Preparations of Rectal Suppositories Containing Artesunate

Rectal artesunate suppositories are a useful option for pre-referral treatment of severe malaria, specifically in children under 6 years of age in remote malaria-endemic areas. The main challenges are to improve the solubility of drugs in the rectal fluids and prevent the product from turning rancid or melting in a tropical climate. In this short proof-of-concept study, three types of rectal suppositories of artesunate were prepared: (i) polyethylene glycol (PEG)-based suppositories carrying free artesunate (non-modified artesunate), (ii) PEG-based suppositories carrying artesunate-loaded micelles and (iii) 3D-printed suppositories carrying a PEG/artesunate mixture. Physical parameters of suppositories, release profiles of artesunate (the fastest to the slowest: ii≥i>iii) and thermostability (the most stable to the least stable: iii>ii>i) of suppositories at increased temperature were assessed to determine the advantages and disadvantages of each formulation.

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Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study

BMJ Open ◽

10.1136/bmjopen-2019-029738 ◽

2019 ◽

Vol 9 (8) ◽

pp. e029738

Author(s):

Anne Herrmann-Werner ◽

Teresa Loda ◽

Lisa M Wiesner ◽

Rebecca Sarah Erschens ◽

Florian Junne ◽

...

Keyword(s):

Medical Students ◽

Role Play ◽

Overweight And Obesity ◽

University Hospital ◽

Secondary Outcome ◽

Teaching Tool ◽

Proof Of Concept ◽

Cross Sectional ◽

Concept Study ◽

Advantages And Disadvantages

ObjectiveWith the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to prevent patients from having stigmatising experiences. In addition, medical students should have training to reduce anti-fat prejudices.DesignCross-sectional proof of concept study.SettingUniversity Hospital Tuebingen, Germany.Participants246 participants (207 second-year medical students, 13 standardised patients (SPs) and 22 teachers) took part in the study.Primary and secondary outcome measuresThe primary outcome was the assessment of degree of reality of the encounter with the SP wearing an obesity simulation suit (OSS). The secondary outcome was the evaluation of students’ awareness and prejudice against patients with obesity in a simulated role play. Additionally, a description of the advantages and disadvantages when using such a teaching tool is delivered.ResultsThe OSS contributed to a realistic perception of the patient group depicted in a role play according to students, teachers and SPs. OSS body mass index estimation by students, teachers and SPs correctly was over 30 kg/m2—thus in the range of obesity. In a selected subscale of the Anti-Fat Attitudes Test, students showed significantly stronger anti-fat stigmatisation compared with teachers and SPs.ConclusionsAn OSS worn by an SP is a valuable teaching tool to raise awareness about patients with obesity. It gives a realistic picture of the encounter. Stigmatisation was low in general but was especially present in the students. Further research should include intervention studies to address this issue.

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