Antifertility Research Articles

Endocrine morbidity in neurofibromatosis 1: A nationwide, register-based cohort study.

Previous studies have found that neurofibromatosis 1 (NF1) is associated with an increased risk for endocrine disorders, but no comprehensive overview of the risk for specific endocrine disorders has been published. We assessed endocrine morbidity in individuals with NF1 from information on hospital admissions, surgery for endocrine disorders, and relevant medication. A nationwide population registry-based cohort study. We identified 2467 individuals with NF1 diagnosed between 1977-2013 from the Danish National Patient Register and the RAREDIS database and 20 132 randomly sampled age- and sex-matched population comparisons. Information on endocrine diseases was identified using registrations of discharge diagnoses, surgery, and medication prescriptions. The rates of endocrine disorders in individuals with NF1 were compared with those in the comparison cohort in Cox proportional hazard models. Individuals with NF1 had a higher rate than the comparison group of any endocrine discharge diagnosis (hazard ratio (HR) 1.72, 95% confidence interval (CI): 1.58-1.87), endocrine-related surgery (2.03, 1.39-2.96), and prescribed medications (1.32, 1.23-1.42). Increased HRs were observed for diseases and surgical operations of several glands, including pheochromocytoma, and for osteoporosis, and osteoporotic fractures. Decreased rates were observed with drugs for type 2 diabetes. Women with NF1 had higher HRs for surgery of the ovaries, uterus, and sterilization, but lower rates of surgeries of cervix and prescriptions for birth control pills. NF1 is associated with a variety of endocrine disorders, surgery, and medication related to endocrine disease. Awareness of endocrine morbidity is important in the clinical follow-up of individuals with NF1.

Cervical Cancer: A Review of Epidemiology, Treatments and Anticancer Drugs

Background: Cancer is the second leading cause of death among men and women and a highly prevalent cause of mortality among women. Having sexual relations at a young age, having multiple sex partners, multiple pregnancies, long-term use of birth control pills, receiving a kidney transplant, and sexually transmitted diseases (STDs) are the major risk factors of cervical cancer. Although the risk of cervical cancer has recently increased, its mortality rate has declined. This study aimed to review cervical cancer, its epidemiology, etiology, treatment methods, and various chemical plant- and microorganism-derived drugs. Material and Methods: Complete information collection was performed by reading most of the available articles. Results: Human papillomavirus (HPV) infection is the main cause of cervical cancer, and the best way to prevent it is vaccination between the ages of 9 and 11 years, screening women and, more importantly, educating girls. One of the easiest methods to screen for this disease is Pap tests and HPV genotyping (high-risk strains 16 and 18). Cervical cancer is asymptomatic in the early stages, but after spreading to other parts of the body, it causes symptoms, such as bleeding, pelvic pain, and dyspareunia. Cervical cancer treatment is based on the stage of the disease and the involvement of other parts of the body. In general, however, surgery, chemotherapy, radiotherapy, and hysterectomy are among the common treatments for cervical cancer. Each of these methods has its side effects; for instance, chemotherapy destroys healthy as well as cancer cells. Conclusion: Nowadays, with molecular knowledge, new drugs have been developed that are free from the side effects of cancer treatment methods and only affect cancer cells. All the results have been reviewed and compiled.

US FDA approves first over-the-counter birth control pill

US FDA approves first over-the-counter birth control pill

Comparison of the cytokine responses to acute strength exercise between oral contraceptive users and naturally cycling women

