Two alternative service delivery strategies to improve the effectiveness and efficiency of the Bangladesh national Family Planning and Maternal and Child Health programme have been tested: (1) service delivery at cluster spots, a centrally located neighbourhood spot, rather than at the client's home, and (2) increased frequency of outreach clinics merged with immunization spots. The cost-effectiveness of these strategies was compared with baseline estimates of the cost of providing services. The data were collected in two rural sites of Bangladesh, Mirsarai Thana of Chittagong and Abhoynagar Thana of Jessore, in August 1996. The results of this analysis indicate that cluster service delivery of contraceptive services in their present form are not more cost-effective than home delivery services. The cost per birth averted was lower in only one out of three services in each of the field sites. When the cost-effectiveness of increasing the frequency of SCs combined with EPI services was examined, the service delivery was found to be more cost-effective for all services in one thana and for two out of three services in the higher performing thana, Abhoynagar. This implies that the provision of a wider range of services is improving overall cost-effectiveness.

Bangladesh↗

PubMedDate not supplied

A follow-up of vasectomy clients in rural Bangladesh.

A one-year follow-up of 585 vasectomy clients sterilized at vasectomy camps in Shibpur and Shalna in rural Bangladesh showed that almost half of the clients were dissatisfied with their vasectomies. The majority of dissatisfied clients stated that their primary reasons for dissatisfaction were: (a) their ability to work had decreased and (b) they had not received all of the incentives they had been promised. However, 58% of the matched nonvasectomized controls also felt that their ability to work had decreased in the last year. Only 2%--7% of the dissatisfied clients cited decreased sexual performance as their primary reason for dissatisfaction. Satisfied vasectomy clients most frequently cited: (a) the permanence of this method of birth control and (b) the incentives they received as their reasons for satisfaction.

Adult↗

PubMedDate not supplied

Radiological recanalization of an occluded anterior resection anastomosis.

We present a case of occluded colorectal anastomosis following surgery for rectal tumor. Contrast enema and antegrade ileography confirmed occlusion by a thin membrane. This was thought amenable to needle puncture and placement of a temporary stent under fluoroscopy guidance, avoiding surgery and its associated morbidity. This provides a minimally invasive alternative to surgery and has only been reported once before.

Aged↗

PubMedDate not supplied

Further studies of the terpenoid content in the gorgonian Eunicea succinea: 12,13-bisepieupalmerin, a new cembranolide.

In a continuing comparative study of the sesquiterpenoid and diterpenoid content of the gorgonian Eunicea succinea from different locations, a new cembranolide, 12,13-bisepieupalmerin (6), was isolated (structure by X-ray analysis) from specimens from St. Croix, U.S.V.I. 12,13-Bisepieupalmerin possesses the correct stereochemistry to be a biosynthetic precursor for the related cembranolides eunicin (1a) and jeunicin (2). The latter compounds were found to occur with 6 in E. succinea from St. Croix. Eunicin and its acetate (1b) were obtained from a South Caicos collection. E. succinea from St. Croix, U.S.V.I. and South Caicos contain complex mixtures of hydrocarbons in which (-)-germacrene-A, (+)-beta-elemene, (+)-beta-epibourbonene, (+)-beta-copaene, and (+)-alpha-muurolene were identified.

Animals↗

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HIV needle risk behaviors and drug use: a comparison of crack-smoking and nonsmoking injection drug users in Ohio.

This study compares the drug use and needle risk behaviors among 733 crack-smoking injection drug users (IDUs) and 518 nonsmoking IDUs. Participants were recruited in Dayton and Columbus, Ohio, for the Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research Program from 1992 to 1996. Crack-smoking IDUs were more likely to be male, African-American, and 30 to 40 years of age, but less likely to be married or living with a sex partner compared to nonsmokers. Daily crack users were less likely to be daily injectors but more likely to use alcohol daily when compared to non-crack users and less-than-daily crack smokers. IDUs who smoked crack less than daily were more likely to have injected with needles and syringes used by others. There is an urgent need for additional research on the relationship between drug injection and crack smoking as well as improved HIV risk-reduction interventions that include drug abuse treatment components focusing on issues surrounding crack-cocaine addiction.

Adult↗

PubMedDate not supplied

Extraction, separation, and detections of 14C-diazepam and 14C-metabolites from brain tissue of mature and old rats.

