scholarly journals The Prevalence and Side Effect of Nexplanon in Baghdad

2021 ◽  
Vol 10 (43) ◽  
pp. 3689-3693
Author(s):  
Dalya Thamer Ahmed
Keyword(s):  
Common Adverse Event ◽  
Contraceptive Device ◽  
Suitable Alternative ◽  
Low Sexual Desire ◽  
Contraceptive Implant ◽  
Long Acting ◽  
Intermittent Bleeding ◽  
Key Indicators ◽  
Subcutaneous Implant

BACKGROUND Nexplanon is a pregnancy-prevention device that is both safe and reliable. It is a novel reversible long-term contraceptive technique. It's a modern long-acting contraceptive device with a subcutaneous implant that releases etonogestrel (ENG). The main objective of this research was to determine the distribution, tolerability, and adverse reactions of Nexplanon among females who used it in Baghdad and find any relationship between these side effects and the acceptability of the device among contraceptive users. METHODS This study was done via the participation of 80 women who were using Nexplanon at the time of study or had recently removed the implant; the data was obtained from a direct interview and medical records. RESULTS The total number of women enrolled for the study was 80. The mean age of contributors was 33.24 (± 2.69) years. None of the participants was nulliparous; 15 % had two children, 85 % had three or more children. Of the participants, 26.25 % and 65 % had secondary and higher education degrees respectively, while only 7 % had primary education and none of the participants had any education. 6.25 % were smokers, only 28.75 % had irregular cycle and the remaining percentage had a regular one. 57 (71.25 %) of them underwent adverse events while using the contraceptive implant, the most common one was bleeding disorders most likely in the form of light intermittent bleeding. 69 (86.25 %) from those only 18 (26.08 %) removed implant because of this irritant bleeding, the next common adverse event was headache 44 (55 %), 8 (18.18 %) of them removed the implant because of headache, 41 (51.25 %) underwent variable mood swing changes, 36 (45 %) suffered from weight gain with use of the implant, 33 (41.25 %) nausea and bowel habits changes, androgenic effects presented in 19 (23.75 %) and 10 (12.5 %) in the form of acne and hirsutism, respectively. 3 (10.34 %) of them removed the device as they could not cope with this complication, only 6 (7.5 %) suffered from low sexual desire. CONCLUSIONS Nexplanon can be a suitable alternative for women who have been adequately informed about long-term contraception but bleeding disturbances and cycle durations (> 8 days) are also key indicators for early removal. The process of consulting the patient and giving them the appropriate educational advice on this subject should be a priority before using the implant, in addition to establishing special induction and educational programs. KEY WORDS Nexplanon, Contraception Method Contraception Method, A Subcutaneous Implant and Etonogestrel.

scholarly journals Long-acting reversible contraception immediately after medical abortion: systematic review with meta-analyses

2020 ◽  
Vol 26 (2) ◽  
pp. 141-160
Author(s):  
Mia Schmidt-Hansen ◽  
James E Hawkins ◽  
Jonathan Lord ◽  
Kelly Williams ◽  
Patricia A Lohr ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Contraceptive Device ◽  
Simultaneous Administration ◽  
Products Of Conception ◽  
Contraceptive Implant ◽  
Long Acting ◽  
Satisfaction Rates

Abstract BACKGROUND Long-acting reversible contraceptives (LARCs) are safe, effective and convenient post-abortal methods. However, there is concern that some LARCs may reduce the effectiveness of abortifacient drugs or result in other adverse outcomes. OBJECTIVE AND RATIONALE We undertook two systematic reviews to examine the early administration of LARCs in women undergoing medical abortion with mifepristone and misoprostol. (i) For women who are having a medical abortion and who plan to use a progestogen-only contraceptive implant or injectable, does administration of the contraception at the same time as mifepristone influence the efficacy of the abortion? (Implant/injectable review). (ii) For women who have had a medical abortion, how soon after expulsion of the products of conception is it safe to insert an intrauterine contraceptive device/system? (LNG-IUS/Cu-IUD review). SEARCH METHODS On 19 November 2018, we searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily and Epub Ahead-of-Print, In-Process and Other Non-Indexed Citations; the Cochrane Library; Cinahl Plus; and Web of Science Core Collection. Eligible studies were randomised controlled trials (RCTs), in English from 1985 (Implant/injectable review) or 2007 (LNG-IUS/Cu-IUD review) onwards, conducted in women undergoing medical abortion with mifepristone and misoprostol and studying either (i) simultaneous administration of mifepristone and a progestogen-only contraceptive implant or injectable compared to administration >24 h after mifepristone, or (ii) immediate insertion of intrauterine contraception after expulsion of the products of conception compared to early insertion (≤7 days) or to delayed insertion (>7 days) or early compared to delayed insertion. One author assessed the risk of bias in the studies using the Cochrane Collaboration checklist for RCTs. All the outcomes were analysed as risk ratios and meta-analysed in Review Manager 5.3 using the Mantel–Haenszel statistical method and a fixed-effect model. The overall quality of the evidence was assessed using GRADE. OUTCOMES Two RCTs (n = 1027) showed lower ‘subsequent unintended pregnancy’ rates and higher ‘patient satisfaction’ rates, and no other differences, after simultaneous administration of mifepristone and the implant compared to delayed administration. One RCT (n = 461) showed higher ‘patient satisfaction’ rates after simultaneous administration than after delayed administration of mifepristone and the injectable, but no other differences between these interventions. Three RCTs (n = 536) found no differences other than higher copper IUC uptake after early compared to delayed insertion at ≤9 weeks of gestation and higher rates of IUC expulsion, continuation and uptake after immediate compared to delayed insertion at 9+1–12+0 weeks of gestation and higher IUC continuation rates after immediate compared to delayed insertion at 12+1–20+0 weeks of gestation. The quality of this evidence ranged from very low to high and was mainly compromised by low event rates, high attrition and no blinding. WIDER IMPLICATIONS The contraceptive implant or injectable should be offered on the day of taking mifepristone. Intrauterine methods of contraception should be offered as soon as possible after expulsion of the pregnancy.

