pill

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Some clinicians and ethicists in the first group object to the combined OCP based on good indirect evidence that it could cause the death of an early embryo.4 Others in this group broaden their moral opposition to include the primary effect of the OCP: direct suppression of fertility for procreative (family-planning) purposes. For the latter, moral objection to the OCP would continue even if it were proven that it was not an abortifacient. 5

Family planning (FP) program contributed to Egypt’s progress in reducing infant and maternal mortality and the total fertility and population growth rates. The Arab spring has brought to the forefront long-held aspirations, which can only be fulfilled by a clear shift to a rights-based and person-centered family planning approach and away from an imposed top-down program with targets for family size and fertility rate. The essence of a rights-based approach to FP is interacting with people as individuals with rights to control ones lives, not as a target of a particular program. The FP program also needs to determine and mitigate the factors that make it difficult for the poor, young, and marginalized groups to exercise rights to receive the services needed. The authors of this report examined the challenges facing Egypt’s FP program through a human rights lens, exploring whether individuals and couples are able to exercise their rights to financial and physical access to good quali...

The purpose of this study was to understand the relationship between daily contextual factors and oral contraceptive (OC) adherence among students who attend college or graduate school. STUDY DESIGN: Data on OC adherence, demographics, contextual factors, and side-effects were collected as part of the acceptability of the NuvaRing (Merck & Co, Whitehouse Station, NJ) vs OC study, in which students were assigned randomly to the contraceptive vaginal ring or to a low-dose OC. We performed bivariate and multivariable analyses to create an explanatory model for nonperfect OC adherence (missed at least 1 pill during 3 months of use). RESULTS: In a multivariable predictive model, missing a pill was associated positively with high perceived stress (odds ratio [OR], 3.16; P ϭ .007), having Ն10 hours per week of paid employment (OR, 2.13; P ϭ .075), and living with a partner (OR, 9.92; P ϭ .040). CONCLUSION: Stressful and hectic lives contribute to poor OC adherence. When counseling women about contraception, clinicians should consider the influence of daily life on contraceptive adherence.

A series of poly(vinyl alcohol) of different commercial grades were prepared and applied onto the surfaces of cotton and blends of cotton/polyester fibers. The molecular structure was confirmed using Fourier Transform Infrared spectroscopy. Physicochemical properties such as viscosity and solid contents (%) were determined and discussed. Factors affecting the performance properties of the finished substrate such as post-treatment with poly(vinyl alcohol) of different grades, concentration and dilutions were studied. Fixation of the poly(vinyl alcohol) onto/or within the cellulose structure is accompanied by the formation of semi-inter-penetrated network structure thereby enhancing the association as well as providing very high stiffness. The results revealed that applications of poly(vinyl alcohol) on the textile fabrics in the finishing processes enables to enhance the stiffness as well as helps to improve its pilling resistance.

Recent evaluations of large scale social interventions have used randomized control trial (RCT) designs that require the identification of comparable areas before the intervention is initiated so that some areas can be randomized to receive the intervention, while others serve as controls. An RCT begins with a baseline survey to collect data before the program is implemented and then a follow-up survey is conducted after the program has run long enough to have an impact. RCT are not only technically, programmatically, and financially difficult, but also delineating between treatment and control groups can be politically challenging. RCT also require lag times that are long enough (3-5 years) to ensure that impact can be validly measured. The remaining part of the report discusses the technical aspects of design and analyses for RCT of nutrition interventions and for the plausibility and the adequacy investigations. It presents technical information for evaluating nutritional interve...

A series of poly(vinyl alcohol) of different commercial grades were prepared and applied onto the surfaces of cotton and blends of cotton/polyester fibers. The molecular structure was confirmed using Fourier Transform Infrared spectroscopy. Physicochemical properties such as viscosity and solid contents (%) were determined and discussed. Factors affecting the performance properties of the finished substrate such as post-treatment with poly(vinyl alcohol) of different grades, concentration and dilutions were studied. Fixation of the poly(vinyl alcohol) onto/or within the cellulose structure is accompanied by the formation of semi-inter-penetrated network structure thereby enhancing the association as well as providing very high stiffness. The results revealed that applications of poly(vinyl alcohol) on the textile fabrics in the finishing processes enables to enhance the stiffness as well as helps to improve its pilling resistance.

