Digital Technologies for Learning at Allama Iqbal Open University (AIOU): Investigating Needs and Challenges

The present study investigated the need of digital technologies for the distance learners of AIOU (Allama Iqbal Open University), and the challenges in its implementation. Within mixed-method approach, an explanatory sequential design was employed to conduct this study. Quantitative data was collected through questionnaires from 963 students to find out the needs for digital technologies. Later 3 administrators and 1 library in-charge were interviewed to find out the challenges in its implementation. Quantitative data was analyzed using descriptive statistics. For qualitative data analysis, inductive analysis was done. Most of the students said that digital technologies were needed for increasing accessibility and flexibility of learning. The challenges for its implementation were in the requirement of diverse online learning resources, access, cost and lack of expertise. The paper recommended that there should be provision of portable devices to students with Wi-Fi, and guidance about its use. Annual need-assessment system was also suggested

Moderna (mRNA-1273) Covid-19 Vaccine, “A Systematic Review”

A Global pandemic, declared by WHO, caused due to a deadly virus known as a “SARS-Cov-2”, has resulted in 4.3 million deaths. Its RNA based genome and lack of proofreading ability has made this virus more prone to get the frequent mutations and results in the formation of new variants and increased pathogenicity. Scientists had been trying hard to develop the ways through which this lethal virus could be eradicated, from the day the genome of SARS CoV-2 was first reported. In order to prevent from this viral infection more than 90 vaccines were developed but few of them were approved by FDA for the human trials. Moderna Inc came up with “mRNA-1273” vaccine which was given EUA approval on 18th December, 2020 by the FDA. The vaccine is based on active mRNA, translated into spike proteins of virus, is developed by the help of nanotechnology. The clinical trials have proved an efficacy of 94.1%. Moreover, the vaccine is able to prevent disease caused by the alpha, beta, gamma and delta variant of SARS-Cov 2 in recent studies. In this review article the composition, technology, mode of action, immune responses, clinical trials and efficacy as well as the comparison of moderna vaccine with other available covid-19 vaccines has been discussed

Virtual Reality in Neurosurgery- A Neurostimulator – Based Postgraduate Residency Training: A Novel Step Towards Skillful Young Neurosurgeons

Introduction/Objective:  Virtual Reality (VR) is the need of time in every field of life. Recent biotechnological advances have molded the surgeon-computer relationship. Department of Neurosurgery Jinnah Hospital Lahore has updated the postgraduate training program by adding the virtual reality simulator. We aim to explore the current and future roles and applications of VR and simulation in neurosurgical training that may reduce the learning curve, improve conceptual understanding and enhance visuospatial skills. Materials & Methods:  Eight residents were enrolled in this program. They exercised the basic skills of neurosurgery e.g. suction, use of bipolar cautery, handling of CUSA, use of micro scissors, etc., and the automated software recorded each participant’s graph of performance separately. After 1.5 years, they were assessed in real-time on actual patients under the direct supervision of a qualified neurosurgeon. The assessment was done on DOPS (Directly Observed Procedural Skills) Performa. Results:  The results showed that there was a gradual upward learning curve in simulator-based procedures from negative marking to 70% in basic surgical skills and 60% in advanced procedures on average for all the residents whereas the DOPS showed that all residents performed above expectation i.e., 4 or above. Conclusion:  Neurostimulator-based postgraduate training program is opening new horizons for the safe and skillful training of residents. With the advancement of artificial intelligence, its use in training programs will lead to structured and systematic training patterns in the world of neurosurgery

Delay in Diagnosis of Brain Tumors: A Dilemma For Neurosurgical Community Due To Spirituality and Quackery In A Developing Country

Objectives:  Primary and metastatic brain tumors are a significant cause of mortality and morbidity. The complex pathway to a cancer diagnosis is not human error and the achievements of better outcomes solely depend on the early diagnosis and management of symptomatic tumors. The estimated time between the first presentation to any health care professional and diagnosis is approximately 3 times longer in the UK as compared to other developed countries. Material and Methods:  It was a descriptive study and included 52 patients who were admitted to the Neurosurgery department at Jinnah hospital Lahore. The required data were collected either directly from the patients or from the hospital record of discharged patients. Our study compares the time interval difference of presentation of a patient to a local care provider (Quacks, Hakeem, and spiritual healers) and Neurosurgeon as well as delay in surgical intervention even after diagnosis and radiological investigations. Results:  54% of patients presented with supratentorial lesions and out of these, parietal lobe lesions were more common (39%) while 29% of lesions were infratentorial. Around 50% of patients presented to a Local Care Provider within 20 days. However, only 42% of patients presented to a neurosurgeon after 6-9 months of the onset of symptoms. Conclusion:  Public awareness is the key to timely diagnosis, proper management, and better outcomes. The availability of specialists in peripheral hospitals can bring a change in this regard

Virtual reality in neurosurgery- a neurostimulator – based postgraduate residency training: a novel step towards skillful young neurosurgeons

