Reduction of nutrient contaminants into shallow eutrophic waters through vegetated treatment beds.

One of the most effective mitigative approaches to eutrophication is the reduction of nutrient loading into water bodies. Bioremediation presents an economically viable and ecologically sustainable technology to nutrient pollution control taking advantage of the remarkable ability of plants and their associated microbial community to assimilate and remove nutrients from the environment. In this study, four emergent macrophytes (Cyperus haspan, Pandanus amaryllifolius, Pontederia cordata and Thalia geniculata) and two floating plants (Hygroryza aristata and Pistia stratiotes) were deployed in bank-side treatment beds and comparatively assessed for their remediative capabilities for nutrient control. P. stratiotes exhibited the highest removal efficiency for both nitrate and phosphate among the six plant species studied. Emergent macrophytes, P. amaryllifolius, C. haspan and P. cordata, were also found to be highly effective in nutrient uptake exhibiting removal efficiencies up to 100%. With the exception of T. geniculata, depletion of nutrients as a result of plant uptake significantly impeded the natural colonization of algae invariably leading to improvements in water quality in terms of turbidity and pH. Suppression of algae proliferation by T. geniculata was not preceded by a reduction in nutrient concentrations suggesting that T. geniculata may be directly inhibiting algal growth through allelopathy.

Hybrid Sargassum-sand sorbent: a novel adsorbent in packed column to treat metal-bearing wastewaters from inductively coupled plasma-optical emission spectrometry.

Laboratory batch and column experiments were carried out to examine the efficiency of algal-based treatment technique to clean-up wastewaters emanating from inductively coupled plasma-optical emission spectrometry (ICP-OES). Chemical characterization revealed the extreme complexity of the wastewater, with the presence of 14 different metals under very low pH (pH = 1.1), high conductivity (6.98 mS/cm), total dissolved solid (4.46 g/L) and salinity (3.77). Batch experiments using Sargassum biomass indicated that it was possible to attain high removal efficiencies at optimum pH of 4.0. Efforts were also made to continuously treat ICP-OES wastewater using up-flow packed column. However, swelling of Sargassum biomass leads to stoppage of column. To address the problem, Sargassum was mixed with sand at a ratio of 40: 60 on volume basis. Remarkably, the hybrid Sargassum-sand sorbent showed very high removal efficiency towards multiple metal ions with the column able to operate for 11 h at a flow rate of 10 mL/min. Metal ions such as Cu, Cd, and Pb were only under trace levels in the treated water until 11 h. The results of the treatment process were compared with trade effluent discharge standards. Further the process evaluation and cost analysis were presented.

Biosorption of lead(ll) and copper(ll) from stormwater by brown seaweed Sargassum sp.: batch and column studies.

This study evaluated the potential use of brown seaweed Sargassum sp to sequester lead and copper (Pb(II) and Cu(ll)) from urban runoff based on batch as well as column experiments. The equilibrium data exhibited Langmuir isotherms. The adsorption capacity of this seaweed was found to be 196.1 mgg(-1) and 84.0 mg g(-1) for Pb(ll) and Cu(ll), respectively, which are in good agreement with those values obtained for the aqueous solution (188.6 mg g(-1) for Pb(ll) and 86.9 mg g(-1) for Cu(II)). The functional group analysis of the seaweed using FTIR demonstrated that the carboxyl functional groups are mainly responsible for biosorption. The cation exchange capacity of the biosorbent was 2.25 meq/g. This observation suggested that ion exchange mechanism is predominantly responsible for the metal ion uptake. The column study showed that the highest bed height and the lowest flow rate result in a substantial enhancement of the metals uptake with the biosorption uptake capacities being 264.3 mg Pb(ll) g(-1) and 86.0 mg Cu(ll) g(-1). In the binary system, the biosorption capacity was observed to be 208.7 mg Pb(ll) g(-1) and 61.0 mg Cu(II) g(-1). The predicted breakthrough curves by the Thomas adsorption model gave a good fit of the experimental data with r2 ranging from 0.92 to 0.99.

Fluorescence studies on binding of amphiphilic drugs to isolated lamellar bodies: relevance to phospholipidosis.

