Drop Outs Research Articles

Menstrual Hygiene among School Girls in A Hilly Area of Bangladesh

Background: Menstrual hygiene is a matter that is not sufficiently acknowledged. Even though menstruation is a natural phenomena in a woman’s life, it is associated with misconceptions, malpractices and challenges among girls in developing countries. School drop outs are more frequent among girls after they have reached puberty and menstruation is increasingly recognized as a major factor for this. The aim of the study was to assess the situation of menstrual hygiene of adolescent girls in a hilly area of Bangladesh.
 Materials and methods: This was a cross-sectional study; convenient type of nonprobability sampling technique was applied. The study was performed in Khagrachari Technical School and College and Khagrachari Government Women College among 300 students.
 Results: Out of 300 adolescent girls studied, the majority was between 16 to 18 years of age. The mean age of menarche in this study subjects was 12.96±1.214 years. Majority (72%) of the adolescents had no idea about menstruation before menarche. One hundred twenty six (42%) girls used sanitary pads during menstruation. In cases of reused cloth, 89 (51.2%) girls dried them outside the house in proper sunlight, 32 (18.4%) girls dried them inside the house hidden under cloths, and 36 (20.6%) girls dried them outside the house but hidden under cloths. Around 264 (88%) girls faced different restrictions during menstruation.
 Conclusion: Formulating Menstrual Hygiene Management (MHM) programs in the country can have an outcome of great interest. To accomplish this, multiple strategies need to be used such as educational session on reproductive health and menstrual hygiene in schools or by media campaigns.
 Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 47-51

The De-Gentrification of New Markets Tax Credits

"I am concerned and I am frustrated because I don't know what the alternates are...It clearly isn't racist; its economics. The real question you have to ask yourself is: Is this good orbad?"-Norman Rice, former Mayor of Seattle, On gentrification in that cityUrban America is in a state of crisis. A huge pool of America's resources is increasingly disconnected from mainstream society. That pool is within the core of major cities and particularly includes African American and Hispanic male youth. By way of illustration, more than half of all core city African American men do not finish high school. The correlation between drop-out rates, unemployment, and incarceration is profound. As of 2004, 72% of African American dropouts who are in their 20's are unemployed, up from 65% in 2000.s Incarceration levels are at historic highs and increasing, where by their mid-30's, 6 in 10 of these high school drop outs have spent time in prison. That rate is four times higher than that of Black men in South Africa under the apartheid regime. Seventy-five percent of African American males incarcerated in Baltimore Maryland did not graduate from high school. The infant mortality rate among all African Americans is more than twice the national average, and is much worse among the poor in the core of urban America. After the Katrina floodwatershave receded, some see an opportunity to buy low and sell high. But themuted voices of the poor cry to keep what they had.' For them it was aKatrina moment. For the urban core poor across the nation, it has been aKatrina erosion over the decades from a series of unnatural disasters.

Muscle oxygenation and time to task failure of submaximal holding and pulling isometric muscle actions and influence of intermittent voluntary muscle twitches

BackgroundIsometric muscle actions can be performed either by initiating the action, e.g., pulling on an immovable resistance (PIMA), or by reacting to an external load, e.g., holding a weight (HIMA). In the present study, it was mainly examined if these modalities could be differentiated by oxygenation variables as well as by time to task failure (TTF). Furthermore, it was analyzed if variables are changed by intermittent voluntary muscle twitches during weight holding (Twitch). It was assumed that twitches during a weight holding task change the character of the isometric muscle action from reacting (≙ HIMA) to acting (≙ PIMA).MethodsTwelve subjects (two drop outs) randomly performed two tasks (HIMA vs. PIMA or HIMA vs. Twitch, n = 5 each) with the elbow flexors at 60% of maximal torque maintained until muscle failure with each arm. Local capillary venous oxygen saturation (SvO2) and relative hemoglobin amount (rHb) were measured by light spectrometry.ResultsWithin subjects, no significant differences were found between tasks regarding the behavior of SvO2 and rHb, the slope and extent of deoxygenation (max. SvO2 decrease), SvO2 level at global rHb minimum, and time to SvO2 steady states. The TTF was significantly longer during Twitch and PIMA (incl. Twitch) compared to HIMA (p = 0.043 and 0.047, respectively). There was no substantial correlation between TTF and maximal deoxygenation independently of the task (r = − 0.13).ConclusionsHIMA and PIMA seem to have a similar microvascular oxygen and blood supply. The supply might be sufficient, which is expressed by homeostatic steady states of SvO2 in all trials and increases in rHb in most of the trials. Intermittent voluntary muscle twitches might not serve as a further support but extend the TTF. A changed neuromuscular control is discussed as possible explanation.