Introduction/Objective: Virtual Reality (VR) is the need of time in every field of life. Recent biotechnological advances have molded the surgeon-computer relationship. Department of Neurosurgery Jinnah Hospital Lahore has updated the postgraduate training program by adding the virtual reality simulator. We aim to explore the current and future roles and applications of VR and simulation in neurosurgical training that may reduce the learning curve, improve conceptual understanding and enhance visuospatial skills. Materials & Methods: Eight residents were enrolled in this program. They exercised the basic skills of neurosurgery e.g. suction, use of bipolar cautery, handling of CUSA, use of micro scissors, etc., and the automated software recorded each participant’s graph of performance separately. After 1.5 years, they were assessed in real-time on actual patients under the direct supervision of a qualified neurosurgeon. The assessment was done on DOPS (Directly Observed Procedural Skills) Performa. Results: The results showed that there was a gradual upward learning curve in simulator-based procedures from negative marking to 70% in basic surgical skills and 60% in advanced procedures on average for all the residents whereas the DOPS showed that all residents performed above expectation i.e., 4 or above. Conclusion: Neurostimulator-based postgraduate training program is opening new horizons for the safe and skillful training of residents. With the advancement of artificial intelligence, its use in training programs will lead to structured and systematic training patterns in the world of neurosurgery

Delay in diagnosis of brain tumors: a dilemma for neurosurgical community due to spirituality and quackery in a developing country

Objectives: Primary and metastatic brain tumors are a significant cause of mortality and morbidity. The complex pathway to a cancer diagnosis is not human error and the achievements of better outcomes solely depend on the early diagnosis and management of symptomatic tumors. The estimated time between the first presentation to any health care professional and diagnosis is approximately 3 times longer in the UK as compared to other developed countries. Material and Methods: It was a descriptive study and included 52 patients who were admitted to the Neurosurgery department at Jinnah hospital Lahore. The required data were collected either directly from the patients or from the hospital record of discharged patients. Our study compares the time interval difference of presentation of a patient to a local care provider (Quacks, Hakeem, and spiritual healers) and Neurosurgeon as well as delay in surgical intervention even after diagnosis and radiological investigations. Results: 54% of patients presented with supratentorial lesions and out of these, parietal lobe lesions were more common (39%) while 29% of lesions were infratentorial. Around 50% of patients presented to a Local Care Provider within 20 days. However, only 42% of patients presented to a neurosurgeon after 6-9 months of the onset of symptoms. Conclusion: Public awareness is the key to timely diagnosis, proper management, and better outcomes. The availability of specialists in peripheral hospitals can bring a change in this regard

The Impact of the COVID-19 Pandemic on Pregnant Women with Perinatal Anxiety Symptoms in Pakistan: A Qualitative Study

The impact of coronavirus disease 2019 (COVID-19) on people with existing mental health conditions is likely to be high. We explored the consequences of the pandemic on women of lower socioeconomic status with prenatal anxiety symptoms living in urban Rawalpindi, Pakistan. This qualitative study was embedded within an ongoing randomized controlled trial of psychosocial intervention for prenatal anxiety at a public hospital in Rawalpindi. The participants were women with symptoms of anxiety who had received or were receiving the intervention. In total, 27 interviews were conducted; 13 women were in their third trimester of pregnancy, and 14 were in their postnatal period. The data were collected through in-depth interviews and analyzed using framework analysis. Key findings were that during the pandemic, women experienced increased perinatal anxiety that was linked to greater financial problems, uncertainties over availability of appropriate obstetric healthcare, and a lack of trust in health professionals. Women experienced increased levels of fear for their own and their baby’s health and safety, especially due to fear of infection. COVID-19 appears to have contributed to symptoms of anxiety in women already predisposed to anxiety in the prenatal period. Efforts to address women’s heightened anxiety due to the pandemic are likely to have public health benefits.</jats:p

Cultural adaptation and psychometric validation of the Pregnancy Experience Scale-Brief version (PES-Brief) in Pakistani women with antenatal anxiety symptoms.

BackgroundPregnancy experiences influence fetal and birth outcomes. There is scarcity of locally validated tools to assess pregnancy experiences. We aimed to validate the Pregnancy Experience Scale-Brief (PES-Brief) in pregnant Pakistani women with anxiety symptoms.MethodsA two-step process was used including 1) adaptation via translation/back-translation followed by cognitive interviewing with 10 participants and 2) factor analysis and validation with 605 women in Rawalpindi Pakistan who had mild-moderate symptoms of anxiety, attended the antenatal clinic, and were ≤22 weeks of gestation and ≥18 years old. We calculated internal consistency and reliability and conducted exploratory and confirmatory factor analyses.ResultsCultural adaptation led to inclusion of one item of the hassles subscale and exclusion of one item in the uplifts subscale, resulting in 9 uplifts and 11 hassles. Exploratory factor analysis supported a two-factor structure, with the adapted items exhibiting loading values of ≥0.24 for their respective factors. Internal consistency was demonstrated for uplifts (Cronbach's alpha = 0.89) and hassles (Cronbach's alpha = 0.85) subscales. Uplift intensity was moderately correlated with the Hospital Anxiety and Depression Scale anxiety subscale (r = 0.54, 95% CI:0.30-0.77).ConclusionThe Urdu PES-Brief is a reliable and valid tool for use in Pakistani pregnant women with antenatal anxiety. Future studies on its validity are needed on women without symptoms anxiety

Influence of polymer ratio and surfactants on controlled drug release from cellulosic microsponges

Microsponge refers to a highly cross-linked particle system with a capacity to adsorb (like a dry sponge) pharmaceutical materials. There are various methods available to prepare microsponge formulations, in this study we used quasi emulsion-solvent diffusion method with a combination of hydrophobic (ethyl cellulose) and hydrophilic polymers (hydroxypropyl methylcellulose) mediated via Tween 80 and polyvinyl alcohol. Various ratios and amounts of the polymers and surfactants were used to prepare microsponge formulations using ketoprofen as a model drug and extensively characterised. Our results, for the first time, indicate successful and optimised formulation with desired pharmaceutical characteristics using a combination of hydrophobic and hydrophilic polymers