Discovery of Michael reaction acceptors from the leaves of Ailanthus altissima by a modified tactic.

Structural characteristics-guided investigation of Ailanthus altissima (Mill.) Swingle resulted in the isolation and identification of seven undescribed potential Michael reaction acceptors (1-7). Ailanlactone A (1) possesses an unusual 1,7-epoxy-11,12-seco quassinoid core. Ailanterpene B (6) was a rare guaianolide-type sesquiterpene with a 5/6/6/6-fused skeleton. Their structures were determined through extensive analysis of physiochemical and spectroscopic data, quantum chemical calculations, and single crystal X-ray crystallographic technology using Cu Kα radiation. The cytotoxic activities of isolates on HepG2 and Hep3B cells were evaluated in vitro. Encouragingly, ailanaltiolide K (4) showed significant cytotoxicity against Hep3B cells with IC50 values of 1.41 ± 0.21 µM, whose covalent binding mode was uncovered in silico.

Current Progress in Natural Deep Eutectic Solvents for the Extraction of Active Components from Plants.

In the last decade, natural deep eutectic solvents (NADESs) have gained more and more attention due to their green, convenient preparation, low toxicity and biodegradability. It is widely used in various fields, especially in the extraction of active components from plants, formed by the combination of hydrogen bond donors (HBDs) and hydrogen bond acceptors (HBAs) at a certain condition. In this article, six preparation methods of NADESs were summarized and the interactions that occur in the eutectic behavior of NADES including hydrogen bonding, electrostatic interaction and van der Waals force were also reviewed. What is more, its significant extraction capacity on flavonoids, phenols, alkaloids and plant pigments endows its extensive applications in the extraction of active components from medicinal plants. Extraction factors including solvents properties (viscosity, carbon chain length, number of hydroxyl groups), extraction condition (water content, extraction temperature, extraction time, solid-liquid ratio), extraction method and recycling method were discussed. In addition, NADESs can also be combined with other technologies, like molecular imprinting, monolithic column, to achieve efficient and specific extraction of active ingredients. Further systematic studies on the biodegradability and biotoxicity are put forward to be urgent.

Trifluoromethylcinnamanilide Michael Acceptors for Treatment of Resistant Bacterial Infections.

A series of thirty-two anilides of 3-(trifluoromethyl)cinnamic acid (series 1) and 4-(trifluoromethyl)cinnamic acid (series 2) was prepared by microwave-assisted synthesis. All the compounds were tested against reference strains Staphylococcus aureus ATCC 29213 and Enterococcus faecalis ATCC 29212 and resistant clinical isolates of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecalis (VRE). All the compounds were evaluated in vitro against Mycobacterium smegmatis ATCC 700084 and M. marinum CAMP 5644. (2E)-3-[3-(Trifluoromethyl)phenyl]-N-[4-(trifluoromethyl)phenyl]prop-2-enamide (1j), (2E)-N-(3,5-dichlorophenyl)-3-[3-(trifluoromethyl)phenyl]prop-2-enamide (1o) and (2E)-N-[3-(trifluoromethyl)phenyl]-3-[4-(trifluoromethyl)-phenyl]prop-2-enamide (2i), (2E)-N-[3,5-bis(trifluoromethyl)phenyl]-3-[4-(trifluoromethyl)phenyl]-prop-2-enamide (2p) showed antistaphylococcal (MICs/MBCs 0.15-5.57 µM) as well as anti-enterococcal (MICs/MBCs 2.34-44.5 µM) activity. The growth of M. marinum was strongly inhibited by compounds 1j and 2p in a MIC range from 0.29 to 2.34 µM, while all the agents of series 1 showed activity against M. smegnatis (MICs ranged from 9.36 to 51.7 µM). The performed docking study demonstrated the ability of the compounds to bind to the active site of the mycobacterial enzyme InhA. The compounds had a significant effect on the inhibition of bacterial respiration, as demonstrated by the MTT assay. The compounds showed not only bacteriostatic activity but also bactericidal activity. Preliminary in vitro cytotoxicity screening was assessed using the human monocytic leukemia cell line THP-1 and, except for compound 2p, all effective agents did show insignificant cytotoxic effect. Compound 2p is an interesting anti-invasive agent with dual (cytotoxic and antibacterial) activity, while compounds 1j and 1o are the most interesting purely antibacterial compounds within the prepared molecules.

