Unearthing the role of septins in viral infections.

Septin proteins are a subfamily of closely related GTP-binding proteins conserved in all species except for higher plants and perform essential biological processes. Septins self-assemble into heptameric or octameric complexes and form higher-order structures such as filaments, rings, or gauzes by end-to-end binding. Their close association with cell membrane components makes them central in regulating critical cellular processes. Due to their organisation and properties, septins function as diffusion barriers and are integral in providing scaffolding to support the membrane's curvature and stability of its components. Septins are also involved in vesicle transport and exocytosis through the plasma membrane by co-localising with exocyst protein complexes. Recently, there have been emerging reports of several human and animal diseases linked to septins and abnormalities in their functions. Most of our understanding of the significance of septins during microbial diseases mainly pertains to their roles in bacterial infections but not viruses. This present review focuses on the known roles of septins in host-viral interactions as detailed by various studies.

Parvimonas micra infection enhances proliferation, wound healing, and inflammation of a colorectal cancer cell line.

The gut microbiota Parvimonas micra has been found to be enriched in gut mucosal tissues and fecal samples of colorectal cancer (CRC) patients compared with non-CRC controls. In the present study, we investigated the tumorigenic potential of P. micra and its regulatory pathways in CRC using HT-29, a low-grade CRC intestinal epithelial cell. For every P. micra-HT-29 interaction assay, HT-29 was co-cultured anaerobically with P. micra at an MOI of 100:1 (bacteria: cells) for 2 h. We found that P. micra increased HT-29 cell proliferation by 38.45% (P=0.008), with the highest wound healing rate at 24 h post-infection (P=0.02). In addition, inflammatory marker expression (IL-5, IL-8, CCL20, and CSF2) was also significantly induced. Shotgun proteomics profiling analysis revealed that P. micra affects the protein expression of HT-29 (157 up-regulated and 214 down-regulated proteins). Up-regulation of PSMB4 protein and its neighbouring subunits revealed association of the ubiquitin-proteasome pathway (UPP) in CRC carcinogenesis; whereas down-regulation of CUL1, YWHAH, and MCM3 signified cell cycle dysregulation. Moreover, 22 clinically relevant epithelial-mesenchymal transition (EMT)-markers were expressed in HT-29 infected with P. micra. Overall, the present study elucidated exacerbated oncogenic properties of P. micra in HT-29 via aberrant cell proliferation, enhanced wound healing, inflammation, up-regulation of UPPs, and activation of EMT pathways.

Genomics and Transcriptomics Reveal Genetic Contribution to Population Diversity and Specific Traits in Coconut.

Coconut is an economically important palm species with a long history of human use. It has applications in various food, nutraceuticals, and cosmetic products, and there has been renewed interest in coconut in recent years due to its unique nutritional and medicinal properties. Unfortunately, the sustainable growth of the coconut industry has been hampered due to a shortage of good quality seedlings. Genetic improvement through the traditional breeding approach faced considerable obstacles due to its perennial nature, protracted juvenile period, and high heterozygosity. Molecular biotechnological tools, including molecular markers and next-generation sequencing (NGS), could expedite genetic improvement efforts in coconut. Researchers have employed various molecular markers to reveal genetic diversity among coconut populations and for the construction of a genetic map for exploitation in coconut breeding programs worldwide. Whole genome sequencing and transcriptomics on the different varieties have generated a massive amount of publicly accessible sequence data, substantially improving the ability to analyze and understand molecular mechanisms affecting crop performance. The production of high-yielding and disease-resilient coconuts and the deciphering of the complex coconut genome's structure can profit tremendously from these technologies. This paper aims to provide a comprehensive review of the progress of coconut research, using genomics, transcriptomics, and molecular markers initiatives.

Food self-sufficiency: Managing the newly-opened tidal paddy fields for rice farming in Indonesia (A case study in West Kalimantan, Indonesia).

