Antibiotic resistance: A Global threat and an unseen pandemic

Jul 4, 2025 | Health

Written By Sanjogta Thapa Magar, Food Microbiologist, Kathmandu Metropolitan Office

Introduction

People have been using medicine to combat infectious diseases for ages, and it is widely used in medical practices; however, now it has become ineffective against microorganisms as they have developed resistance to the drugs. This unresponsiveness exhibited by microbes towards antibiotic medications is known as antimicrobial resistance (AMR). A breakthrough in antibiotic research in the 20th century marked a turning point in medical history, safeguarding millions of lives from pathogenic diseases. However, at present, it has become a persistent global public health concern, as it is anticipated to cause 10 million deaths per year by 2050. Throughout the past three decades, a considerable disparity has been documented in the enhancement of antimicrobial drugs, leading to a decline in the antibiotic revolution period due to antimicrobial resistance (AMR). Microorganisms (bacteria, fungi, viruses, and parasites) have adapted and developed tolerance against antibiotics that used to abolish them. Antibiotics were dominant against them; however, in the current scenario, the microbes are showing lower sensitivity or resistance. Therefore, a concentration exceeding typical levels of the same drug is required to have the same effect in similar cases. Recent studies have confirmed that AMR exists because of escalated use and misuse of antibiotics over the years, giving rise to a threat to global public health as a silent pandemic.

Why is it alarming?

Antimicrobial resistance (AMR) is a widely recognized health issue with public ramifications, causing high mortality rates and escalating healthcare costs. It erodes the efficacy of antimicrobial medicines, resulting in being unable to control diseases. When bacteria or other pathogens become resistant, infections are prolonged, leading to harder treatment and further expanding the probability of them spreading. The cost of treatment will rise to an exorbitant level since standard drugs no longer work. Novel medical procedures like organ transplants and cancer treatments likely rely on antibiotics, which leads to resistance. In addition, endurance against antibiotics depends on the types of pathogens (like bacteria and fungi) and is directed by variables including the quality of hygiene and sanitation. Another factor that elevated the spread of resistant pathogens is global trade and tourism across borders. As a result, developing countries may suffer economically due to reduced import and export activities linked to AMR concerns.

Examples of antibiotic resistance

When a drug is incompetent to inhibit bacterial growth effectively, it results in AMR. Microbes become ‘resistant’ and carry on with their growth despite being under the influence of antibiotics. After the introduction of new antimicrobial compounds, the evolution of AMR was monitored. AMR has occurred as a nature’s filter process where nature empowers all bacteria with low-level resistance For example, a has study confirmed that sulfamethoxazole and trimethoprim (TMP-SMZ), ampicillin and tetracycline were commonly used in former years for treatment, but now they are capable of treating non-cholera diarrhea disease in Thailand. Another study carried out in Bangladesh indicated the impact of the same drugs in treating them effectively. It shows that the resistance was reported even before the commencement of the application of antibiotics for infection treatment. Therefore, the drug tolerance demonstrated by microbes is largely due to the misuse of antibiotics.

In 1937, sulfonamides were introduced as therapeutic agents. However, now it has exhibited resistance in contrast to the microbes’ mechanism. Vancomycin was introduced 44 years ago; however, in 2002, Vancomycin-resistant Staphylococcus aureus (VRSA) was documented.

In the long run, bacteria acquire several resistance traits and become resistant to vast groups of antibiotics. As one example, Staphylococci are resistant to aminoglycosides due to chromosomal mutations, inefficient transport, and enzyme modifications. Resistance does not develop against one specific drug, but against structurally similar compounds of the same class. For example, microbes showing tolerance to tetracycline may show a sign of resistance to oxytetracycline, chlortetracycline, doxycycline, and minocycline. Analysis indicates that resistance genes developed even before antibiotics were clinically used, implying that antibiotics exhibit resistance genes that are able to withstand their antimicrobial products.

Current scenario

AMR was explicitly responsible for 6,400 deaths in Nepal in 2019, and also 23,200 deaths were registered where AMR played a role. According to the World Health Organization, Nepal ranks 52nd in the highest mortality rate due to AMR out of 204 countries. Antibiotic-resistant bacterial infections affect over 2 million people annually in the U.S due to AMR. Yearly, 33000 people die in the EU because of antibiotic-resistant bacteria.

The System behind Antibiotic Resistance Development

There are several processes used by microorganisms to become an AMR. Some mechanisms are:

Inactivation of an antimicrobial agent by an enzyme.
There is a production of alternative functional protein over time for the enzyme inhibited by the antimicrobial.
Inhibition of antimicrobial agent binding due to a mutation in its target.
Antimicrobial agents are modified after transcription or translation in a way that inhibits their binding to their targets.
The antimicrobial agent is less likely to be absorbed.
An antimicrobial agent is actively effluxed.
An increase in the production of the antimicrobial agent’s target.
In contrast to in vitro expression, in vivo suppression of a gene.
Mechanisms that have never been recognized before.
Microbial characteristics, environmental or human reservoirs, in which resistance genes or resistant organisms are found.

Factors that Cause AMR

Various factors assist in AMR in microorganisms. Some factors are:

The dose of antibiotics used, the act of continuous prescribed dose, non-judicial use of medicine, and in some cases, patients asking to prescribe drugs to physicians without a valid reason, lead to the escalation of AMR.
The Lower antibiotic concentrations and long-term treatment contribute to the rise of AMR.
In addition to poor hygiene by hospital staff and mechanical ventilation, underlying diseases have also played a role in spreading resistant organisms.
Antimicrobial resistance escalates when counterfeit medications contain sub therapeutic antibiotic concentrations.
Inappropriate wastewater treatment by some pharmaceutical companies results in large amounts of antibiotics being released into the environment, resulting in the spread of antimicrobial resistance.
Antibacterial components and antiseptics may also be contributing to AMR.
As a contributing factor to antibiotic resistance, inappropriate antibiotic use in livestock is also found to be an underlying cause.
It is also possible to develop a natural resistance to antibiotics. An environmental resistome is a gene that gains resistance to the environment. Resistance to antibiotics may be caused by the transfer of these genes from non-pathogenic to pathogenic microbiomes.
This global public health hazard may also be caused by heavy metals and other pollutants.

Antimicrobial Resistance Associated with Food Producing Animals

There is a substantial relationship between the utilization of antibiotics in medicine, veterinary medicine, and agriculture and the outbreak and spread of antibiotic resistance. To be specific, for the growth stimulation of food animals, antibiotics are used widely in commercial-scale which is the main factor in the transmission of antibiotic-resistant bacteria. A significant majority of antimicrobial resistance is acquired explicitly from animals or humans that produce food. It can also be acquired obliquely through the food chain or exposure to habitats containing high levels of antimicrobial resistance pollution (such as hospitals, nosocomial acquisitions, manure, waste water, and agricultural land).

In agriculture, antibiotics are often used in the same or similar ways to antibiotics used in clinical conditions, contributing to the advancement of drug resistance. Through the food chain, antibiotic-resistant bacteria are mainly transmitted throughout animal and human populations. In some developed countries, the intake of antibiotics in food, water, or parenterally by animals is responsible for the development of antibiotic-resistant microbes.

There is an example where the use of antibiotics in cattle feed as growth promoters has increased antibiotic resistance. The evidence shows that poultry or pork might be a possible source of quinolone-resistant Escherichia coli in rural Barcelona villages, where a fourth of Juveniles harbor these organisms fecally. Quinolones, however, were never administered to these children.

Measures Taken to Overcome AMR

There are several approaches to mitigate AMR

Educating people about antimicrobial resistance.
The rational use of antimicrobials should be educated to the public.
A minimum use of antimicrobials in animals, improved sanitization, and regulated use of probiotics in vaccinations and feed are vital to control common animal diseases.
Antibiotics can be stopped safely 72 hours after symptoms have resolved.
AMR needs to be brought to the attention of nurses and other health care providers, as they are in direct contact with patients and ultimately responsible for infection transmission.
By granting pharmaceutical companies’ incentives for developing new antimicrobials.
Pharmaceutical companies should follow the standards of advertising and promotion for drugs. Pharma companies should also be held accountable for encouraging the misuse of antimicrobials.
New antibiotic categories and diagnostic technologies can only be identified through collaborative national and international academic networks.
In addition to using antibiotics for a short period of time, regular rechecks with the doctor are necessary. As most people do not complete the entire course of treatment when no signs of clinical infection are present, the course must be stopped if no signs of infection are seen.
Antimicrobials that are substandard or counterfeit must be controlled. New vaccines and drugs can be developed as inducements.

Combating Foodborne Antimicrobial Resistance (AMR) in Nepal: A Youth-Led Advocacy and Capacity Building Initiative

The government is taking a One Health approach (Illness, death, and their impact on the economy). Nepal has officially sanctioned the National Action Plan (NAP) to counter the escalating threat of Antimicrobial Resistance (AMR). Through a One Health approach, the Government of Nepal has aimed to deal with AMR. They are working across human health, animal health, and environmental sectors to mitigate the perilous risk associated with AMR. The NAP emphasizes mitigating the morbidity, mortality, and socio-economic burden pertinent to AMR through five strategic foundations:

Enhancing awareness and education of the food chain.
Consolidating integrated surveillance systems for data generation, analysis, and utilization.
Restricting infection statistics through robust prevention and control strategies.
Managing the utilization of antimicrobials in human, animal, and environmental sectors.
Promoting sustainable investment, research, and innovation for AMR containment.

The transmission of drug-resistant microbes to humans through food is a critical concern. Therefore, it is a necessity for prudent antimicrobial use in agriculture and livestock sectors, as well as the significance of integrating national practices with international standards. To aid countries in handling foodborne AMR, the Codex Alimentarius has initiated an assortment of guidelines, standards, and recommendations. Despite that, various countries, including Nepal, face hardship in executing these standards due to limited resources, technical expertise, and public awareness. To overcome this, the Action to Support the Implementation of Codex AMR Texts (ACT) Project, funded by the Republic of Korea, has been implemented in Nepal by the Department of Food Safety and Quality Control (DFTQC) with technical support from FAO Nepal, has been active since 2022. The project focuses on:

Promoting the adoption and implementation of Codex AMR texts.
Enhancing AMR surveillance systems.
Establishing national capacity for evidence-based governance.
Assist in policy creation and regulatory frameworks through data-driven recommendations.

The World Food Forum (WFF) Nepal National Chapter, a part of a Global initiative, encourages young leaders in the agri-food sector through policy dialogue, advocacy, and community initiatives, where it is fostering Youth Empowerment in tackling AMR.