PurposeCytokines are released as part of an inflammatory reaction in response to strength exercise to initiate muscle repair and morphological adaptations. Whether hormonal fluctuations induced by the menstrual cycle or oral contraceptives affect inflammatory responses to strength exercise remains unknown. Therefore, we aimed to compare the response of cytokines after acute strength exercise in naturally menstruating women and oral contraceptive users.MethodsNaturally menstruating women (MC, n = 13, 24 ± 4 years, weekly strength training: 4.3 ± 1.7 h) and women using a monophasic combined pill (> 9 months) (OC, n = 8, 22 ± 3 years, weekly strength training: 4.5 ± 1.9 h) were recruited. A one-repetition-maximum (1RM) test and strength exercise in the squat (4 × 10 repetitions, 70%1RM) was performed in the early follicular phase or pill free interval. Concentrations of oestradiol, IL-1β, IL-1ra, IL-6, IL-8, and IL-10 were assessed before (pre), directly after (post) and 24 h after (post24) strength exercise.ResultsIL-1ra increased from pre to post (+ 51.1 ± 59.4%, p = 0.189) and statistically decreased from post to post24 (– 20.5 ± 13.5%, p = 0.011) only in OC. Additionally, IL-1β statistically decreased from post to post24 (– 39.6 ± 23.0%, p = 0.044) only in OC. There was an interaction effect for IL-1β (p = 0.038) and concentrations were statistically decreased at post24 in OC compared to MC (p = 0.05). IL-8 increased across both groups from post to post24 (+ 66.6 ± 96.3%, p = 0.004).ConclusionWe showed a differential regulation of IL-1β and IL-1ra between OC users in the pill-free interval and naturally cycling women 24 h after strength exercise, while there was no effect on other cytokines. Whether this is associated with previously shown compromised morphological adaptations remains to be investigated.

P69 Baseline characteristics of patients with physician-diagnosed hidradenitis suppurativa: results from a retrospective observational study using data from the Clinical Practice Research Datalink database

Abstract Hidradenitis suppurativa (HS) is a difficult-to-treat, painful, chronic inflammatory skin disorder characterized by nodules, abscesses and skin tunnels. Delay in diagnosis increases disease severity and overall disease burden. In England, HS is associated with a high healthcare resource use, with an estimated prevalence of 1.2% in the general UK population (Ingram JR, Jenkins-Jones S, Knipe DW et al. Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. Br J Dermatol 2018; 178:917–24). Improved understanding of HS patient profiles in England will help optimize patient care and treatment outcomes. This study aimed to characterize the patient profiles, journey, treatment pathways and treatment outcomes of patients with HS in England using data from the Clinical Practice Research Datalink database. Here, we present the baseline characteristics of patients with HS from this database. Overall, 39 860 patients with physician-diagnosed HS were identified from 1 January 2009 to 31 March 2021. The mean (SD) age at diagnosis was 34.49 (13.07) years, and the majority were female (73.8%). Twenty-seven per cent of patients were White, 7.5% were Asian, 5.0% were Black and 27.9% were of mixed race, while 2.1% were from other races and the race was unknown for 30.7%. Overall, 44.6% were current smokers and 12.7% were ex-smokers. Depression (31.7%), anxiety (21.5%) and acne (20.6%) were the most commonly reported comorbidities related to HS. Chronic pulmonary disease was reported in 26.2% of patients; this may, in part, be attributed to relatively high rates of smoking in the HS population. The most frequently prescribed medications prior to HS diagnosis were pain medication, especially ‘non-opioid’ analgesics (21.8%) and opioids (19.8%); oral antibiotics, particularly tetracyclines (15.7%); combined contraceptive pills (7.2%) and metformin (4.8%). Only a few patients (< 0.05%) received a biologic prior to their HS diagnosis for other chronic inflammatory conditions. The various comorbidities, including psychiatric, metabolic, cardiovascular, gynaecological and pulmonary and associated treatments, observed in this real-world study in England suggest that optimal management should involve a multidisciplinary approach to improve outcomes in patients with HS.

