Vitamin D exerts its well-known effects on bone health and calcium-phosphate homeostasis primarily through the vitamin D receptor signaling pathway. Vitamin D also has several extra-skeletal actions and its deficiency is not only implicated in musculoskeletal disorders, but also cardiovascular disorders, diabetes, neurodegenerative conditions and cancers. There is a growing body of research highlighting the link of vitamin D deficiency and alterations in vitamin D signaling with certain infections and autoimmune disorders although the evidence is inconsistent and inconclusive. Vitamin D has been suggested to play a fundamental role in curbing infections and mitigating autoimmune disease processes. The present review was undertaken to explore the promise of vitamin D as a protective agent and a clinically useful therapeutic adjunct against infections and autoimmune diseases and identify knowledge gaps and limitations of the available data for informing future work. An exhaustive search was conducted in established databases including Google Scholar, PubMed, Science Direct and Springer for articles published on vitamin D, immunity, infection and autoimmune disorders. All relevant articles published in the English language between the year 200 and 2020 were retrieved for writing the review. Although a considerable body of evidence highlighting the potential clinical benefits of vitamin D against the development of various autoimmune conditions and for the prevention of infections has emerged over the last decade, the findings are limited by the lack of appropriately designed randomized controlled trials which are needed to formulate precise clinical recommendations.

Ever since discovering the fat-soluble secosteroid vitamin D, an abundance of research has been conducted on the molecular mechanisms for the multiple health benefits of this nutrient. Studies on the beneficial effects of vitamin D supplementation have found appreciable evidence suggesting that it may play a more prime role than initially presumed. Though it has largely been implicated in bone pathophysiology, novel research on vitamin D indicates its fundamental involvement in a wide range of disease processes through its multiple systemic effects, including but not limited to metabolic, cardiovascular, anti-inflammatory, antineoplastic, antioxidant, neuroprotective, and immune actions. Recent work has yielded important mechanistic insights into the functions of vitamin D in mediating immunity. The present work sheds light on the metabolism and immune response mechanisms of vitamin D. Current review is based on a thorough search of the available relevant research findings of the metabolic transformations of vitamin D and the molecular basis of its role in immunity. Apart from its classical mechanistic control of mineral homeostasis, vitamin D has immunomodulatory effects through various mechanisms at both systemic and cellular levels. Disruption of vitamin D reliant molecular pathways in the regulation of immune response can potentially result in the development and/or progression of autoimmune and infective processes.[GMJ.2021;10:e2097]

Objective: The objective of the study is to assess job satisfaction between groups of healthcare workers based on their work experience and monthly salary.Methodology: Healthcare workers (n=81) including clinicians, nurses and medical teachers were recruited from a private medical institute at Lahore. Job Satisfaction Survey (JSS) and Professional Quality of Life (ProQOL) Scale including its component scales of Compassion Satisfaction (CS), Burnout (BO) and Secondary Traumatic Stress (STS) were used to determine aspects of vocational quality of life and satisfaction. Kruskal-Wallis test was used to assess group differences. Spearman correlational analysis was done to assess correlation between income, work experience and job satisfaction.Results: Significantly higher professional satisfaction, lower burnout and stress scores were observed in experienced healthcare workers as compared to less-experienced ones (p value =0.039* for JSS, p value =0.011* for CS, p value =0.055* for BO and p value =0.027* for STS). Significantly higher satisfaction scores were found in workers with higher monthly income as compared to those with lower monthly salary (p value =0.006* for JSS and p value =0.032* for CS). Significant positive correlation was observed between healthcare workers’ job satisfaction and their experience and monthly salary.Conclusion: More experience at work is particularly associated with lower burnout and reduced occupational stress.

Objectives: Obesity is a globally pervasive health concern linked to a plethora of cardiometabolic complications such as hypertension, dyslipidemia and hyperglycemia. Poor dietary proclivity contributes to dyslipidemia, however daily intake of nuts has previously been shown to improve abnormal blood lipid levels. The present study evaluated the effect of almond intake on the lipid profiles of normal, overweight and obese adults to discern which group benefits the most. Study Design: A prospective non-randomized comparative study design was employed. Setting: Institute of Molecular Biology and Biochemistry, University of Lahore and Department of Biochemistry, Central Park Medical College, Lahore. Period: May 2018 and December 2018. Material & Methods: A total of 34 adult subjects (males and females) were recruited for the study with an age range from 21 to 60 years. Participants were categorized into normal, overweight and obese groups based on their Body Mass Index (BMI) values. Baseline fasting blood samples were drawn from each subject and stored. The subjects were then asked to consume 50g/day almonds (without peel) for 30 days after which blood samples were again collected from each subject. Both baseline and post-supplementation serum samples were subjected to lipid profile analysis. Result: Almond supplementation resulted in lowered cholesterol, LDL and VLDL levels (p-values of 0.0001, 0.001 and 0.003, respectively) in Group 1 (normal weight). Lowered cholesterol levels were also observed (p-value 0.007) in Group 2 (overweight). There was no significant change in lipid profile in Group 3 (overweight), upon supplementation. Conclusion: Regular almond supplementation offers improvement in lipid profile and such beneficial effects of almond consumption on lipid profile are more pronounced in normal weight individuals than overweight or obese ones.

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