The synergy of Fe(III) and NO2- drives the anaerobic oxidation of methane.

The anaerobic oxidation of methane (AOM) driven by NO2- or Fe(III) alone was limited by slow electron delivery and ineffective enrichment of microbes. The flexible coupling between Fe(III) and NO2- potentially cooperated to accelerate AOM. One negative control was fed CH4 and NO2-, and four treatment reactors were supplemented with CH4, NO2- and ferric citrate (FC)/ferric chloride (FCH)/ chelate iron (FCI)/ferric hydroxide (FH) and were anaerobically operated for 1200 days to verify the synergy and promicrobial roles of Fe(III) and NO2- in improving AOM. The changes in gas and ion profiles were observed in the reactors, and microbial development was studied using 16S rRNA gene sequencing with the Illumina platform. The results indicated that the combined Fe(III) and NO2- treatment improved AOM, and their synergy followed the order of FC > FCI > FCH > FH. The biochemical reaction of Fe3+ with NO2- and its secondary process accelerated electron transfer to microbial cells and subsequently enhanced AOM in the reactors. The total organic carbon (TOC) content, NH4+ content, NO3- content, and pH value altered the dominant bacteria the most in the FC reactor, FCI, FCH, and FH groups, respectively. Several dominant bacterial species were enriched, whereas only two archaea were highly concentrated in the FC and FCI groups. Only bacteria were detected in the FCH group, and archaea contributed substantially to the FH group. These findings contribute to an improved understanding of the interactions among nitrogen, iron and CH4 that are paramount to accelerating the process of AOM for engineering applications.

Boswellia serrata oleo-gum-resin and ß-boswellic acid inhibits HSV-1 infection in vitro through modulation of NF-кB and p38 MAP kinase signaling.

BACKGROUND: Herpes Simplex Virus (HSV), a highly contagious pathogen, is responsible for causing lifelong oral to genital infection in human. Boswellia serrata oleo-gum-resin possesses a strong traditional background of treating diverse skin ailments including infection but its effect on HSV-1 has not been examined yet. PURPOSE: To exploit its potential, we aimed to explore the antiviral activity of methanol extract of B. serrata oleo-gum-resin (BSE) and one of its major constituent ß-boswellic acid (BA) against HSV-1 along with the underlying mechanism of action involved. METHODS: BSE was subjected to RP-HPLC analysis to quantify the active constituent. Cytotoxicity (CC50) and antiviral activity were evaluated by MTT and plaque reduction assay, followed by the determination of median effective concentration (EC50). The mode of antiviral activity was assessed by time-of-addition assay and confirmed by reverse transcriptase-PCR (RT-PCR). Further, the expressions of various cytokines were measured by RT-PCR, while the proteins by Western blot. RESULTS: BSE and BA potently inhibited wild-type and a clinical isolate of HSV-1 (EC50 5.2-6.2 and 12.1-14.63 µg/ml), with nearly-complete inhibition (EC99) at 10 and 30 µg/ml, respectively. The inhibitory effect was significant at 1 h post-infection and effective up to 4 h. Based on target analysis we examined the inhibition of NF-κB, essential for virus replication, and observed significant down-regulation of NF-κB, and p38 MAP-kinase activation, with reduced expression of tumor necrosis factor (TNF)-α, Interleukin (IL)-1ß and IL-6, involved in scheming NF-κB signaling. CONCLUSION: Thus, our results support the ethnomedicinal use of BSE in skin infection by inhibiting HSV-1 through the modulation of NF-κB and p38 MAPK pathway.

A novel shogaol analog suppresses cancer cell invasion and inflammation, and displays cytoprotective effects through modulation of NF-κB and Nrf2-Keap1 signaling pathways.