INDICATORS OF PHAGOCYTOSIS IN WOMEN WITH ACNE DURING COMPREHENSIVE TREATMENT THAT INCLUDED PRP- AND IPL-THERAPY

Introduction. Acne is one of the most common dermatological diseases. It may have a chronic course, leaving permanent marks, and in last years has been tending to have more and more severe clinical course with widespread skin lesions. According to recent studies, the development of acne is due to the combined effect of endogenous and exogenous factors, among which endocrine diseases, disorders of metabolic processes, reduced systemic immunity and phagocytic ability of mononuclear phagocytes and granulocytes at various stages of phagocytosis of pyogenic cocci, which contributes to more severe clinical course, and frequent relapse of this diseases. It was also proved that the intestinal microbiota plays an important role in the formation of homeostasis and immune response.
 The Objective of the study is to determine the evolution of phagocytosis indices in patients with acne under different comprehensive treatments, using oral antibiotics, immunotherapy (PRPtherapy), probiotics, low-dose birth control pills and IPL- therapy.
 Materials and methods. We observed 93 women with acne aged from 18 to 25 years old. In 19 (20.43%) patient mild acne was diagnosed, in 41 (44.09%) – moderate acne, in 33 (35.48%) persons – severe acne, 54 (58.06%) persons suffered from acne up to 1 year, 39 (41.93%) – from 1 to 3 years. To assess the state of phagocytosis in patients with acne vulgaris, we determined phagocytic activity (PA) and phagocytic index (PI) of polymorphonuclear leukocytes, nitro blue tetrazolium recovery test (NBT test spontaneous) and NBT-test pyrogenal stimulated by recognized methods.
 Results. Analysis of the studied parameters of phagocytosis at the end of treatment showed a significant increase in patients of the core group who were administered a comprehensive treatment which included oral antibiotic, probiotic, and low-dose birth control pills, PRP-therapy and IPLtherapy, as compared with the patients of other groups under study.
 Conclusions. Using combined therapy for women with acne occurring against the backdrop of a sluggish process of phagocytosis and concomittant intestinal dysbiosis leads to normalization of the leading indices of phagocytosis (PI, PA, NBT tests both spontaneous and stimulated), and enhances their phagocytic activity both during capture and formation of bactericidal activity and in the final stages of phagocytosis justifying the feasibility of a combined use of antibiotics, probiotic, low-dose birth control pills PRP-therapy and IPL-therapy in the treatment of acne.

Clinical efficacy of entecavir combined with Biejiajian pills and its influence on TCM syndrome scores during the treatment of chronic hepatitis B with hepatic fibrosis and blood stasis syndrome

Objective: To investigate the clinical efficacy of entecavir combined with Biejiajian pills and its influence on TCM syndrome scores during the treatment of chronic hepatitis B with hepatic fibrosis and blood stasis syndrome by prospective, randomized and controlled study. Methods: Patients with chronic hepatitis B with hepatic fibrosis and blood stasis syndrome were selected as the research subjects and randomly divided into a treatment group and a control group. Entecavir plus Biejiajian pills or entecavir plus a simulant of Biejiajian pills were given for 48 weeks. The changes in liver stiffness measurement (LSM) and TCM syndrome scores before and after treatment were compared between the two groups to analyze the correlation. The data between groups were analyzed by t-test/Wilcoxon rank sum test or χ(2) test. Pearson correlation coefficient was used to analyze the correlation between TCM syndrome scores and LSM values. Results: After 48 weeks of treatment, the LSM values of the two groups were significantly lower than those of the baseline (P < 0.001), liver fibrosis was significantly improved, and the LSM values of the treatment group were lower than those of the control group [(8.67 ± 4.60) kPa and (10.13 ± 4.43) kPa, t = -2.011, P = 0.049]. After 48 weeks of treatment, the TCM syndrome scores of the two groups were significantly reduced compared with the baseline (P < 0.001), and the clinical symptoms were significantly relieved, and the total effective rates of the improvement of the TCM syndrome scores in the two groups were 74.19% and 72.97%, respectively, but the differences between the groups were not statistically significant (χ(2) = 0.013, P = 0.910). Correlation analysis showed that there was no obvious trend between TCM syndrome scores and LSM values. There were no serious adverse reactions associated with the drug during the observation period of this study. Conclusion: Based on antiviral treatment with entecavir, regardless of whether it is combined with the Biejiajian pill, it can effectively reduce the LSM value, improve liver fibrosis, reduce TCM syndrome scores, and alleviate symptoms in patients with chronic hepatitis B with liver fibrosis and blood stasis syndrome. Compared with entecavir alone, the combined Biejia pill has greater efficacy in improving liver fibrosis and a favorable safety profile, meriting its implementation and widespread application.

The morning after: Prescription-free access to emergency contraceptive pills

We analyze the introduction of prescription-free access to morning-after pills—emergency contraceptives that aim to prevent unintended pregnancy and subsequent abortion after unprotected sexual intercourse. Exploiting a staggered difference-in-differences setting for Europe combined with randomization inference, we find sharp increases in sales and manufacturers’ revenues of more than 90%. However, whilst not reducing abortions significantly, the policy triggers an unexpected increase in fertility of 4%, particularly among women aged 25–34. We elaborate on mechanisms by looking at within-country evidence from several EU countries, which suggests that fertility is driven by decreasing use of birth control pills in response to easier access to morning-after pills.