Implementation of Health Belief Models (HBM) Education for Tuberculosis patients at the Tamansari Primary Health Care, Tasikmalaya City

Tuberculosis (TB) is an infectious disease that continues to increase not only nationally but also globally. Tuberculosis is a problem for sufferers both physically and psychologically, it can even cause negative stigma from themselves and society, so the disease affects the quality of life of the sufferer. Tuberculosis treatment that is long enough and requires compliance can cause susceptible to drop out (DO), finally will increase the risk of cases of Multi Drug Resistance (MDR). The role of nurses is needed in ensuring tuberculosis patient adherence in treatment. Patient will be understand that tuberculosis is important in the treatment process. Education is a strategy in increasing patient understanding to change positive behavior for tuberculosis sufferers. The aim of this community service is to implement Health Belief Models (HBM) Education in Tuberculosis patients. This method used lectures, interviews and practice. The results found that the implementation of HBM on 19 patients who visited Tamansari primary health care for 3 months showed a significant result in behavior and quality of life. HBM education can change the quality of life of tuberculosis sufferers by changing perceptions of the disease which includes perceptions of vulnerability, perception of severity, perceived benefits, perceptions of barriers and a person's belief in healthy behavior. It is recommended that HBM education should continue to be implemented for tuberculosis sufferers so that they can maintain their survival.

Relationship of age and family factors with academic performance outcome of students getting higher education.

Introduction: Acquiring higher education has changed its dynamics since the beginning of this century. Covid-19 has added its transformation of remote learning, another dimension of distance learning. At this stage a number of factors seem to be responsible for continued higher education minimizing the chanced of drop outs. At the same time several factors have their impact on performance outcome. In this study we have tried to find the impact of these factors on performance outcome of the students getting higher education.
 Objectives: To assess the relationship of age and family factors on academic performance output of students getting higher education.
 Methodology: This cross-sectional study was conducted between January 4 – April 2, 2021. During this period 216 students; of either gender; getting higher education in institutes recognized by higher education commission were selected through cluster sampling. Students were approached through personal contact, email or WhatsApp.
 Results: The study shows that gender, age and income status have a positive association with CGPA while degree enrolled in, source of Income, marital status and no of children shows a negative relationship with CGPA. Results also shows that age, degree enrolled in, marital status and income have significant relationship ( p= <0.05)with CGPA; while gender, no of children, and source of income have insignificant association ( p= > 0.05)
 Conclusion: Gender, Age and Income Status have a positive association with good CGPA
 Keywords: Academic performance, Higher Education, HEC recognized institutes

A pilot randomised control trial of the efficacy of stability-based training with visualisation for people with chronic ankle instability

Chronic ankle instability (CAI) is associated with recurring symptoms that inhibit daily activity. Stability-based rehabilitative training is recommended for CAI. Visualisation (VIS) produces real-time feedback using motion capture and virtual reality. This pilot study aimed to determine the feasibility, adherence, safety, and efficacy of incorporating VIS into stability training for people with CAI. Efficacy was examined through effect of VIS training on dynamic stability, perception of stability, and rehabilitative experience. Individuals with CAI completed a 4-week stability-based training programme with VIS, or without visualisation (NO-VIS). Participants completed the Star Excursion Balance Test (SEBT) and Cumberland Ankle Instability Tool (CAIT) prior to, and after training. Enjoyment of training was recorded using the Physical Activity Enjoyment Scale (PACES-8). Of 17 participants (VIS = 10, NO-VIS = 7), there were 2 drop outs (VIS = 1, NO-VIS = 1). No adverse events were reported, and participant drop-out was due to injury unrelated to the study. The VIS group showed a significantly greater increase in average SEBT reach distance (d = 1.7, p = 0.02). No significant differences were reported for the CAIT or PACES-8. This study supports the feasibility and safety of stability-based training with VIS in those with CAI. The enhanced performance outcome on the SEBT suggests VIS may enhance stability-based training.Graphical abstract

