United Parcel Service And Service Marketing Business Essay

United Parcel Service And Service Marketing Business Essay Services are economic activities that create and deliver great value to the consumer. It is an act that helps consumers to get things done without having to go do it themselves, and the consumers have to pay for it. Services, which can surprise a customer on the first delivery, always win over with high reputation and excellence or pass with flying colours. This report is on the services offered by UPS, mainly focusing on their call centre. UPS was found in 1907 by two people Jim Casey Claude Ryan who were teenagers at the time, also known as the American Messenger Company, whose messengers delivered packages, and carried notes, baggage and trays of food from restaurants. Most of the delivery was made either on foot or, and bicycles for longer journeys. At the time, only a few automobiles were in existence and department stores of the day still used horses and wagons for merchandise delivery. The company was soon started delivering small parcels for local department stores and changed its name from American Messenger Company to Merchants Parcel Delivery. The company expanded outside Seattle (USA) in 1919 with the acquisition of Oakland (USA) based Motor Parcel Delivery and was renamed United Parcel Service in 1930. UPS began the process of expanding its services by acquiring common carrier rights for the entire country; this took place in the 1950s. Over the past century, UPS has transformed drastically, growing from a small messenger company to a leading provider of air, ocean, ground, and electronic services. In 2003, the company introduced a brand new mark and acronym UPS showing the world that its capabilities extend beyond small package delivery but rather has a broad line of services. However, the company maintains its reputation for integrity, reliability, employee ownership, and customer service. For UPS, the future holds even greater goals to be achieved and accomplished. The UPS Culture As a company, UPS focuses its attention on: Safety: The company spends $38 million a year on safety training, which covers everything from proper body mechanics at work to proper nutrition and exercise at home. As a result, UPS has lowered the number of workdays lost due to injury by more than 50 percent since 1995. Employee education: Many UPS employees at Worldport and other sorting locations are college students. UPS encourages mentors and recruiters from nearby colleges to visit and work with its employees, and it provides additional benefits and perks for college students. Diversity: Minorities make up 35 percent of UPS U.S. employees and 30 percent of its executives. Its also recognized by Fortune magazine as one of the 50 best companies for minorities The Environment: Delivering packages all over the world and moving them between distribution centers requires an enormous amount of fuel. UPS uses several methods to reduce its fuel consumption and its environmental impact. For example, it has developed a hydraulic hybrid package car, and its drivers use route-planning software to minimize the amount of time they spend idling in traffic and making left turns. UPS pilots also fly at the most fuel-efficient speeds possible to meet their delivery deadlines and run only one engine when taxiing to conserve fuel. Current trends in the industry According to Miss Tanya Astley, Customer Representative Officer in the UPS there are no such trends in the company, only the way things are done keep changing, on busy days, like, on festivals and important occasions. ENVIRONMENTAL ANALYSIS SWOT ANALYSIS Strengths Global Brand, Strong Distribution Network Weaknesses Perception of Ground Delivery instead of Overnight Heavy Union presence Opportunities Expansion of online shopping Emergence of international middle class Threats Increasing Fuel Costs Competitive Landscape (DHL, USPS, FedEx), potentially slowing global economy. Now to use strengths to capitalize on opportunities, I would say leverage the brand online by partnering with major shopping sites. To addresses weaknesses to alleviate threats, I would say heavily market overnight capabilities to keep FedEx and DHL at bay. 3. Major competitors: Fedex DHL Speedex Aramex THE SERVICE OFFERING Determining customer requirements There is no particular way of measuring the customer requirements in the type of service done by UPS, but they tend to attract new customer through marketing and telesales. Customer loyalty is held high in UPS. Strategy There are a lot of different factors to build Competitive advantage in the Air Express Industry. The different strategies of the companies based on their core product which they are better in than other companies hence makes all the difference. When a business provides an excellent service to its customers, it gives them a positive service experience which leads to repeat purchases or usage of that specific service. As well as passing on the experience to family and friends this helps UPS build a stronger relationship with their customers. UPS believes that by achieving effective customer service they will hence achieve a competitive advantage in the market. UPS uses a differentiation strategy; it does this by creating something about its product or service that is perceived as unique in the industry. Customers must perceive the service as a unique one compared to the competition. UPS should be aware that its customers must be relatively price insensitive as adding this additional uniqueness to its services as additional costs Differentiation may be attained through many features that make the product or service appear unique. Possible strategies for achieving differentiation may include: