Evaluating Factors Influencing Memorization in Undergraduate Medical Students.

Objectives: To evaluate the techniques used by medical students for better memo-rization and identify factors that directly or indirectly influence the process of memorization.Method: This cross-sectional study included undergraduate medical students from four public/private medical schools of Karachi. Through stratified random sampling, 400 medical students were administered a questionnaire that had been developed through focused group discussions and pre-tested on a smaller population. Data was analyzed using SPSS version 26.0 by applying Pearson’s chi square test for cate-gorical variables and Mann Whitney U test for scale variables.Results: Passion for the medical field was the key motivating factor for most the students (n=133; 33.3%). The source of motivation to study in students was related to the phase of their training at medical school, with preclinical and clinical years showing a slightly significant difference (P=0.049). Silent reading (n=203; 50.8%), intermittent power naps (n=125; 31.2%) and making notes and flowcharts (n=169; 42.2%) were the preferred memorization techniques. 46.9% (n=188) students re-quired < 4 hours of study daily and no significant difference in the number of study hours required per week was observed between the two genders and the students of preclinical and clinical years. Majority of the students considered lack of sleep (n=232; 58%) and social media (n=146;36.5%) their biggest sources of distraction.Conclusion: Desire to help humanity is the main driving force for medical students. The extensive syllabus requires dedicated number of study hours and use of memo-rization techniques suited for oneself.Keywords: Learning preference, Memorization technique, Motivation factor, Memory aid, Academic performance

Prevalence And Morphometric Analysis Of Fossa Navicularis Magna In Dry Human Skulls

Introduction: Basiocciput is the part of occipital bone present on the inferior aspect of skull. Fossa Navicularis Magna-an osseous defect is a variation in normal anatomy of basiocciput. Lately few case reports presented this fossa as a cause of spread of infection from nasopharynx to brain resulting in meningitis and osteomyelitis. Objectives: This study aims to find the incidence and morphometry of this fossa in Pakistani populace to avoid any misdiagnosis or misinterpretations. Materials & Methods: This study was conducted on dry human skulls at King Edward Medical University Lahore. Fossa was measured in its transverse and vertical diameters and to locate the fossa its distance from various anatomical land marks such as foramen ovale, foramen Lacerum, carotid canal, occipital condyles, pharyngeal tubercle and posterior border of vomer was noted. Results:  The incidence of this fossa was found to be 5.3% in Pakistani population. Predominantly oval shaped, fossa measured 5.5 and 3.06 mm in vertical and transverse diameters respectively. It was 12.2 mm posterior to vomer and 5.9 mm anterior to pharyngeal tubercle. Conclusion: This study is useful for radiologists and clinicians in avoiding any misinterpretations on radiographs and unnecessary investigation

Unanticipated hospital admission after ambulatory surgery

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated for various reasons (72%) and patient request (18%). Eighty percent of the admitted patients had received general anaesthesia. Admissions were also related to the male gender (69%), age over 65 years (27%) and surgeries ending in the afternoon (69%). On analyzing the reasons for admission, a large number of admissions were found to be due to preventable causes. We conclude that proper selection of patients, careful scheduling of lists and education of patients and clinical professionals can help to avoid many unanticipated admissions after day care surgical procedures

The cell cycle regulator p27kip1 contributes to growth and differentiation of osteoblasts

The cyclin-dependent kinase (cdk) inhibitors are key regulators of cell cycle progression. p27 and p21 are members of the Cip/Kip family of cdk inhibitors and regulate cell growth by inactivating cell cycle stage-specific CDK-cyclin complexes. Because down-regulation of osteoprogenitor proliferation is a critical step for osteoblast differentiation, we investigated expression of p27 and p21 during development of the osteoblast phenotype in rat calvarial osteoblasts and in proliferating and growth-inhibited osteosarcoma ROS 17/2.8 cells. Expression of these proteins indicates that p21, which predominates in the growth period, is related to proliferation control. p27 levels are maximal postproliferatively, suggesting a role in the transition from cell proliferation to osteoblast differentiation. We directly examined the role of p27 during differentiation of osteoprogenitor cells derived from the bone marrow (BM) of p27-/- mice. BM cells from p27 null mice exhibited increased proliferative activity compared with BM cells from wild-type mice and formed an increased number and larger size of osteoblastic colonies, which further differentiated to the mineralization stage. Although p27-/- adherent marrow cells proliferate faster, they retain competency for differentiation, which may result, in part, from observed higher p21 levels compared with wild type. Histological studies of p27-/- bones also showed an increased cellularity in the marrow cavity compared with the p27+/+. The increased proliferation in bone does not lead to tumorigenesis, in contrast to observed adenomas in the null mice. Taken together, these findings indicate that p27 plays a key role in regulating osteoblast differentiation by controlling proliferation-related events in bone cells

