The Effects of Calcium-Vitamin D and Metformin on Polycystic Ovary Syndrome: A Pilot Study

SummaryObjectiveThe aim of this study was to evaluate the effects of calcium-vitamin D and metformin on the menstrual cycle and ovulation in patients with polycystic ovary syndrome (PCOS).Materials and MethodsIn this pilot study, 60 infertile PCOS patients were enrolled in a randomized clinical trial and divided into three equal groups. Group 1 received 1,000 mg of calcium and 400 IU of vitamin D per day, orally. Group 2 received the same as Group 1, plus 1,500 mg/day of metformin. Group 3 received 1,500 mg/day of metformin. The patients were treated for 3 months and followed up for a further 3 months. Regularity of menses, number of large follicles (≥ 14 mm) and pregnancy rates were compared among the three groups.ResultsGeneralized estimating equation tests showed that the number of dominant follicles (≥ 14 mm) during the 2–3 months of follow-up was higher in the calcium-vitamin D plus metformin group than in either of the other two groups (p = 0.03).ConclusionThe effects of metformin and calcium-vitamin D in regulating the menstrual cycle suggest that they could also be effective for the treatment of anovulation and oligomenorrhea, with possible consequences for pregnancy rates in PCOS patients

Transformers in Small Object Detection: A Benchmark and Survey of State-of-the-Art

Transformers have rapidly gained popularity in computer vision, especially in the field of object recognition and detection. Upon examining the outcomes of state-of-the-art object detection methods, we noticed that transformers consistently outperformed well-established CNN-based detectors in almost every video or image dataset. While transformer-based approaches remain at the forefront of small object detection (SOD) techniques, this paper aims to explore the performance benefits offered by such extensive networks and identify potential reasons for their SOD superiority. Small objects have been identified as one of the most challenging object types in detection frameworks due to their low visibility. We aim to investigate potential strategies that could enhance transformers' performance in SOD. This survey presents a taxonomy of over 60 research studies on developed transformers for the task of SOD, spanning the years 2020 to 2023. These studies encompass a variety of detection applications, including small object detection in generic images, aerial images, medical images, active millimeter images, underwater images, and videos. We also compile and present a list of 12 large-scale datasets suitable for SOD that were overlooked in previous studies and compare the performance of the reviewed studies using popular metrics such as mean Average Precision (mAP), Frames Per Second (FPS), number of parameters, and more. Researchers can keep track of newer studies on our web page, which is available at \url{https://github.com/arekavandi/Transformer-SOD}

Green Tech Enterprise / Mohd Izzanur Rashidi...[et.al]

Green Tech Enterprise is a company that involve in the agriculture business where there are a lot of technologies that already exists and are about to be invented and explore as there are a lot of new things that had been done as the advancement of technology has begun to encourage our country to be more open in term of critical thinking and the acceptance and awareness of new technology. From what we know, the agriculture sector has begun the new revolution in term of managements, systems and technology which the current scenario involves the adolescence to participate in the agriculture field. Based on the current scenario that had been . our company focused on the development of new knowledge and technologies that lead towards an improvement in term of the tools and equipment that had been created based on the problems that had been voiced out by the farmers and people ill the agriculture sector. Based from the product that we had created, the Agro-stake is one of the products that is invented to ease the fanner in term of setting-up the stake and other additional extension feature that the customer desire The objectives of our company is to produce new creation of extension innovation tools and equipment based on the agriculture needs and at the same we wanted to provide a better services for our customer in term of consultancy and service which is to make sure the customer is satisfy with the product created by Green Tech Enterprise. The tools and equipment that had been invented by our company is made for more effective and efficient used in field and any places needed in order to ease the workload of people who love farming activities with affordable price and at the same time encourage the young people to involve in modem farming lifestyle to create a better future in the Agriculture sector of Malaysia and also to terminate the way and perception of people on the agriculture which say that agriculture is Dirty, Dangerous and Difficult. From what we are implementing in the business, our location is a strategic location in Malacca which is at Alor Gajah. From what we can say, Malacca is our target location for our target market as there are huge possibilities that Malacca can be one of the Agricultural District in Malaysia that practices modern farming lifestyle in their daily life. From here, we feel that the chances on the viability of the business are high as the products that we produced are focused on agriculture extension product with affordable prices. As the competitors are still lack of new inventions, we will be able to increase our market share ill a short period of time as our company's member are. still young and fresh graduates that are able to generate more idea based on the current technology that are available nowadays. That is why this business is established in order to increase the number of people that involve in the production of agriculture crop yield. So that there will be more innovation technology that can be discover in the future

Spectroscopy, chromatography and microscopic image of 3-(4-methoxyphenyl)-1-phenylprop-2-en-1-one (MNYAD_1539) crystals

3-(4-methoxyphenyl)-1-phenylprop-2-en-1-one (MNYAD_1539) was synthesized by an Aldol condensation method . MNYAD_1539 was synthesized from two commercially available materials of p-Methoxybenzaldehyde and Acetophenone The physical and chemical properties of MNYAD_1539 was investigated using ATR-FTIR, GCMS and a microscope. The FTIR spectrum of the crude MNYAD_1539 showed the presence of impurities, compared with the crystalline sample. The chromatogram showed that MNYAD_1539 with high purity was produced after re-crystallisation. The current study also found high quality of the transparent needle-like crystal after re-crystallisation

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality among Patients with COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial

