Oral Pills Research Articles

Is There An Advantage of Using Dingkun Pill () alone or in Combination with Diane-35 for Management of Polycystic Ovary Syndrome? A Randomized Controlled Trial.

To evaluate the effects of Chinese medicine Dingkun Pill () alone or in combination with Diane-35 on patients with polycystic ovary syndrome (PCOS). This is a prospective randomized controlled trial conducted at Peking Union Medical College Hospital Beijing, China, from December 2016 to September 2017. Totally 117 PCOS patients were randomly assigned to the Dingkun Pill group (38 cases), Diane-35 group (40 cases), or combined group (39 cases). Patients in the Dingkun Pill group or Diane-35 group took daily 7 g of oral Dingkun Pill or 1 tablet of oral Diane-35, respectively, for 21 consecutive days followed by 7 drug-free days. And the combined group received a combination of Dingkun Pill and Diane-35. The treatment course was 3 months. Fasting plasma glucose and insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), free fatty acids (FFA) and sex hormones were analyzed, quantitative insulin sensitivity check index (QUICKI) was calculated, and menstruation and acne scores were recorded at baseline and after 3-month treatment. Compared with before treatment, QUICKI decreased significantly in the Dingkun Pill and combined groups after 3-month treatment (P<0.05); TC, LDL-C and FFA decreased significantly in the Dingkun Pill group (P<0.01), LDL-C also decreased obviously in the Diane-35 group (P<0.01), while TC increased significantly in the combined group (P<0.01), TG increased significantly in all groups (P<0.01); total testosterone (TT) and menstruation regularity was improved significantly in the Diane-35 and combined groups (P<0.01); acne scores were improved in all groups (P<0.01). After treatment, TC and FFA in the Dingkun Pill group were significantly lower than the Diane-35 group (P<0.05 or P<0.01); TT was lower and regular menstruation rate was higher in the Diane-35 and combined groups than the Dingkun Pill group (P<0.01), and no differences were observed between Diane-35 group and combined group (P>0.05). Dingkun Pill showed better effects than Diane-35 in improving insulin sensitivity, lowering TC and FFA. Diane-35 was more efficient in regulating menstruation and lowering androgen than Dingkun Pill. Combination of Dingkun Pill and Diane-35 may be a better choice to regulate menstruation, lower androgens while improve glucose metabolism in PCOS patients. (Registered on ClinicalTrials.gov, registration No. NCT03264638).

Prevalence and factors associated with modern contraceptive use among women of reproductive age in 20 African countries: a large population-based study

ObjectiveTo assess the prevalence and factors associated with modern contraceptive (CP) use among women of the reproductive age.DesignCross-sectional study.SettingWe used data from the Multiple Indicator Cluster Surveys (MICSs) from 20...

TELEMEDICINE AND AT-HOME IVF KIT: NOVEL APPLICATION DURING THE COVID-19 PANDEMIC

During the COVID-19 pandemic, access to fertility has been difficult due to fear of contracting the virus. Many patients, especially those with diminished ovarian reserve (DOR), strongly desire to pursue their fertility treatments that include oocyte and/or embryo freezing for fertility preservation because it is a time-sensitive matter fearing the loss of all their ovarian reserve. Given this challenging situation and in order to minimize the repeated office visits for monitoring during an IVF cycle, we aimed to test the efficacy of a new modality for IVF treatment using telemedicine and a patented kit called At-HOME IVF kit. Large fertility clinic with university affiliation. A retrospective study assessed the outcome of using telemedicine with At-HOME IVF kit in patients who have DOR (n=22) based on previous history of poor ovarian response, previously documented low serum anti-Mullerian hormone (<1 ng/mL), elevated day 3 follicle-stimulating hormone (>10 mIU/mL), or low antral follicle count (<8). Patients desired either embryo (n=17) or oocyte (n=5) freezing. Telemedicine was used for consultation in order to reduce the total waiting time for seeking fertility treatment and to minimize office visits. The kit was mailed to the patient's home, contained no injectable medications and contained all the necessary medications needed for ovarian stimulation, ovulation suppression, and oocyte maturation trigger. The oral pills were clomid 100 mg taken from cycle day 3 until cycle day 11 and letrozole 5 mg taken from cycle day 3 until cycle day 7, the vaginal pill was the GnRH antagonist (Elagolix) 50 mg taken on cycle days 9 and 11, and nasal spray (lupron 30 IU) taken on cycle days 12 and 13. Oocyte retrieval was then performed on cycle day 14. Each patient took the medications included in the kit without office visits for monitoring and presented only on the day of the oocyte retrieval. The main outcome included the number of oocytes and embryos (cleavage-stage or blastocyst-stage) cryopreserved. Because of the COVID-19 pandemic, embryo transfer was not currently recommended or performed. Data are presented as mean ± sem. The mean age of the participants was 39.9 ± 0.9 years. Upon presentation on the day of oocyte retrieval, blood hormonal testing and transvaginal ultrasound showed that none of the patients had ovulated and that all patients had appropriate ovarian stimulation response with the number of mature follicles (>18mm) up to 8 (3.3 ± 0.4). All patients underwent oocyte retrieval with 21 out of 22 patients having up to 8 mature oocytes collected (2.4 ± 0.4). Ten out of 17 patients who underwent IVF had up to 4 embryos cryopreserved at either the cleavage-stage or blastocyst stage. During the global health emergency and current/future pandemics due to a highly transmissible infectious organism, oocyte and embryo cryopreservation can be performed without frequent monitoring and without the injectable medications using At-HOME IVF kit. This will allow patients with DOR the possibility of proceeding with fertility treatments with minimum exposure to office visits.