The Indonesian government continues to develop a sustainable food self-sufficiency program by increasing national food security through an extension program. One of the instruments is by opening new rice fields. The area of new rice fields in Indonesia is 222,442 ha spreading on the islands of Sumatra, Kalimantan, and Papua. This new rice field is estimated to produce 1.2 million tons of rice per year. In the case of West Kalimantan Province, it has opened new rice fields cover an area of 23,384 ha, mostly in tidal lands. Expansion of newly-opened rice fields does not increase land productivity. Moreover, rice productivity in the newly-opened paddy fields is only an average of 2 t ha-1. The low rice productivity is caused by biophysical factors of land in agriculture, and social-economic, and institutional factors of farmers at the village level. Therefore, it is necessary to have a rice farming model in newly-opened rice fields involving farmer groups, researchers, agricultural extension agents, government agencies, the private sector, and banks. The purpose of this study was to present a sustainable rice farming model in the newly-opened tidal rice fields. The results of this study showed that application of the rice farming model in newly-opened tidal rice fields could increase rice productivity from 2 to 5.7 t ha-1 and farmer income of IDR 10.6 million, involving good collaboration among farmer groups and farmer economic organizations supported by banks for sustainability.

Improving Coconut Using Modern Breeding Technologies: Challenges and Opportunities.

Coconut (Cocos nucifera L.) is a perennial palm with a wide range of distribution across tropical islands and coastlines. Multitude use of coconut by nature is important in the socio-economic fabric framework among rural smallholders in producing countries. It is a major source of income for 30 million farmers, while 60 million households rely on the coconut industry directly as farm workers and indirectly through the distribution, marketing, and processing of coconut and coconut-based products. Stagnant production, inadequate planting materials, the effects of climate change, as well as pests and diseases are among the key issues that need to be urgently addressed in the global coconut industry. Biotechnology has revolutionized conventional breeding approaches in creating genetic variation for trait improvement in a shorter period of time. In this review, we highlighted the challenges of current breeding strategies and the potential of biotechnological approaches, such as genomic-assisted breeding, next-generation sequencing (NGS)-based genotyping and genome editing tools in improving the coconut. Also, combining these technologies with high-throughput phenotyping approaches and speed breeding could speed up the rate of genetic gain in coconut breeding to solve problems that have been plaguing the industry for decades.

DNA Free CRISPR/DCAS9 Based Transcriptional Activation System for UGT76G1 Gene in Stevia rebaudiana Bertoni Protoplasts.

The UDP-glycosyltransferase 76G1 (UGT76G1) is responsible for the conversion of stevioside to rebaudioside A. Four single guide RNAs (sgRNAs) were designed from the UGT76G1 proximal promoter region of stevia by using the online-based tool, benchling. The dCas9 fused with VP64 as a transcriptional activation domain (TAD) was produced and purified for the formation of ribonucleoproteins (RNPs) by mixing with the in vitro transcribed sgRNAs. Protoplast yield was the highest from leaf mesophyll of in vitro grown stevia plantlets (3.16 × 106/g of FW) using ES5 (1.25% cellulase R-10 and 0.75% macerozyme R-10). The RNPs were delivered into the isolated protoplasts through the Polyethylene glycol (PEG)-mediated transfection method. The highest endogenous activation of the UGT76G1 gene was detected at 27.51-fold after 24 h of transfection with RNP30 consisting of CRISPR/dCas9-TAD with sgRNA30 and a similar activation level was obtained using RNP18, RNP33, and RNP34, produced using sgRNA18, sgRNA33, and sgRNA34, respectively. Activation of UGT76G1 by RNP18 led to a significant increase in the expression of the rate-limiting enzyme UGT85C2 by 2.37-fold and there was an increasing trend in the expression of UGT85C2 using RNP30, RNP33, and RNP34. Successful application of CRISPR/dCas9-TAD RNP in activating specific genes can avoid the negative integration effects of introduced DNA in the host genome.

First report of Burkholderia gladioli causing bacterial panicle blight of rice in Malaysia.

