It is well recognized that many injecting drug users are poly-drug users. The intravenous use of Temazepam has become popular recently. In response to the ease of misuse, the pharmaceutical industry produced a formulation that would be as 'resistant' as possible to injecting. The preparation is a gel-filled formulation, one proprietary name being Temazepam Gelthix. General Practitioners have been encouraged to prescribe gel-filled capsules to potential drug misusers in order to reduce the harm Temazepam can cause by its misuse. This study of 23 Temazepam injectors shows that the group still find the gel-filled preparation readily injectable. It appears to be more problematic in causing medical complications including superficial thrombophlebitis, abscesses and deep venous thrombosis. Temazepam misuse can cause drug users to become more chaotic. The study group recognize this and suggest there should be stricter control on the supply of Temazepam to drug dependents. General Practitioners, who are the main source of Temazepam prescribing, require additional training in prescribing to drug users.
Aims-To evaluate a commercial polymerase chain reaction (PCR) kit for the detection of Chlamydia trachomatis. Methods-Two hundred and fifty seven genital specimens, which had been submitted in 2SP medium for chlamydial isolation and subsequently stored at -700C, were retrospectively examined by a commercial PCR kit which detects chlamydial plasmid DNA. Culture negative, PCR positive specimens were examined by immunofluorescence and an in-house major outer membrane protein (MOMP)-PCR. Results-All 49 specimens which were culture positive were also PCR positive. Another 14 specimens were also PCR positive. After resolution of these results by immunofluorescence and a PCR assay for MOMP the sensitivity for PCR was 98-4% and that of culture 79%. The specificities were 99 5% and 100%, respectively. Conclusions-This kit, which is highly sensitive and specific, is straightforward to use and has a built-in safeguard against cross contamination. The role of this test in the examination of routine genital specimens from patients with uncomplicated chlamydial infection is questionable due to its expense. It may have a place in the investigation of trachoma or infertility, however, where it has been shown that DNA can be detected when culture is unsuccessful.
The Government of the United Kingdom has produced a strategic plan called the Health of the Nation aimed at achieving better health in key areas including a reduction in rates of unwanted pregnancies, sexually transmitted diseases and cervical cancer. Conventional health care systems fail some groups with special needs. This cross-sectional interview study was undertaken to determine the level and type of contraceptive use, and the attitudes of female opiate abusers to the use and availability of contraceptives and cytology services. The subjects were 201 opiate-dependent women enrolled in a methadone maintenance programme in a large drug dependency unit: 169 (84.5%) were sexually active and 65 (44.2%) of non-pregnant sexually active women did not use a contraceptive method. Thirty-six (43.9%) of those using a contraceptive were using condoms, with which the majority were dissatisfied. Sixty-one (30.3%) had never had a cervical cytology smear and of those who had, 21.4% reported an abnormal result. The contraceptive practices and uptake of cervical screening services by the women studied are inadequate, reflecting poor use of conventional health care services. In addition to providing information on safer sexual practices, particularly promotion of condom use, we suggest that drug dependency units should expand their role to provide educational and preventative services to include aspects of women's health.
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