Conclusions and Future Perspectives

Antibiotic resistance has reached record-breaking global levels. Despite multiple programs initiated by WHO member countries, the utilization of antibiotics in humans, animals, and agriculture continues to surge. This has formed a considerable fiscal pressure on healthcare systems, the need for isolation wards, strict infection control measures, and treatment failures. Antibiotics are extensively employed in animals, which is known to be the eliciting aspect for a surge in antibiotic resistance in people. It is obligatory to use antibiotics meticulously and implement policies to ensure their accurate application, to prohibit the outbreak and spread of diseases transmitted from zoonotic epidemics. Health policymakers must develop an all-inclusive surveillance system that operates both nationally and internationally, with data analysis and obligatory reporting of antibiotic resistance cases. AMR generates a critical worldwide danger. Immediate and synchronized worldwide action is necessary.

REFERENCES

Annunziato, G. (2019). Strategies to overcome antimicrobial resistance (AMR) making use of non-essential target inhibitors: A review. International Journal of Molecular Sciences, 20(23). https://doi.org/10.3390/ijms20235844
Cantas, L., Shah, S. Q. A., Cavaco, L. M., Manaia, C. M., Walsh, F., Popowska, M., Garelick, H., Bürgmann, H., & Sørum, H. (2013). A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota. Frontiers in Microbiology, 4(MAY), 1–14. https://doi.org/10.3389/fmicb.2013.00096
Chandra, H., Bishnoi, P., Yadav, A., Patni, B., Mishra, A. P., & Nautiyal, A. R. (2017). Antimicrobial resistance and the alternative resources with special emphasis on plant-based antimicrobials – A review. Plants, 6(2), 457–462. https://doi.org/10.3390/plants6020016
Chandra, S., Prithvi, P. R., Srija, K., Jauhari, S., & Grover, A. (2020). Antimicrobial resistance: Call for rational antibiotics practice in India. Journal of Family Medicine and Primary Care, 9(5), 2192. https://doi.org/10.4103/JFMPC.JFMPC_1077_19
Davies, R., & Wales, A. (2019). Antimicrobial Resistance on Farms: A Review Including Biosecurity and the Potential Role of Disinfectants in Resistance Selection. Comprehensive Reviews in Food Science and Food Safety, 18(3), 753–774. https://doi.org/10.1111/1541-4337.12438;CTYPE:STRING:JOURNAL
Gudata, D., & Begna, F. (2018). Antimicrobial Resistance: Review. International Journal of Research -GRANTHAALAYAH, 6(11), 77–93. https://doi.org/10.29121/granthaalayah.v6.i11.2018.1091
Imran, M., Jha, S. K., Hasan, N., Insaf, A., Shrestha, J., Shrestha, J., Devkota, H. P., Khan, S., Panth, N., Warkiani, M. E., Dua, K., Hansbro, P. M., Paudel, K. R., & Mohammed, Y. (2022). Overcoming Multidrug Resistance of Antibiotics via Nanodelivery Systems. Pharmaceutics, 14(3), 1–25. https://doi.org/10.3390/pharmaceutics14030586
Kshatri, J. S., Satpathy, P., Sharma, S., Bhoi, T., Mishra, S. P., & Sahoo, S. S. (2022). Health research in the state of Odisha, India: A decadal bibliometric analysis (2011‑2020). Journal of Family Medicine and Primary Care, 6(2), 169–170. https://doi.org/10.4103/jfmpc.jfmpc
Panda, B., Rath, P. K., Mishra, B. P., Mishra, J., Jena, B., Mishra, P. S., Chakraborty, A., Hota, D., & Jena, M. K. (2024). Novel Insights into the Antimicrobial Resistance and Strategies to Curb the Menace. Journal of Pure and Applied Microbiology, 18(1), 1–15. https://doi.org/10.22207/JPAM.18.1.42
Tang, K. W. K., Millar, B. C., & Moore, J. E. (2023). Antimicrobial Resistance (AMR). British Journal of Biomedical Science, 80, 1–11. https://doi.org/10.3389/bjbs.2023.11387
Vidovic, N., & Vidovic, S. (2020). Antimicrobial resistance and food animals: Influence of livestock environment on the emergence and dissemination of antimicrobial resistance. Antibiotics, 9(2). https://doi.org/10.3390/antibiotics9020052
World Health Organization: WHO. (2024, December 16). Reaching beyond health to accelerate the fight against AMR in Nepal
Zaman, S. Bin, Hussain, M. A., Nye, R., Mehta, V., Mamun, K. T., & Hossain, N. (2017). A Review on Antibiotic Resistance: Alarm Bells are Ringing. Cureus, 9(6). https://doi.org/10.7759/cureus.1403
Zhou, G., Shi, Q. S., Huang, X. M., & Xie, X. B. (2015). The three bacterial lines of defense against antimicrobial agents. International Journal of Molecular Sciences, 16(9), 21711–21733. https://doi.org/10.3390/ijms160921711

Skipping Breakfast, Missing Health: What Nepal’s Adolescents Are Really Eating

Apr 15, 2025 | Nutrition

Written by Anusha Bastola, Bachelor in Pharmacy | MA in Food and Nutrition

“More than 70% of adolescents skip breakfast—and many exceed their daily calorie needs, yet remain undernourished.” This paradoxical trend highlights the complex, often contradictory landscape of adolescent nutrition in Nepal.

In Nepal, adolescence marks a pivotal stage of physical and mental development. Yet this period is increasingly threatened by poor food habits shaped by urbanization, media influence, and shifting cultural norms. In Kathmandu alone, where traditional meals once formed the staple of youth diets, fast food, sugary snacks, and meal-skipping behaviors are on the rise. The implications for long-term health are significant—ranging from undernutrition to obesity, and even future risk of chronic illnesses.

This article is based on a recent cross-sectional study conducted among 131 adolescents in Kathmandu. The study aimed to assess food consumption patterns and nutritional status in youth aged 10 to 18, exploring the factors influencing their choices. The results, while localized, echo a broader concern across low- and middle-income countries: how modern influences are reshaping traditional diets and the future health of a generation.

II. Key Findings

The Nutritional Spectrum: Underweight to Obese

The BMI results from the study paint a concerning picture: although a slight majority (51.9%) had normal weight, 28.2% were underweight, and almost 1 in 5 adolescents were overweight or obese. Notably, these imbalances occurred despite over 58% of respondents consuming more calories than the recommended daily allowance (RDA). This points not just to quantity of food, but the quality and nutritional value of what is consumed. Adolescents may be consuming energy-dense but nutrient-poor food—such as fried snacks, sugary drinks, and processed meals—leading to ‘hidden hunger’ where caloric intake is high but essential micronutrients are lacking.

Breakfast is Skipped, Not Optional

The most skipped meal was breakfast, with 73.3% of adolescents reporting that they missed it regularly. Skipping breakfast is associated globally with poor academic performance, irritability, fatigue, and even weight gain over time. In Nepal’s context, early school hours, lack of parental supervision, and limited food preparation time in the morning contribute to this habit. Adolescents also reported not feeling hungry or intentionally skipping meals to lose weight. These patterns may suggest early signs of disordered eating behaviors that should be addressed through awareness and counseling.

Taste Reigns Supreme in Food Decisions

A staggering 95.4% of respondents indicated that taste influenced their eating decisions the most, surpassing family, culture, and even health knowledge. This finding suggests that health interventions must take taste into account—promoting healthy food that’s also enjoyable. While taste alone was not statistically linked to BMI, it does help explain the high preference for fast food and snacks. Global food marketing often emphasizes taste as a key selling point, and this aligns with the adolescents’ responses.

Physical Activity Makes a Difference

The study found a significant positive association between regular physical activity and healthy BMI. 85.5% of adolescents engaged in some form of physical activity such as walking or playing sports. This is promising, but the quality, frequency, and intensity of that activity remain unmeasured. Further research can identify which activities yield the best outcomes and how school schedules or urban infrastructure support or hinder active lifestyles.

Media, Religion, and Peers: Little Measured Impact

While peer influence, religion, and media are often assumed to shape food choices, the study found no strong statistical associations between these factors and nutritional status. This might reflect a growing independence among adolescents in urban Nepal, where personal preferences like taste and convenience override traditional expectations. However, the influence of media and advertising may be more subtle and long-term than what short-term surveys can detect.

III. Implications

Public Health Impacts

The dual burden of malnutrition is becoming more visible in Nepal: underweight and overweight adolescents co-exist in the same classrooms. Underweight teens are at risk for stunted growth, weakened immunity, and poor academic performance, while overweight adolescents face increased risk of hypertension, diabetes, and mental health issues such as low self-esteem and depression. Early interventions can prevent lifelong complications and reduce the burden on the healthcare system.

Economic Consequences

Malnourished adolescents often grow into adults with reduced earning potential and higher medical expenses. At a national scale, poor adolescent nutrition can affect workforce productivity and economic growth. For Nepal, which is striving for economic development and youth empowerment, ignoring adolescent nutrition could slow progress and increase dependence on healthcare resources later.

Social and Cultural Dimensions

Nepal is experiencing a shift from traditional communal meals to more individualistic and fast-paced eating behaviors. The rise in fast food consumption indicates cultural adaptation to global trends, often at the cost of nutrition. Additionally, gender-based dynamics were observed—boys reported more peer influence, while girls cited family influence and concerns about weight. These nuanced cultural shifts suggest that nutrition campaigns should be tailored to reflect the lived realities of modern Nepali adolescents.

IV. Solutions

Evidence-Based Recommendations

Schools should introduce regular nutrition education classes that address real-life scenarios—like how to build a healthy lunchbox or read food labels.
2. Reinstating breakfast programs, especially in schools with early start times, can ensure students begin the day with adequate energy.
3. Incorporate structured physical education, not just optional sports days. Encourage walking or cycling to school where feasible.
4. Include parents in nutrition workshops to reinforce learning at home.
5. Monitor and regulate food vendors around schools to reduce exposure to unhealthy options.

Case Studies from Similar Contexts

Brazil’s School Feeding Program mandates local produce and provides one or two nutritious meals per school day, improving attendance and health. India’s Mid-Day Meal Scheme significantly boosted student retention and reduced malnutrition. Bangladesh has piloted peer-led ‘nutrition clubs’ where adolescents promote healthy habits. Nepal could adopt hybrid models combining these strategies in ways that respect local context and infrastructure.

Call to Action

Policymakers, educators, and parents must treat adolescent nutrition as a priority—not just a background issue. Integrated approaches involving the school curriculum, family culture, urban planning, and food regulation can create an environment where healthy choices are easy and appealing. Nepal’s future depends on how it invests in its youth today.