Acute Hepatitis B Infection After a Switch to Long-Acting Cabotegravir and Rilpivirine.

Maintenance antiretroviral therapy with combination of two injectable long-acting drugs, cabotegravir and rilpivirine, is a new strategy addressing the challenges of daily adherence to oral pills that has shown non-inferior efficacy to standard of care therapy in patients with suppressed HIV-infection. Patients co-infected with hepatitis B virus (HBV) are not eligible for this dual therapy since it has no activity against HBV, but this strategy should also be restricted to patients with anti-HBs antibodies since people with HIV are still at risk of HBV acquisition due to high risk behavior and since HBV vaccination does not always elicit anti-HBs antibodies, as highlighted in the case report below.

Factors affecting performance and manufacturability of naproxen Liqui-Pellet

AimLiqui-Pellet is potentially an emerging next-generation oral pill, which has shown promising results with unique advantages as well as displaying potential for commercial feasibility. Since Liqui-Pellet technology is still in its infancy, it is important to explore the parameters that can affect its performance, particularly the drug release rate. Therefore, the aim of this study is to investigate thoroughly the effect of Avicel PH101 (carrier) and Aerosil 300 (coating material) ratio (R-value) in Liqui-Pellet.MethodsKey parameter for Liqui-Pellet formulation in this study was the ratio of carrier and coating material. Tests were carried out to assess the physicochemical properties of different formulations. This involved looking into particle size, robustness, flowability, solid-state and drug release profile. The morphology of Liqui-Pellet was investigated by SEM.ResultsIt is found that R-value does not have a major effect on the success of Liqui-Pellet production. However, R-value does seem to have an effect on Liqui-Pellet size at a certain water content level and a slight effect on the drug release rate. A decrease in Avicel PH101 concentration and an increase in Aerosil 300 concentration in Liqui-Pellet formulations can reduce Liqui-Pellet size and slightly increase drug release rate by 9% after 2 h. The data shows Liqui-Pellet is resistant to friability, able to achieve exceptional flow property and have smooth surfaces, which is critical for applying coatings technology. Such properties are ideal in terms of commercial manufacturing. The XRPD and DSC both show the reduction in formulation crystallinity, which is expected in Liqui-Pellet formulation as a result of solubility of the drug in the co-solvent used in the preparation of Liqui-Pellets.ConclusionOverall it seems that R-value can affect Liqui-Pellet drug release rate and size but not on the production success rate.Graphical abstract

Current Use of Modern Family Planning and Fertility Intention Among Women Farmers of Reproductive Age in Ido and Ona-ara Local Government Areas of Ibadan, Nigeria

Abstract Although poor use of contraceptives and high desire for children is characteristic of sub-Saharan Africa, this demographic challenge is more peculiar to more disadvantaged segments of the population like rural farmers. This study was designed to examine current use of modern family planning and fertility intention among women farmers of reproductive age in Ido and Ona-ara Local Government Areas of Ibadan, Nigeria. Using cross-sectional survey design, semi-structured questionnaire were administered via structured-interview to randomly and systematically selected 408 respondents. Chi-square was used to show significance of associations between pairs of variables. Contingency co-efficient was used to examine extent of significant associations. Results indicate that majority of respondents (77%) desired additional children, the mean number of children that respondents already have is 2.94±1.35 while mean fertility intention is 1.85±1.44. The proportion of current users of modern family planning is 45.6%. The use of oral pills (30.6%) is most popular among respondents. There is no significant association between current use of modern family planning and fertility intention among married and divorced respondents, among respondents in all the age sub-groups, and among respondents with no formal education or secondary education (p &gt; 0.05), but there is among respondents with primary and tertiary education (p &lt; 0.05). The synergy between the use of modern family planning and fertility intention among women farmers in the study area is notable but requires significant progression. Having primary education and tertiary education is significantly associated respectively with lower and higher use of modern family planning in relation to fertility intention. Education is an important element of fertility dynamics among women farmers in the study area.