Lysosomal phospholipid storage disorder in lung tissue was observed during chronic treatment with amphiphilic amine drugs. The prevailing and widely accepted mechanism of phospholipidosis is that amphiphilic drugs bind to phospholipids and make the phospholipids unsuitable substrates for the action of phospholipases. We investigated hydrophobic and hydrophilic binding of fifteen drugs to the phospholipid storage organelle, lung lamellar bodies, isolated from male Sprague-Dawley rats. Hydrophobic interactions were studied using 1,6-diphenyl-1,3,5-hexatriene as a fluorescent probe and hydrophilic binding was studied using 1-anilino-8-naphthalene sulfonate as a fluorescent probe. The binding parameters were calculated using Scatchard equations. Of the fifteen drugs used, nine drugs bound to the hydrophobic moiety of lamellar bodies. The order of binding capacities was promethazine greater than chloramphenicol greater than amiodarone = desethylamiodarone greater than promazine greater than chlorpromazine greater than trimipramine greater than propranolol greater than imipramine much greater than chlorphentermine, phentermine, chloroquine, chlorimipramine, cyclizine and chlorcyclizine. Two binding affinities were calculated for all the bound drugs. Binding affinities to hydrophilic sites of lamellar bodies were calculated in terms of emission coefficients for 1-anilino-8-naphthalene sulfonate in the presence of drugs. Hydrophilic binding was in the order chlorpromazine greater than chlorimipramine greater than promazine greater than trimipramine greater than imipramine greater than chlorcyclizine greater than propranolol greater than promethazine greater than chlorphentermine greater than cyclizine greater than phentermine greater than chloroquine much greater than chloramphenicol, amiodarone and desethylamiodarone. The binding affinities of chlorinated analogs were stronger to hydrophilic sites when compared to the parent compound. Amiodarone, which is known to induce pulmonary phospholipidosis and its major non-polar metabolite, desethylamiodarone, bound strongly to lamellar bodies. These two drugs also inhibit phospholipases in vitro. The drugs with weak phospholipidosis-inducing capacity and extensive in vivo metabolism, namely, imipramine, chlorpromazine and promazine, also bound strongly to lamellar bodies with hydrophilic as well as hydrophobic interactions. On the other hand, chloroquine, which is known to induce phospholipidosis and to inhibit phospholipases, did not bind to lamellar bodies. Two major conclusions could be drawn from this study: one is that the drug interactions with isolated lamellar bodies could be studied using membrane fluorescence probes, 1,6-diphenyl-1,3,5-hexatriene and 1-anilino-8-naphthalene sulfonate; second is that the amphiphilic drugs bind to lamellar bodies, as reported for phospholipid vesicles, and the binding of drugs to lamellar bodies could be correlated with their phospholipidosis-inducing capacity only if

A simple and sensitive color test for the detection of human chorionic gonadotropin.

A simple, rapid, sensitive, and reliable ELISA test for the detection of urinary human chorionic gonadotropin (hCG) has been developed using penicillinase (EC no. 3.5.2.6) as the label and a microtiter ELISA plate as a solid support for antibody. The results of the test is assessed visually for the dark blue that indicates the presence of hCG. A minimum of 500 mU of hCG/ml of urine can be detected easily and the test can be completed in 2 hours with good precision. Accurate negative results are obtained in urine samples of normally ovulatory women, postmenopausal women, and adult males, suggesting that the physiologic concentrations of luteinizing hormone do not influence the assay results. In samples referred for pregnancy detection 95.5% accurate results were obtained when compared with histopathologic and/or clinical findings. There were 2 false-negative results, and only in 4 of 132 subjects studied were false-positive results obtained. This test, if properly performed, should prove a valuable tool in the detection of hCG as early as 30 to 35 days from the last menstrual period.

Effects of drug-induced pulmonary phospholipidosis on lung mechanics in rats.