Background-Athletes with injury-related pain, especially National Football League (NFL) players, are at increased risk for opioid use and misuse which may result in medical, psychiatric and social problems. This is the first study to evaluate the intersection of sports pain and opioid use and misuse among former NFL players. Methods-A telephone survey of 644 retired NFL players from the 2009 Retired Players Association Directory was conducted (53.4% completion rate) from March to August 2010. Results-Over half (52%) used opioids during their NFL career with 71% reporting misuse. Additionally, 15% of NFL misusers currently misused vs. 5% among players who used just as prescribed during their NFL career. Prevalence of current opioid use was 7%-3 times the rate of the general population. Multivariate analyses indicated that significant NFL pain increased the adjusted odds (AOR) of any current opioid use vs. non-use (AOR 6.76, 95%CI 2.88-15.87), as did moderate to severe mental impairment (AOR 1.88, 95%CI 1.19-2.98) and heavy drinking in the past week (AOR 2.15, 95% CI 1.17-3.98). Undiagnosed concussions singly predicted current misuse vs. use just as prescribed (AOR 4.25, 95%CI 1.12-16.22). Three variables predicted current misuse vs. non-use: significant pain (AOR 8.33, 95%CI 1.98-35.04), undiagnosed concussions (AOR 3.51, 95%CI 1.98-35.04) and heavy drinking (AOR 3.48, 95%CI 1.63-7.41).

Background: Although emergency contraceptive pills are available over the counter, the quality of consultation, including key areas of contraceptive counseling and prevention of sexually transmitted infections (STI), has not been well documented. Objective: To evaluate actual pharmacist services while dispensing emergency contraception through a mystery shopper technique. Material and Methods: This cross-sectional study was conducted in 81 pharmacies situated in Delhi by 4 trained mystery shoppers posed as customers over a period of 6 months. Results: None of the pharmacists asked about the time lapsed since last unprotected sexual intercourse or last menstrual period before deciding the eligibility of the customer. The majority were unclear about side effects associated with emergency contraception (78.57%) or with anticipated changes in menstrual flow (78.57%); 85.71% did not know whether subsequent unprotected intercourse would be protected. Only 15.71% counseled shoppers regarding risk of STI on asking leading questions and 88.5% did not provide any contraceptive advice. Conclusion: There is a huge gap in the technical knowledge and mindset of the pharmacists when it comes to checking for the eligibility of the client and providing advice regarding use of regular contraception and barrier for protection from STI, which needs to be addressed in order to realize the full benefit of making emergency contraceptive pills available over the counter.

Background Over 100 million women worldwide are using oral contraceptives pills (OCP) and mood changes were being as the primary reason for OCP discontinuation. The purpose of this study was to determine the prevalence and predicting factors of mood changes in oral contraceptive pills users. Methods This was a cross-sectional study of 500 women aged 15–49 years old using low dose (LD) pills attending family planning centers in Ahwaz, Iran. Data were collected via face-to-face interviews using a structured questionnaire including items on demographic, self-efficacy and mood change. Both univarate and multiple logistic regression analyses were performed to assess the relationship between reported mood change and the independent variables. Results In all 406 women reported that they did experience OCP side effects. Of these, 37.7% of women (n =153) reported mood changes due to OCP use. The results of multiple logistic regression revealed that place of living (OR = 2.57, 95% CI = 1.06-6...

To compare bleeding patterns between a 21/7-day triphasic norgestimate/ethinyl estradiol (E2) 25-microgram oral contraceptive pill (OCP) and a 24/4-day drospirenone/ethinyl E2 20-microgram OCP. In a three-cycle, open-label, multicenter study, healthy, sexually active women were assigned randomly to a 21/7-day (norgestimate/ethinyl E2) or 24/4-day (drospirenone/ethinyl E2) OCP regimen. Randomization was stratified to assure a balanced distribution between regimens for "fresh starts" and "switchers." Bleeding data were collected daily using an interactive voice-response system. Bleeding was defined according to the 2007 U.S. Food and Drug Administration's Reproductive Health Drug Advisory Committee-endorsed criteria. Across the three cycles, the 21/7-day OCP group (n=165) reported fewer unscheduled bleeding days than did the 24/4-day OCP group (n=167) (mean 4.6 compared with 6.1 days, P=.003). Women using the 21/7-day OCP had significantly fewer episodes of unscheduled bleeding than did those using the 24/4-day OCP (mean 1.47 compared with 2.01, P=.001). Moreover, women using the 21/7-day OCP had a significantly lower absence of scheduled bleeding at each cycle (P<.001). Both regimens were well-tolerated. A 21-day norgestimate/ethinyl E2 25-microgram regimen results in less unscheduled bleeding and more scheduled bleeding than does a 24-day drospirenone/ethinyl E2 20-microgram regimen. ClinicalTrials.gov, www.ClinicalTrials.gov, NCT00745901. I.

