Impact of diet and physical activity on reproductive profile: A comparison of middle-aged and elderly men.

Age is a known determinant of reproductive health and fertility in both genders. The present work aims to assess the reproductive hormone profile of a middle-aged and elderly man. For this descriptive cross-sectional study, healthy male subjects (n=77) were recruited from the valley. Any individual suffering from any acute or chronic diseases and on drugs was ruled out from the study. Group A consisted of 40 elderly men between 60-70 years of age, and Group B comprised 37 men between 35-46 years of age. Blood samples were taken to estimate the reproductive hormone profile. Level of oxidant and antioxidant: Malondialdehyde and Glutathione. The demographic variables, which included retrospective and prospective questions, helped to assess the physical activity and diet intake behaviour of all inducted individuals. The analysis of the reproductive profile of both groups was similar and within the normal range of standards. However, the median level of LH was higher in group A than in group B: 6.7 mIU/ml versus 3.4 mIU/ml, respectively, and p<0.003. Both groups showed predominantly involvement in physical activity, >90%. The correlation of biochemical variables gives an insight into the fact that the Mediterranean diet and physical activity help to maintain a normal BMI. These implicate the normal secretion of various hormones, leading to intact spermatogenesis. We can safely deduce from this study that physically active lifestyles and a healthy diet are crucial factors in maintaining an endocrine profile.

L'âge est un déterminant connu de la santé reproductive et de la fécondité chez les deux sexes. Le présent travail vise à évaluer le profil hormonal de la reproduction d'un homme d'âge moyen et âgé. Pour cette étude transversale descriptive, des sujets masculins en bonne santé (n = 77) ont été recrutés dans la vallée. Toute personne souffrant de maladies aiguës ou chroniques et prenant des médicaments a été exclue de l'étude. Le groupe A était composé de 40 hommes âgés de 60 à 70 ans et le groupe B de 37 hommes âgés de 35 à 46 ans. Des échantillons de sang ont été prélevés pour estimer le profil des hormones reproductives. Niveau d'oxydant et d'antioxydant : Malondialdéhyde et Glutathion. Les variables démographiques, qui comprenaient des questions rétrospectives et prospectives, ont permis d'évaluer l'activité physique et le comportement alimentaire de tous les individus intronisés. L'analyse du profil reproducteur des deux groupes était similaire et se situait dans la fourchette normale des normes. Cependant, le taux médian de LH était plus élevé dans le groupe A que dans le groupe B : respectivement 6,7 mUI/ml versus 3,4 mUI/ml et p<0,003. Les deux groupes présentaient une participation prédominante à l'activité physique, > 90 %. La corrélation des variables biochimiques donne un aperçu du fait que le régime méditerranéen et l'activité physique contribuent à maintenir un IMC normal. Celles-ci impliquent la sécrétion normale de diverses hormones, conduisant à une spermatogenèse intacte. Nous pouvons déduire de cette étude qu'un mode de vie physiquement actif et une alimentation saine sont des facteurs cruciaux pour maintenir un profil endocrinien.

Molecular Screening of Bioactive Compounds of Garlic for Therapeutic Effects against COVID-19.

An outbreak of pneumonia occurred on December 2019 in Wuhan, China, which caused a serious public health emergency by spreading around the globe. Globally, natural products are being focused on more than synthetic ones. So, keeping that in view, the current study was conducted to discover potential antiviral compounds from Allium sativum. Twenty-five phytocompounds of this plant were selected from the literature and databases including 3-(Allylsulphinyl)-L-alanine, Allicin, Diallyl sulfide, Diallyl disulfide, Diallyl trisulfide, Glutathione, L-Cysteine, S-allyl-mercapto-glutathione, Quercetin, Myricetin, Thiocysteine, Gamma-glutamyl-Lcysteine, Gamma-glutamylallyl-cysteine, Fructan, Lauricacid, Linoleicacid, Allixin, Ajoene, Diazinon Kaempferol, Levamisole, Caffeicacid, Ethyl linoleate, Scutellarein, and S-allylcysteine methyl-ester. Virtual screening of these selected ligands was carried out against drug target 3CL protease by CB-dock. Pharmacokinetic and pharmacodynamic properties defined the final destiny of compounds as drug or non-drug molecules. The best five compounds screened were Allicin, Diallyl Sulfide, Diallyl Disulfide, Diallyl Trisulfide, Ajoene, and Levamisole, which showed themselves as hit compounds. Further refining by screening filters represented Levamisole as a lead compound. All the interaction visualization analysis studies were performed using the PyMol molecular visualization tool and LigPlot+. Conclusively, Levamisole was screened as a likely antiviral compound which might be a drug candidate to treat SARS-CoV-2 in the future. Nevertheless, further research needs to be carried out to study their potential medicinal use.