warranties brand image technology features service quality/value dealer network Economies of scale, such as, lower costs and product differentiation were also prime sources of achieving a competitive advantage in this industry, which were used by UPS to its advantage. This helped UPS to gain a much larger domestic market share three times that of United States postal and twice of Fed Ex, UPS was very cost effective at the time and had a very good reputation in the market. It was only a matter of time when UPS realized that they were not doing as well as they did before and also realized that any competitor could do the same in terms of achieving economies of scale. UPS has been the market leader in this division for a long time. UPS as sited in our essay has always been the leader in market pricing trends. Always the first to charge premiums, and the first to give discounts to the customers. UPS strategy has always been quite different from that of Fed Ex, Aramax or even DHL. UPS is very profitable, well organized, successfully run, has low debt, and a massive ground operation that can financially support a downturn in air express operations. Because of their size and financial strength UPS is in the best position to survive a price war in the industry. The media strategy The usage of an appropriate advertising media, such as, television, press, radio, internet and key broadcast channels, leading titles and publications and strategic outdoor sites can be very influential in helping us to achieve our campaign objectives. The following media imperatives have been set for the region: Television is the key broadcast medium to drive awareness of the new UPS brand identity and offering. Radio will be used as a lead (where budgets dont allow for TV) or support medium, reinforcing primary messages and cultivating top-of-mind awareness. Outdoor will be used to communicate the primary message, ensure new logo exposure and in smaller countries, as a substitute for broadcast media. Press will be used to support the TV creative or stand alone, allowing more opportunity to explain the UPS strategy further High reach media will be used at the launch, covering all audiences, followed by one or two lower bursts ensuring longevity of the new brand message. To build customer relationship, the organization could: Keep in touch with the customer by sending emails with the offers and rates. Get regular feedback from customer who have used the service and improve with their suggestions, to make the customer feel like the king. DEMAND AND CAPACITY 1. Demand cannot be forecasted in this industry. The company can only take the initiative to maintain current sales and hope increase sales in the future by marketing. 2. An increase in demand will lead to more people being employed either part time or full time depending on the tasks that need to be performed. Another important thing needed is the service vehicles, with the increased demand. 3. Customers dont have to go through the hassle of waiting in lines for their doubts to be clarified. All the customer has to do is call, which gets routed to various agents in the call centre, to answer any queries or solve any issues. SPECULATION 1).Opportunities appear to be available in the industry currently the margin for opportunities seems to be very narrow. But strategies could be altered according to the consumer needs. For example, some consumers emphasize on price and the others on the service time taken no matter what the price. Recently, UPS is planning to set up a domestic postal service in China. They plan to introduce a next day delivery service and second and third day delivery products. China is a potential for UPS to grow and offer services and products internationally and this it seems China is an emerging market which could be worth billions. 2. Technological advances In todays day and age the air express industry has become so technologically advanced that goods can be delivered overnight. It is facing intense price competition between the competitors, which exist in this market. The ability to price, route, track and deliver parcels and mail in both domestic and international markets demands a comprehensive. A significant improvement in information technology has enabled package carriers to provide to customers the ability to track their packages movement from origin to destination. Other advances included combining logistics, freight and financial services with traditional package delivery in order to offer customers full supply chain management solutions. Only the organizations that were able to achieve these effectively and efficiently were able to survive in this industry. This is how the existing companies could then make their profit. In this industry the price of the service is the main source for competing. This is the only way in achieving Competitive Success. Competitive advantage can be achieved if, the price of the service provided by competitors is similar and the approach taken to provide the service. For instance, the amount of time taken for the product to reach from point A to point B. 3. Advice to other firms who plan to enter the industry Our advice to the new firms which plan to enter this industry would be to, research the market and the industry and think about strategies that provide the new firm a big competitive advantage including low cost of service and low price charged to the customers. The relationship between the firm and the customers should be healthy. The company should be knowledgeable about everything and should see to it that they have all the information necessary. Customer Relationship Management Customers account for 95% of UPSs shipping information directly. The CRM methodology is a very core part of the UPS