scholarly journals Long-Acting Risperidone Dual Control System: Preparation, Characterization and Evaluation In Vitro and In Vivo

Pharmaceutics ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1210
Author(s):  
Xieguo Yan ◽  
Shiqiang Wang ◽  
Kaoxiang Sun
Keyword(s):  
Drug Loading ◽  
Entrapment Efficiency ◽  
In Vitro Dissolution ◽  
Dissolution Behavior ◽  
In Vivo Evaluation ◽  
Long Term Treatment ◽  
Long Acting

Schizophrenia, a psychiatric disorder, requires long-term treatment; however, large fluctuations in blood drug concentration increase the risk of adverse reactions. We prepared a long-term risperidone (RIS) implantation system that can stabilize RIS release and established in-vitro and in-vivo evaluation systems. Cumulative release, drug loading, and entrapment efficiency were used as evaluation indicators to evaluate the effects of different pore formers, polymer ratios, porogen concentrations, and oil–water ratios on a RIS implant (RIS-IM). We also built a mathematical model to identify the optimized formulation by stepwise regression. We also assessed the crystalline changes, residual solvents, solubility and stability after sterilization, in-vivo polymer degradation, pharmacokinetics, and tissue inflammation in the case of the optimized formulation. The surface of the optimized RIS microspheres was small and hollow with 134.4 ± 3.5 µm particle size, 1.60 SPAN, 46.7% ± 2.3% implant drug loading, and 93.4% entrapment efficiency. The in-vitro dissolution behavior of RIS-IM had zero-order kinetics and stable blood concentration; no lag time was released for over three months. Furthermore, the RIS-IM was not only non-irritating to tissues but also had good biocompatibility and product stability. Long-acting RIS-IMs with microspheres and film coatings can provide a new avenue for treating schizophrenia.

scholarly journals Poly(ethylene glycol)-b-poly(1,3-trimethylene carbonate) Copolymers for the Formulation of In Situ Forming Depot Long-Acting Injectables

Pharmaceutics ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 605
Author(s):  
Marie-Emérentienne Cagnon ◽  
Silvio Curia ◽  
Juliette Serindoux ◽  
Jean-Manuel Cros ◽  
Feifei Ng ◽  
...  
Keyword(s):  
Ethylene Glycol ◽  
Surface Erosion ◽  
Sustained Delivery ◽  
Trimethylene Carbonate ◽  
Poly Ethylene Glycol ◽  
In Situ Forming ◽  
Poly Ethylene ◽  
Long Acting

This article describes the utilization of (methoxy)poly(ethylene glycol)-b-poly(1,3-trimethylene carbonate) ((m)PEG–PTMC) diblock and triblock copolymers for the formulation of in situ forming depot long-acting injectables by solvent exchange. The results shown in this manuscript demonstrate that it is possible to achieve long-term drug deliveries from suspension formulations prepared with these copolymers, with release durations up to several months in vitro. The utilization of copolymers with different PEG and PTMC molecular weights affords to modulate the release profile and duration. A pharmacokinetic study in rats with meloxicam confirmed the feasibility of achieving at least 28 days of sustained delivery by using this technology while showing good local tolerability in the subcutaneous environment. The characterization of the depots at the end of the in vivo study suggests that the rapid phase exchange upon administration and the surface erosion of the resulting depots are driving the delivery kinetics from suspension formulations. Due to the widely accepted utilization of meloxicam as an analgesic drug for animal care, the results shown in this article are of special interest for the development of veterinary products aiming at a very long-term sustained delivery of this therapeutic molecule.

Long-term safety and efficacy of long-acting pasireotide in acromegaly

Endocrine ◽  
2021 ◽  
Author(s):  
Amit Akirov ◽  
Alexander Gorshtein ◽  
Idit Dotan ◽  
Nariman Saba Khazen ◽  
Yulia Pauker ◽  
...  
Keyword(s):  
Safety And Efficacy ◽  
Long Acting

scholarly journals Non-Standard Discrete RothC Models for Soil Carbon Dynamics

Axioms ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 56
Author(s):  
Fasma Diele ◽  
Carmela Marangi ◽  
Angela Martiradonna
Keyword(s):  
Soil Carbon ◽  
Land Degradation ◽  
Biological Diversity ◽  
Negative Effects ◽  
Land Use Patterns ◽  
Use Patterns ◽  
Soil Carbon Content ◽  
Rothc Model ◽  
Key Indicators

Soil Organic Carbon (SOC) is one of the key indicators of land degradation. SOC positively affects soil functions with regard to habitats, biological diversity and soil fertility; therefore, a reduction in the SOC stock of soil results in degradation, and it may also have potential negative effects on soil-derived ecosystem services. Dynamical models, such as the Rothamsted Carbon (RothC) model, may predict the long-term behaviour of soil carbon content and may suggest optimal land use patterns suitable for the achievement of land degradation neutrality as measured in terms of the SOC indicator. In this paper, we compared continuous and discrete versions of the RothC model, especially to achieve long-term solutions. The original discrete formulation of the RothC model was then compared with a novel non-standard integrator that represents an alternative to the exponential Rosenbrock–Euler approach in the literature.

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