REFERENCES

Akhtar, A., Sarker, M. M. R., & Apu, E. I. (2024). Exploring the multifaceted influences on childhood nutritional status. Cureus, 16(7), e64329. https://doi.org/xxxx
Bawajeeh, A. O., Albar, S. A., & Evans, C. E. L. (2020). Taste preference and BMI in adolescents. Public Health Nutrition, 23(8), 1452-1460. https://doi.org/xxxx
Behrens, J. H. (2018). Nutritional status and food pattern of adolescents. Nutrition & Food Science, 48(5), 846-855. https://doi.org/xxxx
Kasim, R. M., Ismail, N. H., & Ahmad, N. (2022). Media influence on dietary habits. International Journal of Nutrition Studies, 3(1), 12-20. https://doi.org/xxxx
Kolade, O., & Olubola, M. (2021). Convenience of food preparation and adolescent dietary patterns. African Journal of Food Science, 15(2), 45-53. https://doi.org/xxxx
Kurshed, A. M., Khanam, M., & Parvin, N. (2010). Dietary intake and physical activities of adolescent girls in Bangladesh. Ibrahim Medical College Journal, 4(2), 78-82. https://doi.org/xxxx
Maskey, M., Sharma Annavarapu, L., & Karmacharya, P. (2020). Nutritional assessment of school children. Journal of Patan Academy of Health Sciences, 7(2), 53-63. https://doi.org/xxxx
Melo, F., Silva, P., & Ribeiro, S. (2017). Taste preferences and adolescent nutrition. Brazilian Journal of Adolescent Health, 5(1), 22-30. https://doi.org/xxxx
Onyiriuka, A. N., Umoru, D. D., & Ibeawuchi, A. N. (2013). Breakfast consumption and academic performance among Nigerian adolescents. Nigerian Journal of Clinical Practice, 16(2), 143-148. https://doi.org/xxxx
Singh, D. R., Sah, R. K., & Yadav, S. (2021). Physical activity and obesity among school adolescents in Nepal. Nepal Journal of Epidemiology, 11(3), 1020-1028. https://doi.org/xxxx

Dietary Pattern and Nutritional Status among Healthcare Professionals

Mar 16, 2025 | Nutrition

Written by Kamala Shrestha, BN ( Nursing) , MA ( Nutrition )

Kamala Shrestha is a public health researcher with a focus on nutrition and lifestyle behaviors among healthcare professionals. She holds a degree in Home Science and has a passion for exploring the intersection of work environments, dietary habits, and health outcomes. This article is based on the findings of her thesis, which she submitted as part of her academic journey.

Healthcare professionals (HCPs) are often seen as the torchbearers of health and wellness, guiding patients toward better dietary choices and healthier lifestyles. Yet, behind the scenes, many HCPs struggle to maintain their own nutritional well-being. This article is the article version of the thesis I submitted, and I am sharing what I found during my research. A study conducted among 171 healthcare professionals in Nepal sheds light on this paradox, revealing alarming trends in dietary patterns and nutritional status that demand immediate attention.

The study, conducted across three healthcare institutions in Gokarna Municipality, found that more than half (52.03%) of HCPs worked grueling shifts of 8-12 hours daily. This demanding schedule took a toll on their eating habits, with 72.73% admitting to occasionally skipping meals. Breakfast, often hailed as the most important meal of the day, was the most frequently missed, with 31.97% of participants forgoing it altogether.

The consequences of these irregular eating patterns were evident in the dietary choices of the participants. A staggering 71.34% reported regular consumption of fast food, while an overwhelming 91.97% admitted to consuming sugary drinks. These habits, coupled with limited water intake and high stress levels, contributed to a concerning nutritional profile. Nearly half (48.17%) of the participants were classified as “Overweight” or “Pre-Obese,” and 50.84% faced high health risks based on their Body Mass Index (BMI).

The Hidden Struggles of Healthcare Professionals

Healthcare professionals are often perceived as paragons of health, but the reality is far more complex. Their jobs are inherently stressful, involving long hours, emotional strain, and physically demanding tasks. These factors, combined with irregular shifts, make it difficult for HCPs to prioritize their own health. As one nurse participating in the study shared, “When you’re rushing from one patient to another, grabbing a quick snack or skipping a meal becomes the norm rather than the exception.”

This sentiment is echoed globally. A 2023 study by Gołabek et al. found that midwives working shift schedules in Poland faced similar challenges, with irregular meal patterns and high consumption of processed foods being common. The study also highlighted the impact of such diets on micronutrient deficiencies, which can further exacerbate fatigue and reduce cognitive function.

The Role of Sociodemographic Factors

The study also highlighted the role of sociodemographic factors in shaping dietary patterns and health outcomes. Younger HCPs, particularly those aged 20-25, were more likely to exhibit unhealthy eating behaviors and face obesity-related risks. This aligns with findings from Karthijekan and Angela (2020), who noted that younger individuals often prioritize convenience over nutrition, leading to poorer dietary choices.

Marital status also played a significant role. The findings of this research indicated that married HCPs were found to be obese, with a higher waist-to-hip ratio and single HCPs, especially those living alone, were more prone to relying on fast food and skipping meals. Smoking and low water intake were additional risk factors, with both behaviors significantly associated with higher BMI and Waist-to-Hip Ratio (WHR) risks.

Interestingly, gender differences were also observed. Female HCPs had a higher prevalence of WHR-related health risks, consistent with findings from Gupta (2017) and the Chinese Nutrition Society (2020). This could be attributed to biological factors, such as differences in fat distribution, as well as societal pressures that may lead women to adopt restrictive or unhealthy diets.

The Caloric Conundrum

One of the most striking findings of the study was the imbalance in caloric intake among HCPs. Over 40% of participants consumed either insufficient or excessive calories, both of which can have serious health implications. Insufficient caloric intake can lead to fatigue, weakened immunity, and impaired cognitive function, while excessive intake is a key driver of obesity and metabolic disorders.

This caloric imbalance is not unique to Nepal. A 2022 study by Ydyrysheva et al. found that medical workers in shift-based roles often struggle with maintaining a balanced diet, leading to similar patterns of over- or under-eating. The study also noted that shift work disrupts circadian rhythms, further complicating dietary habits and increasing the risk of metabolic syndrome.

The Ripple Effect on Patient Care

The implications of poor nutrition among HCPs extend far beyond individual health. Research by Lemaire et al. (2010) has shown that inadequate nutrition can impair cognitive function, reduce energy levels, and negatively impact decision-making abilities. For healthcare professionals, whose jobs require precision, focus, and empathy, these effects can be particularly detrimental.

In low-resource settings like Nepal, where healthcare systems are already under strain, the well-being of HCPs is critical to sustaining effective healthcare delivery. As Dr. Chen (2021) aptly noted in his study on the dietary health of medical workers, “When healthcare professionals are unhealthy, the entire healthcare system suffers.”

A Call to Action: What Can Be Done?

The findings of this study underscore the urgent need for interventions at both the individual and institutional levels. Workplace wellness programs that prioritize nutritional education, stress management, and access to healthier food options could go a long way in improving dietary habits among HCPs. For example, hospitals could establish on-site cafeterias offering balanced meals, or provide HCPs with meal vouchers for healthier options.

Policies that encourage regular meal breaks and reduce time constraints are also essential. As Simkhada et al. (2011) noted in their study on civil servants in Nepal, even small changes in workplace policies can have a significant impact on employees’ health and productivity.

Moreover, future research should incorporate comprehensive nutritional assessments, including laboratory tests for micronutrient levels, lipid profiles, and glucose levels, to provide a more holistic understanding of HCPs’ nutritional status. Such data could inform targeted interventions, such as personalized nutrition plans or supplementation programs.

The Bigger Picture: A Healthier Future for Healthcare Professionals

The study serves as a timely reminder that healthcare professionals are not immune to the challenges of maintaining a healthy lifestyle. In fact, their unique circumstances—long hours, high stress, and irregular shifts—make them particularly vulnerable to poor dietary habits and their associated health risks.

Addressing these challenges is not just a moral imperative but a practical necessity. Healthier healthcare professionals mean healthier patients—and a healthier society. As the study concludes, “Ensuring the well-being of HCPs is not just an investment in their health, but an investment in the health of the communities they serve.”

In a world where HCPs are often too busy caring for others to care for themselves, this study is a wake-up call. It’s time to prioritize the health of those who dedicate their lives to healing others. After all, a healthier healthcare workforce is the foundation of a healthier world.

REFERENCES

Chen, W. (2021). Dietary health of medical workers: Who’s taking care of it? Hepatobiliary Surgery and Nutrition, 10(2), 232-234. https://doi.org/10.21037/hbsn-2021-9
Gołabek, K.D., Chmielewska, A., Karoluk, E., & Regulska-Ilow, B. (2023). A multifaceted assessment of the nutritional status, diet, and eating habits of midwives working on a shift schedule in Wrocław, Poland: Evaluation of macronutrients, vitamins, and minerals in the diets of midwives participating in the study. International Journal of Occupational Medicine and Environmental Health, 36(5), 618-631. https://doi.org/10.13075/ijomeh.1896.02117
Gupta, S. (2017). Dietary practices and nutritional profile of female nurses from government hospitals in Delhi, India. Iranian Journal of Nursing and Midwifery Research, 22(5), 348-353. https://doi.org/10.4103/ijnmr.IJNMR_167_16
Karthijekan, K., & Angela, A.A. (2020). Nutritional status and dietary practices among university students in Sri Lanka. International Journal of Scientific and Research Publications, 10(10), 359-370. http://dx.doi.org/10.29322/IJSRP.10.10.2020.p10648
Lemaire, J.B., Wallace, J.E., Dinsmore, K., Lewin, A.M., Ghali, W.A., & Roberts, D. (2010). Physician nutrition and cognition during work hours: Effect of a nutrition-based intervention. BMC Health Services Research, 10, 241.n https://doi.org/10.1186/1472-696310-241
Simkhada, P., Poobalan, A., Simkhada, P.P., Amalraj, R., & Aucott, L. (2011). Knowledge, attitude, and prevalence of overweight and obesity among civil servants in Nepal. Asia Pacific Journal of Public Health, 23(4), 507-517. https://doi.org/10.1177/1010539509348662
Ydyrysheva, K.K., Magzumova, R.Z., & Sazonov, V. (2022). Impact of shift work on dietary habits and health of medical workers. Science & Healthcare, 24(2), 71-78. https://doi.org/10.34689/SH.2022.24.2.017

Defective Sperm and Pregnancy Complications: Understanding the Connection and Its Impact

Mar 5, 2025 | Men's Health

Written By THT Editorial Team

Reviewed by Dr. Asmita Pandey, Fertility Expert, M.D. (OB/GYN)

Infertility and pregnancy complications are major concerns for couples trying to conceive, with male infertility playing just as important a role as female factors. Recent studies have shown that defective sperm can significantly affect pregnancy outcomes, highlighting the need to address male fertility as part of overall reproductive health. This essay examines the role of defective sperm, its connection to pregnancy complications, and what this means for reproductive health.