Chronic administration of amphiphilic drugs to rats induces pulmonary phospholipidosis (P), a disease characterized by accumulation of phospholipids and large foamy macrophages in alveolar spaces. We investigated whether P induced by chlorphentermine (CPH) causes changes in lung volumes and mechanics in this species. Groups of rats were fed CPH (50 mg.kg-1.day-1) for 1, 2, 3, 5, 9, and 14 wk. After each treatment period, lung volumes and mechanics were studied in the anesthetized, paralyzed, supine rat. Partial pressure-volume (PV) curves were developed at 3 and 6 ml above functional residual capacity (FRC; PV3, PV6), followed by maximal [up to total lung capacity (TLC)] PV curves. FRC was determined by saline displacement. Lungs were then fixed for histopathological examination. A subgroup of animals was allowed a recovery period of 6 wk, after the 9 wk of CPH administration. Pair-fed rats served as controls (CTR) at each time point. Lung weight increased in CPH-treated (CPH-T) rats from 1.5 +/- 0.2 (SD) g at week 1 to 5.8 +/- 1.4 g at week 14, reflecting the development of P. TLC, FRC, transpulmonary pressure at FRC, the shape of maximal PV curves, and static expiratory lung compliance computed from maximal PV data points did not change in CPH-T rats. However, partial PV curves of CPH-T lungs (particularly PV3) were shifted downward and to the right of those of CTR at 2, 3, 5, and 9 wk, indicating increased recoil pressure in phospholipidotic lungs at these time points.(ABSTRACT TRUNCATED AT 250 WORDS)

Seminal plasma concentration of glycerylphosphorylcholine before and after vasectomy and vas reanastomosis.

The concentration of glycerylphosphorylcholine (GPC) was determined in semen obtained from normal fertile, vasectomized, and vas-reanastomosed subjects. Concentrations of GPC were markedly lower in the semen of vasectomized men. GPC levels observed in vas-reanastomosed subjects were similar to those found in normal fertile men. Vasectomy may not affect GPC synthesis significantly.

PIP: Glycerlphosphorylcholine (GPC), an organic component of major consequence in human seminal plasma, was assayed in 3 population groups for comparison: normal fertile men, vasectomized men, and vas reanastomosed men. Subjects were matched for socioeonomic status and age. Long-term effects of vasectomy were apparent: the levels of GPC were significantly lower (P .001) in the vasectomized subjects. When these subjects were divided into various post vasectomy periods and were compared with each other, no significant difference was seen in the level of GPC. Vas reanastomosed seminal fluid showed similar levels of GPC as the levels among normal fertile subjects, even though no sperm were seen in the 1st ejaculate from the reanastomosed men. GPC levels, therefore, may be useful in the evaluation of the surgical success of reversible procedures for male sterilization.

A sensitive and specific enzymeimmunoassay for serum testosterone.

A very sensitive enzymeimmunoassay for testosterone was developed using testosterone-penicillinase conjugate and an antibody to testosterone-3-(O-carboxymethyl)oxime-bovine serum albumin. The specificity of the assay was demonstrated by the fact that estradiol-17 beta, estrone, estriol, progesterone, 17 alpha-hydroxy-progesterone, dehydroepiandrosterone, androstenedione, cortisol and cortisone were ineffective in crossreacting with testosterone while dihydrotestosterone was 8 times less crossreactive as compared to testosterone. The minimum detectable amount of testosterone was 10-15 pg per assay tube. Intra-assay and inter-assay coefficients of variation for samples containing 0.3-6ng/ml of testosterone were 6-8% and 8-10%, respectively. A high degree of correlation (r = 0.97) was observed between serum testosterone values obtained by enzymeimmunoassay and radioimmunoassay. The levels of testosterone in the sera of normal men and women and those in hypogonadal males following stimulation with human chorionic gonadotropin determined by this enzymeimmunoassay appear similar to those reported by other investigators.

Histological observations on the liver of Tilapia mossambica after exposure to monocrotophos, an organophosphorus insecticide.

The histological changes in the liver of Tilapia mossambica were observed after exposure to a sublethal level (2.5 ppm) of monocrotophos. The changes observed after 2 days of exposure were characterized by necrosis and vacuolation of hepatocytes. Fatty degeneration was observed after 10 days of exposure. However, normalization of histological picture was evident after 15 days of treatment, though some patches of degenerating zones were also found to exist concomitantly. A wave of secondary intensively degenerative changes was observed from 30 days up to 45 days of experimentation. The possible significance of histological lesions and adaptation to exposure after sublethal doses as well as continuous exposure are discussed.

