A study of 300 Malaysian women who were fitted with the Copper-7 intrauterine device is presented. Two per cent of the acceptors were nulliparous. Insertion was easy in 97-7% of the cases and the side effects were minimal. In a study of over 4,634 women-months a low cumulative expulsion rate, at 12 and 24 months of use, of 3-1 and 3-6 respectively, was observed. However, relatively high cumulative rates of pregnancy of 4-3 and 9-2 occurred at 12 and 24 months of use respectively. Out of a total of 19 pregnancies, in 12 cases the device was found to have descended, a finding not commonly reported. One woman experienced translocation of the device five months after insertion, and in this instance, the device was removed by laparotomy. The findings in this study and their implications are discussed.
The increase in menstrual blood loss associated with copper-bearing IUDs may cause or aggravate pre-existing anaemia. In order to evaluate this risk, 84 Malaysian women wearing copper-IUDs were studied longitudinally by means of serial measurements of blood haemoglobin concentration (Hb), serum iron (S/Fe) and transferrin saturation (T/S). The initial Hb was under 12 gm% in 33.7% of patients. The mean Hb showed no significant change up to 12 months while S/Fe fell significantly at the end of this time; the T/S was significantly reduced as early as 6 months post-insertion. There is a significant risk of anaemia following copper-IUD insertion, particularly with long-term usage. Progestogen-releasing IUDs may offer the most feasible solution to this problem in our local context since oral medication with iron or drugs to reduce menstrual blood loss is not practicable.
A case of perforation of the uterus by the Multiload CU250 Device is described. To date no perforation of the uterus by this device has been reported. The device was successfully removed under laparoscopic control.
Blood haemoglobin and serum ferritin levels were measured at the initial visit and 12 months following sterilization and IUD insertion. Ferritin levels were unaltered in Progestasert users after 12 months but haemoglobin values increased though not significantly. Ferritin levels fell in Multiload Cu 250 users and in sterilized women; haemoglobin levels were also observed to fall but significantly only in the latter group. Iron-deficiency anaemia was prevalent at initial contact and there appeared to be an increased risk subsequently in Multiload Cu 250 users and in those who were sterilized. Screening and monitoring for anaemia is indicated. From the viewpoint of iron status, the Progestasert is preferable to the Multiload Cu 250 but it suffers the major disadvantages of needing frequent replacement and of causing menstrual disturbances which might compromise its acceptability. Menstrual blood loss studies may help explain why anaemia develops after sterilization.
A simple atomic-absorption spectrophotometry method is described for the determination of silver, bismuth, cadmium, copper, iron, nickel and zinc in lead- and tin-base solders and white-metal bearing alloys, with use of a single sample solution. The sample is dissolved in a mixture of hydrobromic acid and bromine, then fumed with sulphuric acid. The lead sulphate is dissolved in concentrated hydrochloric acid. The method is particularly suitable for the determination of silver and bismuth, which are co-precipitated with lead sulphate. The other elements can also be determined after removal of the lead sulphate by filtration.
Ninety-nine samples of common Chinese medicines were purchased from Chinese medical shops in Singapore and Malaysia and analyzed for mercury, lead, copper, cadmium, cobalt, iron, and nickel. The majority of these medicines were manufactured in China, Hong Kong, and Malaysia. A few of them were of Singapore and Taiwan origin. Atomic absorption method (both flame and flameless) was used for the analyses. Mercury was found to be present in high concentrations in several of the medicines that were for oral consumption.
Eight-hundred patients recruited between September 1981 and December 1984 were admitted to a randomized prospective trial of the Nova T (NTCu200Ag) and Multiload 250 (MLCu250) IUDs. At the cut off date, 31 December 1986, 206 patients had completed the 4-year trial period, 379 had terminated before completion and 215 were in the fourth year of use. For the third and fourth years, the MLCu250 had a significantly lower accidental pregnancy rate (p less than 0.05).
Chemical forms of copper and lead in river water of the Linggi River Basin have been fractionated into ASV labile, moderately labile, slowly labile, and inert metal species, based on a previously proposed scheme. Free (hydrated) metal ions were identified by a potentiometric method using an ion selective electrode. Speciation results showed that the soluble copper and lead species occurred mainly in the moderately labile and slowly labile fractions. The speciation results are primarily interpreted in terms of organic interaction due to agricultural based and light industries, and urban discharges. The measured metal complexing capacity (MCC) of the samples reveals consistency of the results with the nature of the discharge. MCC correlates reasonably well with the value from the permanganate test on the river water. In general, the speciation pattern was found to be consistent with the findings of other workers.
A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed.
PIP: Previous studies have shown the users of intrauterine devices have a 4.4 times greater risk of pelvic inflammatory disease. This present study intends to categorize the distribution of microbes in cultures from different types of extracted copper intrauterine devices (IUCDs). Bacteriological studies of aerobic and anaerobic organisms were performed on the extracted IUCDs of 522 IUCD users; 480 wearing a Multiload Cu 250, 15 wearing a Copper T, 22 Lippes Loop and 5 a Copper 7. Cultures were negative in 46 (8.8%) IUCD cultures where 43 were Multiloads, Copper T (1) and Lippes Loop (2). 91.2% yielded bacterial growth and the commonest organisms isolated were Staphylococcus species, (23%), E.coli (9.6%) and Staphylococcus aureus (4.0%. Candida albicans, E.coli and Staphylococcus sp. were commonly isolated from Multiload, Copper T, Lippes Loop and Copper 7. Beta-hemolytic streptococci, Staphylococcus aureus and Candida sp. were frequently recovered from Multiload, Copper T and Lippes Loop. Only Multiload cultures yielded Bacillus, Streptococcus viridans, Klebsiella, Proteus, Enterobacter, Citrobacter diversus, Citrobacter freundii, Moraxella, Pseudomonas and Acinetobacter. One woman with complaint of PID yielded E.coli in her IUCD culture.
Adhesive bond strength studies for the tray adhesive of an addition vinyl polysiloxane (President) impression material were conducted with an acrylic resin, chromium-plated brass, and plastic trays. Tensile and shear stress studies were performed on the Instron Universal testing machine. Acrylic resin specimens roughened with 80-grit silicon carbide paper exhibited appreciably higher bond strengths compared with different types of tray material and methods of surface preparation.
A new lead(II) electrode has been constructed with poly(hydroxamic acid) (PHXA) as the active material and silicone rubber as the supporting material. The electrode gave near Nerstian response over the concentration range 4 x 10(-5)-1 x 10(-2)M lead(II). The detection limit of the electrode is approximately 4 x 10(-6)M and the electrode works well in the pH range 4.5-6.0. The response time was 50-120 sec over the whole concentration range and the electrode has a working life of at least 4 weeks. Iron(III) severely poisoned the electrode membrane. Nickel(II) and mercury(II) gave very strong interference compared to copper(II), silver(I), cobalt(II), sodium(I), potassium(I), zinc(II) and cadmium(II) which gave some or little interference. Values determined with atomic absorption (AAS) and a commercial lead(II) electrode were in good agreement with those measured with the lead(II) electrode reported here.