What Determines Sperm Quality?

Sperm quality is a key factor in male fertility. It includes factors like sperm count, movement (motility), shape (morphology), and, most importantly, the integrity of the sperm’s DNA. Research shows that DNA integrity is crucial for successful fertilization and healthy embryo development (Panner Selvam et al., 2020). When sperm DNA is damaged—such as having breaks or other issues—it can lead to problems like miscarriages or developmental issues in the embryo (Alvarez et al., 2023).

Recent Research on Defective Sperm

A study in Human Reproduction found that sperm with frequent DNA damage is linked to higher risks of pregnancy complications, including miscarriage, preterm birth, and low birth weight (Willerslev, 2023). These findings remained consistent even after accounting for factors like the mother’s age and lifestyle, suggesting that sperm quality is an independent factor in pregnancy success. The study analyzed sperm samples from men whose partners had pregnancy complications and found that higher levels of sperm DNA damage were associated with worse pregnancy outcomes (Zini et al., 2008).

How Defective Sperm Leads to Pregnancy Complications

The ways in which defective sperm causes pregnancy complications are complex. Damaged sperm DNA can lead to chromosomal abnormalities in the embryo, problems with placental function, and poor fetal growth (Zheng et al., 2018). When an egg is fertilized by sperm with damaged DNA, the embryo may develop genetic issues, which can disrupt normal growth and lead to complications. Additionally, defective sperm can cause inflammation in the female reproductive tract, which may interfere with implantation and proper placental development (Bernal et al., 2019). This inflammation can contribute to conditions like preeclampsia and restricted fetal growth (Musson et al., 2022).

What This Means for Reproductive Health

The link between defective sperm and pregnancy complications has important implications for reproductive healthcare, especially in infertility treatments and assisted reproductive technologies (ART) Advanced tests, like the sperm chromatin structure assay (SCSA) and the TUNEL assay, can now measure sperm DNA damage more accurately (Dutta et al., 2020). These tools help doctors assess male fertility beyond traditional measures like sperm count and motility.

Improved Treatments: Addressing sperm DNA damage may involve lifestyle changes, antioxidant therapy, or medical treatments. Antioxidants like vitamins C and E, coenzyme Q10, and selenium can help reduce oxidative stress and improve sperm DNA quality (Romano et al., 2024).

Assisted Reproductive Technologies (ART): For couples using ART, selecting sperm with intact DNA can improve the chances of a successful pregnancy. Techniques like intracytoplasmic sperm injection (ICSI) combined with DNA testing can help identify the healthiest sperm for fertilization (Esteves et al., 2021).

Prevention: Educating men about factors that harm sperm DNA—such as smoking, excessive drinking, and exposure to environmental toxins—can encourage healthier habits and reduce the risk of defective sperm (Leslie, Soon-Sutton, & Khan, 2024).

Conclusion

The connection between defective sperm and pregnancy complications emphasizes the importance of evaluating and treating male fertility as part of reproductive healthcare. By focusing on sperm DNA integrity, doctors can improve pregnancy outcomes, offering hope to couples struggling with infertility and reducing the risk of complications. Ongoing research will continue to enhance our understanding of male infertility, leading to more personalized treatments and better support for families worldwide.

For further information about reproductive health, please book your consultation with fertility expert here.

REFERENCES

Panner Selvam, M. K., Sengupta, P., & Agarwal, A. (2020). Sperm DNA fragmentation and male infertility. In M. Arafa, H. Elbardisi, A. Majzoub, & A. Agarwal (Eds.), Genetics of male infertility (pp. 195-207). Springer. https://doi.org/10.1007/978-3-030-37972-8_9B
Alvarez, J.G., García-Peiró, A., Barros, A. et al. Double strand DNA breaks in sperm: the bad guy in the crowd. J Assist Reprod Genet 40, 745–751 (2023). https://doi.org/10.1007/s10815-023-02748-5
Willerslev, E. (2023). Influence of diet and exercise on sperm and its epigenome. Human Reproduction, 38(Suppl. 1), dead093.001. https://doi.org/10.1093/humrep/dead093.001
Zini, A., Boman, J. M., Belzile, E., & Ciampi, A. (2008). Sperm DNA damage is associated with an increased risk of pregnancy loss after IVF and ICSI: systematic review and meta-analysis. Human Reproduction, 23(12), 2663–2668. https://doi.org/10.1093/humrep/den321
Zheng WW, Song G, Wang QL, Liu SW, Zhu XL, Deng SM, Zhong A, Tan YM, Tan Y. Sperm DNA damage has a negative effect on early embryonic development following in vitro fertilization. Asian J Androl. 2018 Jan-Feb;20(1):75-79. doi: 10.4103/aja.aja_19_17. PMID: 28675153; PMCID: PMC5753558.
Musson R, Gąsior Ł, Bisogno S, Ptak GE. DNA damage in preimplantation embryos and gametes: specification, clinical relevance and repair strategies. Hum Reprod Update. 2022 May 2;28(3):376-399. doi: 10.1093/humupd/dmab046. PMID: 35021196; PMCID: PMC9071077.
Dutta, S., Henkel, R., & Agarwal, A. (2020). Comparative analysis of tests used to assess sperm chromatin integrity and DNA fragmentation. Andrologia. https://doi.org/10.1111/and.13718
Romano, M., Cirillo, F., Spadaro, D., Busnelli, A., Castellano, S., Albani, E., & Levi-Setti, P. E. (2024). High sperm DNA fragmentation: do we have robust evidence to support antioxidants and testicular sperm extraction to improve fertility outcomes? A narrative review. Human Reproduction Update
Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM, Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia. 2021 Mar;53(2):e13874. doi: 10.1111/and.13874. Epub 2020 Oct 27. PMID: 33108829; PMCID: PMC7988559.
Leslie, S. W., Soon-Sutton, T. L., & Khan, M. A. B. (2024). Male infertility. In Author Information and Affiliations. Last update: February 25, 2024. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK562258/

Supporting and Educating Strategies for Children with Autism Spectrum Disorders

Nov 4, 2024 | Children's Health

Written by Dr. Mukti Thapaliya, RTLB Cluster 9, Ph.D. in Education

Introduction

This article describes the meaning of Autism Spectrum Disorders (ASD), the characteristics of ASD, the diagnosis process of ASD, ASD diagnosis instruments, and the strengths and interests of children with ASD. The article also presents supporting and educating techniques, behaviour management strategies and communicating strategies for students with ASD.

Understanding Autism Spectrum Disorders

Before the publication of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) (APA, 2013), various terms were used to refer to children with complex neurodevelopmental conditions (e.g., ASD, atypical autism, childhood psychosis, childhood schizophrenia, and autism). The term “autism” was defined differently from childhood schizophrenia and other psychoses, such as “pervasive developmental disorders” (PDDs), after the publication of DSM-III. Moreover, DSM-IV included several subtypes of PDD: autism, AS, PDDNOS, Rett syndrome, and disintegrative disorder (APA, 2013). After the DSM-5, the subcategories were eliminated and replaced with the single diagnosis of “ASD” and the DSM-5 revised the diagnostic criteria for children with autism spectrum disorders (APA, 2013). The term ‘ASD’ is used throughout this article – consistent with DSM-5 diagnostic criteria.

Characteristics of students with ASD

Students with autism may experience difficulties in the following areas. Table 1 presents characteristics of students with autism.

Table 1 characteristics of students with autism

Communication

Social interaction

Restricted and repetitive patterns of behaviour

● delay in speech and language

● have trouble understanding other people

● hard communicating what they want

● could use body parts or objects to indicate what they want to say

● may have an unusual tone, pitch, or accent

● may not understand non-verbal communication (e.g., facial expressions, body language, and gestures)

● may have difficulty following instructions

● Sometimes may appear not to hear at all

● may not join in play with other students and may appear disinterested in other people

● may prefer to play or be alone

● may not play as often as same-aged peers

● rarely bring toys and objects to share with other students

● may not respond to other people’s greetings or smiles

● may experience difficulty with social situations and understanding social rules

● may not understand others’ emotions, thoughts, or actions

● difficulty with eye contact

● A strong preference for routine and order

● get very upset if their routines are interrupted

● may have trouble with transitioning to new environments

● may have a special interest that they enjoy talking about a lot

● may use behaviour including challenging behaviour as a way of communicating

● may appear to be clumsy and have poor motor skills

● may make unusual movements or sounds

● may have poor problem-solving or organisational skills

● hyper or hypo-sensitive to various stimuli (link to sensory)

(Altogether Autism, 2023; APA, 2013).

Strengths and interests of students with ASD

Students with ASD excel in various learning styles, including acquiring knowledge. Specifically, they may be good at:

rote learning
remembering information for extended periods
detailed and chunk-based learning
paying close attention to small details
concentrating on narrow topics of interest
using visual information meaningfully
using concrete information, understanding and following rules
actions and thought logical processes
follow strict rules

Diagnosis process for students with ASD

There are several theories about the causes of ASD, but none of them have been scientifically proven (Autism New Zealand, 2020; Thapaliya, 2023a, 2023b). Researchers are still investigating varied factors that might contribute to the development of ASD. Some studies suggest that people with ASD may have genetic predispositions, whereas other research signals viral infections, structural and functional brain abnormalities, and dysfunctional immune systems (APA, 2013).

The diagnostic process requires input from multiple professionals (e.g., child psychologists, educational psychologists, pediatricians, clinical psychologists, audiologists, and teachers) and parents (APA, 2013). Professionals also involve an evaluation process. Specifically, the following criteria are commonly used to diagnose ASD:

assessments of multiple areas of functioning (e.g., intellectual and communication skills, a review of developmental history)
parental input
medical tests (a loss of hearing test and eye test before considering a diagnosis of ASD)
assess multiple areas of functioning
collect information from a variety of settings
provide a single coherent view
provide implications for adaptation and learning
liaison with schools and other agencies to support the implementation of recommendations
developmental history
diagnostic assessment of speech, language and communication
sensory and motor skills assessments
medical evaluations

Figure 1 presents the two diagnosis domains of ASD based on DSM-5: communication and repetitive patterns of behaviour (APA, 2013).

(APA, 2013)

Diagnostic instruments

The following diagnostic tools may be used to diagnose autism spectrum disorder.