success story. UPS grows through engineering and re-engineering of its systems. UPSs growth was achieved slowly and methodically from the inside out. An Excellent service is what distinguishes it from other companies. Companies can use and integrate UPS Worldship hence optimizing their business processes. They can process shipments easily, respond to your customers faster, and reduce costly errors. UPS  provides businesses with  multiple ways to integrate WorldShip with their business: Batch Import/Export: Import a file containing addresses, customer orders, or other shipment information, or export shipping history to your internal systems. Keyed Import:  Allow WorldShip to recognize a customers order simply by entering or scanning a unique identifier, such as a Purchase Order number. Hands-Off Shipping:  Schedule WorldShip to pull addresses from your order entry database and automatically print shipping labels at designated times. XML Auto-Import:  Automate shipment processing using XML code. LOGISTICS Logistics is about getting things where they need to be, at the correct time as effectively and efficiently as possible. But nowadays, logistics is also a strategic way to add value to your business, better served customers, and better long term growth. The logistics provided by UPS can help you manoeuvre the intricacies of global trade with minimal effort. Manage your shipments and minimize their environmental impact. And win repeat and loyal customers by making it easy to return products or parts. The new logistics is more than just getting things to the right place at the right time at the right cost. Its about using the movement of goods as a competitive advantage. Its a whole new way of thinking. And its a powerful force for growing your business. Access to Resources through UPS Businesses dont need a large warehouse, distribution center, or global network to access this new logistics. UPS has built a massive integrated network of physical, technological, and human assets that lets you  tap into the power and passion of logistics. The new logistics from UPS levels playing fields. It lets you act locally or globally. Its for the individual entrepreneur, the small business, or the large company. Its reliable, efficient, and environmentally responsible. Long term growth in the telecommunication UPS needs to learn from other industry best practices to gain a competitive edge in and expand beyond their core markets. An increasing number of companies have redefined themselves and significantly outperformed the markets by growth through services. UPS Moved from traditional parcel services to total supply chain solutions. UPS can better differentiate themselves via services by extending relationship with existing customer base leveraging. Superior customer knowledge as key asset. Customer proximity and delivery competence. In addition, developing the necessary skills and scale by new service-specific processes being developed and service innovations to ensure fast scalability of process and time to market. UPSs evolution to Total Supply Chain Solutions started as:- Standalone development of small service operations within the organization: Worldwide Logistics unit Service Parts Logistics Worldwide dedicated Services UPS Truck Leasing UPS consulting This moved on to:- Expansion of product portfolio and consolidation of existing services resources into UPS Supply Chain Solutions. And finally Reorganization and major MA effort with 16 key acquisitions to develop scale and growth.

Abortion :: essays research papers fc

Abortion With 2000 being a presidential election year, the question of pro-choice or pro-life is once again a prominent issue. I am and have been a pro-choice advocate since I first understood the issue. The upcoming election has made me revisit the main reasons for my position. For me, two main reasons for supporting pro-choice are the medical and social benefits the country has experienced since the Supreme Court legalized abortion in 1973. The most important medical benefit has been the end of the â€Å"back alley butchers† who left many women dead or mutilated. Legal abortion has proven to be safe, while illegal abortion has not. In 1965, 193 women died from illegal abortions, and 17% of all deaths due to pregnancy and childbirth in that year were caused by illegal abortions. (Medical screen 2) Current death rate from abortion is 0.6 per 100,000. This means that abortion is 11 times safer than carrying a pregnancy to term. (Medical screen 2) In other countries where abortion is illegal it is a leading cause of maternal death. (Safety screen 1) Along with the medical benefits, there have also been many social benefits due to the legalization of abortion. Unfit mothers and teenagers no longer are forced to carry out there pregnancies and have to care for an unwanted child. Couples who have a high risk of giving birth to babies with genetic disorders are now more willing to try and conceive because of the availability of safe legal abortions. (Medical screen 2) States with stricter abortion laws spend far more money per child on things such as foster care, welfare, and education then states with more lenient laws. (Medical screen 2-3) Last is my conviction that each individual woman, and no one else, has the right to carry out or abort her pregnancy. Every woman can do what she wants with her bodies without any government intervention. The Supreme Court based women’s right to an abortion on the right of privacy, or the right of people to make choices about their personal and reproductive life without interference from the state. (McDonagh 4) Upon revisiting my reasons for supporting the pro-choice movement, I am more convinced than ever that my beliefs are justified.