Circulating levels of norethindrone in women with a single silastic implant.

PIP: Circulating levels of norethindrone (NET) in 26 women with a single silastic implant were measured up to 32 weeks postinsertion. The initial levels decreased (p .001) with the duration of use. 10 of the women had regular bleeding throughout the study period except for an occasional spotting. The other 16 women had irregularity in bleeding for at least 6 months postinsertion. The bleeding pattern bore no direct correlation with the circulating level, however those women having an initial level of more than 1.5 mg/ml had irregular bleeding throughout the period of study. It appears reasonable to assume that a slower rate of NET release may lead to a normal bleeding pattern. Lower release rates may be achieved by increasing the wall thickness of the implant.^ieng

Invluence of oral contraceptives on circulating immune response. II. Effect of progestogenic and estrogenic components.

PIP: Female mice were treated with chlormadinone acetate (.25 mcg or 6.25 mcg), megestraol acetate (.25 mcg or 6.25 mcg), ethynodiol diacetate (.5 mcg or 12.5 mcg), norgestrel (.25 mcg or 6.25 mcg) or norethynodrel (2.5 mcg or 62.5 mcg) and studied to determine what effect these progestagens had on circulating tetanus antibody titers. None of the progesterones affected the immune response to tetanus toxoid. Mice given ethinyl estradiol or mestranol had enhanced circulating antibody titers. It is conlcuded that combination oral contraceptives act to diminish antibody response as a result of the combined potency of the estrogen and progesterone components.^ieng

Influence of oral contraceptives on circulation immune response. I. Effect of combination type contraceptives.

PIP: Female mice were given either Ovral or Enovid orally and studied to determine what effect the combination oral contraceptive agents (OCAs) had on circulating levels of tetanus antitoxin. Ovral produced significantly lower titers of circulating tetanus antitorin (p.005); the titers decreased with increasing doses of Ovral. Enovid produced borderline significant lowering (.1p.05). Clearance of tetanus antitoxin in mice given Ovulen or Ovral was not greater than in control mice, and treatment with Ovulen or Ovral did not change tetanus antitoxin titers in actively immunized mice. It is concluded that combination OCAs may interfere with antibody synthesis.^ieng

Serum bile acids in women taking combination contraceptives.

A longitudinal study in 60 women was undertaken to observe the changes, if any, in serum bile acids after taking oral combination pills containing either 50 or 30 microgram of ethinyl estradiol. The women were followed up to 12 months. Serum bile acids (cholyglycine conjugates) were estimated by radioimmunoassay. The combination contraceptives had no appreciable effect on serum bile acids.

PIP: 60 women attending family welfare clinics in India were recruited for a longitudinal study designed to test for changes in serum bile acids after oral combination contraceptives were administered which contained either 30 or 50 mcg of ethinyl estradiol. The women were divided into 2 groups according to the drug (dose) ingested, and fasting venous blood was collected between Day 10 and 20 of the menstrual cycle. Blood collection was repeated at either 1, 3, or 6 months after taking pills, and all women were again followed-up at 12 months. The serum bile acids (cholic acid conjugates) were measured by radioimmunassay. The sensitivity of the assay was .06 mcmol/liter. Recovery studies were carried out by adding cold glycocholic acid and recovery was 95%. The interassay coefficient of variation for a plasma pool with a concentration of 1.68 mcmol/liter was 5.4%, whereas the intrassay coefficient was 6.2%. Serum bile levels in women taking the combined preparations showed no significant changes in the levels, up to 12 months of intake, in both groups.

Clinical performance and endocrine profiles with contraceptive vaginal rings containing a combination of estradiol and D-norgestrel.