Contraceptive Use among Slum Women in Slums of Dhaka City

Bangladesh has experienced a dramatic increase in contraceptive use and a sensational decline in fertility over 3 decades since its independence. The family planning program (FPP) in Bangladesh has been considered a success story in a setting without much socio-economic development. With the concerted effort of the Government of Bangladesh (GOB) and Non-Governmental Organizations (NGOs), women are becoming aware of physical health; (Icddr,b). In this context, a study has conducted to unveil the scenario of using contraception in the slum area of Dhaka City. In this research, 101 respondents were selected from two selected slums of Dhaka city. This study examines the use of contraceptives among the slum women. Findings revealed that respondents age 15-20) around 8.6% prefer an oral pill, 2.5% prefer IUD, 6.2% prefer condom (husband’s method) and 4.9% prefer injectable. Respondents aged within (21-25) around 19.8% prefer oral pill, 3.7% prefer IUD, 6.2% prefer condom (husband’s method) and 7.4% prefer injectable. Respondents age (above 25) around 21.0% prefer oral pill, 1.2% prefer IUD, 1.2% prefer condom (husband’s method) and 17.3% prefer injectable. In total, around 49.4% prefer an oral pill, 7.4% prefer IUD, 13.6% prefer condom and 29.6% prefer injectable. Women’s education, exposure to mass media, current work status husband’s working status, age of marriage, decision-making rights, religious restriction are the important determinants of contraceptive use among slum women.

Single oral dose for HIV pre or post-exposure prophylaxis: user desirability and biological efficacy in macaques.

BackgroundDaily oral pre- or post-exposure prophylaxis (PrEP or PEP) is highly effective in preventing HIV infection. However, many people find it challenging to adhere to a daily oral regimen. Chemoprophylaxis with single oral doses of antiretroviral drugs taken before or after sex may better adapt to changing or unanticipated sexual practices and be a desirable alternative to daily PrEP or PEP. We investigated willingness to use a single oral pill before or after sex among men who have sex with men (MSM) and assessed the biological efficacy of a potent antiretroviral combination containing elvitegravir (EVG), emtricitabine (FTC), and tenofovir alafenamide (TAF).MethodsData on willingness to use single-dose PrEP or PEP were obtained from the 2017 cycle of the American Men's Internet Survey (AMIS), an annual online behavioral surveillance survey of MSM in the United States. Antiretroviral drug levels were measured in humans and macaques to define drug distribution in rectal tissue and identify clinically relevant doses for macaque modeling studies. The biological efficacy of a single dose of FTC/TAF/EVG as PrEP or PEP was investigated using a repeat-challenge macaque model of rectal HIV infection.FindingsThrough pharmacokinetic assessment in humans and macaques we found that EVG penetrates and concentrates in rectal tissues supporting its addition to FTC/TAF to boost and extend chemoprophylactic activity. Efficacy estimates for a single oral dose given to macaques 4h before or 2h after SHIV exposure was 91•7%[35•7%-98•9%] and 100%, respectively, compared to 80•1%[13•9%-95•4%] and 64•6%[-19•4%-89•5%] when single doses were given 6 and 24h post challenge, respectively. A two-dose regimen at 24h and 48h after exposure was also protective [77•1%[1•7%-94•7%].InterpretationInformed by user willingness, human and macaque pharmacokinetic data, and preclinical efficacy we show that single-dose prophylaxis before or after sex is a promising HIV prevention strategy. Carefully designed clinical trials are needed to determine if any of these strategies will be effective in humans.FundingFunded by CDC intramural funds, CDC contract HCVJCG2-2016-03948 (to CFK), and a grant from the MAC AIDS Fund and by the National Institutes of Health [P30AI050409] – the Emory Center for AIDS Research (to MZ and TS).

Diabetes Mellitus and Women's Health

Diabetes mellitus leads to high blood glucose due to disturbance in insulin secretion or sensitivity. Diabetes mellitus type 1 results from insufficient insulin release. Diabetes mellitus type 2 and gestational diabetes occur mainly due to insulin resistance which is associated with obesity and pregnancy. Diabetes is a chronic disease that needs three approaches for successive treatment which are food regimen (diet), exercise, and medication (either by insulin or pills). These three treatment strategies should occur together. Insulin treatment is typically used to treat type 1 diabetes, and on the occasion, that type 2 patients don't react to different drugs. Medications that don't contain insulin are given either as oral pills or by infusion. The most distinguished of these medications and the first to be utilized to treat diabetes is metformin. Doing a pancreas transplant is especially valuable for type 1 patients. There is no negative impact of diabetes on the marital relationship because high blood glucose level doesn't affect the menstrual cycle and ovulation happens normally. There is no issue with the wedding a woman with diabetes as diabetes doesn't influence the productivity of the patient, as this woman can manage her sugar level appropriately. Some diabetic women have little sexual desire but unlike diabetic men, they have no difficulties during or after sex. Controlling the blood glucose level during pregnancy is very important for the security of both the mother and the baby. Women with gestational diabetes could begin breastfeeding as non-diabetic women, however, the time of breastfeeding in women with gestational diabetes was two months not as much as that of uninfected women.

