The typical French cuisine is full of fats and considered generally unhealthy. However, the wine loving French, have low heart disease incidence. The heart protective benefit is attributed to polyphenols in wine. However, the French Paradox is also referred to as a myth since the polyphenol content of wine is not considered sufficient to give health benefits. Hence, the knotty problem of French Paradox is an interesting point of research.

Focus is on plant secondary metabolites

Human diet is more than vitamins, minerals, water, carbohydrates, fats and proteins. Plant based food provide the middle nutrients or mesonutrients – examples being polyphenols and carotenoids. Such plant compounds – mesonutrients largely belong to the category of secondary metabolites. Examples include tannins, resins, gums, alkaloids, and latex: these are substances produced by plants that confer non-reproduction related benefits to the plant. They are useful for self-defense of the plant and other plant chemical reactions or plant metabolism. Secondary metabolites are also secreted by non-plant life forms like microbes, fungi, and some animals. Various antibiotics discovered from fungi and bacteria are secondary metabolites. Penicillin and cephalosporin antibiotics are examples of secondary metabolites of specific relevant fungi. Many plant secondary metabolites are useful to humankind.

Polyphenols

Polyphenols are secondary metabolites that protect plants from ultraviolet radiation and plant disease causing agents. Examples of plant polyphenols include curcumin from turmeric, resveratrol from grapes, epicatechins (EGCG) from green tea, and chlorogenic acids from coffee (coffeeceuticals). Consumption of plant polyphenols protects from heart disease, keeps blood vessels healthy, and supports healthy immunity (self-defense of body). Concentrated polyphenols are offered in nutraceutical products to support well-being. Curcumin is one of the largest consumed nutraceutical polyphenol.

Carotenoids

Colored compounds in plants (particularly flowers) that help attract pollinating agents to the flowers are called carotenoids. Examples of carotenoids include beta carotene from carrots (pro vitamin A, which is converted to Vit. A inside the human body), lycopene from tomato skin, lutein from marigold flowers, and capsanthin from capsicum. While carotenoids in plants give colour to plants parts, it is interesting to note that carotenoids are highly beneficial to health of retina in the human eye.

Other secondary metabolites of plants

Tannins, gums, resins and alkaloids are some examples of other secondary metabolites from plants. Tannins are useful as they precipitate proteins and help in healing. Overall, the useful plant compounds have antioxidant benefits and supports human body’s immune system.

Controversial French paradox

Red wine manufactured from grapes contains resveratrol polyphenol. This super antioxidant reduces excess toxins called free radicals and hence, resveratrol is considered a molecule that helps increasing lifespan of humans. However, other research suggests that amount of resveratrol in wine is miniscule and insufficient to provide health promoting benefits. Further, alcohol consumption is associated with addiction and other deleterious health problems. In fact, the Rutgers University research calls the French Paradox a modern day myth.

Sunil S Chiplunkar M Pharm (Pharmacology) MBA (Marketing) PGDHRM (PhD)
VP – Business Development, Group Pharmaceuticals, Bangalore
E mail: 1969sunilchiplunkar@gmail.com
Mob: 6364578669

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The parasite virus is also called ‘visha’ in Sanskrit.  This is due to the toxic nature of many viruses, which have a very simple structure: the outer coat of protein and lipids that encloses either the RNA or DNA genetic material.  RNA stands for ribose nucleic acid and viruses that contain this single stranded RNA are called RNA viruses (eg. SARS-CoV-2 that causes Covid-19).  DNA stands for deoxy ribose nucleic acid and viruses that contain the double stranded DNA are called DNA viruses (eg. adenovirus that causes common cold).

Viruses are obligate (compulsory) intracellular (they live inside host cell) parasites.  They enter host cell, hijack the nucleus, and control cellular machinery and makes copies of itself using the cell as a resource.  These copies of the virus then go on to infect other host cells – the new viruses enter new host cells and again makes viral copies.  This vicious cycle of entering the host cell, viral replication and entering other host cells – causes ever increasing viral load in the host body and thus severity of viral infection goes on increasing.  Either the natural immunity of the host body quells the viral infection or the host body succumbs to the viral infection.  Hence, the toxic nature of pathogenic or disease causing minute viruses can be distressing and at times fatal.