ISSN 2347-954X (Print) Comparative Study of Cardiovascular Response and POGO scoring with McCoy, Machintosh and TruView EVO-2

Abstract: To compare cardiovascular response and POGO scoring with McCoy, Machintosh and TruView EVO-2 laryngoscope. For this randomized prospective study 90 ASA grade Ι and ΙΙ patient of either sex in the age group 20-50yrs, undergoing general anaesthesia for elective surgery were enrolled after approval by the ethical committee. 90 patients were divided randomly in 3 group with (n= 30) TE (Truview EVO-2), MT (Machintosh), MC (McCoy) laryngoscope for proposed surgery under general anaesthesia. Patients were evaluated pre operatively after uniform premedication, induction and relaxation all laryngoscopies were performed by experienced anaesthetist. Vitals were recorded at 1, 3and 5 minutes respectively. POGO (Percentage of Glottic Opening) scoring was done as 100 for full glottis view and 0 as no portion of glottis visualized, by attending anaesthetist. TruView EVO -2 laryngoscope was best in POGO scoring followed by McCoy and then Machintosh. Time taken during laryngoscopy was more with TruView EVO -2 followed by McCoy and Machintosh in that order. Patients were more stable hemodynamically with TruView EVO -2 followed by McCoy and then Machintosh. TruView EVO -2 was found to be a better device in terms of POGO scoring and haemodynamic stability than McCoy and Machintosh laryngoscopes

Disease Burden, Mechanism and Management of Obesity – Where Do We Stand?

The role of increased body mass index in general morbidity and mortality is well documented. This global public health issue continues to represent a major burden and threat to health systems and the population’s wellbeing. Global statistics show that the prevalence of obesity has increased about three times since the mid-1970s, and an upward trend is still observed, not only in developed but also in developing countries. We used several databases, including PubMed, ProQuest, and Google Scholar, to perform a literature search and review on obesity. Keywords such as “obesity”, “overweight”, and “BMI” were used in combination with multiple keywords such as “mechanism”, “factors”, “socio-economic”, “environmental”, “social determinants”, “management”, “treatment”, “non-traditional treatment”, “alternative therapies”, “non-pharmaceutical treatment” etc. and related phrases. According to the literature, the management of obesity is difficult due to the complex nature of this problem in terms of its course, complications, risks, and etiological factors. The role of alternative therapies in obesity management is still unclear, and further research is needed in this area. Recently introduced weight-loss and -management devices can also help in losing excess bodyweight. The present article summarizes relevant information related to obesity, collected from different regions of the world, and discusses diverse interventional approaches to treat obesity

Examination of Air Pollution’s Relationship with COVID-19, Physical and Mental Health

