analysis model that calculated the excess cases of outcomes attributed to nine maternal morbidity conditions with evidence of outcomes in the literature. We then modeled the associated medical and nonmedical costs of each outcome incurred by birthing people and their children in 2019, projected through five years postpartum., Results: We estimated that the total cost of nine maternal morbidity conditions for all pregnancies and births in 2019 was $32.3 billion from conception to five years postpartum, amounting to $8,624 in societal costs per birthing person., Conclusion: We found only nine maternal morbidity conditions with sufficient supporting evidence of linkages to outcomes and costs. The lack of comprehensive data for other conditions suggests that maternal morbidity exacts a higher toll on society than we found., Policy Implications: Although this study likely provides lower bound cost estimates, it establishes the substantial adverse societal impact of maternal morbidity and suggests further opportunities to invest in maternal health., Competing Interests: The authors have declared that no competing interests exist.

Background: Maternal mental health conditions (MMHCs), which include depression and anxiety disorders during pregnancy and through five years postpartum, are among the most common obstetric complications in the United States overall and in Texas in particular. In the context of potential expansion of postpartum Medicaid coverage from 60 days to one year, we sought to capture the societal, financial burden of untreated MMHCs., Methods: We estimated the economic impact of untreated maternal mental health conditions (MMHCs) among births in Texas in 2019 using a cost-of-illness model., Results: We found that MMHCs affected 13.2% of mothers and, when left untreated, cost $2.2 billion among mothers and children born in Texas in 2019 when following the birth cohort from conception through five years postpartum. We found that MMHCs affected 17.2% of mothers enrolled in Texas' Medicaid for Pregnant Women and cost $962 million. In addition, the prevalence of MMHCs and resulting costs varied considerably among women of different races and ethnicities. Employers and health care payers, including Medicaid, bore most of these costs., Conclusions: The Texas Health and Human Services Commission's (HHSC) efforts to increase awareness about MMHCs and increase access to care represent an important step toward improving maternal and child health and maximizing benefits to Texas HHSC, employers, and insurers., (© 2022. The Author(s).)

Recent literature has reported that radiological features of coronavirus disease (COVID-19) patients are influenced by computed tomography. This study aimed to assess the characteristic chest X-ray features of COVID-19 and correlate them with clinical outcomes of patients. This retrospective study included 120 COVID-19 patients. Baseline chest X-rays and serial chest X-rays were reviewed. A severity index in the form of maximum radiological assessment of lung edema (RALE) score was calculated for each lung, and scores of both the lungs were summed to obtain a final score. The mean ± standard deviation (SD) and frequency (%) were determined, and an unpaired t test, Spearman's rank correlation coefficient, and logistic regression analyses were performed for statistical analyses. Among 120 COVID-19 patients, 74 (61.67%) and 46 (38.33%) were males and females, respectively; 64 patients (53.33%) had ground-glass opacities (GGO), 55 (45.83%) had consolidation, and 38 (31.67%) had reticular-nodular opacities, with lower zone distribution (50%) and peripheral distribution (41.67%). Baseline chest X-ray showed a sensitivity of 63.3% in diagnosing typical findings of SARS-CoV-2 pneumonia. The maximum RALE score was 2.13 ± 1.9 in hospitalized patients and 0.57 ± 0.77 in discharged patients ( p value <0.0001). Spearman's rank correlation coefficient between maximum RALE score and clinical outcome parameters was as follows: age, 0.721 ( p value <0.00001); >10 days of hospital stay, 0.5478 ( p value <0.05); ≤10 days of hospital stay, 0.5384 ( p value <0.0001); discharged patients, 0.5433 ( p value <0.0001); and death, 0.6182 ( p value = 0.0568). The logistic regression analysis revealed that maximum RALE scores (0.0932 [0.024-0.367]), (10.730 [2.727-42.206]), (1.258 [0.990-1.598]), and (0.794 [0.625-1.009]) predicted discharge, death, >10 days of hospital stay, and ≤10 days of hospital stay, respectively. The study findings suggested that the RALE score can quantify the extent of COVID-19 and can predict the prognosis of patients., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 Satyanand Sathi et al.)

