COVID-19 pandemic is a global public health disaster and an inducer of physiological stress and fear. Population in every society all over the globe is severely affected directly or indirectly by this pandemic that has created huge stress that will persist in memories for long.[1,2] As we know that the stress is a leading  psychopathological cause responsible for the onset of several neurodegenerative disorders, particularly Alzheimer’s, Parkinson’s, etc., and it has now been speculated that nearly twothirds of the clinical ailments are either induced or exacerbated by physiological stress.[3,4] It is now well established that the physiological and psychological responses to stress are mediated by the hypothalamic-pituitary-adrenal (HPA) axis, sympathoadrenergic and brain monoaminergic systems,[5,6] and most importantly an altered function of HPA-axis was recently reported in patients with COVID-19,[7,8] this is somewhat indicating that stress might be involved in the progression of this ongoing pandemic. It has now been well established that the dysfunctionalities of central neurotransmitters such as noradrenaline, dopamine, and 5-hydroxytryptamine are involved in the onset or progression of several stress-mediated neurodegenerative disorders.[9,10] Similarly, dysfunctionalities of these neurotransmitters in COVID-19 patients have also been recently reported,[7,11,12] indicating that stress may play a role in the progression of this pandemic. Moreover, it is also reported that the dysfunctions of neurotransmitters due to prolonged stressful conditions have also been associated with wide range of central and/or peripheral disorders such as depression, anxiety, drug abuse, obsessive compulsive disorder, eating and sleeping disorders, hyperglycemia, and decreased immune response,[13,14] these symptomatic neurological problems have also been reported in thousands of COVID-19 patients.[15-17] In view of these, it is somewhat clear that physiological stress and COVID-19 have some associated with each other but further investigations at molecular levels are recommended. Herbal remedies are plants used like a medicine. Global populations are using herbal remedies as an alternative AQ2 medicine to help, prevent, or cure disease for getting relief from symptoms, boost energy, relax, and it is believed that these remedies are not having any side effects.[18,19] Numerous herbal plants and their active ingredients have been tested on different disease models and were proved to have anti-disease activities.[20-22] Similarly, several herbal plant extracts or their purified fractions have been tested at molecular level and proved to have anti-stress activities through improving the levels of neurotransmitters and have also been used as immunity boosters.[23] Some examples of herbal medicinal plants have been debated in this article. Bacopa monniera (also known as brahmi) has been reported to possess anxiolytic, antidepressant, neuroprotective activities, and memory-enhancing activity.[26] Another herbal plant Panax quinquefolium also showed neuroprotective potential against neurological stress and also exerted anti-anxiety effects.[25] Most importantly, Panax ginseng applications are also reported to have antiviral effects and also work as immunity booster.[26] Moreover, application of Panax ginseng also reported to prevent the onset of acute respiratory tract infection.[27] Another herbal plant, Withania somnifera (also known as ashwagandha) reported to have potential in reducing the levels of anxiety, stress, and helping the individuals to fight against depression and improve the brain functions.[28] Moreover, another medical plant Ocimum sanctum (or tulsi) popular for its multiple therapeutic potentials including antimicrobial and anti-stress agent and an immunity booster.[29,30] Ocimum sanctum has also been shown to counter metabolic stress through normalization of blood glucose, blood pressure, and lipid levels and also proved to improve memory/cognitive functions through its anxiolytic and antidepressant properties.[29] In addition, Ocimum sanctum also reported to improve the levels of the central monoaminergic, antioxidant systems disturbances and also reported to act as potential agent in the treatment of early/mild flu.[29,30] Interestingly, active phytoconstituents of herbal plants Withania somnifera, Tinospora cordifolia, and Ocimum sanctum predicted to significantly hinder main protease of coronavirus severe acute respiratory syndrome coronavirus-2 through molecular docking and molecular dynamic simulation,[31] indicating that these herbal remedies were anticipated to impede the activity of the coronavirus. Other than these, Zingiber officinale (commonly known as ginger) has also been in use for several medicinal purposes because of its rich nutritional properties.[32] The presence of gingerol makes ginger a perfect immunity booster and an antiviral agent that help us to fight against several infectious diseases.[32] Not only have these, Nigella sativa (or black seed) also reported to have anti-stress potential and also known to work as an immunity booster in several pathological conditions.[33] Recent reports have shown that the people from all over the globe are extensively using herbal remedies as an alternative medicine to fight against the ongoing pandemic as the treatment options are limited.[34-36] Now, it is believed that the usage of herbal remedies in current conditions giving huge strength and ability to develop immunity, psychologically that surely plays a role against pandemic positively. In short, supplementing with herbal remedies is an easy, safe, and effective way to improve health and quality of life in this ongoing pandemic.  

