Expression of Zinc Alpha-2 Glycoprotein in Oral Squamous Cell Carcinoma and Oral Dysplasia

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent cancer of the oral cavity representing 90% among all the common oral malignancies. It is the sixth most common cancer worldwide and ranked second highest in Pakistan. The purpose of the study was to assess the expression of zinc alpha-2 glycoprotein in oral squamous cell carcinoma and oral dysplasia. The study aimed to evaluate the association of zinc α-2 glycoprotein (ZAG) expression with different clinico-pathological parameters of OSCC. Methods: This was a cross-sectional study conducted at Ziauddin University from January 2020-July 2020. The consecutive sampling technique was applied. In this study, 120 cases were of oral squamous cell carcinoma and 24 of oral dysplasia. The tissue samples of both cases were collected from the Histopathology Department of Ziauddin University. The zinc alpha-2 glycoprotein expression was explored through immunohistochemical analysis. The data was analyzed through SPSS and p<0.05 was considered as statistically significant. Results: ZAG positive stained OSCC cases in which 2 (1.6%) were of strong staining intensity, 10 (8.3%) moderate, and 14 (11.6%) mild, but the remaining 94 (78.3%) samples and entire oral dysplasia samples did not stain. The positive stained OSCC samples 23(46.9%) belonged to the early stages of OSCC with statistically significant results (p<0.001). All the positive stained samples were of moderately differentiated OSCC (p=0.008). Conclusion: In this study, positive expression of zinc α-2 glycoprotein was found in the early stages (I and II) and showed a higher association with moderately differentiated tumors. Keywords: Immunohistochemistry; Mouth Neoplasms; Precancerous Conditions; Zn-Alpha-2-Glycoprotein (ZAG)

The Role of Neighborhood Environment in Promoting Risk Factors of Cardiovascular Disease among Young Adults: Data from Middle to High Income Population in an Asian Megacity

Background: Modifiable risk factors of cardiovascular diseases (CVD) have their triggers in the neighborhood environments of communities. Studying the environmental triggers for CVD risk factors is important to understand the situation in a broader perspective. Young adults are influenced the most by the environment profile around them hence it is important to study this subset of the population.Methods: This was a descriptive study conducted using the EPOCH research tool designed by the authors of the PURE study. The study population consisted of young adults aged 18-25 in two areas of Karachi. The study setting was busy shopping malls frequented by young adults in the particular community being studied.Results: Our total sample size was 120 individuals, who consented to be interviewed by our interviewers. Less than 50% of the population recognized some form of restriction regarding smoking in their communities. The largest contributor to tobacco advertising was actors smoking in movies and TV shows with 89% responses from both communities. Only 11.9% of the individuals disapproved of smoking cigarettes among men with wide acceptance of \u27sheesha\u27 across all age groups. Advertising for smoking and junk food was more frequent as compared to smoking cessation, healthy diet and exercise in both the areas. Unhealthy food items were more easily available in contrast to healthier options. The cost of healthy snack food options including vegetables and fruits was higher than sugary drinks and foods.CONCLUSION: This assessment showed that both communities were exposed to environments that promote risk factors for cardiovascular diseases

Twelve Tips for Enhancing Student Learning Experience in the Operating Room

Student learning within the Operating Room (OR) is complex and challenging, especially for medical students who heavily rely upon structured learning plans. Medical students’ OR-based surgical learning experience is heterogenous, unstandardized, and inadequate for many reasons. There is a growing need to evaluate the learning modalities and models that we currently use for medical graduates’ OR-based learning process, create a balance between structured and opportunistic learning encounters and incorporate previously identified factors that have been known to influence the quality of OR-based learning positively. In continuation with our previous work on OR-based learning, here we argue for a structured OR-based learning plan that embodies appropriate learning models and teaching methodologies and focuses on a comprehensive plan that justifies a local needs analysis and addresses factors influencing the quality of OR-based student learning to produce enhanced learning outcomes

Parental Genetics Communicate with Intrauterine Environment to Reprogram Newborn Telomeres and Immunity