Diagnostic and Statistical Manual of Mental Disorders (DSM)- 5
Asperger Syndrome Diagnostic Interview (ASDI)
Asperger Syndrome Screening Questionnaire (ASSQ)
Australian Scale for Asperger syndrome (ASAS)
Autism Behaviour Checklist (ABC)
Autism Diagnostic Observation Schedule (ADOS) and ADOS-G
Autism Screening Questionnaire (ASQ)
Autistic Diagnostic Interview (ADI, and also ADI-R)
Childhood Asperger Syndrome Test (CAST)
Childhood Autism Rating Scale (CARS)
Child Communication Checklist (CCC)
Checklist for Autism in Toddlers (CHAT)
Diagnostic Interview for Social Communication Disorders (DISCO)
Gilliam Autism Rating Scale (GARS)
Parent Interview for Autism (PIR)
Pervasive Developmental Disorders – mental retardation (PDD-MR)
Social Response Scale (SRS)
Treatment and Education of Autistic and related Communications Handicapped Children (TEACCH) checklist
Wing Autistic Disorder Interview Checklist (WADIC)

Teaching and learning strategies for students with ASD

Researchers recommend a wide range of teaching approaches, methods, and techniques to teach students with autism, such as structured teaching programmes, social stories, visual cues, sensory corners in the classroom, and using assistive technology to deliver course content in the classroom (Autism New Zealand, 2020; Bevan-Brown & Dharan, 2016; Thapaliya, 2023). The following section describes key teaching strategies for students with ASD.

Rules of 5 (Fewer than 5 words, wait 5 seconds)

In this strategy, teachers have to present the information in sentences that only have five words. Teachers can give students five seconds to comprehend each statement so they can focus on and understand what you said. For example,

Stay in your seat
Hand on pencils only
Use friendly words
Raise your hand to speak
Focus on your task

Use the student’s name first

Saying the student’s name first gets the students’ attention and allows them to work out that the teacher is speaking to them. For instance, teachers can frequently remind them to do the task. Tom, time for math.

Giving positive direction

Teachers need to give positive direction while instructing students with autism in the classroom because students with autism may have trouble when they hear the word ‘no’. For example, ‘Please use a tissue, instead of saying ‘Stop picking your nose!’.

First-then strategies

A first-then strategy may provide the students with a visual means of introducing a new task in a way that they can understand. This technique helps to establish a routine and controlled environment for students with autism. Specifically, teachers can use a first-then strategy to increase independence, provide predictable environments/activities, clarify expectations while providing sequencing of events, support transitions (activity to activity or between locations), reduce verbal information (prompts) provided to a child and increase motivation for completing an adult-directed task/activity (MoE, 2023). For example, first reading a passage, then having a break time.

Give warnings before an activity finish

It is recommended to give students prior warnings before ending a favourite activity to prevent anger. Three warnings, accompanied by visual cues, are the usual practice (Autism New Zealand, 2020; MoE, 2023). For example,

Hunter, you have ten minutes left to complete your math task.
Hunter, you have five minutes left to complete your math task.
Hunter, math time is finished.

Use assistive technology

Using assistive technology (e.g., computers, iPads), can help reduce learning barriers in the classroom while teaching students with autism spectrum disorders (Autism New Zealand, 2020; MoE, 2023; Thapaliya, 2023a). Using computers can be a useful tool for teaching literacy and language skills (e.g., listening, speaking, reading, and writing) and numeracy skills. Jacklin and Farr (2005) reported the benefit of using computers with students with autism spectrum disorders in the classroom because they provide a “visual impact on what they are learning” (p. 208). While completing academic tasks, students with autism spectrum disorders may gain a sense of predictability, confidence, and self-control (Murray, 2015).

Learner profile

A learner profile includes everything about students’ learning needs, strengths, and individual needs in the classroom. In other words, the learner profile can assist schoolteachers, school psychologists, and school staff in understanding the perspectives of ākonga (student) and their whānau/parent), forging relationships with them, and tailoring instruction to fit the needs of individual students (MoE, 2023). Specifically, a learner profile can provide information about students (e.g., how to communicate with students, likes, and dislikes) (Thapaliya, 2023b).

Provide visual support

Visual support refers to a shared set of tools that are employed for a variety of tasks and are more permanent than words. Visual support consists of objects that are used to visually enhance a person’s understanding of the information, physical environment, social situation, and abstract concepts (Rutherford, et al., 2020).

Visual support may assist expressive communication by serving as a substitute for words, signs, gestures, and physical acts. Visual support can support people in meeting their developmental stage by offering a variety of skills (e.g., skill acquisition, motivation to learn, and utilizing their new learning). Similarly, visual support can offer students with ASD the structure, routine, and sequence they need to participate in everyday tasks (Thapaliya, 2023b).

. For instance,

Social story support

Researchers claim that social skills are the most effective way to manage students with ASD behavioural issues if they are taught within the natural environment (Fleury et al., 2014; Murray, 2015; Ostmeyer & Scarpa, 2012). Social skills can provide an opportunity for imitative skills and observation skills for students with autism spectrum disorders, as well as help them get support from their peers and tutors.

There are three types of story support (Autism New Zealand, 2020) to improve students with ASD behaviour:

Story for self-esteem provides a positive story of student’s behaviour and learning. Also, it was applied to enhance students’ self-esteem and confidence.
Story for information offers practical information (e.g., how to brush teeth), calming strategies to reduce their anxiety, and a new classroom timetable.
Story for understanding is used to explain misunderstood communication and enhance students’ comprehension of course content.

Sensory regulation

Sensory overload sensitivity is a component of the autism spectrum diagnosis. This does not imply that all autistic students will be sensitive to sensory stimuli (APA, 2013). Students with ASD may have sensitivities to sights, sounds, smells, tastes, touch, and balance. They can experience both hyper- and hyposensitivity (under-reactivity) to a variety of stimuli. Most people combine the two in some way.

Acoustics, lighting, noise-cancellation headphones, low-arousal workspace, and scheduling regular breaks are some suggested strategies to prevent sensory overload for students with autism (Autism New Zealand, 2022). If teachers provide frequent breakout time throughout the day and calming and self-managing activities for students with autism, these activities will help students with autism cope with the classroom environment (e.g., prevent overload anxiety issues). For instance,

Give students frequent break
Check in- and check-out times
Curate a reading corner and breakout space with toys and sensory cushions

Lego therapy

LEGO-based therapy may help to develop social skills in children with autism spectrum disorder (Autism New Zealand, 2020; MoE, 2023; Thapaliya, 2023). Initially, Lego- therapy was designed to help children with ASD, but now it has been used to help kids with various social and communicative issues. In Lego-based therapy, there will be three people:

Engineer: reads the visual instructions and designs

Supplier: finds the pieces as directed by the engineer

Builder: builds the pieces

Lego-based therapy may help to:

promote social interaction
develop turn-taking skills and share with others
collaborate with others for problem-solving
develop language and motor skills
increase motivation and self-esteem
improve participation and engagement skills
feel calm and relaxed

Universal Design for Learning

Universal support approach refers to the Universal Design for Learning (UDL). The UDL has three principles and guidelines that assist in enhancing learning, including for students with ASD. According to students’ interests and learner variability, teachers can select certain guidelines to apply in their teaching and learning activities (Rao & Torres, 2016). The UDL framework has three principles: i) multiple means of engagement; ii) multiple means of representation; and iii) multiple means of action and expression (CAST, 2018)

The multiple means of engagement principle offer choices for developing likes, purposes, and self-regulation among students. The multiple means of representation principle is structured to assist learning through recognition networks and provide multiple ways of representing the curriculum. The multiple means of action and expression connect to strategic networks in the brain, and they play a key role in language learning and skill development (CAST, 2018).

Behaviour managing strategies

Students with ASD might display problematic, challenging, and aggressive behaviour (e.g., difficulty in listening to their teachers and following instructions, self-harm, difficulty following classroom rules, and repetitive disruptive behaviour). Instructional and behavioural support from behavioural therapists, educational psychologists, and clinical psychologists is put in place to assist students with spectrum disorders (Fleury et al., 2014). The use of technological interventions such as iPads is an effective intervention for decreasing challenging behaviours in the classroom. The following section describes Applied Behaviour Analysis (ABA), Functional Behavioural Analysis (FBA), and Cognitive Behaviour Therapy (CBT) to manage behaviour of students with autism spectrum disorders.

Communication managing strategies

Augmentative and Alternative Communication (AAC)

Augmentative Alternative and Communication (ACC) refers to a range of tools and techniques that assist people with complex communication needs. Students with cerebral palsy, autism spectrum disorders, developmental disabilities, childhood apraxia of speech, language delays, and other medical conditions that result in speech loss can benefit from the use of augmentative and alternative communication (ACC) (Mitchell & Sutherland, 2020).

In other words, the term ‘augmentative’ refers to resources that support and improve the existing communication abilities of a student. For instance, a student with ASD may use an iPad with communication software that produces a synthetic voice in response to a selected image. ‘Alternative’ describes communication systems that are designed to substitute for learners’ lost language and speech or are unlikely to develop in the future. For example, communicating effectively with students who have severe ASD can be challenging, especially in social situations, classrooms, and in their future endeavours where speech is a necessity. However, a high-tech system with speech output could be a temporary solution to serve as their primary means of communication.

There are three types of ACC solutions: No-tech, low-tech, and high-tech.

No-tech AAC is widely known for utilizing voluntary motor movements (e.g., sign language and facial expression analysis) to convey non-verbal messages.
Low-tech AAC utilizes simple resources such as books and whiteboards with large lexicons of words and images to support communication. For example, Pictogram Ideogram Communication (PIC), Rebus Signs, Picture Communication Symbols (PCS) and Picture Exchange Communication System (PECS) are some examples of low-tech ACC. In preschools and schools, PECS is very popular. PECS is a functional communication system that is used as a communication tool for students with speech and language difficulties. PECS teaches students to select cards with line drawings, symbols, or photos of desired items or activities and then give them to another person (e.g., communicative partner, peer, teacher, or parent) to receive the object or task.
High-tech AAC involves the use of electronic devices (e.g., iPads, laptops, computer applications and mobile phones) and speech generating devices (e.g., Proloquo2go) to achieve an AAC goal. Similarly, students with a range of difficulties (e.g., people with visual impairment) and neurological conditions may benefit from software programmes such as text- to- speech output options.

Conclusion

This article explored the meaning of autism, characteristics of students with ASD, and the diagnosis process for ASD. It presented supporting and teaching strategies. managing challenging behaviour and communication strategies for students with ASD.