Air pollution is a result of natural phenomena or human activities that can cause the release of harmful substances in the environment, leading to adverse health outcomes among living beings. Pollution is associated with adverse health impacts on multiple organ systems among humans. While the respiratory and cardiovascular systems are mainly affected, there are other health issues related to the eyes, skin, brain, blood, immunity, behavioral/mental well-being, and reproduction among exposed individuals. Air pollutants can especially have higher health impacts on people at the extremes of their ages (children and elderly) and on those suffering from underlying respiratory and heart issues. Pollutants such as ozone, sulfur dioxide, particulate matter, and nitrogen dioxide have respiratory effects among children and adults and are associated with increased respiratory diseases, asthma exacerbations, and related hospitalizations. Carbon monoxide interferes with transporting oxygen by forming carboxyhemoglobin leading to cardiovascular, neurological, and respiratory problems. Particulate matter is a heterogeneous mixture of tiny particles of varying compositions found in the atmosphere and has a wide variety of severe health effects. Particulate matter emits from combustion, diesel engines, power generation, and wood-burning, and certain industrial activities. Lead is considered neurotoxic and has more severe consequences among children. Here we summarize characteristics of six criteria air pollutants and associated air quality risk assessment parameters known as the Pollutant Standard Index (PSI). The present manuscript also examines the impact of air pollution on human behavior, mental well-being, and neurological health consequences, as air pollution has been associated with cognitive decline, hyperactivity, dementia, anxiety, depression, aggression, and Alzheimer’s disease-related changes. Lastly, we also attempt to look into any relationship between air pollutants and Coronavirus disease (COVID-19) and examine its possible association with a higher COVID-19 incidence, complications, and mortality

Species-specific glucocorticoid and 1,25-dihydroxyvitamin D responsiveness in mouse MC3T3-E1 osteoblasts: dexamethasone inhibits osteoblast differentiation and vitamin D down-regulates osteocalcin gene expression

The mouse MC3T3-E1 cell line is nontumorigenic and undergoes a typical program of osteoblast differentiation in vitro, producing a bone-like mineralized extracellular matrix. We report responses of these cells to dexamethasone (Dex) and 1,25-(OH)2D3 that are in contrast to findings from other osteoblast culture systems. First, chronic exposure of both early- and late-passaged MC3T3-E1 cells to 10(-7) M Dex, initiated during the proliferation period, blocked osteoblast differentiation, in contrast to the enhanced differentiation observed in cultures of fetal rat calvarial-derived cells. Secondly, 1,25-(OH)2D3 did not up-regulate expression (messenger RNA or protein synthesis) of the endogenous mouse osteocalcin (OC) gene. Several lines of evidence are presented that suggest this response is caused by sequence specific properties of the mouse OC vitamin D response element. We also observed both qualitative and quantitative differences in expression of cell growth (histone H2B) and phenotype-related genes (collagen, OC, osteopontin, glucocorticoid receptor, and 1, 25-(OH)2D3 receptor), between pre- and postmineralization stage osteoblasts, in response to 24 h steroid hormone treatment. Our findings in MC3T3-E1 cells are consistent with current concepts of selective influences of 1,25-(OH)2D3 and glucocorticoids as a function of osteoblast maturation. However, the inhibition of osteoblast differentiation by chronic Dex at 10(-7) M and the down-regulation of OC by 1,25-(OH)2D3 are novel observations relevant to species-specific responsiveness of mouse bone-expressed genes to steroid hormones during osteoblast differentiation

AP-1 and vitamin D receptor (VDR) signaling pathways converge at the rat osteocalcin VDR element: requirement for the internal activating protein-1 site for vitamin D-mediated trans-activation

Responsiveness of genes to steroid hormones is a complex process involving synergistic and/or antagonistic interactions between specific receptors and other nonreceptor transcription factors. Thus, DNA recognition elements for steroid hormone receptors are often located among binding sites for other trans-acting factors. The hormonal form of vitamin D, 1,25-dihydroxyvitamin D3, stimulates transcription of the tissue-specific osteocalcin (OC) gene in osteoblastic cells. The rat OC vitamin D response element contains an internal acitvating protein-1 (AP-1) site. Here, we report for the first time that this AP-1 site is critical for the transcriptional enhancement of rat osteocalcin gene expression mediated by vitamin D. Precise mutations were introduced either in the steroid half-elements or in the internal AP-1 sequences. One mutation within the internal AP-1 site retained vitamin D receptor/retinoid X receptor binding equivalent to that of the wild-type sequence, but resulted in complete loss of vitamin D inducibility of the OC promoter. These results suggest a functional interaction between the hormone receptor and nuclear oncoproteins at the rat OC vitamin D response element. This cooperation of activities may have important consequences in physiological regulation of osteocalcin transcription during osteoblast differentiation and bone tissue development in vivo