Diabetes Mellitus and Women's Health

Diabetes mellitus leads to high blood glucose due to disturbance in insulin secretion or sensitivity. Diabetes mellitus type 1 results from insufficient insulin release. Diabetes mellitus type 2 and gestational diabetes occur mainly due to insulin resistance which is associated with obesity and pregnancy. Diabetes is a chronic disease that needs three approaches for successive treatment which are food regimen (diet), exercise, and medication (either by insulin or pills). These three treatment strategies should occur together. Insulin treatment is typically used to treat type 1 diabetes, and on the occasion, that type 2 patients don't react to different drugs. Medications that don't contain insulin are given either as oral pills or by infusion. The most distinguished of these medications and the first to be utilized to treat diabetes is metformin. Doing a pancreas transplant is especially valuable for type 1 patients. There is no negative impact of diabetes on the marital relationship because high blood glucose level doesn't affect the menstrual cycle and ovulation happens normally. There is no issue with the wedding a woman with diabetes as diabetes doesn't influence the productivity of the patient, as this woman can manage her sugar level appropriately. Some diabetic women have little sexual desire but unlike diabetic men, they have no difficulties during or after sex. Controlling the blood glucose level during pregnancy is very important for the security of both the mother and the baby. Women with gestational diabetes could begin breastfeeding as non-diabetic women, however, the time of breastfeeding in women with gestational diabetes was two months not as much as that of uninfected women.

Feasibility of Continuous Monitoring of Core Body Temperature Using Chest-worn Patch Sensor.

With rapid advancement in wearable biosensor technology, systems capable of real time, continuous and ambulatory monitoring of vital signs are increasingly emerging and their use can potentially help improve patient outcome. Monitoring continuous body temperature offers insights into its trend, allows early detection of fever and is critical in several diseases and clinical conditions including septicemia, infectious disease and others. There is a complex interaction between physiological and ambient parameters including heart rate, respiratory rate, muscle rigors and shivers, diaphoresis, local humidity, clothing, body, skin and ambient temperatures among others. This article presents feasibility analysis of a wireless biosensor patch device called as VitalPatch in capturing this physio-ambient-thermodynamic interaction to determine core body temperature, and details comparative performance assessments using oral thermometer and ingestible pill as reference devices. Based on a study on a cohort of 30 subjects with reference oral temperature, the proposed method showed a bias of 0.1 ± 0.37 °C, mean absolute error (MAE) of 0.29 ± 0.25 °C. Another cohort of 22 subjects with continuous core body temperature pill as reference showed a bias of 0.16 ± 0.38 °C and MAE of 0.42 ± 0.22 °C.Clinical Relevance- Non-invasive, continuous and real time body temperature monitoring can lead to earlier fever detection and provides remote patient monitoring that can result in improved patient and clinical outcome.