Functional predictors of treatment induced diabetic neuropathy (TIND): a prospective pilot study using clinical and neurophysiological functional tests

BackgroundA treatment-induced drop in HbA1c has been suggested to be a risk factor for TIND.MethodsFrom 60 included patients with severe diabetes mellitus (HbA1c over 8.5) only 21 patients adhered to the study protocol over 1 year with a battery of autonomic nervous system tests scheduled before and after starting antidiabetic treatment.ResultsIn patients with a drop of HbA1c greater than 2 per cent points only some neurophysiologic tests and lab values tended to deteriorate with a trend to improve at later time points along the study. None of these changes were statistically significant, most likely because the study failed to reach the planned number of patients.ConclusionPoor adherence to diabetes treatment and to following the study protocol were the assumed obstacles in our patient cohort selected for very high HbA1c levels. In future studies a multi-center trial and case numbers of up to 500 patients may be needed to account for drop outs in the range observed here. Moreover, the number of tests in each patient at each visit may have to be reduced and special educational group sessions are warranted to cope with the limited adherence.Trial registration Ethic Committee University of Leipzig 439/15-ek. Registered 22 April 2016

Completion and attrition of DNP students of the 2006-2015 matriculating cohorts

BackgroundDespite the strong support for DNP education, we have limited knowledge about completion and attrition of DNP students, which are important measures of achievement of DNP programs. PurposeTo examine completion and attrition of students in DNP programs. MethodsThe data were obtained from AACN's Doctoral Student Roster Survey and Annual Survey of Baccalaureate and Graduate Programs in Nursing. 31,320 students who matriculated into DNP programs between 2006 and 2015 were selected. These years were chosen to ensure accurate estimates of graduation and attrition rates. Bivariate and multivariate analyses were used to examine the associations between individual and institutional characteristics and attrition of DNP students. FindingsWe found that the completion rate of DNP students of the 2006-2015 matriculating cohorts was 77.3% and the attrition rate was 19.3%. On average, after matriculation, it took 3 years for the students to graduate and 1.9 years for students who left without graduating to drop out. The mean age at matriculation was 39.9 and the mean age at graduation was 42.2. Our multivariate analysis found that male students, part-time students, students who were not faculty or held a part-time faculty position, and students in DNP programs with more than 50% of courses taught online were more likely to experience attrition. DiscussionThe study findings provide useful information for DNP programs and nursing schools to better understand academic progression of DNP students.

Correlates of COVID-19 vaccination drop-out among health care workers in a tertiary Care hospital of West Bengal

The Government of India launched “COVID-19 vaccination drive” on 16th January, 2021 and health care workers were the first to be prioritised for vaccination. However, the uncertainty regarding safety and efficacy of the vaccine was the major concern amongst them. These led to vaccine hesitancy and ultimately drop out.To estimate the proportion of drop out of COVID-19 vaccination among vaccine-hesitant health care workers (HCWs) of a tertiary care hospital and to find out their perception and other background characteristics responsible for drop out. A facility based descriptive type of observational study, cross-sectional in design was carried out among 329 HCWs of a tertiary care hospital in Kolkata from 16th March- 12thApril, 2021using a pre-designed, pre-tested, structured questionnaire. The study population selected by simple random sampling technique. Data was analysed using Microsoft Excel 2010 and SPSS v25.0 in the form of descriptive statistics and binary logistic regression. About 44.1% of the study population didn’t take the COVID-19 vaccine. Socio-demographic factors like age, gender, religion, education, occupation,perception regarding necessity of vaccination, vaccine efficacy, dose and contraindication, safety in humans and role in future infections were significantly associated with drop out. There was a high proportion of vaccine drop out among health care workers. Different modifiable perceptions with socio-demographic factors had played important roles in COVID-19 vaccination drop out. As the global threat of COVID-19 continues, greater efforts through campaigns that target HCWs are needed to improve the intention of professionals’ vaccine acceptance.