Rice (Oryza sativa) is a staple food for most of the world's populations, particularly in Asia (Gumma et al. 2011). The rice sector provides Malaysians with a food supply, food sufficiency, and income for growers (Man et al. 2009). From January to February 2022, panicle samples showing symptoms of bacterial panicle blight (BPB) disease, including reddish-brown, linear lesions with indistinct margins on flag-leaf sheaths and blighted, upright, grayish straw-colored florets with sterile and aborted grains on panicles were collected in granary areas in Sekinchan, Selangor, Malaysia with 90% disease incidence in fields. Surface-sterilization of infected leaf tissue was performed using 75% ethanol and 1% sodium hypochlorite, followed by rinsing three times in sterilized water. Leaf tissue was macerated in sterilized water and aliquots were spread on King's B agar medium, then cultured for 24 h to 48 h at 35 °C. All isolated bacteria were Gram-negative rods, positive for catalase and gelatinase but negative for indole, oxidase and hydrogen sulfide (H2S), and utilized sucrose, inositol, mannitol, glucose, and citrate. Colonies were circular and smooth-margined, producing a diffusible yellowish-green pigment on King's B agar medium, which are characteristics of Burkholderia species (Keith et al. 2005). Five representative isolates (UPMBG7, UPMBG8, UPMBG9, UPMBG15, UPMBG17) were selected for molecular and pathogenicity tests. PCR using specific primers targeting the gyrB gene for molecular characterization was performed, and the ∼470 bp amplicons were sequenced (Maeda et al. 2006) and deposited in GenBank (OM824438 to OM824442). A BLASTn analysis revealed that the five isolates were 99% identical to the B. gladioli reference strains MAFF 302533, GRBB15041, and LMG19584 in GenBank (AB190628, KX638432, and AB220898). A phylogenetic tree using Maximum-likelihood analysis of the gyrB gene sequences showed that the five isolates were 99% identical to B. gladioli reference strains (AB190628, KX638432, and AB220898). To verify the identification of these isolates, the 16S rDNA gene was amplified using 16SF/16SR primers (Ramachandran et al. 2021), producing ~1,400 bp amplicons. The resulting sequences of the five isolates (OM869953 to OM869957) were 98% identical to the reference strains of B. gladioli (NR113629 and NR117553). To confirm pathogenicity, 10 ml suspensions of the five isolates at of 108 CFU/ml were inoculated into the panicles and crowns of 75-day-old rice seedlings of local rice varieties MR269 and MR219 grown in a glasshouse with temperatures ranging from 37 °C to 41 °C (Nandakumar et al. 2009). Control rice seedlings were inoculated with sterilized water. All isolates produced BPB disease symptoms like those originally found in the rice fields at four weeks after inoculation. Control seedlings remained asymptomatic. To fulfill Koch's postulates, the bacteria were reisolated from symptomatic panicles and were confirmed as B. gladioli by sequence analysis of the gyrB and 16S rDNA genes. To our knowledge, this is the first report of B. gladioli causing BPB disease of rice in Malaysia. Since BPB disease causes a significant threat to the rice industry, it is crucial to investigate the diversity of this destructive pathogen for effective disease management strategies in Malaysia.

Virtual Reality (VR) Technology for Treatment of Mental Health Problems during COVID-19: A Systematic Review.

There was a surge in psychological distress and emotional burnout during the COVID-19 pandemic. Virtual reality (VR) is helpful as a psychological intervention whilst maintaining physical or social distancing. The present systematic review assessed the role of VR as a psychological intervention tool for mental health problems during the COVID-19 pandemic. We conducted a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study used the search-related terms: (Virtual reality OR simulated-3D-environment OR VR) AND (covid! or corona!) AND (mental* OR psychologic* OR well* OR health*) AND (intervention) on six databases, i.e., MEDLINE, PsycINFO, Ovid Medline, EMBASE, ACM digital library, and Cochrane Central Register of Controlled Trials (CENTRAL) from the inception date until 23 June 2021. We finally included four studies in the systematic review out of the 379 references imported for screening. These studies reveal that VR is beneficial as a psychological tool for intervention in individuals with mental health problems. Immersed in the telepresence, interacting in a 3-D format compared to a 2-D layout, having a sense of enjoyment and engagement, activating an affective-motivational state, "escaping" to a virtual from the real world are pivotal faucets of VR as a psychological tool for intervention.