How Customer Service is provoded in business Essay

Costumer service is the ability of an organisation to recognise and consistently meet the costumers’ needs. Costumer service generally involves service teamwork and service partnerships so they can meet customer expectations and produce costumer satisfaction. Costumers contact an organisation when they need something, the main reasons are: * To complain * To request/ order a service/product * To obtain information * To ask for advice * To enquire about an order * To change an order or request * To report a problem to return and exchange goods * To ask for assistance or help The organisation I have chosen to study for this is the National Maritime Museum which consists of the Royal Observatory Greenwich, Queen’s House and National Maritime Museum. Together these constitute one museum working to illustrate for everyone the importance of the sea, ships, time and the stars and their relationship with people. A customer is anyone who has the right to ask or expect a service as part of a job role; this means there are two types of customers – internal and external. Internal customers are all the colleagues who need assistance to fulfil their obligations to their own customers; these include the supervisors, staff, staff teams and managers. External customers are those who contact or visit the organisation because of what it provides or supply’s as it is something they need. There are a wide range of external customers but only a few can apply to each business, some businesses have a wider range of external costumers compared to other businesses, such as a supermarket will have a wider range of external customers as it will sell a wide range of goods whereas a youth club or nursery will have a smaller rage of external customers as its only aimed at a certain age group. The National Maritime Museum has a wide range of customers and provides everyone access to its historical buildings and unique collectors; as a result the customers have a wide range of needs so they provide products and services to fit their needs. On any average day the museum staffs have to deal with * People wishing to research their family history in our archives * Ship model-makers wanting advice on details of a ship * Film companies wanting to use our buildings as a location for an advert or television drama * Domestic tourists wanting a fun day out * Foreign tourists wanting to experience British history * School and college groups wanting to investigate the Museum to help with their studies. The Museum has 7 main categories of customers which have their own special needs and interests and they are the following 1. Individuals – Casual Visitors – Special Interest Visitors – Individual Researchers 2. Families – Parents along with Young Children 3. Groups – Mixed age groups – Special Interest and Education 4. People from different cultures with different languages – Foreign and Domestic Tourists – People from Diverse Ethnic and Religious Communities 5. People with special needs – Blind and Visually Impaired – Deaf and Hearing Impaired – Learning Difficulties – Physical, Emotional or Mental Health Needs 6. Virtual users who access the Museum via our website – People who access the museum via the website 7. Internal customers – Members of Staff who Support the Work of Others The main three types of customers the National Maritime Museum focuses on are families, disabled visitors and groups. Families are an important target audience for the museum as it is a free family-friendly place to visit; it focuses of the key needs and expectations of family audiences which are: – it’s free – the price of tickets can be a barrier for many families, especially with the costs of travel and lunches – it’s fun and educational with lots to see and touch, like the All Hands interactive children’s gallery – there’s lots to do such as special activity workshops, storytelling and treasure trails – it’s easy to get to – only 20 minutes from central London, with good transport links The Museum also has family-friendly events which bring the Museum galleries to life including practical activities for 2-to-6-year-olds (weekly); trails revealing the secrets of their vast collection of objects; action-packed art and science workshops, and actors’ performances for all ages. Their family-friendly facilities include areas for changing and feeding babies, clean and accessible toilets, cafe and picnic areas and online activities in the E-Library and on the website. The Museum aims to increase the number of families who visit the National Maritime Museum by expanding programs of events, activities and special exhibitions for families, especially during weekends and holidays. All this makes the Museum more appealing to families. Along with individuals the Museum has also built up experience in providing for different type of groups who each have a different set of needs. Foreign language students – The Museum provides souvenir guides and essential visitor information on their website in different languages. This service targets both foreign tourists and domestic visitors with English as a second language. They also have non-Eurocentric displays and events which inform customers of the history of people and cultures from all over the world. Large Groups – For large groups coach parking is easily attainable, there are special discounts given to access the charging exhibitions, pre booked tickets make it easier for large groups