Advancing QuantCrit to Rethink the School-to-Prison Pipeline for Latinx and Black Youth

Latinx and Black youth are pushed out of school at a higher than average rate of 7.7% and 5.5%, respectively, compared to 4.1% of White youth. By “pushed out” we are referring to students who are labeled as “drop outs.” This language shift is important, as, “dropout” implies a choice made by students to leave school while “pushout” accounts for the various forces that lead to students leaving school. One factor that contributes to this alarming statistic is that harsh school punishment disproportionately affects racial and ethnic minority students in urban settings, rather than making school more accessible for them. Using data from the California Department of Justice and the Civil Rights Data Collection repository, we provide a descriptive analysis of the school-toprison pipeline in Southern California. This description is based on two innovative critical race methodologies: QuantCrit (quantitative) and Counterstorytelling (qualitative). These methodologies illuminate the experiences of thirty-nine former high school students who were pushed out of high school through the activity of counter-storytelling, these former high school students speak and remember how racism, sexism, and classism manifested in their schooling experiences. This study shows how to use QuantCrit and counter-storytelling in criminal justice education.

Dropout rates and its correlates among the elderly patients attending a community health center

Aim: The current study aimed to evaluate the dropout rates and the reasons for dropouts among elderly patients presenting with mental health problems to a community health centre. Methodology: This naturalistic, longitudinal, follow-up study was carried out in the Outpatient Setting of a community health centre in North India. The study included 169 patients, aged ≥ 60 years diagnosed with mental health problems. They were assessed at the baseline and then followed for a period of 1 year. Those who dropped out from the outpatient clinic were contacted over the phone to evaluate the reasons for dropout from treatment. Results: The mean age of the participants was 67.6 years and the mean number of years of education was 2.9. Most of the patients were female, married, Hindu, unemployed, from lower socioeconomic status, and non-nuclear families. The most common diagnosis was that of depression (42.6%), and this was followed by somatoform disorder (11.2%). The mean age of onset of psychiatric disorder was 62.2 years, with a mean duration of illness being 30.3 months. Nearly half (53.3%) of the patients dropped out of treatment after their first visit and 90% dropped out by 1 year. Overall the most common reason of drop out was complete relief of symptoms, and this was followed by the presence of family problems, and farming-related work. Among the very early drop out (never returned to clinic after the first visit) the most common reason for dropout was complete relief in symptoms, followed by inability to follow up due to family problems, no relief in symptoms, and farming-related work. Among those who dropped out within 6 months, the most common reason was complete relief of symptoms followed by lack of time due to personal reasons. When the reason for “late” dropout (dropout between 6 to 12 months) was evaluated, the most common reason was complete relief of symptoms followed by an inability to follow up due to problems in the family. Conclusion: A significant number of elderly patients with mental health-related problems drop out of treatment prematurely. Psychoeducation about the illness, outcome, and course of illness should be done at each step, and prevailing psychosocial issues need to be evaluated to reduce the rate of dropout among elderly patients with mental health-related problems attending the community health centre.

Symposium

Covid pandemic created a global challenge to all the sectors. In order to prevent the infection, government implemented lockdown, which extensively restricted the public life. Quarantine, Lockdown and lack of proper treatment guidelines created many psychological and behavioral issues among the people especially children. Many children complained of depression, panic disorder and PTSD like symptoms and school drop outs were also increased in the current pandemic. Unexplained somatic complaints, poor social communication, Irregular sleep patterns and nocturnal enuresis are the alarming signals for psychological and behavioural issues among the children. Earlier literature mainly dealt with psychological issues due to pandemic among adults but limited research and literature is available regarding the impact of pandemic on behavioral issues among school children on which the current symposium focuses

COVID -19 Pandemic: A Review Article

Corona virus infection is caused by a virus of COVID- 19 strain. this infection is spread by close contact with infected person and mainly due to droplets, this virus may remain alive on surfaces which was touched by an infected person .so to stop its spread it was necessary to reduce human contact, for that all countries around the world including India declared complete of all places where mass people gatherings were happens. WHO announced Covid- 19 infection as a global pandemic and this was a global emergency required complete lockdown. This necessary lockdown was for stoppage of infection spread but it also impacted very badly on every individual’s lifestyle.
 Conclusion: PHC are the easily assessable and cost friendly for rural peoples but during this pandemic situation these PHC are not prepared for facing COVID -19 pandemic. Due to less accessibility to media and less media coverage exact situation in rural areas was not stated properly also less knowledge in rural peoples about COVID -19 infection was reason of high risk of spread of infection amongst them. Children in rural areas who are economically not that much well can’t get access to internet and cannot afford the mobile or laptops for online education this made the chances of drop outs in these children. During lockdown due to pandemic all the farmers and small shop holders faced huge loss ,this was the period of great earnings from various rabi crops but due to shortage of labor and non-availability of various machineries delay harvest and this lead to huge loss for farmers.

