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International Teva's International group includes Israel and all countries outside North America and Western Europe. Pharmaceutical sales in the International group were $346 million in the second quarter of 2007, an increase of approximately 26% over the comparable period of 2006, reflecting increased sales in the main three subregions within the International group: Latin America, Central and Eastern Europe CEE ; and Israel. Within the International group, growth was primarily driven by higher sales in Israel, Argentina, Venezuela, Russia, the Czech Republic and Brazil. These areas also benefited from the positive currency effects relative to the U.S. dollar. Teva generated approximately 6% of its total pharmaceutical sales in Latin America including Mexico ; , 4% in Israel, 4% in CEE and 1% in other countries. Innovative and Specialty Products Copaxone. During the second quarter of 2007, global in-market sales of Copaxone, Teva's leading innovative drug, totaled $436 million, an increase of 23% over the comparable period of 2006. This growth was driven by increased sales in both the U.S. and Europe, as well as increases in sales in markets outside those regions. The 24% growth in U.S. sales reflects unit growth as well as the effect of two price increases in the last 12 months: in January 2007 of 9.9% and in August 2006 of 4%. Non-U.S. in-market sales increased 23% to $151 million, primarily in Western Europe, where most of the increase was in unit growth primarily Germany, France and the U.K. ; . European growth was also significantly influenced by positive currency effects. Copaxone is sold through Sanofi-Aventis and its subsidiaries in most markets, and Teva records as revenues approximately half of the in-market sales of Copaxone sold by these entities. To date, Copaxone has been approved for marketing in 47 countries worldwide, including the U.S., Canada, Israel, 22 European Union countries, Switzerland, Australia, Russia, Mexico, Brazil and Argentina. Azilect. Total worldwide in-market sales of Azilect rasagiline tablets ; , a once-daily oral treatment for Parkinson's disease and Teva's second innovative drug, continued to grow, reflecting further acceptance in the U.S. and Europe. Global in-market sales in the second quarter reached $28 million compared to $6 million in the comparable period of 2006. Azilect is now available in 27 countries, including the U.S., Canada, Israel, 22 European Union countries, Switzerland and Turkey. Respiratory. Teva's global respiratory business enjoyed significantly increased sales in the U.S. of ProAirTM albuterol HFA ; , Teva's non-CFC respiratory inhaler product, as well as increased sales of Teva's non-CFC inhaler products in Europe, mainly in Italy, France and the U.K. In the U.S., the conversion from CFC based products to HFA based products progressed rapidly throughout the end of 2006 and early 2007. During the second quarter of 2007, continued marketing of CFC based products resulted in a slowdown of the conversion process. Nevertheless, non-CFC based products now constitute 53% of the market, with Teva's ProAir TM capturing over 60% of sales of non-CFC products. Teva has increased its production capacity for ProAir to meet the growing demand as the conversion from CFC to non-CFC based products continues. However, Teva anticipates increased competition in the HFA market as competitors begin to accelerate their production and marketing. Overall, global respiratory sales amounted to $181 million in the second quarter of 2007, an increase of 49% over the comparable period in 2006, with most of the growth coming from the U.S. Sales of Active Pharmaceutical Ingredients API ; API sales to third parties were $143 million in the second quarter of 2007, substantially similar to the second quarter of 2006. Total API sales, including internal sales to Teva's pharmaceutical businesses, were $334 million, a decrease of 6% compared to the same period of 2006. In the comparable quarter of 2006, API sales reflected mainly sales to Teva's pharmaceutical businesses in support of Teva's large finished dose product major launches in the subsequent quarters but also to third parties. In terms of volume, API sales in this quarter were 19 % higher than in the comparable quarter of 2006. Gross Profit Gross profit margin was 52.1% for the three months ended June 30, 2007, compared to 53.9% in the comparable period of 2006, which was exceptionally high due to the launches in the U.S. of simvastatin and pravastatin. The gross margins for the second quarter of 2006 would have been substantially higher but for the impact of a step-up of inventory values at Ivax following its acquisition by Teva, which had the effect of reducing gross profit by $31 million in the second quarter of 2006. The gross profit margin varies from quarter to quarter due to changes in the product and geographic mix. The principal factors that contributed to the relatively high gross profit margin in the second quarter of 2007, compared with the range of 47% to 50% indicated last year as Teva's normal gross margin range, were significant sales of products with exclusivity in the U.S., such as amlodipine besylate benazepril and oxycodone, increased sales of high-margin innovative - 16 and urecholine. NOTES: THE PAST, PRESENT AND FUTURE CHOICES IN CONTRACEPTION SGYN-2 ; Associate Professor Tony Krins Director O&G Services, Angliss Hospital, Victoria, Australia Human beings most of them ; invest an enormous amount of time, resources and energy in having children not to mention the risk to health, shape and wallet ; . This has meant that throughout human history, people have wished to control the timing and number of children that come along. Up until very recently in history, this has been extremely difficult. Humanity now has the help of gynaecologists, family doctors, endocrinologists and others to help in this aim. We as gynaecologists serve the United Nations Declaration that: "The right to decide freely and responsibly on the number and spacing of children if any ; , and the right to adequate information, education and services are Fundamental Human Rights to be granted to all persons." that is what we are about. In this presentation, we will review and evaluate what has been available in the past, is available now and what we can look forward to in the immediate future. The Past By our standards, the past had no satisfactory safe method of family planning. Some of the methods tried will be explored briefly and pioneers of family planning will be acknowledged. The Present The present and recent past have given us: 1. Intrauterine contraception. 2. Hormonal oral contraception. 3. Modern barrier methods. Advantages of some of these will be discussed. The Future The exciting future of contraception to be discussed will include: a. The best oral contraceptive pills ? Mercilon, ? Yasmin ; b. Progestagen only pill Cerazette ; c. Nuvaring d. Contraceptive implants Implanon ; . The development of more versatile laparoscopic instrumentation and the chargedcouplerdevice miniature cameras able to transmit high resolution images on a monitor enabled the surgeon and the operating theatre team to perform many of the surgeries traditionally done via a laparotomy to be completed laparoscopically. To answer the question as to whether myomectomies should be performed laparoscopically, one must first address the need for myomectomy in the first place. In order to relieve symptoms particularly menorrhagia and possibly pelvic pain and pressure symptoms, a myomectomy might be helpful. With regards fertility enhancement, there are no prospective randomized trials with appropriate controls to show the impact of myomectomy on fertility. As to whether fertility is affected by the presence of fibroids, this, still remains unanswered. Retrospective meta-analyses Vercellini 1998; Pritts 2001 ; have shown that, in the presence of submucous fibriods or a submucous extension of an intramural fibroid distorting the uterine cavity, clearly, there is definite evidence of decreased fertility and increased pregnancy wastage. This effect is apparent both in the subfertile patients as well as those women in whom assisted reproduction was undertaken Farhi etal 1995; Ramzi etal 1998 ; . Hence, hysteroscopic resection and transabdominal translaparoscopic myomectomy is indicated when performed to correct distortions of the uterine cavity Farhi etal 1995 ; . The extirpation of the uterine fibroid, a benign tumour, frequently found in a third of women in the reproductive age group, had been elegantly described by Victor Bonney nearly 50 years ago. The technique remained relatively unchanged till the recent advent of laparoscopic minimal access surgery. Dr Suresh Nair Gynecology Associates Women's Medical Centre, Mt Elizabeth Hospital, Singapore LAPAROSCOPIC MYOMECTOMY: SHOULD IT BE DONE? SGYN-3.

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