Natural compounds containing vanilloid and Michael acceptor moieties appear to possess anti-cancer and chemopreventive properties. The ginger constituent shogaol represents one such compound. In this study, the anti-cancer potential of a synthetic novel shogaol analog 3-phenyl-3-shogaol (3-Ph-3-SG) was assessed by evaluating its effects on signaling pathways. At non-toxic concentrations, 3-Ph-3-SG suppressed cancer cell invasion in MDA-MB-231 and MCF-7 breast carcinoma cells through inhibition of PMA-activated MMP-9 expression. At similar concentrations, 3-Ph-3-SG reduced expression of the inflammatory mediators nitric oxide (NO), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and prostanglandin-E2 (PGE2) in RAW 264.7 macrophage-like cells. Inhibition of cancer cell invasion and inflammation by 3-Ph-3-SG were mediated through suppression of the nuclear factor-kappaB (NF-κB) signaling pathway. The 3-Ph-3-SG also demonstrated cytoprotective effects by inducing the antioxidant response element (ARE)-driven genes NAD(P)H quinone oxidoreductase-1 (NQO1) and heme oxygenase-1 (HO-1). Cytoprotection by 3-Ph-3-SG was achieved at least partly through modification of cysteine residues in the E3 ubiquitin ligase substrate adaptor Kelch-like ECH-associated protein 1 (Keap1), which resulted in accumulation of transcription factor NF-E2 p45-related factor 2 (Nrf2). The activities of 3-Ph-3-SG were comparable to those of 6-shogaol, the most abundant naturally-occurring shogaol, and stronger than those of 4-hydroxyl-null deshydroxy-3-phenyl-3-shogaol, which attested the importance of the 4-hydroxy substituent in the vanilloid moiety for bioactivity. In summary, 3-Ph-3-SG is shown to possess activities that modulate stress-associated pathways relevant to multiple steps in carcinogenesis. Therefore, it warrants further investigation of this compound as a promising candidate for use in chemotherapeutic and chemopreventive strategies.

Compliance, counseling and satisfaction with oral contraceptives: a prospective evaluation.

CONTEXT: Oral contraceptive users' risk of accidental pregnancy may be higher than it should be, because of inconsistent pill-taking. However, few reliable data are available on pill users' everyday experiences with their method, especially characteristics that may affect consistency of use. METHODS: Two months after initiating or resuming oral contraceptive use, a nationwide sample of 943 women completed questionnaires examining their compliance with instructions for proper use, the quality of their interactions with their provider, their satisfaction with the method, and the frequency and costs of visits or calls to their providers because of pill-related side effects. Regression analyses were used to determine the factors associated with compliance difficulties and method dissatisfaction. RESULTS: In all, 47% of users missed one or more pills per cycle, and 22% missed two or more. Women who lacked an established pill-taking routine, who did not read and understand all of the informational material accompanying the pill package, or who experienced spotting or heavy bleeding had increased odds of missing two or more pills per cycle. Method satisfaction was most likely among women who were aware of the pill's noncontraceptive benefits, were satisfied with their relationship with their provider, had used the pill in the past and experienced few side effects. Some 22% of users called their provider at least once about pill-related side effects, and 9% made at least one visit for this reason; these women spent $25 and $62, respectively, to treat side effects. CONCLUSIONS: Improving pill use is a shared responsibility of the provider, the patient and, to a lesser degree, pill manufacturers. Awareness of potential difficulties such as inadequate counseling is a key step in helping women use oral contraceptives effectively.

PIP: The Organon Contraceptive Use Study, a prospective cohort study (1994-96) of 943 US women (mean age, 25 years) recruited through private medical practices, Planned Parenthood clinics, and a health maintenance organization, examined oral contraceptive (OC) use patterns. 95% of study participants began or switched to a new OC brand at study enrollment. At follow up 2 months after enrollment, 47% of pill users reported missing 1 or more pill per cycle and 22% missed 2 or more pills in each cycle. Those who missed 1 or more pill were significantly more likely than those who did not to lack an established pill-taking routine, not to have read or understood the informational material accompanying the pill, and to have experienced spotting or heavy bleeding. 34% rated the OC as a very good method and another 30% considered it a good method. Method satisfaction was significantly higher among OC users who were aware of the pill's noncontraceptive health benefits, had a good relationship with their OC provider, had used the pill in the past, and experienced few side effects. 22% of OC recipients called their provider at least once about pill-related side effects and 9% visited at least once for this reason; these women spent US$25 and $62, respectively, to treat side effects. Recommended, to increase patient compliance and satisfaction with OCs, are measures such as counseling on potential side effects, evaluations of consistency of use at all follow-up contacts, and attention to the quality of the provider-client relationship.