Study of Potential Classification of Lost Students in College Based on Information Extraction on Text-Based Social Media; Case Study of Panca Budi Pembangunan University

The main problem studied in this study is the large number of lost students who harm universities because of the difficulty of monitoring or monitoring as a preventive measure. Therefore, this research becomes very important to be done so that college institutions can make efforts to detect early (classification) of students who potentially cannot complete their studies on time or students who will drop out (DO). Thus, PT institutions through related parties such as academic guidance lecturers, academic bureaus and others can do initial prevention by providing the best solution or solution to the problems faced by students. This research aims to determine the training data model consisting of academic and non-academic factors (including the results of extracting information from social media). Furthermore, this model is used as a basis for classifying students who have the potential to "graduate on time", "graduate not on time", and "DO". The method approach used is quantitative with text mining computational algorithms for the process of extracting knowledge / information from social media which is further used in data training, as well as data mining computational algorithms for the process of classification of potential completion of student studies. The mandatory external targeted in the first year is the publication of the international journal Scopus Q4 and in the second year is the publication of the international journal Scopus Q3. For additional external targets in the first and second years respectively are the publication of international journals indexed on reputable indexers, ISBN teaching books and copyrights. The level of technological readiness (TKT) in this study up to level 2 is the formulation of technological concepts and applications to classify the potential completion of student studies using data mining. Keywords: [student lost, knowledge/information extraction, data classification, text mining, data mining].

Abstract 11331: Economic and Social Challenges Faced by People Living with Rheumatic Heart Disease in a Resource Limited Setting

Introduction: Rheumatic heart disease (RHD) has nearly been eradicated in wealthy nations but remains a significant public health concern in low-resource countries like Uganda. Many people living with RHD (PLWRHD) is these settings have not been diagnosed and many who are diagnosed have late-stage disease. Objectives: To explore the social and economic challenges faced by PLWRHD in a resource limited setting. Methods: This was a qualitative study. We conducted in depth interviews on a sample of 36 RHD patients randomly selected from a computer-generated list from RHD registries in the Northern, Central, and South-western regions. The selected participants were interviewed by trained qualitative research staff. All interviews were tape recorded and transcribed verbatim. Data were analyzed by thematic content analysis and useful codes were generated by both inductive and deductive approaches. Generated codes were collapsed into themes. Coding was done by 3 independent researchers who compared their results and agreed on one codebook which was updated iteratively. Results: Of the 36 interviewed participants, 18 had congestive heart and another 18 had no congestive heart failure, a complication of RHD. Economic challenges faced by PLWRHD included financial burdens to family, debts incurred to meet treatment costs, selling off assets and loss of jobs. Social challenges entailed poor support at schools for RHD patients, school drop outs, family instability, poor social relations and poor community perception of RHD. Conclusion: Understanding challenges faced will enable designing of interventions that improve the quality of life of PLWRHD and significantly influence future policies on RHD management.

Enlightening the Brahmamudra- As Per Yogmimansa in Management of Manyastambh w.s.r. to Cervical Spondylosis

Cervical spondylosis (CS) is a degenerative and age-related condition affecting neck joints. It is also known as cervical osteoporosis. This is usually found in men and women at the age of 40 years or above. The aim of present study to reduces the symptoms and increases in functional activities of elderly patients with spondylosis before and after Bramhamudra.(Yoga posture) In this clinical study, total 30 patients were enrolled. All patients were treated on Brahmamudra fallowed by micro exercise and diet on the day of enrollment and after 30 day with the schedule as 0th 7th 15th 30th day fallow up. There is no drop out. Clinical assessment done on day 1st and 30th day of fallow up, shows results of improvement in all the assessment criteria in neck region. Neck pain and the symptoms was assessed examination (X-ray, MRI) by symptomatic score used by VAS (Visual analog scale), physical examination through ROM (range of movement), cervical disability score questionnaire, radiological and examination by pathological test (uric acid, ESR, RA factor, BMD in the patient willing to do) on the day of enrollment. Then after fallow up the neck pain was examination by symptomatic score used by VAS, physical examination through ROM, cervical disability score questionnaire (radiological and examination by pathological test if required). In conclusion, a combination of Yoga with diet control is found to be effective in reducing pain, and facilitating improvement in functional status of elderly people suffering from CS.