Objectives: The current tools for the management of diabetes mellitus (DM) do not prevent its development or complications, so investigations into promising new treatments, for example, honey-royal jelly (H-RJ) mixtures, are needed. This study was conducted to evaluate the effect of royal jelly on DM by measuring the biochemical parameters (fasting blood glucose and glycated hemoglobin [HbA1c]) accompanying streptozotocin (i.p. 75 mg/kg once)-induced type 1 DM (T1DM) in rats. Other objectives were to evaluate the effects of H-RJ on lipid parameters. Methods: Ten healthy control male Sprague-Dawley rats (120–150 g) were compared to untreated T1DM (n = 10), metformin-treated T1DM (n = 10), and H-RJ-treated T1DM rats (n = 10) on plasma and whole-blood glycemic control indices (fasting blood glucose, HbA1c %, insulin, and insulin resistance) and plasma lipid profile (triglycerides [TGs] and total, low-density lipoprotein -, high-density lipoprotein -, and very low-density lipoprotein [VLDL]-cholesterol). Diabetes was induced by a single intraperitoneal injection of streptozotocin (SZT) at 75 mg/kg body weight (BW). The T1DM-H-RJ rat group received daily RJ (100 mg/kg BW). Parametric data are presented as mean ± SD and were analyzed for comparison using one-way ANOVA in SPSS software. Results: H-RJ normalized glycemic control indices, but its effect on lipid parameters was variable. H-RJ and metformin had comparable effects. The H-RJ treatment caused a significant reduction in plasma VLDL-C content in comparison to the control treatment and metformin. The limitation of this study is that it was restricted to T1DM and did not involve type 2 DM. In addition, the study was limited to male Sprague-Dawley rats, with no females. Conclusion: The H-RJ mixture is a promising antidiabetic alternative medicine. It effectively reduces VLDL-C and TG in diabetic rats.

Objective: The objective of this study was to investigate relationship between job satisfaction and turnover intention of health-care professionals using the moderated moderating approach. Methods: Explanatory sequential research design was applied. Non-probability convenience sampling technique was used to determine the sample size using Weiers formula. Scales adopted in the current study were validated through exploratory and confirmatory factor analysis. To test the hypothesis correlation, the hierarchical multiple regression was used. In the second stage, semi-structured face-to-face interviews from 35 interviewees were conducted and transcribed in Nvivo. Results: Job descriptive index, cognitive style index (CSI), cognitive style indicator, and turnover intention scales were found to be reliable. Furthermore, correlation analysis shows that the factors of job satisfaction were significantly correlated with turnover intention. In addition, findings of the interviews highlighted the importance of cognitive styles for increasing the job satisfaction of health-care professionals. Conclusions: Study concludes that the involvement of health-care professionals in making health-care policies enhances their job satisfaction that also reflected on their performance. Moreover, it also reduces their turnover intention of workforce.

Objectives: Lead poisoning accounts for about 0.6% of global burden of disease. Lead-induced toxicity is through confinement of oxidative stress in affected organs. We evaluated the effects of MLF1 (extracted from Morinda lucida leaves) and AMF1 (extracted from Annona muricata leaves) on lipid peroxidation and immunomodulations of Melatonin, tumor necrosis factor-alpha (TNF-α), and p53 proteins in lead acetate (LA)-induced toxicity in rats. Methods: Sixty adult female rats were randomly divided into 12 groups (n = 5). Groups 1 and 2 received physiological saline and 100 mg/kg bodyweight of LA, respectively, for 5 weeks. Groups 3–6 received 100 mg/kg bodyweight LA for 2 weeks, followed by treatments with 7.5 and 15 mg/kg bodyweight of MLF1, and 7.5 and 10 mg/kg bodyweight of AMF1, respectively, for 3 weeks. Groups 7–10 received 7.5 and 15 mg/kg bodyweight of MLF1, 7.5 and 10 mg/kg bodyweight of AMF1, respectively, for 5 weeks. Groups 11–12 received co-administrations of 100 mg/kg bodyweight LA with 15 mg/kg bodyweight MLF1 and 10 mg/kg bodyweight of AMF1, respectively, for 5 weeks. Drugs and extracts were administered orally. Consequently, liver histopathology (Hematoxylin and Eosin), sera Melatonin, and TNF-α (enzyme-linked immunosorbent assay [ELISA]) levels were evaluated. Malondialdehyde (MDA) (thiobarbituric acid assay) and p53 (ELISA) levels were evaluated in liver homogenates. Data were statistically analyzed (P ≤ 0.05). Results: Results showed normal liver histology in all Groups. Statistical analyses showed significant (P ≤ 0.05) and non-significant decreased levels (P ≥ 0.05) of MDA, TNF-α and p53 in Groups 3-12, compared with Group 2. Furthermore, results showed significant (P ≤ 0.05) and non-significant increased Melatonin levels (P ≥ 0.05) in Groups 4–12 compared with Group 2. Conclusion: This study confirmed that MLF1 and AMF1 confer a degree of antioxidant, anticancer and hepato-protetive potentials against LA-induced toxicity in rats.