to book easily and guided tours and talks are especially available for larger groups. Special Interest Groups – At the museum there are enquiry and research facilities accessible via the library, there are archives and online sources at hand and also special curator talks and tours for all the groups that have a special interest. Corporate and Private Hire Groups – There is event planning and support available for Corporate and Private Hire groups including venue hire and catering for those who want to use the museum for private hires and corporate reasons. Educational Groups – The museum provides curriculum recourses and educational talks along with support with visit planning and booking. They also have a lunchroom and cloakroom especially suited for school/ educational groups. Lastly the National Maritime Museum also focuses on developing access for all their visitors and users which includes those who are disabled. It continuously tries to exceed and improve the museums facilities to meet the basic requirements of those who are physically disabled, deaf and blind. They believe good, inclusive customer service is about understanding everybody’s special needs. For visitors with disabilities, the Museum has a range of access facilities as part of its customer service. o Installing new lifts and ramps o The Road Train service o Providing detailed information for disabled visitors o Providing alternative ways to access the Museum o Maintaining a policy of welcoming assistance dog They have added lifts to improve physical access around the Museum site. Members of staff are always at hand to help. The new lifts and ramps that have been installed provide flat or wheelchair access to all levels and galleries. Visitors may also borrow manual wheelchairs from admission areas. Special bookings for those who are disabled are also available by calling the bookings unit who will make any special arrangements. There is also information available online such as the availability of disabled car-parking, mobility buses and the access facilities on all their sites. It is also important that the customer information also describes areas that are not accessible – such as parts of the historic buildings of the Royal Observatory. This avoids frustration and disappointment on the day. Touch Sessions for Visually Impaired Visitors are also available. They have a number of alternative methods to accessing the Museum and its collections. For blind and visually-impaired visitors they provide: o Braille Guides o Raised drawing o Magnifying glasses o Large-print guides o Tactile maps o ‘touch packs’ They also run a program of pre-booked ‘touch talks and tours’ by Museum staff and guest speakers. The National Maritime Museum also has a sign-interpreted talk for deaf and hearing-impaired visitors. They have installed perimeter loops in the galleries, admission areas, information desks and key audio installations. They also run a program of pre-booked British Sign Language sign-interpreted talks and events. Customer service is important to the National Maritime Museum because without customers there would not be a business. Excellent customer service results in: * higher visitor numbers and greater customer diversity – Visits to the sites are increasing each year – provides a public service for groups of people who don’t traditionally visit or use cultural or heritage organizations like museums – Has an outreach community newsletter which has news and events for communities under-represented among the visitors * increased sales – The Museum generates increased income through shops, cafes and charging for special exhibitions – It also supplies hiring venues for corporate events and weddings and sales from the Picture Library. * increasing public image – The Museum has to compete with other organizations for people’s leisure, by providing excellent customer service it increases public image they do this using their website and leaflets * survival in terms of competition – Good customer service can give the Museum an edge over other tourist attractions or leisure facilities, as they compete for customers’ leisure time and money. * satisfied customers and greater job satisfaction for staff – As well as asking for feedback from customers and monitoring visit numbers the Museum pays a market research company to conduct surveys, the customers are asked to rate their experiences and satisfaction levels, this helps knowing the customer’s needs and satisfying them. – The staff also takes pride in being part of an organization which delivers high levels of customer service – Job satisfaction is increased by positive feedback from the customers * repeat business and customer loyalty – Museum donation box Analysis of feedback and visitor surveys indicates that 94% of visitors would recommend the Museum to their friends. – Excellent customer service results in strong customer loyalty and increased visitor numbers – especially repeat visits. The National Maritime Museum believes that to enjoy and learn from a museum’s collections, visitors must first feel welcome, secure and comfortable in their environment. Crucial factors include friendly staff to greet and help, clear signage, queuing systems, gallery plans and well-maintained washrooms and cloakrooms. Improvements to these areas can significantly increase word of mouth recommendations, repeat visits and time and money spent by visitors as competition for the public’s time and attention is intense.