Testosterone: the highly misunderstood hormone in women. How to navigate its importance during a women's reproductive years into menopause

Testosterone is one of the most abundant hormones in women but it is hardly ever discussed or given it’s just due in the treatment of peri-menopause/menopausal women. During this lecture, the provider will learn how testosterone deficiency affects women’s daily quality of life but also put them at risk for chronic illness. They will also learn how birth control pills impact testosterone levels in women and how to consider them in relation to not only the reproductive system but the overall body. We review the affects that testosterone has on breast health and the role of testosterone in treating patients with breast cancer. Lastly, we will review the blatant gender bias that occurs in medicine and in particular the bias in the hormonal treatment of women.

Every ED Visit is an Opportunity to Talk about Contraception

Every ED Visit is an Opportunity to Talk about Contraception

Hormonal contraceptive use and women’s well-being: links with body image, eating behavior, and sleep

ABSTRACT The goal of the current study was to examine associations between hormonal contraceptive use and indicators of well-being including body image, eating behavior, sleep and energy level. Drawing on a health protection framework, we expected that individuals who use hormonal contraceptives would be more attuned to health and report more positive health attitudes and behaviors on these dimensions. Undergraduate college women (N = 270; M = 19.39 years, SD = 2.43, range 18–39 years) from diverse racial/ethnic and sexual orientation groups completed a survey online. Measures included hormonal contraception use, body image, weight control behavior, breakfast consumption, sleep behavior, and daytime energy level. Nearly 1/3 (30.9%) of the sample reported current hormonal contraceptive use, with most users reporting use of birth control pills (74.7%). Women who used hormonal contraceptives reported significantly higher appearance orientation and body surveillance, lower average energy, more frequent night awakenings, and more naps. Longer duration of hormonal contraceptive use was significantly related to higher body surveillance, and engaging in more unhealthy weight control behavior. Hormonal contraceptive use is not related to indicators of greater well-being. Rather, hormonal contraceptive use is related to greater attention to appearance, lower daytime energy, and some indicators of poorer sleep quality. Clinicians who prescribe hormonal contraceptives should attend to body image, sleep and energy concerns among users.

Cost-effectiveness of the dual prevention pill for contraception and HIV pre-exposure prophylaxis.

Women in sub-Saharan Africa (SSA) experience the world's highest rates of both HIV infection and unintended pregnancy. The Dual Prevention Pill (DPP) is a novel multipurpose prevention technology (MPT) that co-formulates HIV pre-exposure prophylaxis (PrEP) and combined hormonal oral contraception into a single daily pill. As a dual indication product, the DPP may be preferred by women facing these overlapping health risks. However, most SSA countries face severe healthcare resource constraints. Research is needed to assess whether, in what populations, and in what use cases the DPP would be cost-effective. We augmented an agent-based SSA HIV model with maternal health parameters including unintended pregnancy, abortion, and maternal mortality. Based on a previous market analysis, we assumed a primary DPP user population of current oral contraceptive users ages 25-49, and alternative user populations in different risk groups (age 15-24, sex workers, HIV-serodiscordant couples) and baseline product use profiles (unmet need for contraception, oral PrEP use, condom use). In three geographies (western Kenya, Zimbabwe, South Africa), we estimated HIV infections averted, pregnancies averted, disability-adjusted life-years (DALYs) averted, and the incremental cost-effectiveness ratio (ICER) over a 30-year time horizon, assuming equivalent adherence to the DPP as to oral contraceptives, higher adherence, or lower adherence. The DPP is likely to be a cost-effective alternative to oral PrEP among users in need of contraception. Among women not already using PrEP, the DPP is likely to be cost-saving in sex workers and serodiscordant couples. The DPP is unlikely to be cost-effective in oral contraceptive users in the general population. Switching from oral contraception to the DPP could be net harmful in some settings and populations if it were to substantially reduces adherence to oral contraception. Results were robust to a range of time horizons or discount rates. The DPP has the potential to be cost-effective and cost-saving in populations at substantial HIV risk. Outcomes are sensitive to adherence, implying that effective counseling and decision-making tools for users considering the DPP will be essential. More research is needed to understand real-life adherence patterns and ensure health benefits achieved from contraception alone are not lost.