Sustained ethical analysis of global dilemmas and country-level decision making during and post the COVID-19 pandemic: A systematic review.

The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.

Design, fabrication, and characterisation of a silicon microneedle array for transdermal therapeutic delivery using a single step wet etch process.

The fabrication of silicon in-plane microneedle arrays from a simple single wet etch step is presented. The characteristic 54.7° sidewall etch angle obtained via KOH etching of (100) orientation silicon wafers has been used to create a novel microneedle design. The KOH simultaneously etches both the front and back sides of the wafer to produce V shaped grooves, that intersect to form a sharp pyramidal six-sided microneedle tip. This method allows fabrication of solid microneedles with different geometries to determine the optimal microneedle length and width for effective penetration and minimally invasive drug delivery. A modified grooved microneedle design can also be used to create a hollow microneedle, via bonding of two grooved microneedles together, creating an enclosed hollow channel. The microneedle arrays developed, effectively penetrate the skin without significant indentation, thereby enabling effective delivery of active ingredients via either a poke and patch application using solid microneedles or direct injection using hollow microneedles. This simple, scalable and cost effective method utilises KOH to etch the silicon wafer in-plane, allowing microneedles with variable length of several mm to be fabricated, as opposed to out-of-plane MNs, which are geometrically restricted to dimensions less than the thickness of the wafer. These microneedle arrays have been used to demonstrate effective delivery of insulin and hyaluronic acid into the skin.

Hollow silicon microneedle fabrication using advanced plasma etch technologies for applications in transdermal drug delivery.

A novel production process flow is presented here for the manufacture of hollow silicon microneedles using deep reactive-ion etching (DRIE) technology. The patent-pending three-step process flow has been developed to produce multiple arrays of sharp-tipped, hollow microneedles, which facilitate easy insertion and controlled fluid injection into excised skin samples. A bevelled tip and vertical sidewalls for the microneedle have been achieved with good uniformity, despite >45% open etch area. Processing steps and etch challenges are discussed, and preliminary skin testing results are presented, showing effective needle insertion and delivery of fluorescent dye into ex vivo skin from human breast tissue.

Relationship of Major Depression with Body Mass Index and Salivary Cortisol.

Introduction Depression is one of the most incapacitating psychiatric diseases that disturb life of millions of people round the globe. Its major causes include stressful life events, bereavement, social abuses or certain biological and genetic factors with complex causal mechanisms. Higher salivary cortisol levels for a long period lead to dyslipidemias which increase body mass index (BMI), elevate adiposity and waist-to-hip ratio (WHR). Such individuals with high quartiles of BMI have considerably higher risk of major depressive disorder. The aim of this study was to establish a correlation between major depression, BMI and salivary cortisol. Methods This cross-sectional analysis was accomplished in the Physiology Department, Sheikh Zayed Federal Postgraduate Medical Institute, Lahore as well as in Punjab Institute of Mental Health, Lahore, Pakistan, over a period of six months. A total of 60 participants aged between 18 and 60 years were included in this study; they were divided equally into two groups as normal healthy individuals with no physical or mental illness and severely depressed groups. The patients were categorized as cases of severe depression on outdoor clinical assessment and further confirmed by ICD-10. Patient's BMI was estimated by measuring height in meters (m) and weight in kilograms (kg), and then dividing weight with square height. Early morning saliva samples were collected. Estimation of cortisol levels in saliva was done through ELISA. SPSS version 20.0 (IBM Corp., Armonk, NY) was used to analyze the data and p ≤ 0.05 was considered statistically significant. Results The mean BMI in normal healthy group was 22.02 ± 4.21, while the mean BMI in severely depressive group was 24.64 ± 3.58. The difference was statistically significant (p = 0.012). The mean salivary cortisol level was significantly raised in patients with major depression (2.23 ± 1.69 nmol/L) in contrast to healthy normal individuals (1.46 ± 0.91 nmol/L), with p-value = 0.031. Conclusion BMI and depression has a very noteworthy correlation and there is a remarkable link between raised salivary cortisol, greater BMI and development of major depression.