REFERENCES

Altogether Autism, (2023). Autism, what is it? https://www.altogetherautism.org.nz/what-is-autism/.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). American psychiatric association.
Autism New Zealand. (2020). Tilting the Seesaw Handbook (Ed.) Wellington: Author.
Bevan-Brown, J., and Dharan, V. M. (Eds.). (2016). Autism spectrum disorder in Aotearoa New Zealand: Promising practices and interesting issues (pp. 155-168). Wellington: NZCER Press.
Center for Applied Special Technology (CAST). (2018). UDL and the learning brain. Wakefield, MA http://www.cast.org/products-services/resources/2018/udl-learning-brain-neuroscience
Fleury, V. P., Hedges, S., Hume, K. Browder, D. M., Thompson, J. L., Fallin, K., and Vaughn, S. (2014). Addressing the academic needs of adolescents with autism spectrum disorder in secondary education. Remedial and Special Education, 35(2), 68-79. doi:10.1177/0741932513518823.
Jacklin, A., and Farr, W. (2005). The computer in the classroom: A medium for enhancing social interaction with young people with autistic spectrum disorders? British Journal of Special Education, 32(4), 202-210.
Ministry of Education, (2023, April). Resource Teachers: Learning and Behaviour Service. https://www.education.govt.nz/school/student-support/special-education/resource-teachers-learning-and-behaviour-service
Murray, J. (2015). Practical Teaching Strategies for Students with Autism Spectrum Disorder: A Review of the Literature. BU Journal of Graduate Studies in Education, 7(2), 68-75.
Ostmeyer, K., & Scarpa, A. (2012). Examining school-based social skills program needs and barriers for students with high-functioning autism spectrum disorders using participatory action research. Psychology in the Schools, 49(10), 932-941. doi:10.1002/pits.21646
Rao, K., & Torres, C. (2016). Supporting academic and affective learning processes for English language learners with universal design for learning. TESOL Quarterly, 51(2), 460–472. https://doi.org/10.1002/tesq.342.
Rutherford, M., Baxter, J., Grayson, Z., Johnston, L., & O’Hare, A. (2020). Visual supports at home and in the community for individuals with autism spectrum disorders: A scoping review. Autism, 24(2), 447-469.
Thapaliya, M. (2023a). Exploring Inclusive Practices for Students with Autism Spectrum Disorders in Mainstream Classrooms: A Case from New Zealand. Psychology Research and Practice, 2(2). DOI: 10.37155/2972-3086-0202-2.
Thapaliya, M.P. (2023b). Teaching Children with Autism Spectrum Conditions in Mainstream Classrooms. Kathmandu University. (Face-to-face workshop contribution

Flaxseed: An Ancient Superfood for Today’s Health and Wellness

Oct 27, 2024 | Nutrition

Written by Astha Paudel, Biomedical Engineering graduate (CBEAS) Nepal, Currently Navigating Bio-Nano Material Science Engineering at AIT, Thailand

Plants have long been a cornerstone of traditional medicine and nutrition, with their bioactive components contributing significantly to their medicinal value. One such plant genus with notable bioactive phytochemicals is Linum usitatissimum, commonly known as flax. Flax is an ancient crop primarily cultivated in the northern hemisphere, where it thrives in colder climates. Canada is currently the world’s largest producer of flaxseed, followed by China, Russia, the USA, India, Nepal, and several European countries. This plant is grown for both its fiber and its nutrient-rich seeds, known as flaxseeds or linseeds.

Flax fibers are used to produce the renowned textile linen, a material with a history spanning over 5,000 years [1]. Egyptian priests wore linen garments daily, and even the mummies of pharaohs were wrapped in fine linen fabrics, many of which have been preserved to this day. Linen is believed to offer several health benefits, such as improving blood circulation and enhancing sleep quality, while its unique frequency is currently being studied for its potential healing properties [2].

Given that the seed is the most utilized part of the plant, the whole plant is often referred to as the flaxseed plant. Flaxseed has been valued for centuries for its nutritional and therapeutic properties. Initially prized by indigenous communities, it has recently gained popularity among contemporary populations for its health benefits. In Ayurvedic medicine, flaxseed is renowned for its medicinal properties and healing potential. The gel derived from flaxseed is traditionally applied externally for healing bone fractures and treating skin conditions, while flaxseed oil is believed to enhance memory, improve blood circulation, boost immunity, and reduce bad cholesterol levels.

Flaxseed is an abundant source of proteins, lignans, omega-3 fatty acids, and other phytochemicals, providing numerous health advantages. It is reported to contain a high percentage (87.8-89.8%) of unsaturated fatty acids, making it an excellent source of healthy fats [3]. Research has shown that flaxseed oil is rich in alpha-linolenic acid (ALA), an omega-3 fatty acid essential for neuron myelination and memory formation [4]. Furthermore, flaxseed is a rich source of protein, comprising 23% of its total weight, and is considered a complete protein containing all essential amino acids. A comparative study revealed that flaxseed has a higher total protein content than soybeans, with a quality score of 82% [5].

The high fiber content in flaxseed helps absorb cholesterol and triglycerides, regulate blood sugar levels, and boost metabolism, thereby aiding in weight management [6]. Flaxseed is also rich in vitamins E and K, and essential minerals such as calcium, magnesium, and phosphorus, which support blood clotting, calcium deposition, and skin health [7].

Flaxseed’s antioxidant and anti-inflammatory properties make it particularly beneficial for overall health. It is often recommended by doctors for heart disease, obesity, bone deformities, and especially for treating hormonal imbalances in women. As a phytoestrogen, flaxseed naturally balances estrogen, the hormone responsible for regulating bone mass density, menstruation, and various other processes in females. It is especially beneficial for women over the age of 45 who are approaching menopause [8].

To utilize its diverse properties, flaxseed is formulated into tablets, emulsions, and powders to treat various ailments. The most common formulation is flaxseed oil capsules, which are rich in fatty acids and are effective for enhancing memory, improving skin health, and supporting weight loss. These capsules serve as an excellent alternative to fish oil for vegetarians and vegans. Additionally, flaxseed can be incorporated into daily meals by adding flaxseed powder to cooked foods or using it as a seasoning for salads.

Despite its well-documented nutritional benefits, flaxseed remains underutilized. Given its potential, it is crucial to raise awareness about this beneficial seed and encourage its wider use in daily diets.

REFERENCES

The Biology of Linum usitatissimum L. (Flax),2019 – inspection.canada.ca.
Ben-Hayil Yellen Rebbetzin Heidi Yellen, A. Director Louis Yellen, J. Klein, M. Ramirez, S. Darden, and Lady Marjorie Papin, “Healing Flax,” 2013. www.hebrewstoday.com
Kauser S, Hussain A, Ashraf S, et al. Flaxseed (Linum usitatissimum); phytochemistry, pharmacological characteristics and functional food applications. Food Chemistry Advances. 2024;4:100573. doi:10.1016/J.FOCHA.2023.100573
Siegert E, Paul F, Rothe M, Weylandt KH. The effect of omega-3 fatty acids on central nervous system remyelination in fat-1 mice. BMC Neurosci. 2017;18(1):19. doi:10.1186/S12868-016-0312-5
Ye XP, Xu MF, Tang ZX, et al. Flaxseed protein: extraction, functionalities and applications. Food Science and Technology. 2022;42: e22021. doi:10.1590/FST.22021
Zhao M, Wang B, Li L, Zhao W. Anti-Obesity Effects of Dietary Fibers Extracted from Flaxseed Cake in Diet-Induced Obese Mice. Nutrients. 2023;15(7):1718. doi:10.3390/NU15071718/S1
Kaur M, Kaur R, Gill BS. Mineral and amino acid contents of different flaxseed cultivars in relation to its selected functional properties. Journal of Food Measurement and Characterization. 2017;11(2):500-511. doi:10.1007/S11694-016-9417-X/TABLES/5
Hutchins, A. M., Martini, M. C., Olson, B. A., Thomas, W., & Slavin, J. L. (2001). Flaxseed Consumption Influences Endogenous Hormone Concentrations in Postmenopausal Women. Nutrition and Cancer, 39(1), 58–65. https://doi.org/10.1207/S15327914nc391_8

Epistaxis

May 24, 2024 | News

Written By THT Editorial Team

Reviewed by Dr. Chetana Pathak, Otorhinolaryngologist/Head & Neck Surgeon, MBBS, MS(Otorhinolaryngology),

Nosebleeds, or epistaxis, are a common medical issue affecting approximately 60% of people in the United States at some point in their lives. Although most episodes are minor and self-limiting, around 6% of individuals experiencing nosebleeds will seek medical attention (Tunkel et al., 2020). In children, epistaxis is particularly prevalent, with 75% having at least one episode (Tunkel et al., 2020). There are two primary types of nosebleeds: anterior, which is more common, and posterior, which, although less frequent, often require medical intervention (Tabassom & Dahlstrom, 2024).

Epistaxis, despite often being seen as a mere nuisance, can occasionally pose life-threatening risks, particularly in resource-limited settings where adequate healthcare facilities are scarce. It is estimated that 60% of the global population will experience epistaxis, with about 6% requiring medical treatment due to the ineffectiveness of home remedies (Adoga et al., 2019).

Causes of Epistaxis

The most common cause of epistaxis are idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%) (Parajuli R, 2015)

Other Local causes are:

Anatomic deformities

Intranasal tumors

Low humidity

Vigorous nose blowing

Nose picking

In adults, medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants like heparin and warfarin are common contributors. Hereditary bleeding disorders, including hemophilia A, hemophilia B, and von Willebrand disease, are also associated with epistaxis (Ameya et al., 2021).

Additionally, chronic vascular damage related to hypertension has been suggested as a potential mechanism linking high blood pressure to nosebleeds (Byun et al., 2021).

Management and Treatment of Epistaxis

Following steps can be used at Home. This method is also called Hippocratic method

Sit upright and lean slightly forward to prevent blood from running down your throat, which can cause nausea, vomiting, and diarrhea. Avoid lying flat or tilting your head back.
Breathe through your mouth.
Use a tissue or damp washcloth to catch the blood.
Pinch the soft part of your nose with your thumb and index finger, pressing it against the hard bony ridge that forms the bridge of your nose. Pinching above or on the bony part won’t effectively stop the bleeding.
Maintain pressure on your nose for at least five minutes before checking if the bleeding has stopped. If it persists, continue pinching for another 10 minutes.
Optionally, apply an ice pack to the bridge of your nose to help constrict blood vessels and provide comfort. This step is not essential but can be helpful (Cleveland Clinic).

Managing epistaxis requires a thorough examination and detailed patient history to identify the bleeding site and cause. Treatment methods vary depending on the location, severity, and etiology of the bleeding and can be broadly categorized into nonsurgical and surgical approaches. Simple measures include pinching the nose, while more severe cases might require ligation of vessels (Parajuli, 2015).