Contraception and culture: the use of yuyos in Paraguay.

The use of herbs (yuyos) as contraception is common practice in Paraguay. This report analyzes data from the 1995-1996 Paraguayan Reproductive Health Survey. The analysis reveals that women are more familiar with yuyos (88%) than any other method of family planning. Modeling the determinants of ever having relied on yuyos as contraception demonstrates that older women (OR = 1.043) and women with more children (OR = 2.283) are significantly more likely to have used yuyos, but an interaction between older women with more children shows they are less likely to have used this method (OR = .982). Women living in rural areas (OR = .664) and those with more education (OR = .883) are less likely to have used the method. These findings show widespread acceptance and use of yuyos for contraception in Paraguay. More research into the chemical properties of yuyos is needed to determine their contraceptive efficacy and to prevent harmful effects from their misuse.

PIP: According to the 1995-96 Paraguayan Reproductive Health Survey of 6465 reproductive-age females, women are more familiar with herbs (yuyos) than any other method of contraception. These herbs are prepared most frequently as teas and drunk every day. 88% of respondents were aware of yuyos. Bivariate analysis indicated that current yuyo users were geographically isolated, older, less educated, poorer, and more likely to speak Guarani in the home than non-users. In the multivariate analysis, ever-use of yuyos was significantly associated with older age (odds ratio (OR), 1.043) and more children (OR, 2.283), while high education (OR, 0.883) and urban residence (0.664) were inversely related to ever-use. Since no protocol exists for yuyo use for contraception, indigenous women rely on word-of-mouth advice and may be at risk of toxic side effects from improper use. Needed, to reduce this risk, are research studies on the use of herbs in other countries for contraceptive purposes and more rigorous testing of the chemical agents found in plants used for fertility control. If efficacy is discovered, additional research is recommended to identify the conditions under which and for how long yuyos should be taken for contraception or menstrual regulation. Any program that builds on yuyo use to promote use of modern contraceptive methods must proceed in a culturally sensitive way.

Teaching about the female condom.

Reality female condoms became available for over-the-counter purchase in the fall of 1994. Because the female condom is a new sexual barrier device, women need to learn how to use it correctly. Health care providers must also be knowledgeable about the correct use of the female condom so that they can teach women how to use it as a barrier method. To facilitate learning about the female condom, a curriculum was developed that included a quiz on knowledge about the female condom. Content validity was established through a content validity index completed by six content experts. This quiz was used to evaluate educational sessions offered to 42 persons in an urban college setting and 18 women in a community setting. The article describes the female condom along with the curriculum that was developed to teach its correct use and the reactions of potential users of the female condom.

PIP: The annual failure rate of the Reality female condom is 21% among inconsistent users compared with 5% among consistent, correct users, a finding that underscores the importance of training in the proper use of this device. This study evaluated a 60-minute curriculum aimed at describing the development of the female condom, demonstrating its correct use, and identifying conditions under which the female condom is the most appropriate choice of barrier method. Course participants included 42 New York undergraduate and graduate students (average age, 23.5 years) and 18 clients from a community-based agency (average age, 36.0 years). Administered, both before and after the training, was a 15-item true/false quiz assessing knowledge about the female condom. Content validity was established through an index completed by six content experts. Among college students, the mean score on the pretest was 10.9 (range, 5-15 correct); this score increased to 12.3 (range, 8-14 correct) at post-test, confirming a significant gain in knowledge as a result of exposure to the curriculum. Among community-based participants, the mean score declined from 10.3 at pretest to 7.8 among the 9 women who completed the post-test; although these women did not seem as comfortable as the students with the lecture format, the decline in knowledge is considered to reflect distractions created by other events occurring at the agency. The quiz is in the process of being modified to improve its validity and ensure that women with lower literacy levels than those in the present study can understand the questions.

Market day midwives.