Reporting of Adverse Events in Randomized Controlled Trials of Therapeutic Exercise for Hip Osteoarthritis: A Systematic Review.

The purpose of this study was to describe adverse events (AEs) and dropouts (DOs) in randomized controlled trials of therapeutic exercise for hip osteoarthritis (HOA) and to identify whether Consolidated Standards of Reporting Trials (CONSORT) guidelines were followed. The Cochrane Library, Embase, PubMed, and CINAHL databases were searched. Randomized controlled trials of therapeutic exercise for HOA published in English from January 1, 1980 to August 1, 2020 were included. Studies were excluded if other interventions were provided, if participants had previous hip arthroplasty, or if AEs and DOs for HOA participants were not reported separately. The internal validity of each study (Physiotherapy Evidence Database [PEDro] scoring) was assessed, participant and intervention characteristics were extracted, and the existence of a clear statement and reasons for AEs and DOs was reported. Descriptive statistics characterized results. Data heterogeneity prohibited the use of meta-analysis. Fourteen studies (mean PEDro score = 7.4; range = 6-10) from 10 countries were included, with 707 participants exercising. Exercise intensity was unspecified in 72.2% of exercise arms. Six studies (42.9%) included a statement of AEs, and 32 AEs were reported. All studies had a DO statement, but 29.0% of DOs occurred for unknown reasons. Six studies (42.9%) gave reasons for DOs that could be classified as AEs in 9 participants; 41 participants (5.8%) experienced exercise-related AEs. Reports of AEs were inconsistent, some DOs were potentially misclassified, and primary components of exercise interventions were frequently unreported. Despite these limitations, the overall low number of nonserious AEs suggests that the exercise-related risk of harm is minimal for individuals with HOA. Understanding the risk of harm associated with exercise for HOA can better inform safe dosing of exercise, clinical implementation, and replicability. Informative, consistent reporting of AEs, DOs, and exercise is needed. Greater use of the CONSORT harms-reporting checklist is warranted.

Comparison of Efficacy and Safety of Sitagliptin and Glimepiride in Treatment of Type 2 Diabetes Mellitus

Objective: To compare the efficacy and safety of sitagliptin and glimepiride in treatment of type 2 diabetes mellitus. Design: It was an observational open comparative study. Study Settings: This study was conducted at Department of Pharmacology over 1 year from March 2017 to March 2018 at DHQ Teaching Hospital, Kohat. Material and Methods: Sixty (60) patients were enrolled in the study meeting the inclusion criteria. Tablet glimipiride 1 mg and sitagliptin 100 mg was used as the treatment option. Patients were randomly divided into two groups: group Glimepiride (30 patients; administered glimepiride 2 mg daily) and group Sitagliptin (30 patients; administered sitagliptin 100 mg daily). If glycemic control was not reached then patient was excluded from the study and given further treatment for benefit of the patient. The samples of blood were taken at 12 weeks visit to test HbA1c level, fating blood sugar (FBG) and post prandial glucose (PPG) level. At the time of follow up patient were evaluated for efficacy, safety and tolerability. All collected data was entered then analysed in SPSS version 19.0. Results: A total of 60 patients were enrolled into the study, with 30 in each group. Mean age in sitagliptin group (A) was 45 years, while that of glimeperide group (B) was 47 years. There were 16 males and 14 females in group A, 18 males and 12 females in group B. We found a significant reduction of HbA1C and BMI in group S taking sitagliptin as compared to glimeperide group. (p<0.05) Reduction in FBS was comparable in both the groups. (p>0.05). Side effects in both the groups mostly included hypoglycemia, and vomiting, nausea and abdominal pain. These side effects were mild and did not need stoppage of medication or resulted in drop outs. Conclusion: Sitagliptin as an adjunct to present monotherapy with metformin showed significant drop out in HbA1c, PPG and FBG values after treatment of 12 weeks and was non inferior to glimepiride. However, no sitagliptin taking patients observed any episodes of hypoglycemia. Also weight loss was observed in sitagliptin group as compared to glimepiride group.. Keywords: Glimepiride, Sitagliptin, Efficacy, Safety, Type 2 Diabetes Mellitus

Tele-Yoga in Long Term Illness–Protocol for a Randomised Controlled Trial Including a Process Evaluation and Results from a Pilot Study

