CONTRACEPTION IN DIABETIC PATIENTS

ABSTRACT A retrospective investigation was made of contraception in diabetic women delivered in our department in 1969 and 1970. Seventy-nine (69 per cent) answered the questionnaires. About one third had found the contraceptive instruction insufficient. A shift from conventional to intrauterine contraception and sterilization was seen, but nearly 25% of the patients were still using conventional methods, mainly the condom. The patients consider this an unreliable method. Thirty-three patients were using intrauterine contraception. Although 10 of them had bleeding irregularities, all were satisfied with the method. Sterilization had been performed on 17 patients, all of whom were fully satisfied and had experienced no side effects. Four of 11 insulin-requiring diabetics, who have used combined oestrogen-progesterone medication have had difficulties in the regulation of the diabetes. Of 24 unwanted pregnancies 12 occurred since the hospitalization in 1969 and 1970. In diabetic women the contraceptive method should either be sterilization, intrauterine device or low dose progestagens, and only in a few cases conventional. A thorough contraceptive instruction as well as a close control of the diabetic women are of importance in order to avoid unplanned pregnancy. The best way to achieve this is by having an out-patient clinic in connection with the obstetrical department to supervise contraception in all diabetic women in the area.

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The use of low-dose trazodone in the treatment of painful diabetic neuropathy

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-89-9-468 ◽

1999 ◽

Vol 89 (9) ◽

pp. 468-471 ◽

Cited By ~ 23

Author(s):

RC Wilson

Keyword(s):

Side Effects ◽

Diabetic Neuropathy ◽

Low Dose ◽

Symptomatic Relief ◽

Complete Relief ◽

Diabetic Patients ◽

Low Doses ◽

Painful Diabetic Neuropathy ◽

Effective Treatment Option ◽

Distal Symmetrical Polyneuropathy

Thirty-one adult diabetic patients with painful distal symmetrical polyneuropathy were treated with low doses of oral trazodone (50 or 100 mg/day). After 2 weeks of therapy, 19 patients (61.3%) experienced symptomatic relief, and 7 (22.6%) experienced complete relief. Although 8 patients (25.8%) discontinued the drug because of side effects, these were relatively minor (dizziness, headache, insomnia). Low-dose trazodone is recommended as an effective treatment option for painful diabetic neuropathy.

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The Side Effects of Intracesarean Intrauterine Contraception: A Descriptive Study

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v5i3.538 ◽

2017 ◽

pp. 139

Author(s):

Karol A Rumopa ◽

John Wantania ◽

Joice Sondakh

Keyword(s):

Abdominal Pain ◽

Side Effects ◽

Vaginal Bleeding ◽

Obstet Gynecol ◽

Intrauterine Device ◽

Descriptive Study ◽

Age Group ◽

Intrauterine Contraception ◽

Early Postpartum ◽

Significant Difference

Objective: To investigate the side effects and acceptance of intracesarean Intrauterine Device (IUD) insertion. Methods: This was a descriptive study. Subjects were all pregnant women who had Cu T380A IUD to be placed after cesarean delivery at Prof. Dr. dr. R. D. Kandou Hospital during the period between August 2016 and September 2016. Results: A total of 52 subjects were recruited in this study.43 (82.69%) subjects were in the age group of 20-30 years. 51 of the subjects accepted the IUD. On the 7th day, 49 (94.23%) and 51 (98.07%) subjects complained of abdominal pain and vaginal bleeding, respectively, while on the 14th day, 48 (92.3%) and 50 (96.1%) subjects had abdominal pain and vaginal bleeding, respectively. There were significant decreases in both complaints on the 14th day, compared to the 7th day. (p<0.05 and p<0.05, respectively). 51 (98.07%) subjects accepted the IUD. There were no significant difference between acceptance on day 7 and 14th (p>0.05). Conclusion: The acceptance of side effects by the acceptor reaches 100%, with the incidence of early postpartum expulsion is 3.8%. The side effects of IUD are minimal. [Indones J Obstet Gynecol 2017; 5-3: 139-141] Keywords: intra-cesarean, intrauterine device, side effects

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Faculty Opinions recommendation of The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737592040.793577059 ◽

2020 ◽

Author(s):

Paul White

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Postoperative Pain ◽

Cesarean Section ◽

Randomized Clinical Trial ◽

Low Dose ◽

Intrathecal Morphine ◽

Double Blind

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Impact of Active Antihyperglycemic Components as Herbal Therapy for Preventive Health Care Management of Diabetes

Current Molecular Medicine ◽

10.2174/1566524019666190219124301 ◽

2019 ◽

Vol 19 (1) ◽

pp. 12-19 ◽

Cited By ~ 1

Author(s):

Harsha Kashyap ◽

Sarika Gupta ◽

Renu Bist

Keyword(s):