The Role of Virtual Reality as a Psychological Intervention for Mental Health Disturbances during the COVID-19 Pandemic: A Narrative Review.

The COVID-19 pandemic spread throughout the world and created many problems. The COVID-19 pandemic caused an increase in mortality and morbidity, including mental health problems. Around the world, the movement control order (MCO) was strictly enforced, but the spread of the infection epidemic was still rampant. The magnitude of the increase in mental health illnesses has caused many individuals to suffer. Given that face-to-face interventions are challenging to carry out during an outbreak, we need to address this critical problem through an online approach, such as virtual reality (VR). This approach is vital to helping patients deal with their existing problems in more pragmatic, practical, and customer-friendly ways. Thus, in the present review, we proposed the development of a virtual digital device for this noble purpose. Various challenges, improvements, and expectations for VR applications were outlined and discussed in this narrative review.

Potentially Toxic Element Levels in Atmospheric Particulates and Health Risk Estimation around Industrial Areas of Maros, Indonesia.

Air quality deterioration is a major environmental problem in Indonesia. This study evaluated the levels and health risks of potentially toxic elements (PTEs) in Maros Regency, Indonesia. Total suspended particulate matter was collected from industrial areas for PTE (Al, Pb, Cr, Cu, Ni, As and Zn) analysis using inductively coupled plasma optical emission spectrometry (ICP-OES). Samples were collected from six critical areas in the Bantimurung region as that is where marble, cement and limestone industries are located. A calculation of the non-carcinogenic and cancer risks was performed to determine the potential health exposures in adults and children. A Monte Carlo simulation with 10,000 iterations and a sensitivity analysis was carried out to identify the risk probability and the most sensitive variable contributing to cancer risk from PTE exposure in humans. The results showed that the concentration of PTEs decreased in the order of Zn > Al > Cr > Pb > Cu > Ni > As in the wet season, and Zn > Al > Pb > As > Cr > Cu > Ni in the dry season. The hazard index (HI) value for children was 2.12, indicating a high non-carcinogenic risk for children. The total cancer risk (TCR) values in adults and children were 3.11 × 10-5 and 1.32 × 10-4, respectively, implying that both are at risk for developing cancer. The variables with the most contribution to cancer risk from As, Cr and Pb exposure in adults and children were As concentration (33.9% and 41.0%); exposure duration (ED) (34.3%) and SA (40.7%); and SA (98.7 % and 45.4%), respectively. These findings could be used as the scientific basis for public health intervention and to raise awareness of the harmful health effects of particulate bound PTEs.

Community Health Risk Assessment of Total Suspended Particulates near a Cement Plant in Maros Regency, Indonesia.

BACKGROUND: Cement plants generate particulate matter (PM) across processes from raw material preparation to packaging. The presence of total suspended particulates (TSP) coming out of the stack causes a high accumulation of dust in residential areas. Human exposure to TSP could affect human health and wellbeing. OBJECTIVES: The present study aims to evaluate concentrations of TSP and to estimate the health risks of TSP exposure through the inhalation pathway in communities surrounding a private cement industry in Maros regency, Indonesia. METHODS: Total suspended particulates were collected using a high-volume air sampler (HVAS) at five locations. Samples were taken by grab sampling for 24 hours. The SCREEN3 program was used to view the maximum range and distribution of pollutants based on the geographical, stack profiles and meteorological factors in the study area. Hazard quotient (HQ) was used to estimate non-carcinogenic risks of TSP in surrounding communities. RESULTS: Total suspended particulate concentrations were measured with a maximum value of 133.24 µg/m3 and a minimum value of 18.48 µg/m3. This maximum value exceeds the minimum acceptable level from Canadian National Ambient Air Quality Objectives (C-NAAQOs). The non-carcinogenic risks from the inhalation pathway were low except for location 3 (HQ>1) across all locations. CONCLUSIONS: The cement plant may significantly contribute to total TSP concentrations in air and may potentially have adverse effects on human health. Communities near the cement plant are vulnerable to TSP exposure and measures are needed to reduce TSP in Maros regency, Indonesia. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: This study was approved by the Health Research Ethics Committee of Hasanuddin University with protocol number 28920093022. COMPETING INTERESTS: The authors declare no competing financial interests.