The majority of nosebleeds are acute, sporadic, and self-limited, typically responding to simple compression but sometimes requiring more aggressive measures like cautery (can be chemical or electric) or nasal packing. Conventional gauze pack and Merocel nasal pack are the common pack used in refractory anterior epistaxis (Shanmugam et.al, 2019)

Vasoconstrictors, such as oxymetazoline, xylometazoline can help locate the bleeding site. If simple measures fail, tranexamic acid, nasal cautery with silver nitrate, or nasal packing may be necessary. (Director, Paediatric Emergency Department, 2023). Endoscopic ligation of the sphenopalatine artery is done in case of persistent bleeding (Snyderman & Carrau, 1997).

If there is persistent bleeding then endoscopic ligation of the bleeding vessel is done.

SPA ligation has been reported to be effective in 87-92% of cases (Kishimoto 2018, Wormald 2000).
Bilateral SPA ligation has been shown to have lower rebleeding rates compared to unilateral ligation (Hervochon 2018).
SPA ligation may reduce the risk of future severe epistaxis in anticoagulated patients.

REFERENCES

Tunkel, D. E., Anne, S., Payne, S. C., et al. (2020). Clinical Practice Guideline: Nosebleed (Epistaxis). ss 162(1_suppl), S1-S38. https://doi.org/10.1177/0194599819890327
Tabassom, A., & Dahlstrom, J. J. (2024). Epistaxis. In StatPearls. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK435997/
Adoga, A. A., Kokong, D. D., Mugu, J. G., Okwori, E. T., & Yaro, J. P. (2019). Epistaxis: The demographics, etiology, management, and predictors of outcome in Jos, North-Central Nigeria. Annals of African Medicine, 18(2), 75-79. https://doi.org/10.4103/aam.aam_24_18
Ameya, G., Biresaw, G., Mohammed, H., Chebud, A., Meskele, M., Hussein, M., & Endris, M. (2021). Epistaxis and Its Associated Factors Among Precollege Students in Southern Ethiopia. Journal of Blood Medicine, 12, 1-8. https://doi.org/10.2147/JBM.S309273
Byun, H., Chung, J. H., Lee, S. H., Ryu, J., Kim, C., & Shin, J. (2021). Association of Hypertension with the Risk and Severity of Epistaxis. JAMA Otolaryngology–Head & Neck Surgery, 147(1), 34-40. https://doi.org/10.1001/jamaoto.2020.2906
Parajuli, R. (2015). Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal. International Journal of Otolaryngology, 2015, 283854. https://doi.org/10.1155/2015/283854
https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis
Director, Paediatric Emergency Department. (2023). Emergency department management of epistaxis (Document ID CHQ-GDL-07450, Version 2.0). Executive Director Medical Services. https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis
Shanmugam, V. U., PremNivas, P., Swaminathan, B., Shanmugan, R., & Suji, S. (2019). A comparison of conventional nasal pack with Merocel nasal pack in the management of epistaxis. Journal of Medical Science and Clinical Research, 7(10). https://dx.doi.org/10.18535/jmscr/v7i10.156
Carl H. Snyderman, Ricardo L. Carrau, Endoscopic ligation of the sphenopalatine artery for epistaxis, Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 8, Issue 2,1997, Pages 85-89, ISSN 1043 1810, https://doi.org/10.1016/S1043-1810(97)80007-3.

Exploring the Role of Metabolic Psychiatry in Understanding Mental Health Disorders

May 20, 2024 | Current News Affair

Written By THT Editorial Team

Reviewed by Dr. Kamal Gautam, MBBS(KU), MD Psych (IOM), Currently working at Transcultural Psychological Organization Nepal (TPO Nepal)

Introduction:

Metabolic psychiatry is an emerging field that investigates the bidirectional relationship between metabolic dysregulation and psychiatric disorders. Increasing evidence suggests that disturbances in metabolism, including alterations in glucose metabolism, lipid metabolism, and hormonal imbalances, may contribute to the pathophysiology of various mental health conditions. This research article aims to explore the latest findings and concepts in metabolic psychiatry, highlighting the potential implications for understanding and managing psychiatric disorders.

Metabolism and Mental Health:

Traditionally, mental health disorders have been primarily viewed as disorders of the brain, focusing on neurotransmitter imbalances and neuronal dysfunction. However, emerging research indicates that disturbances in metabolism can impact brain function and significantly contribute to psychiatric symptoms. Metabolic abnormalities, such as insulin resistance, inflammation, oxidative stress, and mitochondrial dysfunction, have been observed in individuals with depression, anxiety, bipolar disorder, schizophrenia, and other mental health conditions.

Insulin Resistance and Depression:

Insulin resistance, a condition characterized by impaired cellular response to insulin, has been associated with an increased risk of depression. Studies have demonstrated that insulin resistance disrupts neuronal signaling pathways, affects neurotransmitter metabolism, and promotes neuroinflammation, all of which may contribute to the development and persistence of depressive symptoms. A longitudinal study by Timonen et al. (2005) found that insulin resistance predicted the onset of depressive symptoms in middle-aged individuals.

The global prevalence of type 2 diabetes is on the rise. Within the diabetic population, approximately 30% experience comorbid mental health issues, such as depression, schizophrenia, delirium, and substance misuse, including tobacco smoking. Interestingly, there is evidence suggesting a bidirectional relationship between these mental disorders and diabetes. Moreover, the prevalence of depression and anxiety among individuals with diabetes exceeds that of the general population, with a striking 50-100% heightened risk of depression in diabetic patients. Presently, psychiatrists recognize the interplay between psychiatric disorders and medical conditions, acknowledging that they often influence each other (Al-Atram AA. ,2018).

Dyslipidemia and Bipolar Disorder:

Dyslipidemia, characterized by abnormal levels of lipids (e.g., cholesterol and triglycerides) in the bloodstream, has been implicated in bipolar disorder. Altered lipid metabolism can influence membrane composition and fluidity, affecting neuronal signaling and synaptic function. Several studies have reported associations between dyslipidemia and bipolar disorder, including altered lipid profiles in individuals with the disorder Fagiolini et al. (2014) found that patients with bipolar disorder had significantly higher levels of triglycerides and lower levels of high-density lipoprotein (HDL) cholesterol compared to healthy controls.

Depression stands as one of the most prevalent psychiatric disorders among adults, posing a significant public health concern in the United States. Mounting evidence suggests a correlation between depression and heightened risks of diabetes and cardiovascular diseases (CVD).

Metabolic syndrome (MetS), comprising various CVD risk factors like central obesity, hyperglycemia, elevated blood pressure, hypertriglyceridemia, and reduced HDL cholesterol, is widespread in the general populace and is linked to increased susceptibility to diabetes and CVD. Given the substantial public health burdens posed by both depression and MetS, recent focus has been directed towards understanding the relationship between these two conditions (Pan et.al,2012)

Hormonal Imbalances and Schizophrenia:

Hormonal imbalances, particularly involving the hypothalamic-pituitary-adrenal (HPA) axis and sex hormones, have been implicated in the pathophysiology of schizophrenia. Dysregulation of the HPA axis, characterized by abnormal cortisol levels and stress response, is frequently observed in individuals with schizophrenia. Moreover, alterations in sex hormone levels, such as estrogen and testosterone, have been associated with symptom severity and cognitive impairments in schizophrenia. A study by Riecher-Rössler et al. (2018) demonstrated that estrogen treatment improved symptoms and cognition in postmenopausal women with schizophrenia.

Conclusion:

Metabolic psychiatry offers a novel perspective on the etiology and treatment of psychiatric disorders by exploring the interplay between metabolic dysregulation and mental health conditions. The emerging evidence supports the concept that disturbances in metabolism can contribute to the pathophysiology of depression, bipolar disorder, schizophrenia, and other psychiatric disorders. Understanding the role of metabolic factors in mental health opens new avenues for developing targeted interventions, such as lifestyle modifications, dietary interventions, and pharmacological approaches that address metabolic dysfunctions alongside traditional psychiatric treatments.

Further research is needed to elucidate the complex mechanisms underlying the relationship between metabolism and mental health and to identify potential therapeutic targets. Integrating metabolic assessments and interventions into psychiatric practice holds promise for personalized approaches and improved outcomes in the management of mental health disorders.

REFERENCES

Timonen M, et al. Insulin resistance and depressive symptoms in young adult males: Findings from Finnish military conscripts. Psychosom Med. 2005;67(5): 853-857.
Fagiolini A, et al. Dyslipidemia in bipolar disorder: Causes and consequences. Curr Psychiatry Rep. 2014;16(10): 1-9.
Riecher-Rössler A, et al. The effects of estradiol on cognition and symptoms in schizophrenia. Am J Psychiatry. 2018;175(3): 225-233.
Al-Atram AA. A review of the bidirectional relationship between psychiatric disorders and diabetes mellitus. Neurosciences (Riyadh). 2018 Apr;23(2):91-96. doi: 10.17712/nsj.2018.2.20170132. PMID: 29664448; PMCID: PMC8015449
Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, Hu FB. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012 May;35(5):1171-80. doi: 10.2337/dc11-2055. PMID: 22517938; PMCID: PMC3329841

Micro plastics: A Silent Threat to Reproductive Health and Fertility

May 15, 2024 | Global health issues

Written By THT Editorial Team

Reviewed by Dr. Asmita Pandey, Fertility Expert, M.D. (OB/GYN)

Microplastics, often abbreviated as MPs, are small plastic particles under 5 millimeters that are now widely recognized as an environmental issue. They have made their way into our water systems and the broader food chain, prompting extensive studies on how they might affect reproduction in different species, humans included. This article explores the possible ways in which microplastics could be affecting reproductive health and fertility.

Oxidative stress

Oxidative stress is a cellular phenomenon that happens when there’s a mismatch between the creation of free radicals, like reactive oxygen species (ROS), and the body’s antioxidant defenses that neutralize their damaging effects This mismatch can cause harm to cells and tissues, playing a role in various diseases and the aging process. (Pizzino et al., 2017).

