Sheehan’s syndrome with reversible dilated cardiomyopathy: A case report and brief overview

AbstractSheehan’s syndrome is a rare condition characterized by post-partal panhypopituitarism due to necrosis of adenohypophysis resulting from severe post-partum hemorrhage. Lethargy, amenorrhea and failure of lactation are the usual presenting features. Cardiac involvement in Sheehan’s syndrome is rare. The case presented here describes dilated cardiomyopathy in a 36-year-old lady who failed to respond adequately to the standard anti-failure treatment. Further investigation revealed the diagnosis of Sheehan’s syndrome. Besides other manifestations, cardiac function reverted to normal after giving replacement therapy with glucocorticoid, levothyroxine and sex hormone. Physicians, specially those in developing countries, should have high index of suspicion for the diagnosis of Sheehan’s syndrome while dealing with a case of ‘peripartal dilated cardiomyopathy’. Persistent amenorrhea and failure of lactation may be important clues in this context. Timely diagnosis and appropriate treatment can lessen the sufferings of the patients

The quest for better outcomes: a randomized controlled trial comparing letrozole versus clomiphene citrate in polycystic ovarian syndrome related infertility

Background: Infertility is a widespread concern, particularly among individuals with polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) has been a primary treatment for PCOS-related infertility, despite suboptimal pregnancy rates. Letrozole, an aromatase inhibitor, presents an alternative with potential advantages for improving pregnancy outcomes. This study aimed to rigorously compare letrozole and CC in the context of PCOS-related infertility, focusing on Bangladeshi women, adopting incremental dosing protocols, and examining endpoints to contribute valuable insights. Methods: A randomized controlled trial was conducted at a tertiary care center in Bangladesh from July 2021 to June 2023. Participants included women aged 18-35 with anovulatory infertility due to PCOS. They were randomized into two groups: letrozole and CC. Treatments were administered following incremental dosing protocols, and outcomes included endometrial thickness, ovulation rate, mono-follicular development, pregnancy rate, and time to pregnancy. Results: Out of 187 patients assessed for eligibility, 102 were enrolled, with 51 in each group. Demographics were comparable between groups. While endometrial thickness did not significantly differ between the groups, letrozole demonstrated a higher rate of mono-follicular development (72.55% versus 50.98%), a significantly higher pregnancy rate (47.06% versus 23.53%), and a shorter time to pregnancy (9.23 weeks versus 11.7 weeks) compared to CC. Conclusions: This study suggests that letrozole may be a preferred option for ovulation induction in PCOS patients due to its superior pregnancy rates and shorter time to pregnancy compared to CC. However, limitations such as a relatively small sample size and variations in dosages should be considered. Further research is needed to validate these findings and address the evolving needs of patients with PCOS-related infertility

Enhanced electrocatalytic effects of Pd particles immobilized on GC surface on the nitrite oxidation reactions

Ajuts: Manel del Valle thanks the support from program ICREA Academia.Nitrite (NO 2− ) oxidation reactions (NOR) have been performed using a pristine glassy carbon (GC) electrode and Pd modified GC electrode to investigate catalysis and kinetics of oxidation reaction. The XPS analysis revealed that Pd nanoparticles (NPs) on GC is differed electronically from Pd particles alone. Electrochemical observations entailed that the Pd-GC electrode improved the catalytic efficiency by lowering peak potential and improving peak current compared to those obtained by GC or Pd electrode alone. Additionally, the onset potential (E i ) of kinetic process concerning NOR was appeared at 0.63 V for Pd-GC electrode which is smaller than 0.81 V and 0.75 V observed by GC and Pd electrodes, respectively. These observations suggest that the Pd-GC electrode can obtain faster electron transfer and maximum catalytic sites. The validation of Pd-GC as noble catalyst is also supported by observing least free energy of activation at peak (ΔG p‡ = 0.461 eV). The nitrite ions involve a single electron transfer reaction with NO 2 molecules being the product, which later undergoes through a dispropornation reaction yielding NO 2− and NO 3− as final products. The precise observations by RDE experiments revealed that the charge transfer reaction followed by an irreversible first order kinetics with standard rate constant (k 0 ) of 1.98 × 10 −4 cm/s and formal potential (E o ' ) of 0.03 V