Objective: This study aimed to determine the clinical and epidemiological characteristics and outcomes of Coronavirus disease (COVID)-19 patients. Methods: In this large cohort study, 15,409 confirmed patients with the COVID-19 of different severities were followed-up from three specialized COVID-19 hospitals between March 18 and October 11, 2020 in Iraqi Kurdistan. The predictors of mortality and severity were examined in binary logistic regression analysis. Results: The incidence rate of severe/critical status was 12.3% with a median age of 36.0 and case fatality rate (CFR) of 1.98%. The incidence rate of severe/critical conditions and CFR rose with increased age groups; except for 0–14 years (11.9%). The incidence rate of severe/critical patients and CFR was 8.3% and 0.5%, 21.1% and 4.0%, and 23.7% and 8.7% in 15–49 years, 50–64 years, and 65 and older age groups, respectively. The severity of the disease and CFR was associated with coexisting chronic diseases such as cardiovascular diseases (18.2% and 3.1%) and diabetes mellitus (19.8% and 3.4%). The asymptomatic patients (8400 and 54.5%) had statistically higher CFR; 2.3% versus 1.6% (P = 0.006). The most common symptoms on diagnosis were fever (31.9%), cough (23.5%), loss of smell/taste (16.3%), sore throat (15.7%), shortness of breath (9.8%), and headache (9.5%). The results showed that being older was the only predictor of mortality and severity in COVID-19 patients. Conclusions: This region has a low incidence of severe-critic status and CFR. The patients with coexisting medical conditions are more likely to have severe conditions and die of COVID-19. The older age predicts severe/critic status and higher CFR.

Objective: Chondrosarcoma is a rare tumor that has a variable biological characteristic, and its treatment is controversial. We performed a comparison review of different regional institutions series to assess the clinical outcome of patients. Methods: A retrospective review of 33 chondrosarcomas (Grades I, II, and III) patient data since 2013, compared with 15 author’s total 868 patients published literature results to find more about clinical and statistical advantages and similarities with author institute cases. Here is the mentioning of clinical information, surgery type categorized, adjuvants types, genders, follow-up years, recurrence, affected areas, death rates, successful outcome, and survival rates using statistical methods. Results: The overall survival rate was 94%, successful outcome 85% in 4.3±1.2 years follow-up. Observed wide resection, distilled water as adjuvant, chemo and radiotherapy significantly shows excellent results over our compared chondrosarcoma literature data. We have also marked that females and humerus bone are more affected by chondrosarcoma among those literature data. Conclusions: Low-grade chondrosarcoma of the skeleton can be treated with wide resection. Using distilled water give good oncological outcome and a very low rate of post-surgical complications for chondrosarcoma all grades recurrence.

Gastrointestinal (GI) tract manifestations of amyloid deposition include diarrhea, GI hemorrhage, steatorrhea, or constipation. Here, we report an elderly female presenting with GI hemorrhage due to gastric ulceration and 4–6 polypoidal lesions with intermittent ooze in the duodenum as a first presentation of primary systemic amyloidosis. The bleed was managed with proton-pump inhibitors and hemospray application. She received chemotherapy for multiple myeloma after stabilization. A high index of suspicion is needed to diagnose amyloidosis causing GI hemorrhage.