A rapid, sensitive, and accurate ultra-performance liquid chromatography-UV detection method was developed and validated for simultaneous determination of seven active alkaloids, berberine, palmatine, coptisine, jatrorrhizine, epiberberine, evodiamine, and rutaecarpine, in the Coptis-Evodia herb couple and the Zuojin pill preparation. The original validated method had a total time of about 11 min, which was reduced to 4.7 min by further optimization of gradient elution conditions with eluent A comprising water/ methanol/formic acid (v/v/v, 90:10:0.1) and eluent B ACN. An accelerated solvent extraction method was used for the rapid extraction of herb products and pill preparations. Linear behavior over the investigated concentration ranges was observed, with values of r 2 greater than 0.9987 for all analytes. Experiment results were satisfactory for both intra-day and inter-day precision, and method accuracy. Method recovery ranged from 95.7 to 103.5% based on pure reference standards. The validated method was successfully applied to determine amounts of bioactive alkaloid compounds in five samples, in the Coptis-Evodia herb couple, and the commercial Zuojin pill products. The developed method achieved baseline resolution for all seven main basic compounds and is suitable for use as a routine procedure for the rapid identification and quantification of basic compounds in the Coptis-Evodia herb couple and related products.

What factors must be weighed when deciding whether to promote local manufacturing of pharmaceuticals in developing countries? Andreas Seiter's note summarizes pros, cons and key issues. Pharmaceuticals are essential in every health care system. The objective of pharmaceutical policy is to make sure that there is a reliable supply of good quality medicines at affordable prices. Local manufacturing is sometimes offered as a potential solution to the access problem. Supporters of this concept suggest that local production in a developing country should result in a cheaper final product. Skeptics argue that small manufacturing units don't achieve economies of scale, and that higher unit costs outweigh potential advantages such as lower transportation costs.

A series of poly(vinyl alcohol) of different commercial grades were prepared and applied onto the surfaces of cotton and blends of cotton/polyester fibers. The molecular structure was confirmed using Fourier Transform Infrared spectroscopy. Physicochemical properties such as viscosity and solid contents (%) were determined and discussed. Factors affecting the performance properties of the finished substrate such as post-treatment with poly(vinyl alcohol) of different grades, concentration and dilutions were studied. Fixation of the poly(vinyl alcohol) onto/or within the cellulose structure is accompanied by the formation of semi-inter-penetrated network structure thereby enhancing the association as well as providing very high stiffness. The results revealed that applications of poly(vinyl alcohol) on the textile fabrics in the finishing processes enables to enhance the stiffness as well as helps to improve its pilling resistance.

A series of poly(vinyl alcohol) of different commercial grades were prepared and applied onto the surfaces of cotton and blends of cotton/polyester fibers. The molecular structure was confirmed using Fourier Transform Infrared spectroscopy. Physicochemical properties such as viscosity and solid contents (%) were determined and discussed. Factors affecting the performance properties of the finished substrate such as post-treatment with poly(vinyl alcohol) of different grades, concentration and dilutions were studied. Fixation of the poly(vinyl alcohol) onto/or within the cellulose structure is accompanied by the formation of semi-inter-penetrated network structure thereby enhancing the association as well as providing very high stiffness. The results revealed that applications of poly(vinyl alcohol) on the textile fabrics in the finishing processes enables to enhance the stiffness as well as helps to improve its pilling resistance.

Objective: To assess the interaction between insulin resistance and endothelial function and the optimal treatment strategy addressing cardiovascular risk in polycystic ovary syndrome. Design: Randomized controlled trial. Setting: Controlled clinical study. Patient(s): Overweight age-and body mass index-matched women with polycystic ovary syndrome. Intervention(s): Six months metformin (1 g two times per day, n ¼ 36) or oral contraceptive pill (OCP) (35 mg ethinyl E 2-2 mg cytoproterone acetate, n ¼ 30). Main Outcome Measure(s): Fasting and oral glucose tolerance test glucose and insulin levels, endothelial function (flow-mediated dilation, asymmetric dimethylarginine, plasminogen activator inhibitor-1, von Willebrand factor), inflammatory markers (high-sensitivity C-reactive protein), lipids, and hyperandrogenism. Result(s): The OCP increased levels of glucose and insulin on oral glucose tolerance test, high-sensitivity C-reactive protein, triglycerides, and sex-hormone binding globulin and decreased levels of low-density lipoprotein cholesterol and T. Metformin decreased levels of fasting insulin, oral glucose tolerance test insulin, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein. Flow-mediated dilation increased only with metformin (þ2.2% AE 4.8%), whereas asymmetric dimethylarginine decreased equivalently for OCP and metformin (À0.3 AE 0.1 vs. À0.1 AE 0.1 mmol/L). Greater decreases in plasminogen activator inhibitor-1 occurred for the OCP than for metformin (À1.8 AE 1.6 vs. À0.7 AE 1.7 U/mL). Conclusion(s): In polycystic ovary syndrome, metformin improves insulin resistance, inflammatory markers, and endothelial function. The OCP worsens insulin resistance and glucose homeostasis, inflammatory markers, and triglycerides and has neutral or positive endothelial effects. The effect of the OCP on cardiovascular risk in polycystic ovary syndrome is unclear. (Fertil Steril Ò 2010;93:184-91. Ó2010 by American Society for Reproductive Medicine.)