 Cancer is a frightening word

Cancer is a frightening word; this is a disease of the body in which body’s cells become enemy of the body.  When normal human cells turn abnormal due to genetic reasons or influence of certain chemicals or radiation – these cells start to multiply in an unrestricted way.  In cancer, there is uncontrollable growth of abnormal cells and this often leads to swelling, pain and bleeding as common signs and symptoms of cancer.  Carcinogens are established compounds or entities that are known to be cancer causing, they stimulate conversion of normal cells to abnormal cells and cancer is the result, as such, cancer can occur anywhere in the body.  Cancer can occur in the liquid component of the body (blood cancer) or in non-liquid part of the body too, in various organs.

Cancer can occur outside on the skin, lips and nose or in any of the internal organs like liver, pancreas, bone marrow and brain.  Well known carcinogens that cause cancer include tobacco smoke, benzene, radon, asbestos, various workplace chemicals, radiation, biological agents like viruses and even medications.  Getting afflicted with cancer implies severe loss in quality of life, many a time – death and a severe drain in finances.  The cancer patient’s social life and family life, plus the quality of life of caregivers’ in the family and friend circle is full of stress, anxiety, trauma and disruptions.

Viruses that cause cancer

If cancer is a dreaded disease causing much pain, anguish, trauma and death, just imagine how much suffering can be caused by a cancer causing virus, which is a toxic parasite.  Hence, from time immemorial holistic systems of healing like Ayurveda have emphasized detoxification to boost immunity or self-defense function.  If toxic overload is there in the body, metabolism and immunity are impaired and diseases like cancer occur in the individual.

Viruses that cause cancer are called oncoviruses.  Many of these oncoviruses are retrovirus, which means they can insert their RNA into the DNA of the host cell.  This RNA insertion into the host cell genetic makeup causes formation of cancerous tumours. Human tumour viruses are said to cause 12% to 20% of the global cancers.  These tumour viruses are known to cause persistent infection; they infect the host cell but do not kill them and cancer occurs years after infection. The oncoviruses are: Epstein – Barr Virus, Papillomaviruses 16 and 18, Herpes virus, Hepatitis B virus, Hepatitis C virus, HTLV-1, Merkel Cell Polyomavirus, and HIV.  

 An example of the oncovirus is the HTLV-1, which stands for human T-lymphotropic virus 1 and as the name indicates, this virus is having a strong affinity towards the T lymphocyte (a type of white blood cell).  HTLV-1 is a retro virus – this is a type of virus that inserts its RNA into the DNA of the host cell.  After this the HTLV-1 virus changes the normal pattern of DNA folding in the host cell.  The viral RNA acts on many sites of the human genome to cause this disruption of gene function by inducing abnormal human DNA folding inside the host cell.  This makes the T lymphocytes overactive immune cells and turns them into cancerous.  This rare type of cancer caused by HTLV-1 is called Adult T-cell leukemia (ATL).

As seen above oncoviruses cause persistent infection and the cancer may develop after several decades of the viral infection as in the case of ATL (due to HTLV-1).  There are an estimated 50 lakh to 1 crore carriers of this HTLV-1 virus in the world, in Japan alone it is estimated there are 10 lakh carriers.  The chronic activation of T lymphocytes by HTLV-1 is a phenomenon of research study and holds the key to anticancer drug development.

 Post Covid-19 scientific approach.

The other interesting facet of ongoing research is the carcinogenic potential of SARS-CoV-2 virus that causes Covid-19 pneumonia and multiorgan damage.  Even non retroviruses like coronavirus SARS-CoV-2 are known to cause persistent infection.  There are certain viral structural reasons for investigating carcinogenic potential of SARS-CoV-2.  Thus, besides long Covid complications – other long term complications are also being investigated.  Hence, good immune nutrition, hygiene practices and scientific detoxification practices to reduce oxidative stress – due to overproduction of toxic free radicals – and decreasing other toxin overload, is a post Covid-19 scientific approach.

Oncoviruses gain entry and infect humans through infected bodily fluids like semen, blood, and breast milk.  Thus, unprotected sex, injecting drug use, tissue transplantation, and blood or blood product transfusion can be a source of HTLV-1 transmission (and other oncoviruses).  Human immunity can be made strong only through optimal immune nutrition, and reducing entry of pathogenic microbes like viruses & bacteria, and infectious proteins like prion proteins.  Hence, staying safe through precautionary methods is good sense!

