The outcomes of dapagliflozin use in real-life clinical settings in endocrinology clinics of Islamabad, Pakistan

Introduction: Dapagliflozin is a member of a novel class of drugs (sodium-glucose cotransporter-2 inhibitors) used to treat type 2 diabetes mellitus and licensed in Pakistan in 2017. This retrospective observational study evaluated the effects of dapagliflozin on glycated hemoglobin (HbA1c) concentrations in patients treated at endocrinology clinics in Islamabad, Pakistan. The secondary objectives included assessing the effects of dapagliflozin on weight reduction and blood pressure control and to determining its safety.Methodology: Patients with type 2 diabetes who were treated with dapagliflozin were identified by screening the electronic medical records at tertiary care hospitals in Islamabad. Data were collected at the first visit and at follow-up. Categorical variables were recorded as frequencies and percentages and compared by McNemar’s tests, and continuous variables were recorded as means and standard deviations and compared by paired sample t-tests.Results: Mean HbA1C concentration was significantly lower at follow-up than at the first visit (7.57%±0.98% vs. 9.07%±2.07%, respectively; p\u3c0.001). Bodyweight (85.09±15.92 kg vs. 87.07±16.11 kg, respectively; p\u3c0.001) and diastolic blood pressure (80.34±7.12 mmHg vs. 82.34±9.61 mmHg, respectively; p\u3c0.001) were also significantly lower at follow-up than at the first visit, whereas systolic pressure showed a marginally significant reduction (123.5±16.57 mmHg vs. 126.83±19.97 mmHg, p=0.048).Conclusion: This first observational study of patients in Pakistan treated with dapagliflozin found that HbA1c concentration, weight, and blood pressure were reduced after initiation of dapagliflozin treatment

Graphical Views of Intuitionistic Fuzzy Double-Controlled Metric-Like Spaces and Certain Fixed-Point Results with Application

In this article, we establish the concept of intuitionistic fuzzy double-controlled metric-like spaces by “assuming that the self-distance may not be zero”; if the value of the metric is zero, then it has to be “a self-distance”. We derive numerous fixed-point results for contraction mappings. In addition, we provide several non-trivial examples with their graphical views and an application of integral equations to show the validity of the proposed results

New Fixed Point Results in Neutrosophic Metric Spaces

In this manuscript, we give the generalization of banach’s, Kannan’s and Chatterjee’s fixed Point theorems in neutrosophic metric spaces by using new (TS-IF⍺) contractive mappings. Also, we establish common fixed point results in neutrosophic metric space by using Occasionally weakly compatible maps for integral type inequalities

Cloreto de potássio como condicionador osmótico nutritivo de sementes para aumentar a tolerância ao sal em milho

The objective of this work was to determine if KCl could be a useful nutrient primer for safe seed germination in maize crop under salt stress conditions. Seed priming was done using 50 mmol  L-1 of muriate of potash, and germination and seedling growth were evaluated after salt stress with NaCl up to 50 mmol L-1. Another set of seeds was tested under the same salt stress conditions without priming. Under salinity stress, germination percentage, germination rate index, germination coefficient, and seedling vigor indexes were higher in primed seeds. In unprimed seeds, mean germination time increased, while the germination rate index and the fresh and dry matter mass decreased more sharply with salinity stress. The Na/K ratio was higher in unprimed seeds.O objetivo deste trabalho foi determinar se o KCl pode constituir um condicionador osmótico nutritivo, para a germinação segura da cultura do milho em condições de estresse salino. O osmocondicionamento das sementes foi feito com 50 mmol L‑1 de muriato de potássio, e a germinação e o desenvolvimento de plântulas foram avaliados após estresse salino por NaCl, até 50 mmol L‑1. Outro lote de sementes foi testado nas mesmas condições de estresse salino, sem condicionamento. Em condições de estresse salino, a percentagem de germinação, o índice da taxa de germinação, o coeficiente de germinação e os índices de vigor das plântulas foram maiores nas sementes condicionadas. Em sementes não condicionadas, o tempo médio de germinação aumentou, e o índice da taxa de germinação e as massas de matéria fresca e seca diminuíram mais acentuadamente com o estresse salino. A relação Na/K foi maior nas sementes não condicionadas

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

Background: The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. Methods: PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (<50 years vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031. Findings: Between Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir. Interpretation: Molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community

Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

BackgroundThe safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population.MethodsPANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (<50 years vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031.FindingsBetween Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir.InterpretationMolnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community

On Graphical Fuzzy Metric Spaces with Application to Fractional Differential Equations

In this article, the authors introduced the concept of graphical fuzzy metric spaces which is a generalization of fuzzy metric spaces with the help of a relation. The authors discussed some topological structure, convergence criteria, and proved a Banach fixed-point result in graphical fuzzy metric space. As an application of obtained results, the authors find a solution of an integral equation and nonlinear fractional differential equations in the context of graphical fuzzy metric spaces. The authors provided some examples to illustrate the obtained results herein

Approximating Common Solution of Minimization Problems Involving Asymptotically Quasi-Nonexpansive Multivalued Mappings

In this paper, an iterative scheme for finding common solutions of the set of fixed points for a pair of asymptotically quasi-nonexpansive mapping and the set of minimizers for the minimization problem is constructed. Using the idea of the jointly demicloseness principle, strong convergence results are achieved without imposing any compactness condition on the space or the operator. Our results improve, extend and generalize many important results in the literature

A New Iteration Scheme for Approximating Common Fixed Points in Uniformly Convex Banach Spaces

In this paper, firstly, we introduce a method for finding common fixed point of L-Lipschitzian and total asymptotically strictly pseudo-non-spreading self-mappings and L-Lipschitzian and total asymptotically strictly pseudo-non-spreading non-self-mappings in the setting of a real uniformly convex Banach space. Secondly, the demiclosedness principle for total asymptotically strictly pseudo-non-spreading non-self-mappings is established. Thirdly, the weak convergence theorems of the proposed method to the common fixed point of the above mappings are proved. Our results improved, extended, and generalized some corresponding results in the literature

Strong Convergence Theorems for a Finite Family of Enriched Strictly Pseudocontractive Mappings and &Phi;T-Enriched Lipschitizian Mappings Using a New Modified Mixed-Type Ishikawa Iteration Scheme with Error

In this paper, we introduce two new classes of mappings known as &lambda;-enriched strictly pseudocontractive mappings and &Phi;T-enriched Lipshitizian mappings in the setup of a real Banach space. In addition, a new modified mixed-type Ishikawa iteration scheme was constructed, and it was proved that our iteration method converges strongly to the common fixed points of finite families of the above mappings in the framework of a real uniformly convex Banach space. Moreover, we provided a non-trivial example to support our main result. Our results extend and generalize several results existing in the literature