Bangladesh arsenic mitigation programs: lessons from the past

Ensuring access to safe drinking water by 2015 is a global commitment by the Millennium Development Goals (MDGs). In Bangladesh, significant achievements in providing safe water were made earlier by nationwide tubewell-installation programme. This achievement was overshadowed in 1993 by the presence of arsenic in underground water. A total of 6 million tubewells have been tested for arsenic since then, the results of which warranted immediate mitigation. Mitigation measures included tubewell testing and replacing; usage of deeper wells; surface water preservation and treatment; use of sanitary dug wells, river sand and pond sand filters; rainwater collection and storage; household-scale and large-scale arsenic filtrations; and rural pipeline water supply installation. Shallow tubewell installation was discouraged. Efforts have been made to increase people's awareness. This paper describes the lessons learned about mitigation efforts by the authors from experience of arsenic-related work. In spite of national mitigation plans and efforts, a few challenges still persist: inadequate coordination between stakeholders, differences in inter-sectoral attitudes, inadequate research to identify region-specific, suitable safe water options, poor quality of works by various implementing agencies, and inadequate dissemination of the knowledge and experiences to the people by those organizations. Issues such as long-time adaptation using ground water, poor surface water quality including bad smell and turbidity, and refusal to using neighbor's water have delayed mitigation measures so far. Region-specific mitigation water supply policy led by the health sector could be adopted with multisectoral involvement and responsibility. Large-scale piped water supply could be arranged through Public Private Partnerships (PPP) in new national approach

Electrocatalytic Reduction of O₂ by ITO-IrOx: Implication for Dissolved Oxygen Sensor in the Alkaline Medium

Water pollution has badly affected human health, aquatic life, and the ecosystem. The purity of surface water can be measured in terms of dissolved oxygen (DO) measurements. Hence, it is desirable to have a portable and simple-to-use dissolved oxygen sensor. One possible remedy is an electrochemical sensor. Thus, we proposed an ITO-IrOx electrocatalyst for an effective and interference-free DO sensor utilizing the principle of oxygen reduction reaction (ORR). The ITO-IrOx was characterized using cyclic voltammetry (CV), scanning electron microscopy (SEM), electrochemical impedance spectrometry (EIS), X-ray photoelectron spectroscopy (XPS), and reflectance spectroscopy-based techniques. Reflectance spectra of the ITO-IrOx electrode showed the photoresist capability. The EIS spectra revealed lower charge transfer resistance for the ITO-IrOx electrode in ORR. The IrOx film on ITO exhibited a quick (one electron, α = 1.00), and reversible electron transfer mechanism. The electrode demonstrated high stability for oxygen sensing, having a limit of detection (LOD) of 0.49 ppm and interference-free from some common ions (nitrate, sulphate, chloride etc.) found in water

pH dependent electro-oxidation of arsenite on gold surface: Relative kinetics and sensitivity

A detailed kinetic investigation of As(III) oxidation was performed on gold surface within pH between ∼3.0 and ∼9.0. It was found that the As(III) oxidation on the gold surface follows a purely adsorption-controlled process irrespective of pH. The evaluated adsorption equilibrium constant decreased from 3.21 × 105 to 1.61 × 105 mol L−1 for acidic to basic medium, which implies the strong affinity of the arsenic species in the acidic medium. Besides, the estimation of Gibbs free energy revealed that an acidic medium promotes arsenic oxidation on gold surface. In mechanistic aspect, the oxidation reaction adopts a stepwise pathway for acidic medium and a concerted pathway for neutral and basic medium. From the substantial kinetic evaluation, it is established that a conducive and compatible environment for the oxidation of arsenic was found in an acidic medium rather than a basic or neutral medium on gold surface. Besides, in sensitivity concern, neutral and highly acidic medium is quite favourable for the arsenite oxidation on gold surface

Comparison of Rectangular and Circular Microstrip Fed Patch Antennas at 5.76 GHz

A Comparative study of rectangular and circular shape microstrip patch antennas at 5.76 GHz band is presented in this paper. Computer Simulation Technology (CST) microwave studio is used as the software environment to design and compare the performance of the antennas. Based on the results and analysis, it is found that rectangular patch antenna shows about 8 dB higher return loss then return loss of circular patch antenna. In addition, rectangular patch antenna has improved gain value of 7.499 dB then that of the circular patch with gain 7.114 dB. The radiation efficiency of both rectangular and circular shaped microstrip fed patch antennas is nearly the same. &nbsp

Kinetics of Electrocatalytic Oxygen Reduction Reaction Over an Activated Glassy Carbon Electrode in an Alkaline Medium

Hydrogen peroxide is a promising substitute for fossil fuels because it produces non-hazardous by-products. In this work, a glassy carbon GC was anodized in sulphuric acid at +1.8 V to prepare the working electrode. It was utilized to investigate the oxygen reduction reaction (ORR) in a basic medium containing 0.1 M NaOH as a supporting electrolyte. The objective of this investigation was to synthesize hydrogen peroxide. X-ray photoelectron spectroscopy (XPS), electrochemical impedance spectroscopy (EIS), linear polarization, cyclic voltammetry (CV), and rotating disk electrode voltammetry (RDE) were performed for characterization and investigation of the catalytic properties. The RDE analysis confirmed that oxygen reduction reactions followed two electrons’ process at an activated GC electrode. Hence, the prepared electrode generated hydrogen peroxide from molecular oxygen at a potential of around −0.35 V vs. Ag/AgCl (sat. KCl), significantly lower than the pristine GC surface. The transfer coefficient, standard reduction potential, and standard rate constant were estimated to be 0.75, −0.27 V, and 9.5 × 10−3 cm s−1, resectively