Pathogens and Carcinogenesis: A Review.

Cancer is a global health problem associated with genetics and unhealthy lifestyles. Increasingly, pathogenic infections have also been identified as contributors to human cancer initiation and progression. Most pathogens (bacteria, viruses, fungi, and parasites) associated with human cancers are categorized as Group I human carcinogens by the International Agency for Research on Cancer, IARC. These pathogens cause carcinogenesis via three known mechanisms: persistent infection that cause inflammation and DNA damage, initiation of oncogene expression, and immunosuppression activity of the host. In this review, we discuss the carcinogenesis mechanism of ten pathogens, their implications, and some future considerations for better management of the disease. The pathogens and cancers described are Helicobacter pylori (gastric cancer), Epstein-Barr virus (gastric cancer and lymphoma), Hepatitis B and C viruses (liver cancer), Aspergillus spp. (liver cancer), Opisthorchis viverrine (bile duct cancer), Clonorchis sinensis (bile duct cancer), Fusobacterium nucleatum (colorectal cancer), Schistosoma haematobium (bladder cancer); Human Papillomavirus (cervical cancer), and Kaposi's Sarcoma Herpes Virus (Kaposi's sarcoma).

Risk identification of heavy metals in well water surrounds watershed area of Pangkajene, Indonesia.

OBJECTIVE: This study wants to evaluate heavy metals pollution and ecological risk level of well water in Pangkajene watershed area. METHODS: The total concentration of Cd, Cr(VI), Pb and Ni were determined using AAS. We used heavy metal pollution index (HPI), metal index (MI), hazard quotient (HQ) used to estimate metals pollution and ecological risk level. Pearson correlation analysis is executed to evaluate the relationship between all measured parameters. RESULT: The concentration of Cd, Ni and Pb are below detection limit value. The mean concentration of Cr(VI) 0.0017±0.0006mgL-1. The mean of HPI and MI value are 3.06 and 0.06, respectively. The upstream area of Pangkajene has HQ value for Cr(VI) is higher than 1, it indicates that exposure of Cr(VI) may cause adverse effects to the ecological system and human health. CONCLUSION: The Cr(VI) is the main risk factor for well water contamination surrounds Pangkajene watershed area.

Ecological risk assessment of hexavalent chromium and silicon dioxide in well water in Maros Regency, Indonesia.

OBJECTIVE: This paper assesses the potential ecological risk of hexavalent chromium (Cr(VI)) and silicon dioxide/silica (SiO2) in well water. Both of pollutants have been classified as carcinogenic compound. The ecological risk assessment of drinking water is an effective tool to evaluate drinking water quality to reduce further risk. METHOD: Fourteen well water samples were collected around the residential area near cement industrial activity and karst mining area. Estimating the ecological risk of well water which consumed daily evaluated based on Hazard Quotient (HQ) ratio. RESULTS: The mean values of Cr(VI) and SiO2 in well water samples were 0.0017mg/L and 12.94mg/L, respectively. Drinking water in this area are unacceptable. HQ values for SiO2 at all stations are more than 1 (moderate level). CONCLUSIONS: Cr(VI) and SiO2 are discoverable within well water surrounding the research location. This finding is used as scientific data and references for ecological protection of drinking water in Maros.

