Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-07
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • 2024-04

    • br Results Response rate of participating pharmacists was i

    2018-10-26


    Results Response rate of participating pharmacists was 70.6%, i.e., 60 out of 85 approached agreed to participate in the study. Number of packs sold in a month per pharmacy varied from 2 to 500 packs/month, with a mean of 62 packs every month. Thirty‐eight pharmacists claimed that clients took the EC once every month while the rest (62%) claimed that majority of the clients repeated use during the same month. Two pharmacists reported that the same clients bought pack of EC as high as even 30 times a month (Figure 1). Levonorgestrel 1.5 mg single dose within 72 hours is the most preferred regimen. Eighteen percent of the clients were referred by doctors while 82% directly approached the pharmacists (Figure 2). There was a nearly equal clientele of both sexes, with 47% females and 53% males approaching the pharmacy. Information regarding discussion of pharmacists with clients is shown in Figure 3. Only two pharmacists (3.33%) asked about the last menstrual period or the time elapsed since the last unprotected intercourse. No pharmacist inquired whether there were one or multiple unprotected acts of intercourse. None of them asked if any regular contraceptive method was being used or explored the reason for EC intake like bursting of condom or oral contraceptive missing.
    Discussion In 1960, the first clinical trials of hormone emergency contraceptive were conducted using high‐dose JQ1 hormone. In 1970, Yuzpe method was initiated using high‐dose combined oral contraceptive containing ethinyl estradiol, and levonorgestrel. Nowadays available options of emergency contraceptive methods are Levonorgestrel (0.75 mg, 2 tabs 12 hours apart or 1.5 mg single dose), danazol, mifeprestone, and intrauterine contraceptive device. Mechanism of action of EC depends on the phase of menstrual cycle. Suggested mechanisms of action are inhibition of or delayed ovulation, prevention of implantation, fertilization or dysynchrony in transport of the sperms or ovum. Levonorgestrel‐containing preparations are found to exhibit fewer side effects with identical efficacy to Yuzpe method and are the dedicated EC in India [5]. Concerns that easy access to EC may lead to careless sexual behavior have been dispelled [5]. A number of studies have now demonstrated that facilitating access neither reduces compliance with contraceptive use nor increases rates of unprotected sexual intercourse or sexually transmitted infections (STIs) [3,6,7]. However, no study has demonstrated that increased availability of EC reduces unintended pregnancy rates. At a population level, it is becoming apparent that improved access to EC has no significant impact on abortion rates [7-9]. A recent study on the impact of increased access to EC concluded that, ultimately, the greatest health benefit of EC may be achieved indirectly by health workers counseling women at the time they present for procuring EC to improve use of their current method or to change to a more reliable method [9,10].
    Introduction Penile erection is a complex neurovascular event modulated by psychological, hormonal factors and some cellular components such as endothelial cells and biochemical factors [1]. Erectile dysfunction (ED) has a long list of causes especially in patients who have neurological or vascular problems. So, its prevalence is higher among diabetic men, even at a younger age compared with men without diabetes [2]. Pathophysiology of diabetic ED is multifactorial due to occurrence of neural, vascular, endocrinal, metabolic, and psychogenic changes [3]. This study focused on the vascular and neural aspects of the diabetic ED, trying to discover which precedes the other. Diabetic neuropathy initially affects small unmyelinated fibers and later, larger myelinated fibers. The putative pathogenesis of diabetic neuropathy includes the accumulation of sorbitol and fructose, auto‐oxidation of glucose leading to the formation of reactive oxygen species, advanced glycation end‐products produced by nonenzymatic glycation of proteins, inappropriate activation of protein kinase C and a deficit of neurotrophic supports [4].