The Effect of Calcium and Vitamin D Supplements as an Adjuvant Therapy to Metformin on Lipid Profile - Free Essay Example

Sample details Pages: 7 Words: 1999 Downloads: 1 Date added: 2019/06/13 Category Management Essay Level High school Tags: Profile Essay Did you like this example? ABSTRACT: Objective: This study aims to investigate the impact of combining calcium and vitamin D supplements with metformin on lipid profile in vitamin D deficient/insufficient polycystic ovary syndrome (PCOS) women. Study design: A randomized, placebo-controlled clinical trial. Setting: Damascus University of Obstetrics and Gynecology Hospital and Orient Hospital, in Damascus, Syria. Don’t waste time! Our writers will create an original "The Effect of Calcium and Vitamin D Supplements as an Adjuvant Therapy to Metformin on Lipid Profile" essay for you Create order Materials and methods: Forty PCOS women with 25-hydroxyvitamin D KEYWORDS: Polycystic Ovary Syndrome; Lipid Profile; Calcium; Vitamin D; Metformin. INTRODUCTION: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among females of reproductive age, with a worldwide prevalence of 5-20% depending on the criteria is used [1,2]. The main manifestations of this syndrome are ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology [2]. Noticeably, PCOS is associated with several metabolic disturbances such as insulin resistance, compensatory hyperinsulinemia, dyslipidemia and central obesity, which increase the risk for long-term complications like type 2 diabetes mellitus, metabolic syndrome, and cardiovascular diseases [3]. However, the exact aetiology of PCOS remains unclear and current treatments are only moderately effective at controlling PCOS symptoms and preventing its complications [4]. Thus, seeking for alternative or adjuvant therapies, numerous studies investigated the impact of dietary supplements such as zinc [5], omega-3 fatty acids [6], and vitamins [7] in management this syndrome. Some of those studies focused on vitamin D. Vitamin D is no longer considered a vitamin solely responsible for bone metabolism and calcium homeostasis as several studies demonstrated its influence on cell proliferation, differentiation, apoptosis, immune regulation, genome stability, and neurogenesis [8]. Growing evidence suggests a role of vitamin D in female reproductive diseases, as the expression of Vitamin D Receptors (VDR) was identified in many organs throughout the female reproductive tract, such as ovary (particularly granulosa cells), uterus, and placenta [9]. On the top of that, vitamin D regulates over 300 genes, including genes that are important for glucose and lipid metabolism. Thus, vitamin D deficiency may be the missing link between insulin resistance and PCOS [3]. Moreover, vitamin D deficiency is a common condition among women with PCOS [10,11], and several studies indicated an association between low levels of serum 25-hydroxyvitamin D (25-OH-Vitamin D) and manifestations of PCOS including insulin resistance [10â€Å"14], hyperandrogenism [12], and infertility [15,16]. However, Although pre-clinical data have suggested a possibility for calcium and vitamin D to modulate lipid profile [17â€Å"19], clinical studies about the impact of calcium and vitamin D supplements on lipid profile in PCOS subjects are scarce and inconsistent [20â€Å"23]. Considering the aforementioned data, we conducted this placebo-controlled clinical trial to assess the effect of calcium and vitamin D supplements as an adjuvant therapy to metformin on lipid profile in vitamin D deficient/insufficient PCOS women. MATERIAL AND METHODS: Study design: This randomized, single-blinded, placebo-controlled clinical trial was conducted on women with PCOS who referred to the outpatient clinic at Damascus University of Obstetrics and Gynecology Hospital, and Orient Hospital, in Damascus, Syria, from December 2016 to December 2017. The Ethical Committee of Damascus University approved the study protocol, and a written informed consent was obtained from all participants. Participants: In this study, we included PCOS women diagnosed according to the Rotterdam criteria [24], which require the presence of at least two of the following three criteria: 1) Oligo or anovulation, 2) Clinical and/or biochemical signs of hyperandrogenism, 3) Polycystic ovarian morphology on ultrasound examination (defined as the presence of 12 or more follicles in each ovary measuring 2â€Å"9 mm in diameter and/or an ovarian volume 10 mL). Patients who were diagnosed with androgen-secreting tumours, Cushings