Contraceptive vaginal rings (CVRs) impregnated with a combination of estradiol and d-norgestrel were studied in 39 women. The rings were inserted as three weeks "in" and one week "out" schedule to allow withdrawal bleeding. Ovulation was inhibited in all cycles and promptly resumed on completion of the treatment cycles. Bleeding control was excellent. Incidence of breakthrough bleeding was 2.11 per cent in 273 cycles studied, with 89 per cent of the cycles within the acceptable range (25 - 35 days). Levels of estradiol after an initial rise were maintained between 50-100 pg/ml and, d-norgestrel levels were relatively constant between 1.8-3 ng/ml during the period while the ring remained in situ. Clinical acceptance was good. The main problem encountered was of spontaneous expulsion of the ring in the toilet, which might be due to the squatting toilet habits of Indian women and laxity of vaginal wall.

PIP: Contraceptive vaginal rings (CVRs) impregnated with a combination of estradiol and d-norgestrel were studied in 39 women. The rings were inserted on a 3 weeks "in" and 1 week "out" schedule to allow withdrawal bleeding. Ovulation was inhibited in all cycles and promptly resumed on completion of the treatment cycles. Bleeding control was excellent. Incidence of breakthrough bleeding was 2.11% in 273 cycles studied, with 89% of the cycles within the acceptable range (25-35 days). Levels of estradiol after an initial rise were maintained between 50-100 pg/ml and, d-norgestrel levels were relatively constant between 1.83 ng/ml during the period while the ring remained in situ. Clinical acceptance was good. The main problem encountered was of spontaneous expulsion of the ring in the toilet, which might be due to the squatting toilet habits of Indian women and laxity of the vaginal wall.

Release of norethisterone from a bioabsorbable implant in female bonnet monkeys (Macaca radiata).

Bioabsorbable implants prepared by fusion of 85% norethisterone (NET) and 15% cholesterol were inserted subdermally in four cycling bonnet monkeys (Macaca radiata). No skin reaction or inflammation was observed at the site of implantation. Plasma concentration of norethisterone (NET) measured by radioimmunoassay were monitored for 14 to 16 months at monthly intervals. In the first month weekly samples were analysed. NET was released into circulation within 24 hours after insertion of the implant. In all the monkeys, except one, a sharp rise in NET (1.9 to 20 ng/ml) occurred immediately after insertion. Levels then remained between 1.7 and 0.6 ng/ml for about 4 months. Thereafter they remained steady up to about 9 months in two monkeys and gradually declined to about 0.4 ng/ml in the remaining two. In all except one, there was a sudden burst of NET release between the 10th and 11th month. The hormone almost cleared out of circulation by the 14th to 16th month. Initial menstrual cycles after pellet insertion were disturbed, leading to spotting and irregular bleeding. Regular cycles appeared from 5 to 8 months after the insertion of the implant. These cycles were ovulatory, as determined by the progesterone levels.

Short-term effect of ovral and norgestrel on the vitamin B6 and B1 status of women.

PIP: An attempt was made to determine the effect of steroidal contraceptives on the utilization of Vitamins-B1 and B6. Subjects, aged 22-38 years, were not taking any external source of vitamins. A 24-hour urine sample was collected and a fasting blood sample drawn for the estimation of erythrocyte amino-transferases and transketolase. Then each subject was given 2 gm of L-tryptophan. Another 24-hour urine specimen was then collected. Xanthurenic acid values in urine specimens were compared. Ovral or norgestrel was then given for 3 cycles. After these 3 cycles, blood collections and tryptophan load tests were repeated. Erythrocyte alanine aminotransferase (EAIT) and aspartates aminotransferases (EAsT) were measured. Also, erythrocyte transketolase (ETK) was estimated and the "TPP" effect determined by adding 75 mcg of thiamine pyrophosphate. of 11 women taking Ovral, 7 showed an abnormal response to the tryptophan load as shown by the xanthurenic acid excretion. Responses of all 11 women on norgestrel to tryptophan loads were normal. EAIT and EAsT tests were normal with both drugs (p more than .05). Erythrocyte transketolase activity was not significantly changed by either preparation (p more than .05). The increased xanthurenic acid excretion with Ovral after tryptophan load is thought to indicate Vitamin-B6 deficiency. Basal levels of ETK decreased in 7 of 10 women on Ovral but increased in 5 of 8 women on norgestrel therapy. Also, in vitro stimulation with TPP was observed in 4 of these women. The relation of this finding to Vitamin-B1 is not clear. Urinary thiamine, blood pyruvic acid, and alpha-ketoglutaric acid and transketolase activity require study to assess the Vitamin-B1 status under contraceptive therapy.^ieng

A study of interaction of a low-dose combination oral contraceptive with anti-tubercular drugs.