EFFICACY OF ORAL VITAMIN D SUPPLEMENTATION OR SIMULATED SUNLIGHT ON BONE DURING MILITARY TRAINING

25-hydroxyvitamin D (25(OH)D) ≥50 nmol·L-1 is essential for bone health. Vitamin D deficiency during arduous training has implications for increased stress fracture risk. Vitamin D is mainly synthesised from skin exposure to the sun; around 20% of vitamin D is obtained from the diet. PURPOSE: This study compared the efficacy of vitamin D supplementation by oral pill versus simulated sunlight on bone macro- and micro-architecture during a 13-week military training course in winter. METHODS: Eighty male infantry recruits (mean ± SD, age 22 ± 3 years, height 1.78 ± 0.07 m, body mass 77.9 ± 10.7 kg) received oral vitamin D3 (1,000 IU·D-1 for 4 weeks and then 400 IU·d-1 for 8 weeks, n = 21), an oral placebo (n = 19), solar-simulated radiation (SSR, 1.3 × standard erythemal dose in T-shirt and shorts, 3 d·wk-1 for 4 weeks and 1 d·wk-1 for 8 weeks, n = 22), or placebo SSR (n = 18). Total 25(OH)D was measured by LC-MS/MS in week 1, 5 and 13, and bone density and structure was assessed at the ultra-distal dominant tibia by HR-pQCT (Xtreme CTI, Scanco) in week 1 and 13. RESULTS: Oral vitamin D3 and SSR increased 25(OH)D from week 1 (51 ± 22 and 43 ± 21 nmol·L-1) to week 5 (78 ± 23 and 79 ± 15 nmol·L-1) and week 13 (75 ± 15 and 76 ± 12 nmol·L-1 , P < 0.001). The oral and SSR placebos did not change 25(OH)D from week 1 (51 ± 40 and 41 ± 17 nmol·L-1) to week 5 (45 ± 4 and 41 ± 16 nmol·L-1), but 25(OH)D increased in both groups by week 13 (60 ± 4 and 65 ± 15 nmol·L-1, P ≤ 0.010). Supplementation and training did not affect total, trabecular or cortical volumetric bone mineral density, cortical area, trabecular volume, number or thickness, or cortical pore diameter (main effects of time, P ≥ 0.105; group × time interactions, P ≥ 0.258). Training increased cortical thickness (1.30 ± 0.25 to 1.32 ± 0.25 mm), and reduced trabecular area (682 ± 133 to 680 ± 133 mm2) and spacing (360 ± 58 to 345 ± 71 μm, main effects of time, P ≤ 0.041), but supplementation had no effect (group × time interactions, P ≥ 0.181). There was a significant group × time interaction for cortical perimeter (P = 0.033) and porosity (P = 0.049); training had no effect on either measure for any group (P ≥ 0.068). CONCLUSION: Vitamin D supplementation in winter, using strategies to increase total 25(OH)D above 50 nmol·L-1, exerted no effect on bone macro- or micro-architecture beyond the osteogenic effects of exercise training.

A study on awareness and behavior of women towards contraceptive use among women attending tertiary care center in northern Andhra Pradesh, India

Background: In spite of the constant efforts by the government, the unmet need for contraception (12.8% in 2006 WHO report) is still there. There are many social factors, taboos, myths, and ignorance, which is responsible for the underutilization of contraceptive services. This leads to many unwanted pregnancies causing maternal morbidity and mortality. The aim of the study was to assess the knowledge, attitude, practices, and behavior of women regarding various contraceptive methods. Material and Methods: It was a cross-sectional study of 1244 married women attending gynaecology OPD of Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh (India). All participants were interviewed with a predesigned proforma. Results: Almost 88.5% of women were from a rural area and more than one-third were illiterate, belonging to low socioeconomic status. Awareness level about contraceptive methods was 92.3% among the participants and almost all of them knew about barriers and oral pills. The main source of knowledge was Healthcare Workers followed by media and social circles. Approximately 43.5% were currently using one or the other method of contraception. The barrier method was the most commonly used. The main reason for not using contraception was Desirous for Conception. Conclusion: There is a need to create awareness about the benefits of contraception.

The use of green spectroscopy with multivariate calibration models for simultaneous analysis of ternary drug mixture in combined oral antidiabetic pill.

In this work, different chemometric calibration models were developed and validated for the purpose of determining of ternary mixture of oral antidiabetic drugs; vildagliptin (VDG), saxagliptin (SAX) and sitagliptin phosphate (STG). The used models were Partial least squares (PLS) and Artificial Neural Networks (ANN). However, on these various models the impact of genetic algorithm (GA) as a form of variable selection was also investigated. The UV spectral data was used as basis in the quantitative study of the drugs analyzed in bulk and product formulations. The concentration range of the calibration curves of VDG, SAX and STG were 10-22μgmL-1, 24-40μgmL-1 and 82-130μgmL-1, respectively. The calibration set included nineteen mixtures and the others six were used as a validation set to test the predictability of the developed multivariate models. The validation parameters of the evaluated methods were statistically determined. For the analysis of drugs studied in laboratory-prepared mixtures and their dosage forms, PLS-1, GA-PLS-1, ANN, and GA-ENN were successfully employed. The results obtained by the developed methods were compared to those given by a reported method and there were no statistically significant differences regarding accuracy and precision.