A rapid method for simultaneous determination of brain concentrations of diazepam and each of its three major metabolites in brain tissue by a reverse isotope dilution procedure is presented. Radiolabeled diazepam and metabolites were extracted from brain tissue of mature and senescent rats with ethyl ether. After the ether was evaporated the benzodiazepines were separated from the residue by passing the water soluble portion through C-18 bonded-phase extraction columns. High pressure liquid chromatography (HPLC) was used to separate the benzodiazepines from each other. Reverse isotope dilution analysis was used to quantify diazepam and its metabolites. The percent recovery of diazepam and its metabolites from the brain of mature or senescent rats did not vary significantly.

Aging↗

PubMedDate not supplied

Osteonecrosis as a complication of steroid dependent asthma: a case report and review.

Corticosteroid associated osteonecrosis is a complex disease requiring high physician suspicion to make an early diagnosis. Although the exact cause is not completely known, it appears that systemic illness, anatomic location and elevated interosseous pressures interact to produce this lesion. Plain film and technetium bone scan are most commonly used for diagnosis, but occasionally, invasive procedures are required. Surgical treatment, ranging from decompression to total hip replacement, is most commonly, but not always recommended.

Asthma↗

PubMedDate not supplied

Improved safety, pharmacokinetics and therapeutic efficacy profiles of a novel liposomal formulation of mitoxantrone.

We describe here the preclinical studies of a novel formulation of liposome-entrapped mitoxantrone (LEM). The liposome entrapment efficiency of mitoxantrone was 93.4 +/- 2.8%. In vitro cytotoxicity studies in HL60 cells comparing LEM with conventional mitoxantrone (MTO) showed IC50 values of 0.31 +/- 0.05 ng/ml and 0.48 +/- 0.06 ng/ml for LEM and MTO, respectively. In CD2F1 mice, LEM was significantly less toxic as compared with MTO. A single intravenous (i.v.) dose of 15 mg/kg MTO produced 100% mortality in CD2F1 mice by Day 10, whereas a single i.v. dose as high as 35 mg/kg LEM caused no mortality for at least up to Day 60 post-treatment. Multiple doses of MTO (i.v., 5.0 mg/kg, 1x daily, x5) caused 100% mortality by Day 10, whereas a similar dose regimen of LEM caused no mortality in CD2F1 mice. Clinical and histopathology evaluations indicated long-term normal tissue protection in mice treated with relatively high single dose (i.v., 35 mg/kg) or multiple doses of LEM (i.v., 5.0 mg/kg, 1x daily, x5). LEM also demonstrated favourable pharmacokinetic profiles. CD2F1 mice injected with 5 mg/kg i.v. dose of LEM showed plasma levels 51-fold higher than with an equivalent dose of MTO. The area under the plasma concentration-time curve was 200-fold greater with LEM as compared to MTO. The plasma half-lives were 0.96 hours and 0.11 hours for LEM and MTO, respectively. An altered tissue distribution was observed with LEM; cardiac tissue demonstrating at least 2.6-fold lower levels of mitoxantrone with LEM vs. MTO. LEM exhibited significant anti-tumor activity against murine ascitic L1210 leukemia in CD2F1 mice. Treatment with a single dose of 20.0 mg/kg LEM resulted in 100% long-term survivors. LEM 2.5 mg/kg (i.v., x4) had antitumor activity against a human hormone-independent prostate carcinoma (PC-3) grown in athymic mice, while a comparable dose of MTO was too toxic. A significant decrease in toxicity, altered pharmacokinetics, and enhanced efficacy of LEM suggest that LEM may provide a viable alternative to the clinical use of conventional mitoxantrone.

Animals↗

PubMedDate not supplied

Poverty-led higher population growth in Bangladesh.

Explore the source record for details and available documents.

Asia↗

PubMedDate not supplied

Fish transgene expression by direct injection into fish muscle.

The ability of a promoter sequence to drive expression of a reporter gene can be determined by direct injection of copies of the cloned sequence into fish muscle, followed by biopsy of muscle from the site of injection. We describe a set of experiments in which copies of the constructs FV1 and FV2, both comprising a carp beta-actin promoter sequence spliced to the bacterial reporter gene CAT, were injected into the muscle of tilapia fish )Oreochromis niloticus) of between 5 and 8 cm body length. The site of injection was carefully determined so that biopsy samples could be recovered from the injection site 24 hours, 48 hours, and 7 days after injection. Biopsy samples of muscle were homogenized and used for CAT assays. CAT activity was successfully detected in many of the muscle samples.

Actins↗