Sunil S Chiplunkar

M Pharm (Pharmacology) MBA (Marketing) PGDHRM (PhD)

VP – Business Development

Group Pharmaceuticals, Bangalore

E mail: 1969sunilchiplunkar@gmail.com

Mob: 63645 78669

Further reading:

• https://www.who.int/news-room/fact-sheets/detail/human-t-lymphotropic-virus-type-1
• https://www.imperial.ac.uk/news/232637/how-virus-transforms-immune-cells-into/
• Further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267909/
• https://www.mdanderson.org/publications/focused-on-health/7-viruses-that-cause-cancer.h17-1592202.html
• https://www.imperial.ac.uk/news/186970/cancer-causing-virus-htlv-1-changes-dna-loops/
• https://www.sciencedirect.com/science/article/pii/S0306987720311531

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The magic of social life depends on meeting people, greeting, smiling, exchanging views, speaking, shaking hands and even being  physically close and dining together.  Such exchanges are common place in sales, marketing and social life – but this does open a window to transmission of disease causing germs.  The complexity of germ transmission has increased with changing food habits, people movement and animal-human conflict.

With expanding human population, traditional animal territory is being encroached on.  Animal and human contact increases probability of novel germs being transferred from animals to humans.  And  if food consumption patterns change, with it comes the problem of zoonotic infections or disease causing microbes being transferred from animals including non-veg food to humans.

Corona virus refers to a big family of viruses – there are approx. 200 types of corona virus – many cause routine common cold infection.  Similarly, rhinoviruses are also a cause of the common cold infection in humans.  However, the recent corona virus from epicenter Wuhan, Hubei province, China is a sub-type apart from all other corona viruses.  Various theories are afloat as to the origin of this virus in humans:

 1.Consumption  of  bat soup and other forms of wild animal food (there are bat corona viruses)

2.This novel new corona virus may have come from the wet non-veg wildlife food market of Wuhan where snakes, bats and other wildlife meat (including live animals such as dogs too) is sold in the open.

3.Or it could be a leak from the Wuhan National Biosafety Lab level 4 (where a novel bioengineered virus could have escaped).

None  of  above points are proven, however, the danger of this novel corona virus 2019 nCoV or Covid-19 infection has caused economic spasm, human tragedy and social paralysis in China and now rest of world. Wuhan corona virus 2019 nCoV or Covid-19 causes death mainly through respiratory collapse including due to lung infection or pneumonia.  Other common cold infection symptoms such as sneezing, headache, fever, sore throat, runny nose, cough and nasal congestion may occur.

Some patients did not show any initial respiratory symptoms, only gastrointestinal symptoms diarrhea and nausea – so by the time they were diagnosed and quarantined they had already infected many people including medical professionals.  The corona virus infection is a droplet infection, spreads through casual contact, and air borne droplets.  As per WHO release of 27.2.2020, ‘when someone who has Covid-19 coughs or exhales they release droplets of infected fluid’.   Hence, in prone areas it is a good idea to wear face or mouth masks, the best bet is the N95 mask – however, ordinary face masks will also do.

The other important take-care precautions are:

1. It is also important to wash hands with disinfectant, avoid touching the face frequently as also casual inter-personnel contact and other commonsensical approaches of hygiene and personal safety.

2. Drinking water (preferably warm) on and off to ensure oral cavity and throat is not parched helps as secretions are continuously drawn towards acidic stomach where germs die.

3. If you see someone coughing, sneezing or looking sick, keep a distance of minimum 1 m from them.

4. In places suspected to have corona virus patients, it is better to avoid crowds since  infected carriers do not show symptoms but may be in the crowd and can spread the germ easily.

5. Invisible corona virus infected droplets present on door knobs, outside of face mask, desk surfaces, cups, digital devices etc definitely are sources of contamination and spread of infection. When people touch such surfaces and then their face or eyes there is sure shot transmission of infection.

6. The contaminated surfaces may have live corona viruses for upto 48 hours. Regular hand wash and not sharing towels is vital for safety.

The maximum vulnerable population includes those above 40 years, patients with weak immunity and conditions like diabetes, heart and lung disease.It is important that  workplace and in public places like metro trains and malls people  follow various guidelines like propagating  safety information to prevent spread of Covid-19 virus.  This includes poster display, use of face masks, and tissues for use by those suffering runny nose and cough.  It is generally advised that only essential travel domestic and international – be taken up.  Following travel advisories from various governments is important.

