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If less than 21 days postpartum and not breastfeeding, she can start POPs at any time. If she is more than 21 days postpartum and her menstrual cycles have not returned, she can start POPs at any time, if it is reasonably certain she is not pregnant. She will need to abstain from sex or use additional contraceptive protection for the next 2 days. If she is post-abortion, she can start immediately and no additional contraception needed. SWITCHING FROM OTHER METHODS 1. Switching from hormonal methodsShe can start POPs immediately if she has been using another hormonal method consistently and correctly and it is certain she is not pregnant. If her previous method was injectable Depo, she could start POPs when the repeat injection would have been given. No additional contraception is needed. 2. Switching from non hormonal methods including an IUCDIf she is switching from an IUCD, she can start POPs within 5 days of the start of her menstrual bleeding. No additional protection is needed. The IUCD can be removed at that time. She can also start at any other time, if it is reasonably certain she is not pregnant. If she has been sexually active and it is more than 5 days since menstrual bleeding started, it is recommended that the IUCD be taken out at the time of her next menstrual bleeding. What to do if she has missed pills: If the client missed 1 pill, take it as soon as she remembers. If 3 or more hours late in taking the pill, abstain from sex or use a backup method for the next 2 days. If 2 or more pills are missed in a row, start the backup method. Restart the pills right away. If the menstrual period does not start within 4 to 6 weeks, see a Medical Officer for an examination and a pregnancy test. What to do if she has problems: If there are spotting or bleeding between periods, keep taking the pills on schedule. If bleeding is heavy, consult a medical officer. If vomiting or diarrhoea, use the backup method along with the pills until 48 hours after the illness subsides and continue to take the pill. If vomiting within 2 hours of taking active pills, repeat the pill. ADVANTAGES: * There is no age restriction because the POP contains no oestrogen that may have adverse effects on the cardiovascular system of older women. 50. References: 1 ; Vento S, Garofano T, Renzini C, et al. Fulminant hepatitis associated with hepatitis A virus infection in patients with chronic hepatitis C. N Engl J Med 1998; 338: 286. ; Vento S. Fulminant hepatitis associated with hepatitis A virus superinfection in patients with cronic hepatitis C. J Viral Hepat 2000; 7: 78 ISE.204 Reliability of Antibiogram and Plasmid Profiling in Detection of Epidemic Strains of Shigella Spp S.H. Farshad1, R. Sheikhi2, E. Basiri2, A. Alborzi1, A. Japoni1, M. Kalani1, J. Nasiri1. 1Prof. Alborzi Clinical Microbiology Research Center, Shiraz, Iran; 2Department of Microbiology, Medicine School, Shiraz University of Medical Sciences, Shiraz, Iran Background: Epidemiological investigations of Shigella members have been hampered by the lack of suitable markers for strain discrimination. The aim of this study was to investigate reliability of drug sensitivity patterns and plasmid profiles in discrimination of epidemic strains of Shigella spp. isolated from epidemics of bacillary dysentery in Iran. Methods: Eighty two Shigella strains isolated from OB + stools of patients during the period of May-Sep 2004 were investigated. Shigella, for instance, lotensin htc. Department of Surgery, Ogaki Municipal Hospital; Department of Surgery, Gifu Municipal Hospital; Department of Surgery, Kumiai Hospital; Department of Surgery, Ibi General Hospital; Department of Surgery, Toki General Municipal Hospital; Department of Surgery, National Matsumoto Hospital; Department of Surgery, Nagano Red Cross Hospital; Department of Surgery, Okaya Enrei Hospital; Department of Surgery, Komoro Kosei Hospital; Department of Surgery, Iida Municipal Hospital; Showa Inan Hospital; Department of Surgery, Nagano Chuo Hospital; Department of Surgery, Iiyama Red Cross Hospital; Department of Surgery, Nagano Prefectural Welfare Federation of Agricultural Cooperatives Hokushin General Hospital; Department of Surgery, Toyoshina Red Cross Hospital; The First Department of Surgery, Faculty of Medicine, Mie University; The Second Department of Surgery, Faculty of Medicine, Mie University; Department of Surgery, National Mie Chuo Hospital; Department of Surgery, Yamada Red Cross Hospital; Department of Surgery, Matsusaka Chuo General Hospital; Mie Prefectural Shima Hospital; Department of Surgery, Ise Municipal General Hospital; Department of Surgery, Yokkaichi Municipal Hospital; Department of Surgery, Matsusaka City Hospital; The Department of General Surgery, Suzuka General Hospital; Department of Surgery, Saiseikai Matsusaka General Hospital; Yamamoto General Hospital; Department of Surgery, Yokkaichi Social Insurance Hospital; First Department of Surgery, Hamamatsu University School of Medicine; Tosei National Hospital; Department of Surgery, Shizuoka General Hospital; Fukuroi Municipal Hospital; Yaizu City Hospital; Hamamatsu Medical Center; Fuji City General Hospital; Seirei mikatahara Hospital; Seirei Hamamatsu General Hospital; Ensyu General Hospital; Shizuoka Kosei General Hospital; Seirei Numazu Hospital; Fujinomiya City General Hospital; Second Department of Surgery, Toyama Medical and Pharmaceutical University; Kurobe City Hospital; Department of Surgery, Kouseiren Takaoka Hospital; Tonami General Hospital; Department of Surgery I ; , Kanazawa University School of Medicine; Department of Surgery II, Kanazawa University Hospital; Kanazawa Social Insurance Hospital; Kanazawa Social Insurance Hospital; Department of Surgery II, University of Fukui; Fukui Red Cross Hospital; Fukui Prefectural Hospital; First Department of Surgery, Faculty of Medicine, University of Fukui. 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Most opposition to embryonic stem cell research to date has been motivated primarily by concern with the moral status of the embryo. This emphasis has obscured a number of other important ethical issues raised by women's health advocates Norsigian, 2005 ; . Beyond the health concerns already discussed, the most immediate concerns include conflicts of interest pertaining to those promoting egg harvesting, the use of misleading and coercive language in promoting cloning research, and the exploitation of impoverished women both in the West and in less developed countries in the expanding global market for human eggs. Additional concerns about how focusing on embryo stem cells deflects resources from work to eliminate upstream causes of disease, and about the excessive costs public and private ; of these molecular approaches are serious and warrant attention, but are beyond the scope of this paper and lotrel.
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