Ceftriaxone versus ampicillin/cloxacillin as antibiotic prophylaxis in elective caesarean section.

We carried out a prospective, randomized, controlled clinical trial to evaluate the clinical efficacy of ceftriaxone and ampicillin/cloxacillin prophylaxis in decreasing the frequency of post-caesarean section infection-related morbidity. Two hundred patients randomly received either ceftriaxone (single dose) or ampicillin/cloxacillin (3 doses) intravenously at induction of anaesthesia. There was no statistical difference in incidence of endometritis (P = 0.34), wound infection (P = 0.44), or other febrile morbidity (P = 0.5). Eleven babies had a low Apgar score (< 8) in the ceftriaxone group and 13 in the ampicillin/cloxacillin group (P = 0.82). There were 2 perinatal deaths in each group. One dose of ceftriaxone was as effective as ampicillin/ cloxacillin in preventing post-caesarean section complications and is easier to administer.

Ceftriaxone versus ampicillin/cloxacillin as antibiotic prophylaxis in elective caesarean section

We carried out a prospective, r and omized, controlled clinical trial to evaluate the clinical efficacy of ceftriaxone and ampicillin/cloxacillin prophylaxis in decreasing the frequency of post-caesarean section infection-related morbidity. Two hundred patients randomly received either ceftriaxone [single dose] or ampicillin/cloxacillin [3 doses] intravenously at induction of anaesthesia. There was no statistical difference in incidence of endometritis [P = 0.34], wound infection [P = 0.44], or other febrile morbidity [P = 0.5]. Eleven babies had a low Apgar score [< 8] in the ceftriaxone group and 13 in the ampicillin/cloxacillin group [P = 0.82].There were 2 perinatal deaths in each group. One dose of ceftriaxone was as effective as ampicillin/ cloxacillin in preventing post-caesarean section complications and is easier to administer

A multicenter comparative trial of triphasic and monophasic, low-dose combined oral contraceptives.

A comparative multicenter clinical trial of two combined oral contraceptives (OCs) was conducted at clinics located in the Sudan, Sri Lanka, Chile, the Dominican Republic and Ecuador. The trial was designed to determine if there were differences in efficacy, safety and acceptability between a triphasic and a low-dose monophasic OC. This report includes analysis of 1088 women. At each center, subjects were randomly allocated to one of the two OCs. Follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. There were two accidental pregnancies attributed to user failure reported during the study period; one in the triphasic group and one in the monophasic group. Adverse experiences were mainly minor with headaches and dizziness being the most common complaints; frequency of reports was similar in both groups. Cycle control was good in both groups with women in the triphasic group reporting fewer complaints of intermenstrual bleeding. Both OCs were safe and effective.

PIP: Researchers compared the efficacy, safety, and acceptability of a triphasic oral contraceptive (OC), Triquilar, with those of a monophasic OC, Lo-Femenal, among 1088 women attending clinics in Chile, the Dominican Republic, Ecuador, Sri Lanka, and the Sudan. Both OCs contained levonorgestrel and ethinyl estradiol. 90% of women in each group exhibited good user compliance. Only 1 unplanned pregnancy occurred in each group, and both pregnancies were attributed to user failure. The gross cumulative efficacy rates at 11 months were 0.3/100 woman-years for the triphasic OC and 0.2/100 woman-years for the monophasic OC. The continuation rate at 11 months was lower for Lo-Femenal than it was for Triquilar (80.8% vs. 84.6%), but the difference was not significant. The leading side-effect-related reason for discontinuation in both groups was headache. Another key reason for OC discontinuation in both groups was personal reasons, such as planning a pregnancy. Most women in both groups did not have menstrual complaints (78.8% for the Triquilar group and 77.1% for the Lo-Femenal group). Intermenstrual bleeding rates were low (7.6% for the Triquilar group and 9% for the Lo-Femenal group). Significant intercenter differences for women reporting intermenstrual bleeding and side effects (e.g., headaches) existed (p .05). Women from both groups at the clinic in the Sudan always had lower reports of intermenstrual bleeding than those at the other clinics. In fact, no woman discontinued OC use because of intermenstrual bleeding in the Sudan. Women in Sri Lanka reported fewer side effects than those in other countries, suggesting they could better tolerate OCs than the other women. This multicenter study's findings indicates that both Triquilar and Lo-Femenal are effective and safe. In addition, they exhibit good cycle control.

Infertility in Africa.

PIP: Infertility is of particular concern in Africa because of the extent of the problem and the social stigma attached to it. The highest prevalence of infertility in Africa occurs south of the Sahara, but 5-8% of couples are estimated to experience infertility at some point in their reproductive lives (50-80 million people worldwide). The average infertility in Africa is 10.1% of couples, with a high of 32% in some countries, and certain tribes have high infertility rates. While primary infertility is higher in other regions of the world, secondary infertility is more common in Africa, and secondary infertility rates are very complicated to determine. The World Health Organization Task Force on the Diagnosis and Treatment of Infertility instituted a standardized approach to studies of infertility which was adopted in 33 countries. Between 1978 and 1982, a pilot study of this approach examined 8504 couples and found that less than 50% of male and female infertile partners were primarily infertile, and 66% did achieve a pregnancy within the union. The cause of infertility was not determined for 35% of the women and 50% of the infertile men in the sample. Infertility was accounted for by endocrine factors (usually menstrual or ovulatory disturbances) in 35% of infertile cases and tubal factors (such as unilateral or bilateral tubal occlusion, pelvic adhesion, and other abnormalities) in 32%. About 66% of African women experienced tubal factors compared to about 33% worldwide. About 9% of women reported a history of sexually transmitted disease (STD), and 8% reported abortion complications. 46% of men in sub-Saharan Africa reported a history of STDs. About 24% of women with primary infertility and 40% of women with secondary infertility had no previous history of pelvic inflammatory disease or STDs and had tubal disease. African infections are common due to inadequate health services, improper use of antibiotics, and penicillin-resistant strains of gonorrhea. Public health programs should be implemented to prevent infection-related infertility.^ieng

A crossover pill study among Sudanese women.

A crossover study from a standard-dose to a low-dose oral contraceptive was conducted in the Sudan. Reported side effects were very few, with a headache the most frequently reported. Switching to the other pill did not affect the rate of any side effects.

A comparative study of two estrogen dosages in combined oral contraceptives among Sudanese women.

A prospective study of two combined oral contraceptives was conducted in the Sudan. No pregnancies occurred. Overall incidence of side effects was low. Headache was most frequently reported. Elevations were observed for weight, systolic and diastolic blood pressures, and SGOT and SGPT values while a decrease was seen for hemoglobin levels. Menstrual irregularities were not a problem for the users. Total 6-month use discontinuation rates were low for both pill groups.

Arterial blood pressure in Sudanese women of childbearing age.

The casual blood pressure of 1276 married and unmarried Sudanese women between 15 and 50 years of age, living in Khartoum, was recorded. The study showed a low range of blood pressure and no tendency to rise with advancing age. No correlation with parity was observed.

Inducing labor with oral prostaglandin E2 in Khartoum hospital.

Prostagland-n E2 (PGE2) was administered orally to 109 patients to induce labor. Sixty-five of these patients had an amniotomy prior to PGE2 administration. PGE2 was administered to the remaining. 44, who subsequently underwent amniotomy only after their cervices had reached approximately 6 cm dilation. Labor was successfully induced in 95 patients, but its duration was shorter when amniotomy was immediatedly followed by PGE2 administration. Failed cases were successfully managed with amniotomy and oxytocin infusion. Maternal side effects were minimal. No fetal complications occurred.