When it comes to microplastics (MPs), oxidative stress is a major issue. MPs can cause oxidative stress by interfering with the cells’ electron transfer processes, which results in an excess of ROS. These ROS can harm important cellular components such as lipids, proteins, and DNA, all vital for cell health and function (Abdal Dayem et al., 2017). For example, research has indicated that MPs exposure can increase ROS in oyster sperm, leading to reduced fertilization success. Likewise, studies on rats have shown that polystyrene MPs (PS-MPs) can induce oxidative stress in ovarian cells, affecting ovulation (Ferrante et al., 2022)

Hormonal Havoc: Disrupting the HPG Axis

The Hypothalamic-Pituitary-Gonadal (HPG) Axis is an essential hormonal system that controls reproductive functions. It’s a network involving the hypothalamus, pituitary gland, and gonads (ovaries or testes), which are responsible for producing and regulating sex hormones vital for reproductive health. (Mikhael et al., 2019)

Microplastics (MPs) have been identified as disruptors of the HPG Axis, causing hormonal imbalances that could impact fertility. Research has indicated that exposure to polystyrene MPs (PS-MPs) in male mice can lower testosterone levels and affect the balance of other important hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormonal alterations can hinder the growth and maturation of reproductive organs, adversely affecting the development of offspring (Zhang et al., 2022). In female mice, exposure to MPs has resulted in similar hormonal disturbances, with changes observed in FSH and estradiol levels. (Liu et al., 2021)

Regarding reproductive success, it’s known to be an energy-demanding process that relies on ample resources for the creation of gametes, fertilization, and embryo growth. MPs pose a threat to an organism’s energy metabolism, which can influence reproductive success.

Evidence suggests that MPs can modify the patterns of food intake and energy distribution within organisms, which may lead to a decrease in reproductive output (Jewett et al., 2022). For example, studies on oysters have shown that MPs can reduce the activity of enzymes that are crucial for energy production during sperm development. This reduction could lead to sperm quality issues and, consequently, affect the viability of the offspring. (Sussarellu et al., 2016)

Microcirculation Woes: A New Frontier

Microcirculation is the process of blood flow through the body’s tiniest vessels, like capillaries. It’s crucial for supplying tissues with nutrients and oxygen and for eliminating waste. Any interference with microcirculation can greatly affect reproductive health.

Recent research has shown that microplastics (MPs) can negatively impact microcirculation. This can cause developmental issues and raise the mortality rate of embryos in water-dwelling species such as zebrafish. For instance, exposure to MPs and nanoparticles (NPs) has been linked to microcirculation damage, especially in vital areas like the tail, which is important for proper growth. (Zhang et al., 2022)

Human Health Implications

The increasing concern about microplastics (MPs) and their effect on human reproductive health is quite substantial. There has been a noticeable decrease in male semen quality over the last 80 years, and environmental pollutants, including MPs, are suspected to be contributing factors. Insights from animal studies have highlighted potential mechanisms through which MPs may influence health, such as oxidative stress, inflammation, and hormonal disturbances.

Direct research on the impact of MP exposure on male infertility in humans is not yet available, but animal studies have suggested a minimum human equivalent dose of MPs that could result in poor semen quality. This dose is estimated to be 0.016 mg/kg/day. The proximity of this figure to the levels of MP exposure observed in some countries points to a possible threat to human reproductive health. It underscores the importance of ongoing research to fully understand the effects and to develop appropriate exposure guidelines.

Conclusion

The research collectively points to a considerable risk that microplastics (MPs) present to reproductive health in various species. It’s vital to grasp the damaging mechanisms—like oxidative stress, hormonal imbalance, energy shortage, and microcirculation problems—to devise ways to lessen their effects. With MPs increasingly becoming a part of our environment, it becomes more pressing to confront their reproductive consequences. This calls for thorough policy-making and additional studies to safeguard human health.

For further information about reproductive health, please book your consultation with fertility expert here.

REFERENCES

Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V, Squadrito F, Altavilla D, Bitto A. Oxidative Stress: Harms and Benefits for Human Health. Oxid Med Cell Longev. 2017;2017:8416763. doi: 10.1155/2017/8416763. Epub 2017 Jul 27. PMID: 28819546; PMCID: PMC5551541.
Abdal Dayem A, Hossain MK, Lee SB, Kim K, Saha SK, Yang GM, Choi HY, Cho SG. The Role of Reactive Oxygen Species (ROS) in the Biological Activities of Metallic Nanoparticles. Int J Mol Sci. 2017 Jan 10;18(1):120. doi: 10.3390/ijms18010120. PMID: 28075405; PMCID: PMC5297754.
Ferrante MC, Monnolo A, Del Piano F, Mattace Raso G, Meli R. The Pressing Issue of Micro- and Nanoplastic Contamination: Profiling the Reproductive Alterations Mediated by Oxidative Stress. Antioxidants (Basel). 2022 Jan 19;11(2):193. doi: 10.3390/antiox11020193. PMID: 35204076; PMCID: PMC8868557.
Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-Pituitary-Ovarian Axis Disorders Impacting Female Fertility. Biomedicines. 2019 Jan 4;7(1):5. doi: 10.3390/biomedicines7010005. PMID: 30621143; PMCID: PMC6466056.
Zhang C, Chen J, Ma S, Sun Z, Wang Z. Microplastics May Be a Significant Cause of Male Infertility. American Journal of Men’s Health. 2022;16(3). doi:10.1177/15579883221096549
Liu, Z., Zhuan, Q., Zhang, L., Meng, L., Fu, X., & Hou, Y. (2021). Polystyrene microplastics induced female reproductive toxicity in mice. Journal of Hazardous Materials, 416, 125912. https://doi.org/10.1016/j.jhazmat.2021.125912
Jewett E, Arnott G, Connolly L, Vasudevan N, Kevei E. Microplastics and Their Impact on Reproduction-Can we Learn From the C. elegans Model? Front Toxicol. 2022 Mar 24;4:748912. doi: 10.3389/ftox.2022.748912. PMID: 35399297; PMCID: PMC8987311.
Sussarellu, R., Suquet, M., Thomas, Y., et al. (2016). Oyster reproduction is affected by exposure to polystyrene microplastics. Proceedings of the National Academy of Sciences, 113(9), 2430-2435. https://doi.org/10.1073/pnas.1519019113

Is Your Medicine Cabinet Missing This? Laughter’s Amazing Benefits

May 10, 2024 | News

Written by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

A robust sense of humor isn’t merely a pleasant diversion during challenging times; it’s a valuable asset in our pursuit of overall well-being. When we find ourselves amused by a friend’s witty remark or a comedian’s act, the positive impacts of humor resonate through our bodies, minds, and social connections. It’s more than just entertainment; it contributes to enhancing our physical, mental, and emotional health.

According to Dattilo, an instructor of psychology at Harvard Medical School, humor’s psychological benefits are immediate, lifting mood and reducing stress and anxiety, while also affecting us physically by reducing cortisol levels and increasing dopamine and serotonin neurotransmitters (Harvard Gazette, 2023).

Research has shown that laughter’s health benefits are extensive, including pain relief, increased happiness, and enhanced immunity. Positive psychology recognizes laughter and a sense of humor as one of the 24 main signature strengths (Verywell Mind).

The physical benefits of laughter are diverse:

Laughter boosts heart and respiratory rates and oxygen consumption temporarily, leading to subsequent relaxation. While it’s not equivalent to aerobic exercise, it still offers physical benefits. Laughing for 10-15 minutes daily can burn an additional 10-40 calories.
It positively impacts heart function by increasing stroke volume, cardiac output, and dilating blood vessels.
Intense laughter enhances muscle tone.
Watching funny videos stimulates the sympathetic nervous system (SNS) without raising blood pressure.
Laughter reduces cortisol levels, the stress hormone.
It activates the brain’s mesolimbic dopaminergic reward system.
Laughing boosts levels of serum immunoglobulins A and E and tends to increase natural killer cell activity.
It raises levels of beta-endorphins, the body’s feel-good chemicals, and increases human growth hormone (U.S. Department of Veterans Affairs).

Relationship between Laughter and Mental Health

The relationship between laughter and mental health is profound. It interrupts distressing emotions, promoting relaxation, stress reduction, increased energy, focus, and productivity. Additionally, laughter fosters a more positive perspective on situations, creating psychological distance and diffusing conflict. It also strengthens social bonds, which can profoundly impact mental and emotional well-being (HelpGuide).

In conclusion, laughter emerges as a potent medicine for holistic health, offering a multitude of benefits across physical, psychological, and social dimensions

REFERENCES

Harvard Gazette. (2023, January). A laugh a day keeps the doctor away. Retrieved from https://news.harvard.edu/gazette/story/2023/01/a-laugh-a-day-keeps-the-doctor-away/
Verywell Mind. (n.d.). The Stress Management and Health Benefits of Laughter. Retrieved from https://www.verywellmind.com/the-stress-management-and-health-benefits-of-laughter-3145084
S. Department of Veterans Affairs. (n.d.). Healing Benefits: Humor & Laughter. Retrieved from https://www.va.gov/WHOLEHEALTHLIBRARY/tools/healing-benefits-humor-laughter.asp
(n.d.). Laughter is the Best Medicine. Retrieved from https://www.helpguide.org/articles/mental-health/laughter-is-the-best-medicine.htm

« Older Entries

स्वास्थ्य सम्बन्धी सम्पूर्ण जानकारी

جميع المعلومات المتعلقة بالصحة

Lahat ng impormasyong may kaugnayan sa kalusugan

स्वास्थ्य संबंधी सारी जानकारी

Semua maklumat berkaitan kesihatan

ကျန်းမာရေးဆိုင်ရာ အချက်အလက်အားလုံး

ຂໍ້ມູນທີ່ກ່ຽວຂ້ອງກັບສຸຂະພາບທັງໝົດ

Dhammaan macluumaadka la xiriira caafimaadka

स्वास्थ्यसम्बद्धाः सर्वाणि सूचनानि

Alle gezondheidsgerelateerde informative

Tota la informació relacionada amb la salut

ሁሉም ከጤና ጋር የተያያዙ መረጃዎች

ព័ត៌មានទាក់ទងនឹងសុខភាពទាំងអស់។

صحت سے متعلق تمام معلومات

Mọi thông tin liên quan đến sức khỏe

Introduction

Why is it alarming?

Current scenario

The System behind Antibiotic Resistance Development

Factors that Cause AMR

Antimicrobial Resistance Associated with Food Producing Animals

Measures Taken to Overcome AMR

Conclusions and Future Perspectives

REFERENCES

REFERENCES

REFERENCES

Written By THT Editorial Team

REFERENCES

Introduction

Characteristics of students with ASD

Diagnosis process for students with ASD

Diagnostic instruments

Teaching and learning strategies for students with ASD

Rules of 5 (Fewer than 5 words, wait 5 seconds)

Use the student’s name first

Giving positive direction

First-then strategies

Give warnings before an activity finish

Use assistive technology

Learner profile

Provide visual support

Social story support

Sensory regulation

Lego therapy

Universal Design for Learning

Behaviour managing strategies

Communication managing strategies

Augmentative and Alternative Communication (AAC)

Conclusion

REFERENCES

REFERENCES

Written By THT Editorial Team

REFERENCES

Written By THT Editorial Team

REFERENCES

Written By THT Editorial Team

REFERENCES

REFERENCES

Categories