Low-dose combination contraceptive (containing norethisterone acetate 1 mg and ethinyl estradiol 30 micrograms) was administered to women receiving concurrent therapy with either Rifampicin or "triple" antitubercular treatment consisting of paraaminosalicylic acid (PAS), isonicotinic acid hydrazide (INH) and streptomycin. Plasma levels of norethisterone (NET) and ethinyl estradiol (EE), PAS and INH were measured and the area under curve (AUC) was calculated for NET and EE. Rifampicin treatment (9 women) caused a statistically significant reduction of the plasma NET levels as well as the AUC of NET. In this group of women, though a trend for reduction in EE levels was observed in individual subjects, it was not statistically significant. Out of 7 regularly menstruating women on Rifampicin therapy, 2 showed a premenstrual rise of plasma progesterone (P) levels (> 4 ng/ml) suggesting an ovulatory cycle and 3 experienced menstrual irregularities. In contrast, plasma levels of NET and EE as well as their AUCs were not altered in 8 women receiving "triple" antitubercular therapy. Only one woman out of 8, had menstrual irregularity and all women had P levels in the anovulatory range. Furthermore, oral contraceptive treatment did not alter the plasma levels of PAS and INH.

A study of interaction of low-dose combination oral contraceptive with Ampicillin and Metronidazole.

Plasma levels of norethisterone (NET), ethinyl estradiol (EE), Ampicillin or Metronidazole were estimated in 16 women, who were taking low-dose oral combination contraceptive pills (containing norethisterone acetate 1 mg and ethinyl estradiol 30 microgram) and in whom concurrently, either Ampicillin (6 women) or Metronidazole therapy (10 women) was given. Neither Ampicillin nor Metronidazole therapy altered the 'peak' or 24-hour plasma levels and area under the curve, for NET and EE. Furthermore, oral contraceptive treatment did not alter the 'peak' levels of Ampicillin or Metronidazole. Progesterone (P) levels were in the anovulatory range in all Ampicillin treated cycles. However, in Metronidazole treated group, two out of 10 women showed a P rise of more than 4 ng/ml. The study was expanded to include another group of 15 women treated with Metronidazole, where only one women showed a P rise of more than 4 ng/ml. The occurrence of 'escape ovulation' as suggested by P rise of more than 4 ng/ml in three out of 25 Metronidazole treated women is either a chance incidence due to a different pharmacological response in them, or most probably due to the default in the regular intake of pills in these women. This is supported by the observation that one out of three women showing a P rise (greater than 4 ng/ml( during concurrent Metronidazole therapy, also showed ovulatory P values in oral contraceptive-only treated cycles. Furthermore, in the control group also, one out of 10 women had ovulatory P levels (greater than 4 ng/ml) in oral contraceptive-only treated cycles.

PIP: Plasma levels of (NET) norethisterone, (EE) ethinyl estradiol, Ampicillin, or Metronidazole were estimated in 16 women who were taking low-dose (OC) oral contraceptives (containing norethisterone acetate, 1 mg, and ethinyl estradiol, 30 mcg) and in whom concurrently, either Ampicillin (6 women) or Metronidazole therapy (10 women) was given. Neither drug altered the peak or 24-hour plasma levels and area under the curve for NET and EE. Furthermore, OC treatment did not alter the peak levels of either Ampicillin or Metronidazole. (P) Progresterone levels were in the anovulatory range in all Ampicillin-treated cycles. However, in Metronidazole-treated group, 2 of 10 women showed a P rise of more than 4 ng/ml. The study was expanded to include another group of 15 women treated with Metronidazole and only 1 woman showed a P rise of more than 4 ng/ml. The occurrence of 'escape ovulation' as suggested by a P rise of more than 4 ng/ml in 3 of 25 Metronidazole-treated women is either a chance incidence due to a different pharmacological response in them, or most probably due to the default in the regular intake of pills in these women. This is supported by the observation that 1 out of 3 women showing a P rise ( 4 ng/ml) during concurrent Metronidazole therapy also showed ovulatory P values in OC-only treated cycles. Furthermore, in the control group, 1 out of 10 women had ovulatory P levels ( 4 ng/ml) in OC-only treated cycles.