Background: For people with long-term illness, debilitated by severe symptoms, it can be difficult to attend regular yoga classes. We have therefore developed a tele-health format of yoga that can be delivered in the home. The tele-yoga was co-designed with members of a patient-organisation, yoga-instructor, and IT-technician. It includes live-streamed group-yoga sessions twice a week and an app with instructions on how to self-perform yoga. Aim: To describe a study protocol for a randomised controlled trial (RCT) including a process evaluation and report on a pilot study evaluating method- and intervention-related components including feasibility, safety, and efficacy. Methods: Ten participants with heart failure aged between 41–76 years were randomised to tele-yoga (n = 5) or to the control group (n = 5). In the pilot study recruitment, enrolment, randomisation, and data collection of all outcomes including primary, secondary and process evaluation measures were tested according to the study protocol. Fidelity, adherence and acceptability to the tele-yoga group training and app use was determined. Safety was assessed by adverse events. Results: The pilot revealed that the methodological aspect of the protocol worked sufficiently in all aspects except for missing data in the physical test of two participants and one participant in the control-group that dropped out of the study at three months follow-up. The tele-yoga training did not lead to any adverse events or injuries, adherence of tele-yoga was sufficient according to preset limits. The tele-yoga intervention also showed some favourable trends of improvements in the composite-end point compared to the active control group. However, since data only was presented descriptively due to the small sample size, the impact of these trends should be interpreted carefully. Conclusion: Our pilot study showed promising results in feasibility, safety, and acceptability of the tele-yoga intervention. Some changes in the protocol have been made to decrease the risk of missing data in the measures of physical function and in the full-scale RCT now ongoing the results of the sample size calculation for 300 participants have included the estimated level of drop outs and missing data.

Feasibility of Interdigitation of Intracavitary High Dose Rate Brachytherapy for Locally Advanced Carcinoma Cervix in the Era of Concurrent Chemoradiation

The detrimental effect of treatment prolongation in patients of cervical cancer receiving radiotherapy alone is well established. However, the impact of overall treatment time (OTT) in patients with locally advanced disease treated with concurrent chemo-radiotherapy and high dose rate brachytherapy (BT) has not been adequately addressed. Aim of the present study (1) assess the feasibility of reducing the OTT to 5 weeks by interdigitating BT with external beam radiotherapy (EBRT) (2) compare loco-regional control and toxicities of interdigitated BT with conventional sequential BT.The prospective study involved 40 patients of cancer cervix who met the inclusion and exclusion criteria. They were randomized into study and control arms. All the patients received EBRT (45 Gy/20 fractions over 4 weeks) with concurrent weekly Cisplatin@40mg/m2 and 3 fractions of high dose rate BT (7 Gy/fraction to Point A, interval of 1 week between 2 fractions). Patients in the control arm received BT after a gap of one week following EBRT completion where three fractions of BT were delivered weekly to complete the entire treatment in 7 weeks. In the study arm, BT was initiated on 20th day after 15 fractions of EBRT i.e., 33.75 Gy. These patients received subsequent BT fractions on days 27 and 34 to complete the treatment in 5 weeks. Both the groups were compared in terms of OTT, loco-regional control and normal tissue toxicities.A total of 36 patients completed the planned treatment. There was significant difference in the OTT in study arm and control arm; 36.7 ± 3 days and 52.5 ± 5 days, respectively (P = 0.001). The mean biologically equivalent dose (BED10Gy) and Equivalent dose in 2 Gy fractions (EQD2) was also significantly higher in the study arm after appropriate correction for accelerated repopulation (P = 0.001 for both). However no significant difference was found at nine months follow up in terms of local control, 94.1% patients in the study arm had complete response as compared to 89.5% patients in the control arm (P = 0.615). The overall rate of toxicity, though numerically higher in study arm, was not statistically significant.A shorter treatment schedule of 5 weeks by interdigitating BT during EBRT appears to be a feasible and radiobiologically superior option to achieve a possibly better local control of disease with acceptable toxicities in comparison to sequential brachytherapy following EBRT. Additionally, patient compliance might be better with shorter treatment duration with fewer drop outs along with decreased health care cost and machine occupancy.S. Singh: None. U. Shahi: None. L.M. Aggarwal: None. S. Choudhury: None. S. Pal: None. A. Pandey: None.