Male infertility is approaching a concerning prevalence worldwide, and inflicts various impacts on the affected couple. The hormonal assessment is a vital component of male fertility evaluation as endocrine disorders are markedly reversible causatives of male infertility. Precise hormonal regulations are prerequisites to maintain normal male fertility parameters. The core male reproductive event, spermatogenesis, entails adequate testosterone concentration, which is produced via steroidogenesis in the Leydig cells. Physiological levels of both the gonadotropins are needed to achieve normal testicular functions. The hypothalamus-derived gonadotropin-releasing hormone (GnRH) is considered the supreme inducer of the gonadotropins and thereby the subsequent endocrine reproductive events. This hypothalamic–pituitary–gonadal (HPG) axis may be modulated by the thyroidal or adrenal axis and numerous other reproductive and nonreproductive hormones. Disruption of this fine hormonal balance and their crosstalk leads to a spectrum of endocrinopathies, inducing subfertility or infertility in men. This review article will discuss the most essential endocrinopathies associated with male factor infertility to aid precise understanding of the endocrine disruptions-mediated male infertility to encourage further research to reveal the detailed etiology of male infertility and perhaps to develop more customized therapies for endocrinopathy-induced male infertility.

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Objective: Anemia bears a high global prevalence with about 1.6 billion people living with this affliction. Malaysia carries the burden of 13.8% anemia prevalence which urges for extensive research directed to its prediction and amelioration. This is the first study that aims to (a) propose simple non-invasive predictive anthropometric markers and their specific cut-off values for early prediction of anemia among the young adults in Malaysia, (b) provide anemia prevalence based on both gender and ethnicity among young adults of Malaysia.Method: The present cross-sectional study included 245 participants (113 men and 132 women) aged between 18 and 30 years. Anthropometric parameters were measured following the standard protocols. Blood samples were collected and hemoglobin levels were determined using the HemoCue haemoglobinometer (Hb 201+ System, Angelhom, Sweden) to detect the presence of anemia. The receiver operating characteristics (ROC) curve was employed to assess and compare the efficacy of anthropometric indices in the prediction of anemia. Data were analyzed using SPSS (v. 22.0, IBM, Chicago, IL, USA) and MedCalc (v. 19.05, Ostend, Belgium).Result: The ROC analysis indicates that body mass index (BMI) is the best anthropometric marker with the highest area under the curve (AUC) and specificity (SP) for predicting the presence of anemia in young adults in Malaysia. Thus, the study proposes the optimal cut-off value of BMI for young men of Malaysia as 20.65 kg/m2 (AUC: 0.889) and young women of Malaysia as 19.7 kg/m2 (AUC: 0.904). The study also reports that Malaysian Indians have the highest prevalence of anemia (26.22%) followed by Malays (21.54%), “Others” (indigenous ethnic group) (20%), and Chinese (14.5%), with an overall higher prevalence of anemia in young adult women (21.96%) than in men (18.6%) of Malaysia.Conclusion: The proposed anemia-predictive anthropometric markers with optimal cut-off values will aid early detection of anemia among young adults in Malaysia, and given its simple, inexpensive, and intelligible approach, it can be widely used. The ease of anemia prediction together with the reported distribution of anemia prevalence based on gender and ethnicity will facilitate in gauging the necessary extent of strategies of anemia management in the young adult population of Malaysia.

Introduction: There is a number of research elaborating the role played by the emotional intelligence in educational performance at primary and high school level but seldom among medical students. Objective: The aim of this review paper is to ascertain the relationship between emotional intelligence and academic performance among the medical students. Materials and methods: All articles searched using relevant finalised MeSh (Medical Subject Headings: is the NLM controlled vocabulary thesaurus used for indexing articles for PubMed.) terms are of English language between the years 1980 and 2018 among the following electronic database Ovid-MedLine, ProQuest, Scopus, Science Direct, CINAHL. Articles are further filtered based on the inclusion and exclusion criteria set up by the reviewers with mutual consent. Knowledge about academic output based on the methods involved in measuring emotional intelligence and study design was extracted. Results: The literature review cited 511 relevant articles. These articles are further scrutinised by removing duplicates, considering full text articles, and abstract review availed 07 articles which were considered for final review. It was found that six out of seven showed women had higher EI than men and only one of the seven showed no difference between men and women. Conclusion: In line with literature review, one can safely conclude emotional intelligence (EI), in general, improves academic performance. However, in contrast it is also seen among medical students the EI decreasing over the time of study years. Further research is necessary to find out the cause for this decline in emotional intelligence during the course and whether timely intervention of structured training can improve or not.

Irisin is a novel skeletal muscle- and adipose tissue-secreted peptide. It is conventionally regarded as an adipomyokine and is a cleaved fragment of Fibronectin type III domain-containing protein 5 (FNDC5). It is involved in the browning of white adipose tissue, glucose tolerance, and reversing of metabolic disruptions. Fertility is closely linked to energy metabolism and the endocrine function of the adipose tissue. Moreover, there is established association between obesity and male infertility. Irisin bears strong therapeutic promise in obesity and its associated disorders, as well as shown to improve male reproductive functions. Thus, irisin is a molecule of great interest in exploring the amelioration of metabolic syndrome or obesity-induced male infertility. In this review we aim to enumerate the most significant aspects of irisin actions and discuss its involvement in energy homeostasis and male reproduction. Though current and future research on irisin is very promiscuous, a number of clarifications are still needed to reveal its full potential as a significant medicinal target in several human diseases including male infertility.

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Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction–Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age.

Background: Medical education has migrated online as a result of the COVID-19 pandemic. Formative and summative evaluation are critical in medical education to support the learning process. However, many problems occur during online assessment, such as internet access, proctoring, and reliable software. To mitigate this situation, there is presently no standardised model available that demonstrates reliability and validity, particularly when it involves high-stake examinations. The goal of this study was to introduce an evidence-based operational model that was used to conduct a comprehensive high stake online examination to Year 2 MBBS students during the COVID-19 pandemic. Prior to entering the clinical years (year 3-5), year 2 MBBS students were expected to pass their high-stake examination earlier conducted as face-to-face session which is now administered online. Methods: The model proposed enables the conduct of an online, synchronous, proctored, closed-book examination in real-time that is comparable to the face-to-face (FTF) manual examination. The examination and invigilation were carried out using the Learning Management System (LMS) and Google Meet applications with the existing information technology (IT) facilities and the Standard Operating Procedure (SOP) was developed to optimise and integrate the technology effectively. Results: Both students and faculty were satisfied with the online examination, with the latter being more so. The online examination with a Cronbach alpha score of 0.71 suggested good internal consistency and reliability and various test of validity ensured this online model was dependable, reproducible and concurrent with other examinations. Conclusions: We concluded that this operational model is a credible alternative to the FTF examination that requires new learning technology and is very cost effective. Thus, we highly recommend this model for all examinations that involve participation of off campus students.