Ecological risk assessment of hexavalent chromium and silicon dioxide in well water in Maros Regency, Indonesia

Objective: This paper assesses the potential ecological risk of hexavalent chromium (Cr(VI)) and silicon dioxide/silica (SiO2) in well water. Both of pollutants have been classified as carcinogenic compound. The ecological risk assessment of drinking water is an effective tool to evaluate drinking water quality to reduce further risk. Method: Fourteen well water samples were collected around the residential area near cement industrial activity and karst mining area. Estimating the ecological risk of well water which consumed daily evaluated based on Hazard Quotient (HQ) ratio. Results: The mean values of Cr(VI) and SiO2 in well water samples were 0.0017 mg/L and 12.94 mg/L, respectively. Drinking water in this area are unacceptable. HQ values for SiO2 at all stations are more than 1 (moderate level). Conclusions: Cr(VI) and SiO2 are discoverable within well water surrounding the research location. This finding is used as scientific data and references for ecological protection of drinking water in Maros. (AU)

Risk identification of heavy metals in well water surrounds watershed area of Pangkajene, Indonesia

Objective: This study wants to evaluate heavy metals pollution and ecological risk level of well water in Pangkajene watershed area. Methods: The total concentration of Cd, Cr(VI), Pb and Ni were determined using AAS. We used heavy metal pollution index (HPI), metal index (MI), hazard quotient (HQ) used to estimate metals pollution and ecological risk level. Pearson correlation analysis is executed to evaluate the relationship between all measured parameters. Result: The concentration of Cd, Ni and Pb are below detection limit value. The mean concentration of Cr(VI) 0.0017 ± 0.0006 mg L−1. The mean of HPI and MI value are 3.06 and 0.06, respectively. The upstream area of Pangkajene has HQ value for Cr(VI) is higher than 1, it indicates that exposure of Cr(VI) may cause adverse effects to the ecological system and human health. Conclusion: The Cr(VI) is the main risk factor for well water contamination surrounds Pangkajene watershed area. (AU)

Effects of Grafting on Morphophysiological and Yield Characteristic of Eggplant (Solanum melongena L.) Grafted onto Wild Relative Rootstocks.

Grafting is regarded as an integral component of sustainable vegetable production. It is important in the management of soil-borne diseases, and reports suggest that grafting with viable rootstocks can enhance crop growth and yield. This research was conducted using splices and cleft grafting techniques to investigate graft compatibility among varieties of high yielding eggplant scion (MCV1, MCV2, CCV1, CCV2, CCV3, NCV, and TCV) grafted onto wild rootstocks (MWR, BWR, and TWR) to study their morphophysiological and yield characteristics. High yielding scions grafted onto wild relative rootstocks were compared with two controls including self-grafted and non-grafted. All the scion had a high rate of germination (≥95%) and remarkable graft success (100%) was recorded in MCV1, MCV2, and TCV using the cleft techniques. Generally, the use of rootstocks resulted in higher total and marketable fruit yield compared to the non-grafted and self-grafted scion plants, respectively. In particular, MWR and TWR rootstock conferred the highest vigour to the scion, resulting in the highest values recorded for total and marketable fruit yield, number of fruits per plant and average fruit weight. A similar result was obtained in fruit length and diameter, where long and wide fruits were observed in scions grafted onto MWR and TWR rootstocks, respectively. Grafting of high yielding eggplant scion onto resistant MWR, BWR and TWR eggplant rootstock was found to be beneficial for eggplant cultivation. The remarkable compatibility and vigour of the rootstock with scion led to the improvement in total and marketable yield of the fruits. As such, it can be concluded that the use of wild relative rootstocks of eggplant species can be a valuable method of improving eggplant production.

The Novelty of Bupropion As a Dopaminergic Antidepressant for the Treatment of Adult Attention Deficit Hyperactive Disorder.