Side Effects ◽

Healthy Lifestyle ◽

Preventive Health Care ◽

Diabetic Patients ◽

Steroidal Saponin ◽

Herbal Therapy ◽

Diabetes Type Ii ◽

Artificial Insulin ◽

Artery Disease ◽

Sensory Fibers

Diabetes is a metabolic hyperglycemic condition that progressively develops, effect small and large sensory fibers in the affected population. It has various complications as hypertension, coronary artery disease, stroke, blindness, kidney disease as well as peripheral neuropathy. Sulfonylureas, thiazolidinediones, metformin, biguanidine, acarbose and insulin are commonly used drugs for diabetic patients, but these all have certain side effects. Even metformin, that is known as the miracle drug for diabetes has been found to be associated with side effects, as during treatment it involves complications with eyes, kidneys, peripheral nerves, heart and vasculature. In the present article, we hypothesize recent discoveries with respect to active ingredients from Indian medicinal plants i.e., polypeptide-p (protein analogue act as artificial insulin), charantin (a steroidal saponin), momordicin (an alkaloid) and osmotin (ubiquitous plant protein and animal analogue of human adeponectin) possessing anti-hyperglycemic potential for diabetes type II. Therefore, plants as herbal therapy have preventive care of hyperglycemia accompanied with healthy lifestyle which can provide significant decline in the incidences of diabetes in future.

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‘Every medicine is part poison’: a qualitative inquiry into the perceptions and experiences of choosing contraceptive methods of migrant Chinese women living in Australia

BMC Women s Health ◽

10.1186/s12905-021-01226-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hankiz Dolan ◽

Mu Li ◽

Deborah Bateson ◽

Rachel Thompson ◽

Chun Wah Michael Tam ◽

...

Keyword(s):

Decision Making ◽

Contraceptive Method ◽

Intrauterine Device ◽

Qualitative Inquiry ◽

Medical Advice ◽

The Body ◽

Hormonal Contraceptives ◽

Contraceptive Methods ◽

Structured Interviews ◽

Women’S Perceptions

Abstract Background In Australia, ethnic Chinese people are one of the largest, youngest and fastest growing overseas-born groups. Yet, little is known about their perceptions of contraceptive methods and their experiences with choosing one. Decisions about contraceptive methods are preference sensitive. Understanding the influencing factors of Chinese migrant women’s contraceptive method choice and practices will help cater to their decision-making needs in a culturally sensitive and responsive way. Methods A qualitative study design underpinned by critical realism approach was used to explore Chinese migrant women’s perceptions and experiences of choosing contraceptive methods. Semi-structured interviews were conducted with 22 women who self-identified as being ethnically Chinese and had been living in Australia for no more than 10 years. The interview guide was adapted from the Ottawa Decision Support Framework. Majority of the interviews were conducted in Mandarin Chinese. Transcribed data was analysed using thematic analysis method. Results Four major themes were identified, including: ‘every medicine is part poison: hormonal contraceptives cause harm to the body’; ‘intrauterine device, a device used in the past for married women’; ‘it takes two (or one) to decide, depending on the relationship dynamics and contraception preferences’; and ‘it is not necessary to seek medical advice in choosing contraceptive methods’. Conclusions Our findings suggest that Chinese migrant women’s perceptions and experiences of choosing contraceptive methods are influenced by complex personal, cultural, societal and inter-relational factors. Chinese migrant women were cautious of using hormonal methods due to fears of side-effects, including reduced or absent menstrual bleeding. Women were also reluctant to consider intrauterine devices as options due to associating them with past experiences of other women and themselves and also fears of potential complications. There was a reluctant attitude towards seeking medical advice regarding contraception due to beliefs that needing to use contraception is not an illness requiring treatment. Such findings are likely to be useful in increasing healthcare professionals’ and policy makers’ understanding of Chinese migrant women’s contraceptive method preferences, beliefs and behaviours. They also help to develop culturally and linguistically sensitive strategies, which goes beyond the provision of contraceptive counselling, in assisting Chinese migrant women’s decision-making needs.

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Low-dose IL-2 therapy limits the reduction in absolute numbers of circulating regulatory T cells in rheumatoid arthritis

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x211011370 ◽

2021 ◽

Vol 13 ◽

pp. 1759720X2110113

Author(s):