Telomeres, markers for cellular senescence, have been found substantially influenced by parental inheritance. It is well known that genomic stability is preserved by the DNA repair mechanism through telomerase. This study aimed to determine the association between parents&ndash;newborn telomere length (TL) and telomerase gene (TERT), highlighting DNA repair combined with TL/TERT polymorphism and immunosenescence of the triad. The mother&ndash;father&ndash;newborn triad blood samples (n = 312) were collected from Ziauddin Hospitals, Pakistan, between September 2021 and June 2022. The telomere length (T/S ratio) was quantified by qPCR, polymorphism was identified by Sanger sequencing, and immunosenescence by flow cytometry. The linear regression was applied to TL and gene association. The newborns had longest TL (2.51 &plusmn; 2.87) and strong positive association (R = 0.25, p&nbsp;&le; 0.0001) (transgenerational health effects) with mothers&rsquo; TL (1.6 &plusmn; 2.00). Maternal demographics&mdash;socioeconomic status, education, and occupation&mdash;showed significant effects on TL of newborns (p &lt; 0.015, 0.034, 0.04, respectively). The TERT risk genotype CC (rs2736100) was predominant in the triad (0.6, 0.5, 0.65, respectively) with a strong positive association with newborn TL (&beta; = 2.91, &lt;0.0011). Further analysis highlighted the expression of KLRG 1+ in T-cells with shorter TL but less frequent among newborns. The study concludes that TERT, parental TL, antenatal maternal health, and immunity have a significantly positive effect on the repair of newborn TL

Internal quality control of blood products: An experience from a tertiary care hospital blood bank from Southern Pakistan

INTRODUCTION: Internal quality control (IQC) is the backbone of quality assurance program. In blood banking, the quality control of blood products ensures the timely availability of a blood component of high quality with maximum efficacy and minimal risk to potential recipients. The main objective of this study is to analyze the IQC of blood products as an indicator of our blood bank performance. METHODS: An observational cross-sectional study was conducted at the blood bank of Liaquat National Hospital and Medical College, from January 2014 to December 2015. A total of 100 units of each blood components were arbitrarily chosen during the study. Packed red cell units were evaluated for hematocrit (HCT); random platelet concentrates were evaluated for pH, yield, and culture; fresh frozen plasma (FFP) and cryoprecipitate (CP) were evaluated for unit volume, factor VIII, and fibrinogen concentrations. RESULTS: A total of 400 units were tested for IQC. The mean HCT of packed red cells was 69.5 ± 7.24, and in 98% units, it met the standard (<80% of HCT). The mean platelet yield was 8.8 ± 3.40 × 109/L and pH was ≥6.2 in 98% bags; cultures were negative in 97% of units tested. Mean factor VIII and fibrinogen levels were found to be 84.24 ± 15.01 and 247.17 ± 49.69 for FFP, respectively. For CP, mean factor VIII and fibrinogen level were found to be 178.75 ± 86.30 and 420.7 ± 75.32, respectively. CONCLUSION: The IQC of blood products at our blood bank is in overall compliance and met recommended international standards. Implementation of standard operating procedures, accomplishment of standard guidelines, proper documentation with regular audit, and staff competencies can improve the quality performance of the transfusion services

Histomorphological study of mucormycosis in COVID-19 patients

Background: Mucormycosis is a rapidly progressive angioinvasive fungal infection which has a high rate of mortality and morbidity. Mucormycosis most commonly invades the nose and paranasal sinuses presenting as rhinosinusitis. We noted an upsurge in the number of patients affected with Mucormycosis during Covid-19 infection era. Aim: Our study aims to illustrate the histopathology of Mucormycosis in post-Covid-19 patients and also to study the fungal morphology by utilizing special stains. Materials and Methods: We prospectively analysed the histopathological findings of fungal elements in 260 different histopathological samples of mucormycosis in post-covid-19 patients. The clinical and histopathological findings were noted and tabulated. Statistical Analysis Used: The data collected was tabulated and coded in Microsoft excel. All the data of demographic and clinical characteristics were analysed by descriptive statistics and percentage. Tables and graphs were added wherever applicable. Results: Out of 260 cases analysed, most of the patients presented with periorbital swelling followed by headache and nasal block. Histopathologically, most of the cases showed chronic inflammatory reaction with wide areas of necrosis and granuloma formation. The fungal elements have been appreciated and sensitivity of different stains to appreciate the fungal structures have been compared.

Perceptions of the learning environment, learning preferences, and approaches to studying among medical students in Pakistan

Students at a Pakistani medical college were surveyed using instruments taken from Western research. The students who rated their courses positively tended to adopt an organised approach in their learning and studying. The students who perceived that their assessment and workload were inappropriate preferred a transmissive approach to teaching and adopted a surface approach in their learning and studying. The students who preferred a student-centred approach to teaching tended to adopt a deep approach in their learning and studying. This confirms the idea, well established in Western research, that there exists a strong relationship between students’ perceptions of their courses and the approaches that they adopt on those courses. However, the incorporation of problem-based learning in the medical curriculum had not led to any enhancement of their perceptions and preferences, nor had it led to an unambiguous improvement in their approaches to studying. This is attributed to the hybrid nature of their programmes, in which problem-based activities were combined with more conventional forms of teaching and assessment, and to the anxiety and stress which seem to be common among students at medical schools in Pakistan