syndrome, congenital adrenal hyperplasia, hyperprolactinemia, hypercalcemia, malabsorption disorders, diabetes mellitus, thyroid disorders, liver disease, renal disease, history of kidney stones, epilepsy, or cardiovascular disease were excluded. Pregnant, postpartum or breastfeeding women were excluded as well. All women at the baseline were vitamin D deficient or insufficient according to the Endocrine Society Clinical Practice Guideline [25]. All study participants reported no use of any hormonal therapy, corticosteroids (other than topical corticosteroids forms), insulin sensitizers, hypolipidemic agents, anti-obesity medications, vitamin D or calcium supplements, anti-epileptic drugs, or any other drugs known to affect endocrine parameters, carbohydrate metabolism, or calciotropic hormone concentrations during the last 3 months. Every patient who met the inclusion criteria and approved to participate in this trial had a face-to-face interview at the baseline to answer a comprehensive questionnaire, which embraced; age, smoking and alcohol drinking habits, dress code, skin colour, outdoor exposure to the sunlight and the use of sunscreens. All women were advised to maintain their usual dietary habits, and not to modify other lifestyle factors such as sunlight exposure or physical activity during the study. Intervention: Patients were randomly assigned into two groups when they came back in the early follicular phase (2-5 days of menses) using a randomization table. Patients in group A received metformin and placebo; patients in group B received metformin, calcium carbonate and vitamin D3 (Cholecalciferol), orally for 8 weeks. The metformin dose was increased stepwise, starting with 500 mg once daily for the 1st week, 500 mg twice daily in the 2nd week, followed by 500 mg 3 times daily from the 3rd week onward. The dose of calcium carbonate (1000 mg/daily) and vitamin D3 (6000 IU/daily) remained constant throughout the study period. Clinical Assessment: Standard anthropometric data were obtained from each subject (height, weight, waist circumference, and Hip circumference), in an overnight fasting status without shoes with light clothes, at the baseline and after 8 weeks of intervention. Body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared (kg/m2). Menstrual regularity was assessed as the presence of a menstrual cycle with 21-35 days. Hirsutism was evaluated using the modified Ferriman-Gallwey score (m-FGS) [26], with a threshold (m-FGS) ?†°?6. Assessment of biochemical variables: All assays were conducted at the laboratories of Damascus University of Obstetrics and Gynecology Hospital. All blood samples were taken after an overnight fast. We took 10 millilitres of venous blood from each participant at the baseline and after 8 weeks of intervention. Samples were centrifuged at 4000 rpm for 10 min to separate serum. Then, the serum was stored at -60c until assayed. Serum concentrations of calcium and phosphorus were assayed by colourimetric method using kits from AMS (AMS S.p.A., Italy). Serum concentrations of LDL and HDL were assayed by direct method using kits from AMS (AMS S.p.A., Italy). Serum concentrations of TC and TG were assayed by enzymatic colourimetric method using kits from AMS (AMS S.p.A., Italy). Serum concentrations of 25-OH-Vitamin D were assayed using Immunofluorescence kits from I-CHROMA (Boditech Med Inc., Korea). Statistical analysis: All statistical analyses were performed using a Statistical Package for Social Science software (SPSS) version 24.0 (IBM Corp., Armonk, N.Y., USA). Continuous variables were expressed as mean ? ± standard deviation and categorical variables as counts with percentages. The Kolmogorovâ€Å"Smirnov test was used to evaluate the normality of data distribution. Between groups comparisons were performed using the independent t-test for normally distributed variables, the Mannâ€Å"Whitney U test for non-normally distributed variables, and Chi-square or Fishers exact test as appropriate for categorical variables. Within-group comparisons were performed using the paired t-test for normally distributed variables and the Wilcoxon paired rank test for non-normally distributed variables. For testing all hypotheses, tests were two-tailed, and p values less than 0.05 were considered statistically significant.RESULTS: Of 82 patients with PCOS, 45 women met the inclusion criteria and participated in the study, of which 5 patients were lost before randomization while waiting for their menses. Forty Patients were randomly assigned into the tw