PIP: In August 1994 in Uganda, the Social Marketing for Change (SOMARC) project invited midwives to counsel clients and sell low-dose oral contraceptives (OCs), condoms, and the progestin-only OCs in local markets. They now sell these contraceptives from vendor stalls in busy markets, which allows clients to speak privately with the midwives. The midwives refer clients to their maternity clinics or to hospitals for other contraceptive methods and reproductive/maternal and child health (MCH) services. All Market Day Midwives have taken a 1-month family planning course and a course in quality of customer service. By the end of March 1994, 17 midwives served 22 marketplaces ranging from rural village markets operating once every 2 weeks to very busy, daily city markets. Some markets have 15 permanent stalls, while other midwives move within markets. Market Day Midwives have been able to add more than 1900 women to the list of women using the OC Pilplan. 65% of the new acceptors had not used any OC before Pilplan. 46% of them would be women considered to be high risk if they were to become pregnant (teenagers, women over 35, and women with many children). These midwives have been successful because they operate where the people are and they provide anonymity. Market Day Midwives have also brought in men who seek them out for family planning/sexually transmitted disease prevention services. They have sold more than 1000 Protector condoms. Another benefit of the market day approach is professional growth of the midwives. They often invest their earnings into new equipment and their private maternity clinics. They have learned the significance of advertising and the value of high-quality customer service. They look to expand into other markets and to integrate MCH products (e.g., oral rehydration) into their contraceptive business.^ieng

Induced abortion among the Pati Rabha women of Boko area, Kamrup district, Assam.

"Acceptance of induced abortion as a device of family planning among the Pati Rabha of Boko area [India] was studied. Out of 345 couples, practising various family planning devices, 86 (24.93%) accepted induced abortion. Of the total 629 conceptions of these 86 women, 137 (21.78%) conceptions were terminated by induced abortion.... The highest percentage (18.24%) of the induced abortion was done at the 6th order of pregnancy, 62.79% of the women accepted the induced abortion only once in their reproductive period. Most (91.86%) of the acceptors were illiterate and all of them were house wives." Consideration is given to the use of traditional methods of inducing abortions.

Achieving self-sufficiency. The Turkey Contraceptive Social Marketing project sold 2.1 million cycles of low-dose pills in 1992.

PIP: To encourage women in lower socioeconomic groups to realize the benefits of low-dose oral contraceptive (OC) use, the Turkey Contraceptive Social Marketing (CSM) project was initiated in December 1991. Until this time, most Turkish women who used OCs could only obtain high-dose preparations. Many discontinued use because of health concerns, causing the OC market to decline. Working with 3 OC manufacturers, Wyeth, Schering, and Organon CSM is promoting 5 different low-dose OCs with a method-specific educational campaign. Packaging of the OCs contains use instructions written for low-literacy women. Survey results show an increase in OC use in Metropolitan areas from 8 to 12% during 1990-92, with low-dose OCs capturing 61% of the market in 1992 vs. 50% in 1991. With sales at 128% of the first year's objective, the total OC market showed its first increase in years (to 18%). The low-dose OCs have an approval rating of 84%, and 61% of current acceptors are from lower socioeconomic groups. The success of the program was assured by the marketing efforts of the manufacturers, who tripled CSM's efforts. This result has led to plans to include injectables and implants in CSM's marketing efforts, with commercial distribution to being in 1994.^ieng

Integrated birth spacing and MCH Program in Narativas Province.

PIP: The author describes the birth control situation and the success achieved by the intensification of the Maternal and Child Health (MCH) service in Narativas, one of the provinces of Thailand. In Narativas the contraceptive prevalence rate (CPR) in 1984 was 25.9, while the national average was 64.6 percent. The "Expansion of Maternal and Child Health and Birth Spacing Program" was introduced in order to alter the situation. As a result, CPR increased to 34.3 percent in 1989, and the number of new acceptors doubled from 4,337 in 1983 to 8,299 in 1988. Since 78% of the population is Moslem, birth control methods cannot be introduced directly. Emphasis was laid on the role of religious leaders who were trained centrally. Community involvement in birth control was stimulated by selecting model mothers fulfilling strict criteria. Village health volunteers, traditional birth attendants and auxiliary midwives contributed to the project. Teams visited the villages at definite times to give information about birth spacing, conduct routine examination of pregnant mothers and children, administer immunizations and dispense drugs. Women already motivated to use modern contraceptives were offered services. 2 teams doubled the increase of MCH and birth spacing acceptors. The strategy, described in the review in detail, increased MCH coverage and reduced infant mortality. The service served 5,064 mothers in Narativas. Altogether 5,542 new family planning acceptors were referred to health centers for contraceptive services during the period of June 1985 - December 1988.^ieng

Modern health services and health care behavior: a survey in Kathmandu, Nepal.