 Zoonotic infections not new to India:  

Zoonotic infections that have origin in animals and wildlife are not new to India.  The list is big: major public health zoonotic diseases in India include Rabies, Brucellosis, Toxoplasmosis, Cysticercosis, Echinococcosis, Japanese Encephalitis (JE), Plague, Leptospirosis, Scrub typus, Nipah, Trypanosomiasis, Kyasanur forest disease (KFD) and Crimean-Congo haemorrhagic fever (CCHF).

Helminthiasis or worm  infestation  happens through  improperly cooked food – including  non-veg food, and is sourced from contaminated  water and food.  Worm infestation is commonly understood to be an intestinal infestation.  However, worms can break through the intestine; enter blood stream and cause fatal or life threatening situations.  These include cysts in the brain and other organs:

1. Neurocysticercosis due to pork tapeworm larvae in brain

2. Cystic hydatid disease in liver and lung due to dog tapeworm larvae

3. Eye cysticercosis – cysts or swellings due to larvae in eye

4. Generalised muscular and submucous and cutaneous infestation

Thus, zoonotic infections like the Covid-19 viral infection, worm infestations and other animal to human infections, pose a potential or actual threat to health and social life.  It is imperative we take adequate care – avoid possible contamination through impure water and food.  Once health is lost, wealth loss is inevitable; hence, prevention is better than cure.  In active social life, eating out at hygienic joints manned by trained service personnel and cooks is critical.  Do not go only by the restaurant’s presentation – hygiene in kitchen, processing of the procured raw materials and hygiene practices of cooks and workers are vital to quality of food.

How to avod zoonotic infections?

To summarize, zoonotic infections like communicable coronavirus infection (requires upto 14 days to 28 days to cause symptoms), require us to practice good hygiene, cleanliness habits, reduce unnecessary human to human contact and other useful practices:

1. Avoid close contact with people who are sick

2. Avoid touching your eyes, nose, and mouth with unwashed hands

3. Stay home when you are sick

4. Cover your cough or sneeze with a tissue, then throw the tissue in the trash

5. Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe

6. Use face mask if recommended by doctor

7. Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.

8. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

It is better to practice prevention, wish you good health, and an active great social life!

Sunil S Chiplunkar
B Pharm M Pharm (Pharmacology) MBA (Marketing) PGDHRM (PhD – Pharmaceutical Sciences)
VP – Business Development, Group Pharmaceuticals, Bangalore-560055
Ph: 080 2337 6766 Mob: 6364578669
Email: 1969sunilchiplunkar@gmail.com

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The word ‘listen’ contains the same letters as ‘silent’: Alfred Brendal.

It was another busy day for Dr. Sharma.  His next patient was Umang, a young guy of the internet generation; as soon Umang sat in front of Dr. Sharma, he reeled out his symptoms and also gave the diagnosis based on his internet research.  Dr. Sharma, an elderly authoritarian GP, nearly lost his temper in this confrontation.  Taking a deep breath, Dr. Sharma gave his point of view, however, unabashedly, Umang started arguing in favour of the internet enabled self – diagnosis.  The tension was thick in the clinic, you could cut the tension with a knife.

Active listening: a two-way process

The internet information super highway has revolutionized knowledge.  E-empowerment of the patient is a reality.  Moreover, health websites are abuzz with health tips and recovery suggestions.  Old grandma remedies are making a comeback on the strength of internet and social messaging tools.  The doctor has to take all this into cognisance while delivering his prescription and therapy guidelines.  E-savvy doctors too are leveraging on the internet medical knowledge platforms, and constantly improving their diagnosis and prescribing or therapy delivery skills.  This is particularly so with the younger generation doctors.

The naiveté of the patient was particularly high in the pre-internet times.  However, the modern day patient has to his advantage abundant knowledge on health issues at his fingertips, thanks to the smartphone penetration.  On the medical side, it is not uncommon for doctors to get reports and case photos on whatsapp, and they provide remote diagnosis and suggestions to patients and peer – doctors.  Modern technology has facilitated communication, broken the information divide and improved health outcomes, but somewhere the human touch may also be missing.