The efficacy of different vitamin D supplementation delivery methods on serum 25(OH)D: A randomised double-blind placebo trial

The use of vitamin D supplementation has increased due to greater recognition of widespread deficiency. There has been little research on the effectiveness of different delivery methods and therefore the aim of was to test the efficacy of different delivery methods on serum 25(OH)D. Using a randomised repeated measures double-blind placebo design (registered under ClinicalTrials.gov Identifier no. NCT03463642), changes in serum 25(OH)D over a 4-week period using a capillary spot method were monitored. 62 female participants blindly chose a number related to a supplementation delivery method: pill placebo, pill, oral liquid, oral liquid placebo, Skin oil application (SOA) placebo, SOA plus vitamin D3 suspension, or SOA plus vitamin D3 suspension with essential oil enhancer; active vitamin D supplements contained 100,000IU. Participants took their allocated supplements over a 24-hr period with serum 25(OH)D retested 4 weeks later. Liquid chromatography-tandem mass spectrometry method was applied to dried blood spot samples by an independent laboratory. ANCOVA reported a significant difference between the groups (F1,6=146.68; p<0.001, eta2=0.51). Separate analysis within the delivery methods (pill, SOA, oral liquid) indicated significant differences between the active and placebo supplementation groups (p<0.01). Post hoc analysis of absolute changes indicated vit D pill and SOA+vit D+essential oil had significant increases (p<0.05) in serum 25(OH)D compared to all other interventions with no significant difference between them. In human participants vitamin D oral pill has the greatest effect on serum 25(OH)D levels. Skin oil application delivery of vitamin D using a penetrator enhancer has also been shown to be an effective method of delivery.

P1027THE DIFFERENCES EFFECTS OF GLUCAGON LIKE PEPTIDE-1(GLP-1) ANALOGUES AND SODIUM-COTRANSPORTER 2 (SGLT-2) INHIBITORS ON TYPE 2 DIABETES PATIENTS WITH RENAL IMPAIRMENT

Abstract Background and Aims Diabetes mellitus (DM) is a progressive multifactorial disease associated with cardiovascular complications. To prevent the progression of cardiovascular complications in DM patients, glycemic control is important. In this study, we examined impact on cardiac function between glucagon like peptide-1(GLP-1) analogue and sodium-glucose cotransporter-2 (SGLT-2) inhibitors to treat type 2 diabetes patients with renal impairment. Method A total of 125 type 2 DM patients with renal impairment were recruited for this study. All patients were divided into two groups according to the anti-diabetic agents at baseline: Group G; 0.9mg/day liraglutide, n=53, Group S; n=72; 5mg/day dapagliflozin, n=32, empagliflozin n=14, 20mg/day tofogliflozin n=19, or 50mg/day ipragliflozin n=16. Blood glucose levels, glycosylated hemoglobin (HbA1c), serum creatinine, and albuminuria were obtained 12 months before and every 3 months for 36 months. Echocardiography, ankle brachial pressure index(ABI) and cardio-ankle vascular index(CAVI) were obtained every 12 months for 36 months. Results At baseline, the mean age was 68.5±6.0 years, DM vintage was 12.0±6.0 years, and mean total oral pill counts was 12.0±6.0. Compared with baseline, mean total pill counts were reduced at 12 months after initiation of new anti-diabetic agents (ADA) and remained afterward (Group G; 12.3±5.3 at baseline, 8.9±4.0 at 12 months (p&amp;lt;0.05), Group S; 11.8±4.2 at baseline, 8.6±3.4 at 12 months (p&amp;lt;0.05)). The counts of ADAs were also decreased (Group G; 3.85±2.61 at baseline, 1.41±2.01 at 12 months (p&amp;lt;0.01), Group S; 3.48±2.43 at baseline, 2.41±1.44 at 12 months (p&amp;lt;0.05)). HbA1c and systolic blood pressure were significantly decreased after initiation of GLP-1 analogue or SGLT-2 inhibitor in both groups. Nevertheless, eGFRs were gradually decreased in both groups. Albuminuria indicated by urinary albumin creatinine ratio were decreased significantly after initiation of anti-diabetic agents. Left ventricular mass index (LVMI) (Group G; 135.8 at baseline, 110.2 at 12 months,114.5 at 24 months, 107.2 g/m2 at 36 months, Group S; 130.0 at baseline, 113.2 at 12 months,106.4 at 24 months, 115.9 g/m2 at 36 months) and left atrial volume index (LAVi) (Group G; 25.6 at baseline, 22.3 at 12 months, 21.4 at 24 months, 20.8 mL/m2 at 36 months, Group S; 24.0 at baseline, 21.8 at 12 months,21.7 at 24 months, 22.7 mL/m2 at 36 months) were significantly decreased in both groups. Cardiac systolic function indicated by ejection fraction (EF) and diastolic function indicated by E/e’ (Group G; 12.9 at baseline, 10.4 at 12 months, 9.4 at 24 months, 9.5 at 36 months, Group S; 12.4 at baseline, 10.6 at 12 months, 12.5 at 24 months, 12.9 at 36 months) or left atrial dimension were remained or improved only in group G. Moreover, arterial stiffness indicated by cardio-ankle vascular index (CAVI) was improved in group G (Group G; 10.2 at baseline, 9.9 at 12 months, 9.9 at 24 months, 9.9 at 36 months, Group S; 10.3 at baseline, 10.5 at 12 months, 10.6 at 24 months, 10.6 at 36 months) (Table1). With respect to admission due to cardiovascular events, cerebrovascular infarction were occurred higher in group S (3.8% vs 1.3% / yea; p&amp;lt;0.05), congestive heart failure were higher in group G (1.9%. vs 0.5% / year; p&amp;lt;0.05). Conclusion These findings suggest that liraglutide and SGLT-2 inhibitor for type 2 DM patients with renal impairment have similar effects on renal function including eGFR and albuminuria and left ventricular and atrial volume. However, liraglutide could provide more benefit for arterial stiffness than SGLT-2 inhibitors.

