State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS)

PCOS, a heterogeneous disorder characterized by cystic ovarian morphology, androgen excess, and/or irregular periods, emerges during or shortly after puberty. Peri- and post-pubertal obesity, insulin resistance and consequent hyperinsulinemia are highly prevalent co-morbidities of PCOS and promote an ongoing state of excess androgen. Given the relationship of insulin to androgen excess, reduction of insulin secretion and/or improvement of its action at target tissues offer the possibility of improving the physical stigmata of androgen excess by correction of the reproductive dysfunction and preventing metabolic derangements from becoming entrenched. While lifestyle changes that concentrate on behavioral, dietary and exercise regimens should be considered as first line therapy for weight reduction and normalization of insulin levels in adolescents with PCOS, several therapeutic options are available and in wide use, including oral contraceptives, metformin, thiazolidenediones and spironolactone. Overwhelmingly, the data on the safety and efficacy of these medications derive from the adult PCOS literature. Despite the paucity of randomized control trials to adequately evaluate these modalities in adolescents, their use, particularly that of metformin, has gained popularity in the pediatric endocrine community. In this article, we present an overview of the use of insulin sensitizing medications in PCOS and review both the adult and (where available) adolescent literature, focusing specifically on the use of metformin in both mono- and combination therapy

Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis

Abstract Purpose: To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent. Methods: Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software. Results: Sixty eight studies (2023 participants) were included. Approach in acute phase was performed four times more than in chronic phase. Approach: abdominal 65% (IC 95% 63-67%), thoracic 23% (IC 95% 21-24%), abdominal in the acute phase 75% (IC 95% 71-78%), and chronic 24% (IC 95% 19-29%), thoracic in the acute phase 12% (IC 95% 10-14%) and chronic 69% (IC 95% 63-74%). Thorax opening in the abdominal approach: 10% (95% CI 8-14%). Abdomen opening in the thoracic approach: 15% (95% CI 7-24%). Conclusions: The most common approach was the abdominal. The approach in the acute phase was more common. In the acute phase the abdominal approach is more frequent than the thoracic approach. In the chronic phase the thoracic approach is more frequent than the abdominal one. The requirement to open the second cavity was similar in both approaches

Measurement of Λb0 , Λc+ , and Λ decay parameters using Λb0→Λc+h− decays

A comprehensive study of the angular distributions in the bottom-baryon decays Λ0 b → Λ c+h−(h = π, K), followed by Λþ c → Λhþ with Λ → pπ− or Λþ c → pK0 S decays, is performed using a data sample of proton-proton collisions corresponding to an integrated luminosity of 9 fb−1 collected by the LHCb experiment at center-of-mass energies of 7, 8, and 13 TeV. The decay parameters and the associated charge-parity (CP) asymmetries are measured, with no significant CP violation observed. For the first time, the Λ0 b → Λþ c h− decay parameters are measured. The most precise measurements of the decay parameters α, β, and γ are obtained for Λþ c decays and an independent measurement of the decay parameters for the strange-baryon Λ decay is provided. The results deepen our understanding of weak decay dynamics in baryon decays

<em>Rheum spiciforme</em> Royle—the medicinal herb with positive modulatory effect on controlled <em>in vitro</em> oxidative stress

556-564Oxidative stress is the root cause of many diseases, affecting the humans by deranging the balance between the oxidants and antioxidants. Pathologies, such as Alzheimer’s, Parkinson’s, diabetes and cancer have been well associated with the production of free radicals during various metabolic processes. Many medicinal plants are used to treat such kind of diseases since ancient times. Here, we evaluated the medicinal herb Rheum spiciformis Royle (RS), used commonly in folklore to treat many aliments for its potential against oxidative stress. Five different extracts (aqueous, chloroform, ethyl acetate, methanol and PET ether) of RS were evaluated against oxidative stress generated in vitro. Phytochemical constituents were assessed followed by total phenolics, DPPH, reducing power, hydroxyl radical scavenging activity and in vitro calf thymus DNA damage. The highest phenolic content (TPC) of 1191.65 mg GAE/g was observed in RS-MeOH extract. DPPH radical scavenging activity was found to be highest in RS-MeOH (96.60%) with IC50 125.91 µg/mL. The reducing power of the extracts increased in a concentration dependent manner. Again superoxide radical scavenging activity of RS extracts with IC50 values 34.10 µg/mL (RS-MeOH) for methanol was highest. The H2O2 scavenging activity 84.76 µg/mL shown by RS-MeOH extract at 250 µg/mL of plant extracts was the maximum. RS-MeOH showed great effect to scavenge free radicals as such prevents Calf thymus DNA damage induced by Fenton reaction. These results clearly indicate that RS-MeOH and RS-EtA among the five extracts possesses the highest positive modulatory effect on free radical scavenging on wide variety of free radicals as such can be employed as potential antioxidant and anti-inflammatory agent against various oxidative stress related pathological conditions

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Not AvailableThe present investigation was conducted on thirty eight accessions of onion at the experimental farm of Central Institute of temperate Horticulture to study the variability and their interrelationship and divergence pattern based on quantitative and qualitative traits during 2009 to 2011. Multivariate analysis was used to classify 38 long day onion accessions. All accessions were grouped into six different clusters. The highest inter cluster distance was observed between IV and V and lowest between II and VI. Based on cluster means the important cluster was I for plant height and percent marketable bulbs cluster IV for mean yield, total yield and equatorial diameter and cluster III for the number of leaves, collar thickness and average bulb weight. Accordingly, parents could be selected for hybridization. Principal component analysis, first two principal component accessions accounted for 59.29% of the variance among 38Not Availabl

Character association and path analysis in garlic (Allium sativum L) for yield and its attributes

Character association and path analysis in twenty genotypically diverse indigenous genotypes of garlic (Allium sativum L.) were studied at the Central Institute of Temperate Horticulture, Srinagar during the years 2010 and 2011 for nine important characters. Total bulb yield showed positive and significant genotypic and phenotypic associations with plant height, number of leaves per plant, pseudo-stem length, bulb weight and number of cloves per bulb, indicating that selection based on these traits will help increasing the yield of garlic. Path coefficient analysis provides an effective means of a critical examination of specific force action to produce a given correlation and measure the relative importance of each factor. In this analysis bulb yield was taken as dependant variable and rest characters were considered as independent variable. Bulb weight showed high positive and direct effect and significant positive correlation with total bulb yield. Therefore, bulb with higher weight should be considered in selection criteria for increasing the total bulb yield and emphasis should be given for selecting the genotypes with higher bulb weight. Overall path analysis indicated that direct effect of bulb weight and equatorial bulb diameter and indirect effect of plant height, number of leaves per plant, pseudo stem length, polar bulb diameter, equatorial bulb diameter, number of cloves per bulb and average weight of 50 cloves should be considered simultaneously for amenability of total bulb yield. DOI: http://dx.doi.org/10.3329/sja.v11i1.18374 SAARC J. Agri., 11(1): 45-52 (2013)</jats:p