The most important problem regarding health service utilization in Third World countries is that established indigenous forms of health care are readily available and compete with modern health care. Thus, in addition to understanding the components of the decision to seek medical help, we must understand the conditions that affect the choice of a specific health care system. This study examines the impact of medical pluralism on the use of modern forms of health care in Nepal. The findings show that the presence of medical pluralism is a significant factor which delays use of modern health services. Policy implications are discussed, and the need for more research in this area is stressed.

PIP: This study examines the impact of medical pluralism on the use of modern forms of health care in Nepal. The findings show that the presence of medical pluralism is a significant factor which delays use of modern health services. This is a very important problem for health service utilization in 3rd World countries. Thus, in addition to understanding the components of the decision to seek medical help, it is necessary to understand the conditions that affect the choice of a specific health care system. Several variables were found to affect significantly the time taken to seek modern health care services. In general, older persons and women tended to delay seeking modern health care longer than younger persons and men. However, individuals who had been to school and/or had higher total household incomes took less time to seek modern health care services than individuals who had never been to school and/or had lower total household incomes. Similarly, persons who turned to the modern health sector on the basis of their own subjective assessment of the problem took longer to come to the modern hospitals than those who did not seek such services because of the nature of the problem. The use of home remedies emerged as a significant factor in delaying use of modern health service. Also, results showed that when individuals turned to the modern health sector, they did so because they were dissatisfied with the previous folk or traditional professional consultation and/or because folk or traditional practitioners had advised them to seek modern hospital services. The present findings show that the indigenous health care system is a popular source of health care and is here to stay.

Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s.

PIP: Between 1955 and 1975 total fertility in Peninsular Malaysia dropped from 6.2 to 4.2. However, the change was not consistent among the 3 major ethnic groups: Malays, Chinese, and Indians. Data from the 1976-1977 Malaysian Family Life Survey (MFLS) were used to construct individual contraceptive histories of 1191 ever-married women and to study contraceptive method switching in a total of 7154 interpregnancy intervals for the population as a whole and by ethnic group. Contraceptive methods considered were: sterilization; pill, IUD, injection (referred to in this analysis simply as "pill"); condoms; safe time (includes abstinence and withdrawal), folk methods; and no method. 80% of the samples from all intervals reported "no method"; Indians had the greatest proportion (84.5%) of unprotected intervals. The most popular contraceptive method was the pill (31% for the whole population, 42% for the Chinese, 23% for Indians and Malays). Sterilization was highest among Indians (20.5%). Since "no method" was used in all pregnancy intervals by 47% of the sample, the ever-use rate for the sample was 53% (67% for Chinese, 57% for Indians, 40% for Malays). Only 16.6% of ever-users reported use of more than 1 category of contraceptive method. Individual contraceptive histories were analyzed for acceptance, discontinuation, or change of method at each transition, i.e., each pregnancy interval. 84% of all transitions represented continuation of the same method. The probability of continuation of the same method was greater the less effective the method. Most switches were from less effective to more effective methods; 92% of these were from no method to the pill. Most of the switches to less effective methods were switches to no method, and switches to no method increased with increasing effectiveness of the method. The rate of new acceptances was 13.7%, but the discontinuation rate was 20.3%. Only 83 couples were sterilized, and most of them had previously used no method. For all ethnic groups the majority of new acceptors were pill users. New acceptance, however, was less common than discontinuation, especially among the Indians (40%). Malays were the least likely to accept contraceptives, but when they did, they were very unlikely to change method. The Chinese had the highest acceptance rate, the highest probability of switching methods, and the highest probability of switching to a more effective method. Indians had the highest percentage of unprotected pregnancies, the highest discontinuation rate, and were the least likely to switch to more effective methods. Implications of these data for program policy are that there are still many nonacceptors to be reached; that the more effective methods should be promoted, since most couples continue using the method with which they started; that the largest ethnic group that needs to be reached is the Indian population; and that different contraceptive methods should be available for choice.^ieng

Family planning programme news.

