Articles: disease.
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Reports of the phase III clinical trials on four combined progestogen-estrogen once-a-month injectable contraceptives, Deladroxate, Cyclofem, Mesigyna and Chinese Injectable No. 1, are reviewed focussing on efficacy and reasons for discontinuation. Deladroxate, currently used in many Latin American countries has proved to be highly effective and well accepted. However, this combination was withdrawn by the original manufacturer because the progestogen component of this drug induced a high number of breast cancers in dogs and very curious pituitary hyperplasia in rats. ⋯ After doubling the dose in the first month of use, the efficacy was satisfactory. It was found that all monthly injectable contraceptives provided better cycle control than the every 3 months depot-medroxyprogesterone acetate, although abnormal bleeding was still the main drug-related complaint and reason for discontinuation. Missed appointment is another reason for discontinuation which might reflect the problem of frequent injection schedule, thus indicating the need for proper selection of the users and good counselling.
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Randomized Controlled Trial Comparative Study Clinical Trial
Psychoeducational group approach: HIV risk reduction in drug users.
In two trials of a small-group AIDS prevention approach, 50 methadone maintenance patients and 98 heroin abusers in outpatient detoxification were randomly assigned to experimental or comparison conditions. Experimental condition subjects received a 6-hour, small-group intervention that aimed to improve their knowledge and attitudes about AIDS, skills in syringe sterilization and condom use, and changing high-risk needle use and sexual behaviors. ⋯ Although outpatient detoxification subjects displayed considerably more risk behaviors at study outset, the intervention's effect appeared to be more robust in methadone maintenance patients. The relative lack of impact on subjects' behaviors points out that more potent, sustained interventions need to be developed to slow the spread of HIV among injecting drug users.
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Comparative Study
Attitudes to malaria, traditional practices and bednets (mosquito nets) as vector control measures: a comparative study in five west African countries.
Five West African communities were visited to assess the knowledge of the cause of malaria and to document traditional ways of treating and preventing the infection. Knowledge of the cause of malaria was low in the five communities visited. ⋯ Malaria was treated by a number of traditional practices, including herbal remedies. Bednets were used to a varying extent, from 44% Ghana to 86% Gambia, in each community to protect against mosquito bites but also for other purposes such as privacy, decoration and protection from roof debris dropping on the bed.
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A retrospective study of 21,442 Singaporean women who gave birth at the National University Hospital, Singapore, between January 1986 and November 1991 is used to assess the effects of increasing age on obstetric performance. The results show that reproduction after the age of 35 years in Singapore is associated with a higher incidence of antenatal complications such as hypertension and diabetes and a higher rate of obstetric intervention. However, given the current level of obstetric and neonatal care in Singapore, these adverse features do not prejudice the obstetric and neonatal outcomes.