Sheng-Xiao Zhang ◽

Jia Wang ◽

Cai-Hong Wang ◽

Rui-Huan Jia ◽

Ming Yan ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

T Cells ◽

Side Effects ◽

Regulatory T Cells ◽

Disease Activity ◽

Immune Tolerance ◽

Low Dose ◽

Fold Increase ◽

Plain Language ◽

T Subsets

Background: Circulating regulatory T cells (Tregs) are responsible for mediating immune tolerance and maintaining immunological homeostasis. Decreases in Tregs may be involved in the onset of rheumatoid arthritis (RA). Low-dose interleukin-2 (IL-2) has been considered for the treatment of inflammatory diseases mediated by T cells. This study focused on the status of circulating CD4+T subsets and the clinical feasibility of IL-2 therapies in patients with RA. Methods: The subjects included 888 patients with RA and 100 healthy controls (HCs); 233 RA patients received IL-2 treatment with 0.5 million international units (MIU)/day from days 1 through 5. The demographic features, disease activity, and levels of CD4+T cells measured by modified flow cytometry were collected in all RA patients before and after treatment. Results: RA patients had lower absolute Treg counts (but not Th17) compared with HCs, which was associated with disease activity; previously treated RA patients had the fewest circulating Tregs ( p < 0.05). Patients treated with low-dose IL-2 had a three-fold increase in absolute anti-inflammatory Treg counts, as well as a two-fold increase in the other CD4+T subsets. Moreover, post-treatment levels of markers of disease activity in RA patients treated with IL-2 were significantly lower than the baseline values ( p < 0.001), with no apparent side effects. Conclusion: Decreased absolute counts of circulating CD4+T lymphocyte subsets were observed in patients with RA. Circulating Tregs, which mediate immune tolerance, may be involved in the pathogenesis and progression of RA; however, this was ameliorated by low-dose IL-2, without obvious side effects. Plain language summary Low-dose IL-2 treatment for rheumatoid arthritis • Circulating Tregs may be involved in the pathogenesis and progression of RA. • The absolute count of Tregs was significantly correlated with disease activity measures. • Low-dose IL-2 was able to effectively expade Tregs and help for RA patients’ symptoms remission without evaluated side effects.

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Low dose Mifepristone (100 mg) for medical termination of pregnancy

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v3i1.254 ◽

2011 ◽

Vol 3 (1) ◽

Author(s):

Shikha Seth ◽

Arun Nagrath ◽

Neeru Goel

Keyword(s):

Side Effects ◽

Success Rate ◽

Low Dose ◽

Medical Abortion ◽

First Trimester ◽

Effective Regimen ◽

Minimal Dose ◽

Medical Termination ◽

Gestation Age ◽

Post Abortion

Background: Abortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100 mg) of Mifepristone (PO) instead of the presently recommended 200 mg for medical abortion in early first trimester cases. Objectives: The objective of the study was to determine the efficacy of low dose (100 mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800 μg, 24 hours later.Design: A prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions.Method: Pregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100 mg Mifepristone orally on Day-1, followed by 800 μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours. Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention.Results: The total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours.Conclusion: Mifepristone 100 mg, followed 24 hours later by Misoprostol 800 μg orally, is a safe and effective regimen for medical abortion.

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Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

10.53350/pjmhs211592753 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2753-2756

Author(s):

Shahid Adalat Chaudhry ◽

Madiha Zafar ◽

Usman Zeeshan ◽

Mubashar Iqbal ◽

Arooj Fatima ◽

...

Keyword(s):

Side Effects ◽

Pain Score ◽

Low Dose ◽

Operative Time ◽

Oral Intake ◽

Respiratory Complications ◽

Group I ◽

Male Patients ◽

Group Ii ◽

Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

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Efficacy of ultra-low-dose (0.1 mg) ranibizumab intravitreal injection for treatment of prethreshold type 1 retinopathy of prematurity: A case series

European Journal of Ophthalmology ◽

10.1177/1120672118812266 ◽

2018 ◽

Vol 30 (1) ◽

pp. 40-47 ◽

Cited By ~ 2

Author(s):

Islam SH Ahmed ◽

Ahmed MA Hadi ◽

Hassan H Hassan

Keyword(s):

Side Effects ◽

Intravitreal Injection ◽

Retinopathy Of Prematurity ◽

Large Scale ◽

Low Dose ◽

Case Series ◽

Results Of Treatment ◽

Case Series Study ◽

Systemic Side Effects

Aim: To report the results of treatment of type 1 prethreshold retinopathy of prematurity using intravitreal injection of ultra-low dose of ranibizumab (0.1 mg in 0.01 mL). Design: A retrospective observational case series study. Methods: Review of files of eligible infants who received this form of treatment to determine the outcome of treatment and any associated ocular or systemic side effects. Results: The study included 24 eyes of 12 preterm infants with mean gestational age of 29.75 ± 1.54 weeks and mean birth weight of 1074.58 ± 320.59 g. A total of 22 eyes (91.67%) had zone II disease while 2 eyes of one infant (8.33%) had zone I disease. All cases showed regression of the signs of the active retinopathy of prematurity with complete retinal vascularization. None of the cases required retreatment. Three eyes developed ocular complications. Apart from mild feeding intolerance that lasted for 24 h after injection in one infant, none of the cases developed systemic side effects. Conclusion: Intravitreal injection of ultra-low-dose ranibizumab showed promising efficacy and good ocular safety. However, further large-scale studies are required to give stronger evidence about the efficacy and safety of ultra-low-dose ranibizumab.

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