Phase I comparative clinical trial with subdermal implants--bioabsorbable levonorgestrel or norethisterone pellet fused with cholesterol.

The potential for antifertility effect of two bioabsorable pellets, one containing norethisterone (NET) and the other containing levonorgestrel (LNG) fused with cholesterol, was studied in a group of healthy, menstruating but sterilised women. The pellets weighed approximately 30 mg and contain 85% steroid and 15% cholesterol. A single NET pellet was inserted in 4 subjects, out of which 2 were also studied for steroid pattern in blood. After reaching peak levels within 48 hours, the plasma NET levels declined gradually within a fortnight's time, and thereafter, ranged between 200 to 700 mg/ml up to 90 days post-insertion. After this period, occassional spurts of NET release were seen. Bleeding pattern was studied in 37 cycles; mid-luteal progesterone (P) estimation was done in 16 cycles, mid-cycle cervical mucus was studied in 27 cycles and post-coital test (PCT) in 7 cycles. Cycle length with pellet insertion was of 25 to 37 days duration except one cycle of 55 days duration. All cycles studied during the treatment were ovulatory (P greater than 5 ng/ml) and no consistent effect was observed on cervical mucus as well as on PCT. Thus, a single NET pellet does not seem to have a reliable contraceptive potential. A single LNG pellet was inserted in 8 subjects, and steroid patterns were studied in 6 women. Peak levels of LNG were reached within 24 hours of pellet insertion and the levels fell gradually in a week's time. Thereafter, LNG levels ranged between 100-400 pg/ml up to 8 months. In contrast to the observation with NET pellets, only one subject showed frequent spurts of LNG release until the 4th month of treatment. Bleeding pattern was studied in 90 cycles, P was estimated in 52 cycles, mid-cycle cervical mucus studied in 55 cycles and PCT done in 26 cycles. Breakthrough bleeding (BTB) occurred on 15 occasions, 11 episodes being in 2 subjects. Cycle length varied between 21 to 42 days. The LNG pellet did not exert a consistent effect either on ovulation inhibition or cervical mucus or PCT. In their present form, therefore, a single LNG pellet also does not appear to have a reliable contraceptive effect.

Oral contraceptives and sex hormone binding globulin capacity.

PIP: Ths study examines the effects of SHBGc (sex hormone binding globulin capacity) of 4 oral combination contraceptives containing either norethindrone acetate (NET acet) or levo-norgestrel (Levo-Ng) and ethinyl estradiol (EE2): 1) 6 women used 250 ug levo Ng and 50 ug EE2 for 6 months; 2) 10 women used 150 ug levo-Ng and 30 ug EE2 for 6 months; 3) 5 women used 150 ug levo-Ng and 50 ug EE2 for 3 months; and 4) 9 women were on 1 mg NET acet and 30 ug EE2 for 1 month. Concentration of SHBGc in human plasma varied markedly depending on amount of estrogen and nature of progestational compounds. Levo-Ng reduced the EE2-induced SHBGc depending of the amount of dose. Mean % decrease with 250 ug levo-Ng + 50 ug EE2 was 30.6 + or - 20.9 (P 0.05). A decrease in levo-Ng to 150 ug actually increased the SHBGc. SHBGc remained almost unchanged when dosage of both levo-Ng and EE2 was low (150 ug and 30 ug respectively). NET acet alone did not lower SHBGc but when combined with 30 ug EE2, 1 mg NET acet increased SHBGc. The findings may be useful in the selection of combination therapy for conditions like hirsutism which benefits from increase in SHBGc.^ieng