Association of the Cervicovaginal Microbiome With Contraceptive Methods in Hispanic Women Living in Puerto Rico [ID: 1376364

INTRODUCTION: Recent studies have demonstrated an association linking the cervicovaginal microbiome with susceptibility to infectious diseases and overall cervical health. We aimed to evaluate the effect of contraceptive methods used by Hispanic females living in Puerto Rico on their cervical microbiome. METHODS: An analysis of 85 women, aged 21–45, grouped by the contraceptive method used at time of sampling, was performed. The methods included birth control pills, intrauterine devices (IUDs), injectable progesterone, male condoms, and female sterilization. The control group did not use any contraception. Swabs collected from the posterior fornix underwent DNA extraction and sequencing of the 16S rRNA gene, being characterized for microbial diversity, and taxonomic composition. IRB approval was obtained. RESULTS: Women using male condoms or sterilization had the highest microbiome richness, and those using IUDs and female sterilization had the highest microbiome diversity. Birth control pills and male condoms had the least effect on the microbiota as participants had a dominance of Lactobacillus. Injectable progesterone and IUDs use were associated with increased levels of Gardnerella. The IUDs group has a noticeable presence of Clostridium when compared to other groups. The female sterilization group is copious in Atopobium and Streptococcus. The injectable progesterone group has an elevated abundance of Megasphaera. CONCLUSION: Preliminary analyses indicate that contraceptive methods may affect the cervicovaginal microbiome, injectable progesterone and IUDs being the methods most associated with vaginal dysbiosis. These findings allow information about the microbiome of Hispanic women living in Puerto Rico to guide further investigations that could contribute to better gynecologic care.

Abstract #1398468: Lymphocytic Hypophysitis Successfully Treated with Prednisone

Lymphocytic Hypophysitis is an inflammatory disorder of the pituitary gland that has classically been described in pregnant and postpartum women. It is the most common type of Primary Hypophysitis which refers to inflammation of the pituitary gland that is not secondary to other systemic diseases or drugs. This is a rare group of disorders with an estimated annual incidence of 2.4 in 10 million. We present the case of a young woman diagnosed with Lymphocytic Hypophysitis and successfully treated with prednisone. A 27-year-old previously healthy female presented with daily headaches and fatigue that began 4 months after an uncomplicated vaginal delivery. She was amenorrheic despite cessation of breast milk production. Physical exam was within normal limits. Laboratory evaluation revealed an AM cortisol of 1 mg/dl (4-22), Free T4 of 0.4 ng/dL (0.8-1.8), LH of 0.5 mIU/mL (1.9-12.5), and estrogen of 30 pg/ml (12.5-166, follicular), consistent with adrenal insufficiency, hypothyroidism, and hypogonadism. Prolactin was normal. She had no evidence of Diabetes Insipidus. MRI pituitary with and without contrast revealed an intensely and homogenously enhancing sellar mass measuring 2 x 2 x 1.3 cm with suprasellar extension and mass effect on the optic chiasm. She did not have any abnormalities in her visual fields or acuity. Lymphocytic Hypophysitis was felt to be the most likely diagnosis based on her clinical presentation and imaging features. Via shared decision-making, she was started on 40 mg of oral prednisone daily in addition to levothyroxine and oral combined contraceptive pills. On reevaluation 2 months later, her symptoms improved and a repeat MRI revealed a dramatic improvement in the appearance of the lesion following which prednisone was reduced to 30 mg with a plan for revaluation after 2 more months. Lymphocytic Hypophysitis should always be suspected in pregnant and postpartum women with neurological complaints of headaches or visual abnormalities and pituitary hormonal deficiency. The investigation involves obtaining an anterior pituitary hormonal profile including TSH with free T4, ACTH with cortisol, FSH, LH, estradiol, and prolactin. Serum sodium with plasma and urine osmolality can be used to evaluate diabetes insipidus in suspected cases. MRI pituitary with and without contrast frequently reveals a symmetric sellar lesion that enhances intensely and homogeneously with gadolinium. A pituitary adenoma, in contrast, enhances less than the normal pituitary tissue. A tool based on clinical and radiological features called the Gutenberg score can also aid in differentiating lymphocytic hypophysitis from an adenoma. Treatment involves management of hormonal deficiencies including Diabetes Insipidus and relief of symptoms of mass effect. Glucocorticoids can induce remission and possible recovery of hormonal function. Follow-up with serial imaging in a few months after initiation of glucocorticoids is essential. Diagnosis needs to be reconsidered if there is no improvement in the appearance of the lesion and a pituitary biopsy may be indicated.