Background: Although abortion was legalized in Nepal in 2002, many women are not able to obtain legal services. Using qualitative data from women who were denied legal abortion services, we examined reasons for seeking an abortion, options considered and pursued after being denied an abortion, reasons for delaying seeking care, as well as complications experienced among women who were denied legal abortion., Methods: After obtaining authorization from two health facilities in Nepal, we requested informed consent from all women who were seeking abortion services to complete a case report form to determine their eligibility for the study. We then recruited all eligible and interested women in to the study. Two months after recruitment, we conducted in-depth interviews with 25 women who were denied abortion services from the two recruitment facilities due to advanced gestational age (>12 weeks). Interviews were translated and transcribed, and the transcripts were analyzed through an iterative process grounded in thematic analysis, involving both a priori and emergent codes., Results: Eleven women were recruited from the government hospital and 14 from an NGO facility. The majority of women (15 women or 60 %) were living rural settings, ranged in age from 18 to 40 years and had an average of 2 children. None had completed any post-secondary education. Women most commonly cited financial concerns and health concerns as reasons for seeking termination. Not recognizing pregnancy, uncertainty about how to proceed, needing time to coordinate the trip to the facility or raise money, and waiting to know the sex of fetus were the commonly cited delays. Among the women interviewed, 12 decided to continue their pregnancies following denial, 12 terminated their pregnancies elsewhere, and one self-induced using medication. At least two women experienced significant complications after obtaining an abortion. Most women who continued their pregnancies anticipated negative consequences for their health, family relationships, and wellbeing., Conclusions: Barriers to seeking early abortion need to be addressed in order to reduce utilization of abortion services that may be unsafe and to improve women's health and wellbeing in Nepal.

Background: The WHO estimates that 13% of maternal mortality is due to unsafe abortion, but challenges with measurement and data quality persist. To our knowledge, no systematic assessment of the validity of studies reporting estimates of abortion-related mortality exists., Study Design: To be included in this study, articles had to meet the following criteria: (1) published between September 1(st), 2000-December 1(st), 2011; (2) utilized data from a country where abortion is "considered unsafe"; (3) specified and enumerated causes of maternal death including "abortion"; (4) enumerated ≥100 maternal deaths; (5) a quantitative research study; (6) published in a peer-reviewed journal., Results: 7,438 articles were initially identified. Thirty-six studies were ultimately included. Overall, studies rated "Very Good" found the highest estimates of abortion related mortality (median 16%, range 1-27.4%). Studies rated "Very Poor" found the lowest overall proportion of abortion related deaths (median: 2%, range 1.3-9.4%)., Conclusions: Improvements in the quality of data collection would facilitate better understanding global abortion-related mortality. Until improved data exist, better reporting of study procedures and standardization of the definition of abortion and abortion-related mortality should be encouraged.

Intimate partner violence (IPV) is widely prevalent in Tanzania. Inequitable gender norms manifest in men's and women's attitudes about power and decision making in intimate relationships and are likely to play an important role in determining the prevalence of IPV. We used data from the RESPECT study, a randomized controlled trial that evaluated an intervention to prevent sexually transmitted infections in a cohort of young Tanzanian men and women, to examine the relationship between couples' attitudes about IPV, relationship power, and sexual decision making, concordance on these issues, and women's reports of IPV over 12 months. Women expressed less equitable attitudes than men at baseline. Over time, participants' attitudes tended to become more equitable and women's reports of IPV declined substantially. Multivariable logistic regression analyses suggested that inequitable attitudes and couple discordance were associated with higher risk of IPV. Our findings point to the need for a better understanding of the role that perceived or actual imbalances in relationship power have in heightening IPV risk. The decline in women's reports of IPV and the trend towards gender-equitable attitudes indicate that concerted efforts to reduce IPV and promote gender equity have the potential to make a positive difference in the relatively short term.

Although keloids were recognised in the Smith Papyrus of ancient times, the precise definition, cause and management have remained elusive. Several forms of treatment have been used with varying success.Objectives This study assesses and compares the value of intralesional steroid (Triamcinolone acetonide 40mg/ml), cryotherapy and cryotherapy with intralesional steroid in the treatment of keloids.Methodology 33 patients were studied, 11 each in the three arms and the volume of the keloids was recorded using wax patterns of alginate impressions of the keloids to note the change in size postoperatively.Results The best average percentage response was observed is patients who received both Cryotherapy (CRY) and Intralesional Steroid (ILS) (69.02%) followed by patients who received only intralesional steroid (43.98%). Among the patients who received only cryotherapy, the average percentage response was only 39.24%. 72.73% patients who received intralesional steroid with cryotherapy showed more than 50% improvement (good response) while only 9.09% patients who received intralesional steroid alone and cryotherapy alone showed similar improvement.Conclusion In patients with keloids good response can be obtained with CRY with ILS as compared to ILS alone and CRY alone.