PIP: In this quarterly newsletter from the Population Centre of Uttar Pradesh state, India, data on contraception and sterilization acceptors for the 1st quarter of 1987 and center activities are summarized. IUD/Copper-T insertions, Nirodh and pill acceptor quotas rose 3, 13.5 and 47.9% above the percent of quota for the same period in 1986, while sterilizations fell 10% below the percent of target for last year's 1st quarter. A lecture on organizing for results was given at the Centre. Faculty promotions and participation in career development were announced. The Population Center presented 2 training courses on population education for college students of Ayurvedic and Unani medicine. The topics included population education, dynamics, policy, socioeconomic impact, and communication in India. Students were given a history of Ayurveda as applied to population and health, and lectures on coordinating Ayurvedic Dispensaries and primary health care services, as well as the role of Ayurvedic doctors as change agents. Students prepared actions plans for introducing population education in the Ayurvedic and Unani curricula. A 2-week Management Development Programme for primary health care and district level medical officers posted at Universal Immunisation Programme districts of Uttar Pradesh was held at the Population Centre.^ieng

Oral contraception in Bangladesh: social marketing and the importance of husbands.

This is a report on a study that examined the characteristics of three types of commercial providers of oral contraceptives, as well as users and users' husbands. The study also examined how and from whom users and/or their husbands obtain oral contraceptives and instructions for use. The socioeconomic level of providers and user-couples was, on average, higher than for the general population. Husbands were particularly important for obtaining supplies from the commercial sector and acting as instructors. The findings suggest that: a special effort will be required if social marketing techniques are to increase oral contraceptive prevalence among the rural poor in Bangladesh, and family planning researchers and managers should give more attention to husbands in countries where men dominate communication networks.

PIP: This is a report on a study that examined the characteristics of 3 types of commercial providers of oral contraceptives, as well as users and users' husbands. The study also examined how and from whom users and/or their husbands obtain oral contraceptives and instructions for use. The socioeconomic level of providers and user-couples was, on average, higher than for the general population. Husbands were particularly important for obtaining supplies from the commercial sector and acting as instructors. The findings suggest that: 1) a special effort will be required if social marketing techniques are to increase oral contraceptive prevalence among the rural poor in Bangladesh', and 2) family planning researchers and managers should give more attention to husbands in countries where men dominate communication networks. In most countries, users of oral contraceptives obtain their own supplies. This may not be true, however, in some Islamic countries such as Bangladesh, where women generally do not venture outside the area of their homes. 1 implication of this behavior is that men, including husbands, generally dominate in purchasing household supplies, including supplies of pills.

[Assessment of the performance of a copper intrauterine device: MLCu 375]. / Bilan des performances d'un dispositif intra-uterin au cuivre: le MLCu 375.

PIP: Between November 1977 and May 1978, 120 Multiload Cu 375 (ML Cu 375) IUDs were inserted to be used for periods of 24 months in 24 women or 36 months in 96 women. 4 patients were aged 24 years or younger, 38 were 25-29, 40 were 30-34, 21 were 35-39, 13 were 40-44, and 4 were 45 or over. 9 were nulliparous, 30 were primaparous, and 81 were multiparous. 35 women had used another type of IUD and 5 had expelled another model. At 12, 24 and 36 months respectively there were 1, 2, and 0 pregnancies; 3, 4 and 0 expulsions; 5, 3, and 4 removals for pain; 0, 2, and 1 removal for other medical reasons; 0, 1, and 1 removals for personal reasons; and 2, 4, and 3 removals because of desire for pregnancy. The number of cycles included at 12, 24, and 36 months respectively were 1354, 2454, and 3081, and a total of 20 patients were lost to follow-up over 36 months. The small sample size and limited number of cycles of use prohibit a complete evaluation of the ML Cu 375, but the author's experiences confirm the simplicity of insertion, efficacy, good retention and acceptable tolerance of the device. A review of the literature suggests that IUDs with large doses of copper, such as the ML Cu 375, offer contraceptive efficacy that will be difficult to improve, at least with copper devices.^ieng