Correlation Between History of Birth Control Usage and Incidence of Gingivitis among Pregnant Women in Ambulu Public Health Center, Jember District: A Cross-sectional Study

Using birth control (BC) can affect gingiva tissue, increasing the risk of developing gingivitis among women of reproductive age. Based on the Central Bureau of Statistics census, in 2021 61,77% of women in their reproductive age have used contraception and birth control in East Java. This study aims to find the correlation between the history and birth control usage and the incidence of gingivitis among pregnant women in Ambulu Public Health Center. This study uses a cross-sectional method with an analytical observational approach on pregnant women who visited the Dental Outpatient and received dental examinations in April and May of 2022. Thirty respondents were gathered with a history of birth control usage and evaluated using the dentist's Periodontal Index (PI). The results show that nine respondents (30%) had no history of using BC, two respondents (6.6%) used BC pills, ten respondents (33.3%) used 1-month injection BC, five respondents (16.6%) used 3-month injection BC, two respondents (6.6%) used implants BC and two respondents (6.6%) used IUD. From the cross table, one respondent (3.3%) was in the normal category, 1 respondent (3.3%) was in the simple gingivitis category, 15 respondents (50%) were in the early destructive periodontal disease category, and 13 respondents (43.4%) were in the destructive periodontitis. The data are analyzed using Chi-square result, showing that the significant value is p = 0,049 (p&lt;0,05), so it can be concluded there is a significant relation between history of birth control usage and incidence of gingivitis in Ambulu Public Health Center. Dental and oral examinations are highly recommended in routine as early detection of health problems among pregnant women.

ANALYSIS OF REPRODUCTIVE AGE (PUS) COUPLES EDUCATION LEVEL BY CHOOSING OF CONTRACEPTIVE METHODS AT CEMPAKA PUTIH HEALTH CENTER

Contraception is one of the efforts made by the government to reduce the growth rate of the population at high risk of unwanted abortions and pregnancies. 1.45% in the 1990-2000 period to 1.49% in the 2000-2010 period. Couples of Reproductive Age are expected to use contraceptive methods to reduce the population. The objectives of this study is to find out the analysis of reproductive age (PUS) couples educational level by choosing of contraseptive methods at Cempaka Putih Health Center. This study used a cross-sectional quantitative approach. Cross Sectional Measurement is a research design by measuring or observing at the same time. The result is found that most couples of reproductive age had a secondary education level of 19 respondents (63.3%), height of 9 respondents (30.0%), basic of 2 respondents (6.7%) and the choice of contraception for couples of reproductive age the most are modern, 25 respondents (83.3%) and as many as 5 respondents choose traditional (16.7%). The conclusion of this study is most of the respondents had the highest level of education (middle school and high school) and chose the most types of modern contraception (birth control pills, injections, implants, IUDs).

Prevention of mania in a primigravida at ultra-high risk of postpartum recurrence.

Prevention of mania in a primigravida at ultra-high risk of postpartum recurrence.

Efficacy and mechanisms of Dingxian pill combined with valproic acid on pentylenetetrazol-induced chronic epilepsy in rats.