Influences on willingness to use vaginal or oral HIV PrEP during pregnancy and breastfeeding in Africa: the multisite MAMMA study.

IntroductionWomen in sub‐Saharan Africa spend a substantial portion of their reproductive lives pregnant and/or breastfeeding (P/BF), yet they have limited options to prevent HIV during these maternal stages. In preparation for phase 3b prevention trials in P/BF women, we explored attitudes about using a vaginal ring or oral pills for pre‐exposure prophylaxis (PrEP), perceptions of HIV risk during P/BF and key influences on future PrEP use.MethodsIn 2018, we conducted 16 single‐sex focus group discussions (FGDs) with community‐ and clinic‐recruited HIV‐uninfected women, currently or recently P/BF, aged 18 to 40, and men with (currently or recently) P/BF partners, aged 18+. Participants completed a behavioural questionnaire, viewed an educational video and handled prototype placebo products. FGDs were conducted in local languages and transcribed, coded and analysed, using a socio‐ecological framework, for key influences on willingness to use products, HIV risk perceptions and opinions on product attributes.ResultsOf the 128 participants (65 women, 63 men) 75% lived with their partner and 84% had a child. Women reported the most important influencers when P/BF were partners, and all stated that health decisions when P/BF are typically made jointly (e.g. medication use; ante/postnatal and baby care). There was consensus that P/BF women are at high risk for HIV, primarily because of their partner’s infidelities, and new prevention options were welcomed. Participants valued multiple options and stated that woman’s personal preference would be key to product choice. Anticipated concerns about products included risk of miscarriage, impact on infant development, complications during delivery and adequate production or taste of breastmilk. Specific perceived disadvantages emerged for the ring (e.g. vaginal discomfort, difficulty inserting/removing) and for pills (e.g. nausea/vomiting) that may be exacerbated during pregnancy. Health care providers’ (HCPs) knowledge and approval of product use during P/BF was needed to mitigate anticipated fears.ConclusionsParticipants perceived pregnancy and breastfeeding as high HIV risk periods and valued new prevention options. HIV protection of the mother‐child dyad, safety of the baby, and ultimately, health of the family were paramount. Endorsement by HCPs and support from partners were key to future product acceptance. Participants recommended involving partners and HCPs in sensitization efforts for future trials.

Determinants of modern contraceptive use among married Somali women living in Kampala; a cross sectional survey

BackgroundLow contraceptive uptake exposes women to unintended pregnancies and often the resultant obstetric complications. The immigrant communities especially from countries with low contraceptive use present a unique challenge. The main objective of the study was to describe modern contraceptive use and associated factors among married Somali women living in Kampala.MethodsA community based cross sectional survey was conducted among Somali women living in Kampala from August to November 2016. Using consecutive sampling, 341 respondents were recruited after informed consent. Data was collected using interviewer administered questionnaires on contraceptives use and factors associated. Data was entered in Epidata 3.1 and analyzed using STATA 11.0. Logistic regression analysis was used to determine the factors associated with use of modern contraceptives.ResultsMajority of the participants were refugees 317/341(94%), with a mean age of 30.4 (±6.7) years and 136/341 (40%) had no formal education. More than 325/341 (95%) of respondents desired to have five or more children (Average 9 + 3) and 164/341 (45%) had five or more living children. Only 29% of women were using modern contraceptives, of which 51% used oral pills, 15% condoms and 15% injectables. Having tertiary education, one who had ever used modern contraceptives and desire for spacing of more than two years were independently associated with current of use modern contraceptives.ConclusionsThe Contraceptive prevalence rate among married Somali women in Kampala was (29%). A majority of the respondents were using short acting contraceptive methods. Attaining tertiary education, ever use of modern contraceptives, those whose source of contraceptive information was health worker and desire to space for more than two years were associated with current use of modern contraceptives. There is a need for improvement of girl child education, contraceptive awareness and male involvement to increase contraceptive uptake in this community. Research looking at attitude of this community towards use of long term contraception is recommended.