Thus, it is the era for medical professionals and patients to recast their listening attitude to incorporate a two – way process, ‘Active Listening’ – for good health!  The concept of active listening was defined by the Conflict Research Consortium of University of Colorado, USA as: ‘a way of listening and responding to another person that improves mutual understanding’.   So active listening implies the receiver of message shows positive response and is involved rather than being passive.  Such a person seeks clarity, has responsive facial expressions such as nodding and talking in agreement, overall there is improved information flow from sender to recipient.  Often, message senders do their job of providing the message regardless of whether the recipient has understood or not.  This leads to several errors, including medical errors such as wrong intake of medicines.

For active listening to happen, listener should have interest, this shall translate into involvement and the listener will eventually remember the message.  Ideally a doctor must elicit active listening from a patient despite the condition of patient, and the patient’s attender though anxious, must also provide attentive listening.  The challenge in active listening is ensuring comprehension of the message.  There are several barriers to this process.  Bias or prejudice, language problem, defensiveness, memory failure and preconceived notions – all act as barriers to effective listening.  Hence, trust is the key to good active listening.

Medical practitioners too now take great pains to practice active listening, since it gives clues to the patient’s status and lifestyle.  This will enable providing the right therapeutic approach.  Thus, successful doctors enquire about the diet, past allergies, vocation, habits, co-existing diseases, medicines or healthcare products currently consumed and other lifestyle factors of patients to provide a successful therapeutic recommendation.  Several other doctors further emphasize points in their prescription and get a confirmation of the patient’s understanding of the instructions, to ensure safe and efficacious treatment.  For example, taking medicines like antiulcerant pantoprazole on an empty stomach is vital for efficacy.

Practice of active listening is a good habit:

Taking feedback of patients after starting medicines is critical since, prompt action can be taken by doctors in case of any adverse reactions or other unwanted side effects.  For example, diarrhea due to antibiotics is often controllable through probiotic products, which doctors recommend as adjuvant. Practice of active listening is a good habit. Due to the habit of active listening, patients strengthen their learning habit and earnestness for knowledge that makes them happy, healthy and active.  Active listening is one crucial habit that helps people develop rapport and is proven to improve relationship outcomes.  This eventually, contributes to mental well-being and better social health.  Lack of active listening makes a person dull and mechanical.  This leads to challenges in social well-being and impinges negatively on mental health.

NGOs abroad run active campaigns such as LISTENING IS HELPING.  This apparently innocuous skill to have active listening helps not only the recipient of the message, but also helps provide an emotional prop to the mentally stressed.  Pharmacists are trained to offer an active listening ear, which improves health outcomes – particularly in the case of elderly.

Patient-centric communication by healthcare providers includes active listening.  In this era of internet enabled learning, it is inevitable that there is high tech and high touch phenomena.  Active listening by patients and healthcare practitioners will be a game changer approach, doctors stand to gain through goodwill, pharmacists will be seen as extremely helpful and patients themselves will gain valuable tips for their improved health.  Active listening encourages people to talk beneficially.  Active listening is a common sense approach for gaining insights into issues that will help make a person healthier.

Sunil S Chiplunkar
M Pharm (Pharmacology) MBA (Marketing) PGDHRM
VP-Business Development
Group Pharmaceuticals, Bengaluru.
Ph: 6364578669
sunilchiplunkar@gmail.com
www.pharmaceuticalshealthcare.blogspot.in

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The testicles or testis are core organs of the male reproductive system. Covered by a sac called scrotum, the two egg shaped testicles hang between the legs – they make sperms and male hormone testosterone. The other important intra – testicular structures are vas deferens, seminiferous tubules, epididymis and the tunica covering layers. Germ cells in the seminiferous tubules help in making the sperms. Leydig cells located between the seminiferous tubules release testosterone, the male hormone that helps germ cells make sperm.

Infertility
Barrenness, lack of fertility, subfertility, infecundity or lack of fertility and lack of fruitfulness are all expressions to indicate the inability to conceive. Infertility as a term applies to both genders and is defined as: a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (WHO-ICMART glossary)”, this definition is available at the national portal of GOI. While female infertility is spoken of widely, TOI, dated, 14.1.19 report has stated 50% of infertility cases is male infertility. Important aspects reflecting male infertility are loss of libido or decreased desire to have sex, erectile dysfunction, difficulty in ejaculation, low sperm count and sperm problems, and decreased volume of ejaculate. Male infertility cases may have repeat respiratory infections, inability to smell and decreased facial hair. Male infertility cases have less than 1.50 crore sperms per ml of spermathecal fluid. Normal sperm count is 1.50 crores to 20.00 crores sperms per ml of spermathecal fluid.