Attention deficit hyperactive disorder (ADHD), a hyperactivity disorder prevalent among children may continue as an adulthood attention deficit. To date, treating an individual with an adult ADHD may be an arduous task as it involves numerous challenges, which include a need for high index of suspicion to diagnose this medical condition. Many psychiatric disorders masquerade as ADHD and delay the necessary assessment and proper treatment for this debilitating medical disorder. Adult ADHD is often misdiagnosed (or under diagnosed) due to the fact that this medical condition is being masked by the patients' high level of intellectual achievement. As the ADHD in adult persists, it may end-up with impairment in the personal-social-occupational function in which the management becomes a great challenge. The treatment of ADHD can be optimized by using various drugs targets agents like norepinephrine-dopamine reuptake inhibitor (NDRI), with or without psycho stimulants like methylphenidate, which is marketed as Ritalin. Bupropion, an NDRI has a novel effect on ADHD as the molecule exerts its effects by modulating the reward-pleasure mesolimbic dopaminergic system and at the same time regulates the elevating mood dimension of the noradrenergic neurotransmission. The role of Bupropion in the neural and psychopharmacological perspective treatment of ADHD was deliberated. The present review highlights the novel effects of Bupropion in ADHD treatment, together with the help of other successful bio-psycho-social measures. This may be of immense benefit to the psychiatrists for treating their patients.

Co-Morbid Erectile Dysfunction (ED) and Antidepressant Treatment in a Patient - A Management Challenge?

Throughout the world, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are the commonly prescribed psychopharmacological agents for treating patients with co-morbid mental health problem and sexual dysfunction (SD). The serotonergic and noradrenergic ADs, although effective, are not without any SD adverse-effects, especially erectile dysfunction (ED). ED is a failure to obtain a satisfactory erection for rewarding sexual coitus during the phases of male's sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who were on AD. AD intervention caused remission to some of the pre- treatment psychopathology of ED. However, in many patients, AD potentially magnified the unwanted sexual sideeffects. This made the situation challenging for the mental health professional. These challenges are based on the complexity of ED, its etiology and the associated risk factors, which further add to its AD side-effect. The neuro-psychopharmacological basis for AD treatment selection was deliberated. Bio-psycho-social interventions are recommended at two pivotal stages. Firstly, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identify few modifiable risk factors for ED and associated mental health issues. Secondly, with guidance of an algorithm pathway, a practical intervention should include strategies such as dose reduction, augmentation or changing to an AD with lesser or no sexual adverse-effects. It is recommended that bupropion and mirtazepine to be prescribed when patients develop adverse sexual effects with serotonin selective reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI) and tricyclic antidepressant (TCA). Few suggestions which may be borne in mind are revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other nonpharmacological approaches which may be beneficial to both patients and their partners.

Serotonin Selective Reuptake Inhibitors (SSRIs) and Female Sexual Dysfunction (FSD): Hypothesis on its Association and Options of Treatment.

Sexual dysfunctions are commonly seen in women on selective serotonin reuptake inhibitors (SSRIs). The complexities of female sexual functioning are reflected through modulation of inter- playing factors like the neuropsychophysiological factors, inter-personal and relationship issue, psychiatric co-morbidities and physical disorder. The incidence of SSRIs-induced FSD is difficult to estimate because of the potential confounding effects of SSRIs, presence of polypharmacy, marital effect, socio-cultural factors and due to the design and assessment problems in majority of the studies. The exact mechanism of FSD-induced SSRIs is unknown. It has been postulated that although SSRIs may modulate other neurotransmitter system such as nitric oxide (NO), noradrenergic and dopamine in inducing FSD. In the present review, we highlight current evidence regarding potential mechanism of SSRIs in causing FSD, which include low sexual desire (low libido), arousal difficulties (lack of lubrication), and anorgasmia. The specific association of FSD to SSRI use, has not been ellucidated. The relationship is dose-dependent, and may vary among the groups with respect to mechanism of serotonin and dopamine reuptake, induction of release of prolactin from the pituitary gland, anticholinergic side-effects, inhibition of NO synthesis and emotional-memory circuit encryption for sexual experiences. Various interventional strategies exist regarding the treatment of SSRI-induced FSD and this includes tolerance, titration dosage, substitution to another antidepressant drug and psychotherapy. There is a need of better understanding of SSRIs-induced FSD for better treatment outcome.