Association of burnout with doctor-patient relationship and common stressors among postgraduate trainees and house officers in Lahore-a cross-sectional study.

INTRODUCTION: Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. METHODS: A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs" (recent graduates doing their 1 year long internship) and post-graduate trainees or "PGRs" (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. RESULTS: A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. CONCLUSION: Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.

Burnout and its Associated Factors in Medical Students of Lahore, Pakistan.

INTRODUCTION: Burnout is a widely known phenomenon. It is defined as a state of prolonged physical and psychological exhaustion and is experienced virtually by every medical student due to the highly demanding nature of medical education. This study probes into the prevalence and psychosocial determinants of burnout in Pakistani medical students. METHODS: A descriptive, cross-sectional study design and convenience (non-probability) sampling technique were employed in undergraduate medical students from years 1-5. A total of 777 medical students from two medical colleges were included in the study from May-August, 2014. An English version of the Copenhagen Burnout Inventory (CBI) and a series of demographic questions, intermixed with questions from other topics, were included in the questionnaire. Data was analysed by using SPSS ver.21. RESULTS: The majority of students were females and enrolled in the third year of MBBS. Of the medical students involved, 30.6% were found to have high/very high levels of burnout (Kristenson's burnout scoring). Although 38.7% of students said that they did not feel burned out after reading the definition of burnout given in the questionnaire, 35.9% out of these students actually had high levels of burnout according to CBI. According to the multiple regression analysis, burnout in medical students was significantly associated with age, gender, doctor parents, no help or no supportive resources (e.g., from colleagues), lack of time off, lack of belief in what you do, fear of big consequences of failure, family responsibilities, and uncertain future. Perception of teachers lacking leadership skills and doing too much study with little balance was associated with low burnout scores. CONCLUSION: There is a high prevalence of burnout in Pakistani medical students. The present study identifies several factors associated with burnout in Pakistani medical students. Although these factors are a part of daily life of medical students, their identification should prompt the use of effective coping strategies and skills, thus, minimising their burnout levels.

Advanced deep reactive-ion etching technology for hollow microneedles for transdermal blood sampling and drug delivery.

Using an SPTS Technologies Ltd. Pegasus deep reactive-ion etching (DRIE) system, an advanced two-step etching process has been developed for hollow microneedles in applications of transdermal blood sampling and drug delivery. Because of the different etching requirements of both narrow deep hollow and large open cavity, hollow etch and cavity etch steps have been achieved separately. This novel two-step etching process is assisted with a bi-layer etching mask. Results show that the etch rate of silicon during this hollow etch step was about 7.5 microm/min and the etch rate of silicon during this cavity etch step was about 8-10 microm/min, using the coil plasma etching power between 2.0 and 2.8 kW. Especially for the microneedle bores etch, the deeper it etched, the slower the etch rate was. The microneedle bores have successfully been obtained 75-150 microm in inner diametre and 700-1000 microm long with high aspect ratio DRIE, meanwhile, the vertical sidewall structures have been achieved with the high etch load exposed area over 70% for the cavity etch step.