To investigate the efficacy and mechanisms of Dingxian pill combined with valproic acid (VPA) on pentylenetetrazol-induced chronical epilepsy in rats. A rat model of epilepsy was established by administering pentylenetetrazol (PTZ) water solution (35 mg/kg). Rats were divided into 4 groups, among which three groups were treated with different drugs once a day for 28 d including Dingxian pill (2.4 g/kg), VPA (0.2 g/kg), or a combination of Dingxian pill (2.4 g/kg) and VPA (0.2 g/kg) respectively, and the control group was given the same volume of saline. Rats in different groups were compared based on animal behavior, electroencephalograms, Morris water maze, immunohistochemistry, transcriptomics and real-time polymerase chain reaction. The combination therapy of Dingxian pill and VPA inhibited PTZ-induced seizure-like behavior and reduced seizure grades more significantly than VPA alone. Compared with the control group, the learning and memory ability of chronic PTZ-induced epileptic rats was improved in all the drug treatment groups, especially in the group that received both Dingxian pill and VPA. Similar to the results of MWM tests, expression of the neuroexcitability marker gene c-Fos was reduced after Dingxian pill and/or VPA treatment, and the effect was most pronounced in the combined treatment group. Transcriptomic analysis revealed that gene expression in the rodent hippocampus, which is involved in epilepsy, was upregulated by combined treatment with Dingxian pill and VPA, compared with VPA treatment alone. Our results not only highlight the anti-epileptic effects of combined Dingxian pill and VPA treatment, but also shed light on the underlying molecular mechanisms and provide a way to apply Traditional Chinese Medicine in the treatment of epilepsy.

Using a medication event monitoring system to evaluate self-report and pill count for determining treatment completion with self-administered, once-weekly isoniazid and rifapentine

BackgroundTreatment completion is essential for the effectiveness of any latent tuberculosis infection (LTBI) regimen. The Tuberculosis Trials Consortium (TBTC) Study 33 (iAdhere) combined self-report and pill counts – standard of care (SOC) with a medication event monitoring system (MEMS) to determine treatment completion for 12-dose once-weekly isoniazid and rifapentine (3HP). Understanding the performance of SOC relative to MEMS can inform providers and suggest when interventions may be applied to optimize LTBI treatment completion. MethodiAdhere randomized participants to directly observed therapy (DOT), SAT, or SAT with text reminders in Hong Kong, South Africa, Spain and the United States (U.S.). This post-hoc secondary analysis evaluated treatment completion in both SAT arms, and compared completion based on SOC with MEMS to completion based on SOC only. Treatment completion proportions were compared. Characteristics associated with discordance between SOC and SOC with MEMS were identified. ResultsOverall 80.8% of 665 participants completed treatment per SOC, compared to 74.7% per SOC with MEMS, a difference of 6.1% (95%CI: 4.2%, 7.8%). Among U.S. participants only, this difference was 3.3% (95% CI: 1.8%, 4.9%). Differences in completion was 3.1% (95% CI: −1.1%, 7.3%) in Spain, and 36.8% (95% CI: 24.3%, 49.4%) in South Africa. There was no difference in Hong Kong. ConclusionWhen used for monitoring 3HP, SOC significantly overestimated treatment completion in U.S. and South Africa. However, SOC still provides a reasonable estimate of treatment completion of the 3HP regimen, in U.S., Spain, and Hong Kong.

The effects of oral birth control pills (contraceptive pills) intake on lyophilized saliva and its oral manifestations

A woman is susceptible to oral diseases at various stages in her life span. Besides, multiple biological, behavioral, and social factors affect the general health condition. Many drugs or chemicals can influence the oral cavity &amp; associated structures. An example of these drugs group is oral contraceptive pills (OCS) which women widely use to prevent pregnancy and determine the number of children, and hormonal therapy. This study aims to evaluate the effect of oral contraceptive pills use on salivary secretion and composition in addition to the occurrence of any oral manifestations with the uses of these drugs among women aged 16-45 years. The total number of sample subjects is 51 women. The samples were separated into two groups: The first group included 21 unmarried women with no previous experience with oral contraceptive pills (control group). In contrast, the second group consisted of 30 women who were married and using this drug (study group). This study is considered to be a comparative study between these two groups concerning the analysis of the salivary composition, unstimulated salivary flow rates and PH level: The results obtained from this study showed a marked significant difference in salivary analysis between the drug user &amp; nonuser drug groups concerning the salivary flow rate while the PH had no statistical differences between them. However, the two groups had a significant difference in alkaline phosphatase enzyme. The salivary analysis showed highly substantial variations in immunoglobulin A (IgA) &amp; total protein levels in saliva between control &amp; study groups; also, in this study, there was a positive association between gingival inflammation with gingival index score (2) (80%), gingival index score (3) (100%) and duration for taking the drug. By this drug administration, the altered salivary flow rate &amp; levels of salivary contents that include (secretary proteins, IgA and enzymes) may influence and play an essential role in oral &amp; dental health. Keywords: saliva; oral health; oral contraceptive pills.