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Endogenous ovarian follicular function is intermittently present in only 11.1% of Asian Indian women with POI. However, the 95% CI (1.4-34.7%) was large due to a small sample size.

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Sphingomyelin (SM) belongs to a class of lipids termed sphingolipids. The disruption in the sphingomyelin signaling pathway is associated with various neurodegenerative disorders. TNF-α, a potent pro-inflammatory cytokine generated in response to various neurological disorders like Alzheimer’s disease (AD), Parkinson’s disease (PD), and Multiple Sclerosis (MS), is an eminent regulator of the sphingomyelin metabolic pathway. The immune-triggered regulation of the sphingomyelin metabolic pathway via TNF-α constitutes the sphingomyelin signaling pathway. In this pathway, sphingomyelin and its downstream sphingolipids activate various signaling cascades like PI3K/AKT and MAPK/ERK pathways, thus, controlling diverse processes coupled with neuronal viability, survival, and death. The holistic analysis of the immune-triggered sphingomyelin signaling pathway is imperative to make necessary predictions about its pivotal components and for the formulation of disease-related therapeutics. The current work offers a comprehensive in silico systems analysis of TNF-α mediated sphingomyelin and downstream signaling cascades via a model-based quantitative approach. We incorporated the intensity values of genes from the microarray data of control individuals from the AD study in the input entities of the pathway model. Computational modeling and simulation of the inflammatory pathway enabled the comprehensive study of the system dynamics. Network and sensitivity analysis of the model unveiled essential interaction parameters and entities during neuroinflammation. Scanning of the key entities and parameters allowed us to determine their ultimate impact on neuronal apoptosis and survival. Moreover, the efficacy and potency of the FDA-approved drugs, namely Etanercept, Nivocasan, and Scyphostatin allowed us to study the model’s response towards inhibition of the respective proteins/enzymes. The network analysis revealed the pivotal model entities with high betweenness and closeness centrality values including recruit FADD, TNFR_TRADD, act CASP2, actCASP8, actCASP3 and 9, cytochrome C, and RIP_RAIDD which profoundly impacted the neuronal apoptosis. Whereas some of the entities with high betweenness and closeness centrality values like Gi-coupled receptor, actS1PR, Sphingosine, S1P, actAKT, and actERK produced a high influence on neuronal survival. However, the current study inferred the dual role of ceramide, both on neuronal survival and apoptosis. Moreover, the drug Nivocasan effectively reduces neuronal apoptosis via its inhibitory mechanism on the caspases.

Aim: To find out the prevalence and intensity of non-specific, mechanical low back pain (LBP) among traffic wardens and security guards. Study design: A Cross sectional study was designed and data collection was done by convenient sampling. Place and duration: The sample was collected from the traffic wardens and security guards from Cantt area and Johar Town, Lahore from 15th September 2021 to 10th December 2021. Methodology: After approval of from ethical committee the data collection was started. Informed consent was taken. A sample of 200 participants including security guards (SCG) and traffic wardens (TW) meeting the inclusion and exclusion criteria after consent filled a questionnaire about the prevalence of low back pain (LBP). Visual analogue scale and MC Gill pain questionnaire were used. SPSS version 21 was used for data analysis. Data was analyzed in form of frequencies, means, standard deviation and bar charts. Results: The mean age of participants was 32±5.64. Males were 160(80%) in number and 40(20%) were females. The prevalence of LBP was 81.5%. Majority of participants had mild to moderate levels of pain severity (49.8%). Independent sample T test showed significant difference in pain severity between both SCG and TW. (p=0.01; p<0.05). Conclusion: There was high prevalence of Low back pain in security guards and traffic wardens. Mild to moderate intensity of pain was reported in majority of participants. There was significant difference in pain intensities in both populations. Keywords: Low back pain, non-specific backache, musculoskeletal disorders, security guards

Objective: To study the impact of isolated oligohydramnios at term on mode of delivery and perinatal outcome. Study Design: Prospective comparative study. Place and Duration of Study: Combined Military Hospital Okara, from Aug 2019 to Aug 2020. Methodology: A total of 250 patients were recruited in the study. They were divided in 2 groups. In group A there was 123 patients, with isolated oligohydramnias at term, amniotic fluid index of ≤5cm, while in group B 127 patients, with normal liquor volume were included through lottery method. Demographic parameters, Intrauterine fetal demise, mode of delivery, perinatal out comes like meconium stained amniotic fluid, low birth weight, APGAR score at 1 and 5 minutes, of two groups were compared. Results: A total of 57 (46.3%) patients in group A delivered through cesarean section and 27 (21.3%) in group B. Meconium staining of liquor was in 56 (45.5%) in group A versus 13 (10.2%) in group B. As compared to group B the patients in group A lower birth weight babies 2.6 ± 0.34 kg versus 3.0 ± 0.33 kg were delivered. Mortality in group A, intrauterine fetal demise was 4 (3.3%) and still birth was 2.3%. There were no perinatal mortality in controlled group B. Conclusion: Isolated oligohydramnias at term is not associated with adverse perinatal outcome. Umbilical cord compression, potential utero-placental insuffiency and increased incidence of meconium stained liquor possibly explains the increased perinatal morbidity. The delivery should be routinely advocated as in otherwise uncomplicated pregnancy with appropriately grown fetus.