Importance: Thrombotic events are commonly reported in critically ill patients with COVID-19. Limited data exist to guide the intensity of antithrombotic prophylaxis. Objective: To evaluate the effects of intermediate-dose vs standard-dose prophylactic anticoagulation among patients with COVID-19 admitted to the intensive care unit (ICU). Design, Setting, and Participants: Multicenter randomized trial with a 2 � 2 factorial design performed in 10 academic centers in Iran comparing intermediate-dose vs standard-dose prophylactic anticoagulation (first hypothesis) and statin therapy vs matching placebo (second hypothesis; not reported in this article) among adult patients admitted to the ICU with COVID-19. Patients were recruited between July 29, 2020, and November 19, 2020. The final follow-up date for the 30-day primary outcome was December 19, 2020. Interventions: Intermediate-dose (enoxaparin, 1 mg/kg daily) (n = 276) vs standard prophylactic anticoagulation (enoxaparin, 40 mg daily) (n = 286), with modification according to body weight and creatinine clearance. The assigned treatments were planned to be continued until completion of 30-day follow-up. Main Outcomes and Measures: The primary efficacy outcome was a composite of venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days, assessed in randomized patients who met the eligibility criteria and received at least 1 dose of the assigned treatment. Prespecified safety outcomes included major bleeding according to the Bleeding Academic Research Consortium (type 3 or 5 definition), powered for noninferiority (a noninferiority margin of 1.8 based on odds ratio), and severe thrombocytopenia (platelet count <20 �103/µL). All outcomes were blindly adjudicated. Results: Among 600 randomized patients, 562 (93.7) were included in the primary analysis (median interquartile range age, 62 50-71 years; 237 42.2% women). The primary efficacy outcome occurred in 126 patients (45.7%) in the intermediate-dose group and 126 patients (44.1%) in the standard-dose prophylaxis group (absolute risk difference, 1.5% 95% CI,-6.6% to 9.8%; odds ratio, 1.06 95% CI, 0.76-1.48; P =.70). Major bleeding occurred in 7 patients (2.5%) in the intermediate-dose group and 4 patients (1.4%) in the standard-dose prophylaxis group (risk difference, 1.1% 1-sided 97.5% CI,-� to 3.4%; odds ratio, 1.83 1-sided 97.5% CI, 0.00-5.93), not meeting the noninferiority criteria (P for noninferiority >.99). Severe thrombocytopenia occurred only in patients assigned to the intermediate-dose group (6 vs 0 patients; risk difference, 2.2% 95% CI, 0.4%-3.8%; P =.01). Conclusions and Relevance: Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days. These results do not support the routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients admitted to the ICU with COVID-19. Trial Registration: ClinicalTrials.gov Identifier: NCT04486508. © 2021 American Medical Association. All rights reserved

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Pregnancy outcome in a pregnant patient with idiopathic Pulmonary Arterial Hypertension: a case report and review of the literature

Abstract Background Idiopathic pulmonary arterial hypertension is a rare and progressive condition which is aggravated by the physiologic changes during pregnancy. Because of high mortality rate, most physicians recommend early termination of pregnancy in patients with idiopathic pulmonary arterial hypertension. Case presentation Here we describe a case of a 30-year-old primigravida Caucasian housewife with functional class 1 idiopathic pulmonary arterial hypertension and a positive vasoreactive response to adenosine who had a full-term non-complicated delivery. Right-sided heart catheterization before the pregnancy showed severe pulmonary hypertension with mean pulmonary arterial pressure of 60 mmHg, and pulmonary vascular resistance of 12.2 WU. Vasoreactivity was positive after infusion of 200 μg/kg per minute adenosine. During pregnancy, she did not receive medication other than prophylactic enoxaparin. She had an elective cesarean section under general anesthesia at 39 weeks of gestation without complication and delivered a healthy baby. After delivery, her hemodynamic status was stable. One month postpartum, she was in a stable clinical condition in functional class 1. Conclusions In pregnant patients with pulmonary arterial hypertension, decreased mortality has been observed over recent years particularly in patients with well-controlled pulmonary pressure and a positive vasoreactivity test

Evaluation of incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism in patients admitted to Imam Reza Hospital, Tabriz, Iran (primary results)

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a late complication of pulmonary thromboembolism, which is associated with high morbidity and mortality. Although the pathogenesis is not fully understood, the damage and frequency of this complication have a wide range. The aim of this study was to evaluate the incidence of CTEPH following the first episode of acute pulmonary embolism (PE). Methods: In a cohort study, 101 patients with acute embolism who had undergone anticoagulant therapy were followed up for at least one year. Patients that presented symptoms of dyspnea were selected. Echocardiography was performed on these patients, and they were evaluated for symptoms of right heart failure and increased pulmonary artery pressure of more than 35 mmHg. Results: 101 patients with a mean age of 85.2 ± 17.7 years, including 57 men (56.4%) and 44 females (43.6%), were treated for a diagnosis of acute PE and were followed up for one year. 77.2% of patients had an idiopathic PE and 22.8% had it as the underlying cause. During follow-up, 23 patients (22.8%) experienced dyspnea. Echocardiography was normal in 13 cases and 10 cases had signs of right heart failure and pulmonary artery pressure. The overall incidence of CTEPH was 9.9%. Demographic data and computed tomography (CT) angiography findings were not associated with higher incidence of CTEPH. Conclusion: CTEPH is a serious complication of acute PE, and the incidence of pulmonary hypertension after pulmonary emboli is relatively high. Age and gender did not influence its occurrence. Moreover, there was no relationship between the findings of CT angiography in the initial PE and chronic pulmonary hypertension rate of incidence