Mayo clinic, USA communication states about infertility cases: 1/3rd are male infertility, 1/3rd are female infertility and in another 1/3rd cases, the causes are unknown or there are health issues in both males and females.There are many causes of male infertility: structural and functional problems of male reproductory system including premature ejaculation, physical problems (metabolic issues, obesity etc), chemical and environmental factors like smoking, alcohol, side effects of certain medications, pollutants and cancer treatments.

Testicular temperature and male infertility
There is a hypothermic testis in male humans – it means there is reduced temperature in the testicles. The testicular temperature is normally 2 to 4 degree Celsius less than core body temperature. Sperm formation is temperature dependent. There is proper sperm formation only when testis temperature is slightly lower than rest of body. When there is raised scrotal temperature, inner testicular temperature is also raised leading to what is called as genital heat stress. This causes sperms of inferior quality. Heat stress damages sperm cells. Such sperms have damaged DNA, poor fertilizing capacity and can even die prematurely. Scrotum structure, tissues and functioning is such that it helps maintain lower temperature in the testicles.

Human sperm production in the testicles requires 72 days, and only 12% of the total sperms produced have fertilization potential. Rest of the sperms are defective or die prematurely. Sperm formation is best when there is an optimal temperature range in the testes. Increase of even 1 degree centigrade scrotal temperature results in 14% drop in sperm formation inside the testes. Scrotal temperature minimum of 2 degrees below core body temperature is best for sperm formation. Normal body temperature is 37 degree centigrade and sperm formation is ideal with scrotal temperature at 34 degree centigrade or Celsius. (Celsius or centigrade refer to same units). Generally speaking, normal testis temperature is 35 degrees Celsius.

What causes raised scrotal temperature?

• Scrotal position: hanging testis has better and easy heat dissipation. The unclothed and upright body has least scrotal temperature. When walking, scrotal temperature is lower due to good heat dissipation and air circulation. In one study, seated male paraplegics on wheel chairs with unmoving thighs had higher deep scrotal temperature and less motile sperms compared to able bodied men who sat freely. Testicular temperature increases when movement is minimized such as in prolonged sitting where scrotum is resting between the thighs closely. ‘Sitting disease’ certainly compounds the problem of male infertility. Seated position increases scrotal temperature
• Heated seats: prolonged sitting on heated surfaces such as heated car seat or heated floor further adds to the increased scrotal temperature due to sitting
• Layers of clothing and bedding that traps heat: Clothing can increase temperature by upto 2 degree centigrade. Similarly, tight underwear may contribute to raised genital temperature through less air circulation
• Long term sustained hot baths and saunas also have a negative effect on semen quality
• The use of laptops and mobiles on the lap close to genital area causes dip in all sperm parameters
• Long hours of cycling with tight clothing and being seated on the saddle seat elevates scrotal temperature
• Other factors: obesity where excess scrotal and other types of abdominal fat raises scrotal temperature, radiant heat due to occupational reasons (eg., welders), and pathological abnormalities in scrotal region, including repeat fevers causes abnormal sperm parameters.

Fitness is a government supported trend in India, today. Being fit implies healthy habits, exercise and walking, and nourishing oneself with good food. A fit body and good lifestyle almost always supports good fertility in males and females. Small things such as appropriate change in seat, dress, bedding, clothing and other lifestyle factors will ensure absence of deleterious effect on the male reproductive system. Good health comes from a fitness attitude. A fit attitude of males, means a robust and well-maintained male reproductive system that avoids heat stress on testicles.

Sunil S Chiplunkar
M Pharm (Pharmacology) MBA (Marketing) PGDHRM
VP – Training (Marketing), Juggat Pharma:
Pharma division of Jagdale Ind. Pvt. Ltd.,
Bangalore – 560078 Ph.: 9379077788
email : sunilchiplunkar@gmail.com
www.pharmaceuticalshealthcare.blogspot.in

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