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Indian Journal of Medical Research. October 1978; 68(Suppl):80-87.Cross-sectional and longitudinal studies were made to assess vitamin nutritional status of women using oral contraceptives (OCs). In the cross-sectional study, data obtained on 20 women, who had used Ovulen 50 for 6-12 months, were compared with data obtained on matched controls who had never used OCs. In the longitudinal study, 23 women were examined initially (before OC use) and again at 1 or more points during the next 6 months of OC use. Changes were found in several parameters of nutrition tested. 1) OC use produced a highly significant rise in plasma vitamin A within 1 month of treatment. 2) Thiamine activity measurements showed a slight fall, but did not affect the TPP effect, suggesting that OCs did not seriously alter thiamine status. 3) Erythrocyte riboflavin concentration showed a fall, revealing a very high incidence (> 80%) of biochemical riboflavin deficiency in women before starting OCs which was further reduced after treatment. 4) There was a marked rise in urinary excretion of xanthuremic and kynurenic acids after a standard tryptophan load, indicating impaired tryptophan metabolism due to pyridoxine deficiency. 5) Erythrocyte folate levels showed a small but significant fall. These observations on Indian women belonging to low income groups show clearly that OC use does affect the vitamin economy of the body adversely. Biochemical evidence presented argues that OCs alter vitamin economy through rise in levels of some proteins which bind vitamins. Vitamin supplements are recommended not only for patient benefit but for program acceptability.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1982 Dec 10; 57(49):381-4.In view of reports of resistance of the Malaria parasite Plasmodium falciparum in localities in East Africa to the prophylactic drug chloroquine, the WHO has made medium-term recommendations for drug suppression, pending a thorough review. There are 3 types of drugs available for malaria suppression: the dihydrofolate reductase inhibitors (DHFR), the 4-amino-quinolines (chloroquine and amodiaquine), and the dihydropteroate synthetase inhibitors (DHPS). The DHPS drugs, proguanil, pyrimethamine or others, are no longer considered adequate used alone. The DHPS drugs Fansidar and Maloprim are already being used in part of South America and East Asia where the M. falciparum has become chloroquine resistant. Recommendations for prophylaxis in Africa depend on the type of risk. Non-immune travellers should take chloroquine or amodiaquine 300 mg weekly and carry a treatment course of sulfadoxine-pyrimethamine in case of fever. The triple drug regimen is not advised because of chance of selection of resistant malaria parasites. Non-immune residents may take chloroquine as recommended for a total of 6.5 years. Those residing longer should take preventive measures against mosquito bites and use treatment if affected. Among semi-immune residents, only pregnant women past the 4th month should take chloroquine, and if infected use quinine or antibiotics (not tetracycline). Special at-risk groups such as army units should rely on preventive measures to reduce selection of resistant parasites.