S208. COMPARISON OF MEDICATION PREFERENCE FOR LONG-ACTING INJECTABLE VERSUS ORAL ANTIPSYCHOTICS IN PATIENTS WITH SCHIZOPHRENIA: ANALYSIS OF A PATIENT-REPORTED QUESTIONNAIRE FROM A DOUBLE-BLIND RANDOMIZED CONTROLLED STUDY

BackgroundThere is limited information on patient’s perspective on choice of long-acting injectable (LAIs) or oral antipsychotic pills used in the management of schizophrenia. Assessing factors that determine patients’ preferences for LAI or oral antipsychotics could help understand their expectations from the treatment and reduce potential barriers to LAI use in schizophrenia.MethodsPost-hoc analyses were conducted from a double-blind, randomized, non-inferiority study (NCT01515423) of 3-monthly vs 1-monthly paliperidone palmitate in patients with schizophrenia. Data from the Medication Preference Questionnaire, administered to patients on day 1 (baseline; open-label stabilization phase), were used. The questionnaire includes 4 sets of items: (1) reasons for general treatment preference based on goals/outcomes and preference for LAI vs pills based on (2) personal experience (3) injection-site (4) dosing frequency. A logistic regression analysis was performed to assess the effect of baseline variables on preference for LAIs or pills.ResultsPatients who preferred LAIs identified these outcomes as important: “I feel more healthy” (57%), “I can get back to my favorite activities” (56%), “I don’t have to think about taking my medicines” (54%). Most common reasons for medication preference (LAI vs pills) were: “LAIs/pills are easier for me” (67% vs 18%), “more in control/don’t have to think about taking medicine” (64% vs 14%), “less pain/sudden symptoms” (38% vs 18%) and “less embarrassed” (0% vs 46%). Majority of patients (59%) preferred deltoid over gluteal injections: (reasons: faster administration [63%], easier [51%], less embarrassing [44%]). 50% of patients preferred 3-monthly over 1-monthly (38%) or every day (3%) dosing (reasons: fewer injections [96%], fewer injections are less painful [84%], fewer doctor visits [80%]). In the logistic regression analysis (n=1402), 77% of patients preferred LAI over pills and culture and race appeared to play a role in this preference.DiscussionPatient empowerment and quality-of-life-related goals were important for patients who preferred LAI antipsychotics and when given an option, patients preferred less-frequent, quarterly injections over monthly injections and daily oral medications.

Investigation the effect of oral Aloe Vera gel pills supplementation on the intensity of primary menstrual pain (Dysmenorrhea)

Introduction. This study was conducted to evaluate the effects of oral aloe vera gel pills supplementation on the intensity of menstrual pain. A randomized, single-blind clinical experimental plan was conducted amongst 150 single students aged 20 to 26 years who suffered from menstrual pain, at the Islamic Azad University of Medical Sciences from December 24, 2015 to October 22, 2016. The extent of pain was evaluated using the Cox Menstrual Symptom Scale (CMSC). Material and method. Each participant was randomly assigned to aloe vera gel pill or the anti-PG drug Ibuprofen, ending with 60 participants in each group equally. The first trial group received 10 mg of aloe vera gel orally four times daily until the pain grade reached one or less. The control group received Ibuprofen and three tablets orally three times a day. The participants were permitted to take another drug that they usually took for their pain relief, in addition to the allocated treatment in case of continued pain. At the end of the trial, these participants were excluded in data analysis. Results and discussions. Changes in the grade and the duration of the pain of participants were compared at the first and second months in both groups. Sample size was computed using alpha = 5 and absolute error equal to 0.24 for correlation between medication and pain with acceptable absolute precision formula (AAPF). Result of this study showed that the mean age was 22.1 +/- 1.4and 20.4 +/- 1.2 years in aloe vera gel pills and Ibuprofen groups, respectively. No significant difference was observed for the matched characteristics studied between the treated groups. the mean pain grade amongst aloe vera group was decreased from 2.81 +/- 0.65 to 2.02 +/- 0.34, while in Ibuprofen group from 2.48 +/- 0.4 to 1.32 +/- 0.15, respectively, using the described given dose. As result obtained that there was no statistically significant decrease in pain duration for the women who received Ibuprofen compared to those who used aloe vera. Also there was no significant difference in pain grade between the groups at the second month of intervention (p=0.61). Pain duration at the second month of trial was similar between the both groups (p=0.76). Conclusions. In conclusion we could suggest that aloe vera gel pill as a novel herbal pain killer represents an effective treatment for the menstrual pain with no important side effects, although further clinical trials are recommended to look at the possible side effects in an extended spectrum of subjects.