o groups, 20 patients in each group. However, only 34 patients (85%) completed the study (group A: metformin and placebo, n = 16; group B: metformin, calcium carbonate and vitamin D3, n = 18). The details about the study design and subjects lost to follow-up are illustrated in Figure 1. At the baseline, the two groups did not differ significantly in age, BMI, or other baseline characteristics as shown in Table 1. The mean age was 23.38 ? ± 3.54 and 23.06 ? ± 3.32 years in group A and B, respectively. The mean BMI was 28.01 ? ± 4.41 and 25.48 ? ± 4.97 kg/m2 in group A and B, respectively. After 8 weeks of intervention, vitamin D3 and calcium supplementation, compared to placebo, led to a significant increase in 25-OH-vitamin D levels (+19.38 ? ± 7.78 vs +0.11 ? ± 4.79 ng/mL, respectively), and calcium levels (+0.83 ? ± 0.82 vs +0.01 ? ± 0.86 mg/dL, respectively), but no significant change was detected in phosphorus levels (+0.38 ? ± 0.85 vs +0.26 ? ± 1.78 mg/dL, r espectively) (Table 3). Notably, 25-OH-vitamin D levels normalized after supplementation in all patients of group B. Weight, BMI and waist to hip ratio decreased significantly in both groups with a higher reduction in the group received metformin plus calcium and vitamin D (table 2), but the means of changes from baseline didnt differ significantly between them (table 3). However, no significant changes were noticed in any studied lipid profile parameters in both groups (table 2 and 3).DISCUSSION: The results of our study indicated that adding calcium and vitamin D to metformin therapy had no superior effect on improving lipid profile in vitamin D deficient/insufficient subjects with PCOS. Previous studies have suggested several mechanisms by which vitamin D may affect lipid profile like increasing the expression of very low-density lipoprotein cholesterol receptors (VLDL-R), reducing PTH concentration and improving insulin sensitivity [17]. Besides, vitamin D enhances intestinal calcium absorption which reduces lipids solubility and absorption from the gut [18,19]. On the other hand, a recent study disclosed that vitamin D might inhibit the expression of apolipoprotein AI gene, the major apoprotein of HDL [27], and animal studies showed an increase in TC levels in both male and female vitamin D knock-out mice, but HDL levels increased only in the male vitamin D knock-out mice [28]. So, it is still unknown whether combining these elements will lead to a beneficial, detrimental, or even null effect on lipid profile. Concerning clinical studies on PCOS subjects, previously the single arm study of Wehr et al.[20] showed that supplementation with vitamin D3 (20000 IU/weekly) caused a significant increase in LDL and TC and a significant decrease in TG levels. On the other hand, Irani et al study [22] demonstrated that 8 weeks of vitamin D3 supplementation (50000 IU/weekly) in vitamin d deficient PCOS subjects led to a signifi cant decrease in TG levels, but no effects on other lipid profile parameters were detected compared to placebo. On the contrary, our results did not indicate any beneficial (nor detrimental) effects of supplementation with calcium and vitamin D supplements on serum lipid profile in vitamin D deficient/insufficient PCOS subjects, which is consistent with the study of Raja-Khan et al.[21] as they could not detect notable effects on lipid profile when PCOS patients were treated with a high dose of vitamin D3 (12000 IU/daily) for 12 weeks compared to placebo. Moreover, although Asemi et al. study [23] demonstrated that calcium carbonate (1000 mg/day) and vitamin D (50000 IU/week) co-supplementation for 8 weeks in overweight-obese vitamin D deficient PCOS patients caused a significant decrease in serum TG (P value=0.02) and VLDL levels (P value=0.02), these effects disappeared after adjustment for baseline values (P value=0.12 for both TG and VLDL). Nevertheless, none of those studies co ncerned about the impact of combining calcium and vitamin D supplements with metformin on lipid profile. A recent study showed that vitamin D3 analogs can modulate glucose parameters and lipid metabolism in a diabetic rat model with additional protective effects when combined with metformin [29]. However, our study does not support the effects on lipid profile in vitamin D deficient/insufficient PCOS subjects. CONCLUSIONS: Adding calcium and vitamin D to metformin therapy had no superior effect on lipid profile in vitamin D deficient/insufficient subjects with PCOS.CONFLICT OF INTEREST: The authors declare no conflict of interest.