Can developing countries like Pakistan successfully finance SDG 2030?

The 2030 SDGs of the UN, while well-intentioned, presume a uniformity of achievement across the globe. In this post, Fatima Nadeem and Abid Rehman argue that despite their best intentions, low and middle income countries like Pakistan will find it extremely difficult to achieve those goals, even with their best intentions; a more realistic way forward may be to harness and share resources and ideas common to similarly economically weak countries, rather than presume that all countries will reach 2030 targets irrespective of their endemic structural specificities

An innovation in flipped class room: A teaching model to facilitate synchronous and asynchronous learning during a pandemic

Objective: To conduct an on line Flipped Class Room (FCR) to facilitate synchronous (in class activity) and asynchronous learning [Virtual Learning Environment (VLE)] and acquire feedback of the learning experience from medical students at Aga Khan University.Methods: This interventional study was conducted with year II students undergoing Endocrine Reproduction Module at the Aga Khan University during April 13 to May 22, 2020. Pre reading material and pretest was shared with the students via Virtual Learning Environment (VLE) one week before the class. Microsoft Teams was used to conduct online session by two facilitators, where student discussion on case studies was encouraged. A WhatsApp group was created with the facilitators to respond to any student queries. The session was recorded and later uploaded on VLE. Posttest and a student satisfaction survey was conducted at the end of the session.Results: The average score for the pretest and posttest was 19.67 ± 1.37 and 24.60 ± 1.34 respectively (p value \u3c0.05). The learner curve showed an increase in the knowledge learned by 4.93 points (p value \u3c0.05). Fifty-five percent students felt that placement of session was appropriate and were satisfied with the instructions and expected outcomes, received constructive feedback for improvement and generated positive attitude towards learning.Conclusions: The innovative model of FCR through facilitation of synchronous and asynchronous learning empowered student\u27s engagement and interactive learning. Students perceived this as a great learning experience which they enjoyed with positive reinforcement from feedback given by the facilitators. They suggested continuation of this model for further learning sessions in other modules of undergraduate medical education at Aga Khan University

GABA activates liver regeneration pathways through regulation of CDK9 activity after one hour

Liver regeneration after partial hepatectomy requires a rapid production of growth factors in order to induce the hepatocyte cell cycle. During this process RNA Polymerase II plays a big role in transcription of mRNA for proteins needed for hepatocytes to go through the cell cycle appropriately. Cyclic-dependent kinase 9 (CDK9) aids in this process by phosphorylating and regulating RNA Polymerase II. Previously we have found that Gamma-Aminobutyric acid (GABA) can help with liver regeneration and has been found to arrest hepatocytes at the G2 phase of the cell cycle. The purpose of this study is to examine if GABA exerts its effect on cell cycle through CDK9 upregulation or activation. HepaRG cells were treated with GABA in vitro and CDK9 expression was examined by immunofluorescence at 0, 1, and 8 hours post GABA treatment. Results showed that peak CDK9 activity occurred during the first hour after GABA treatment and helps support the hypothesis that GABA induce liver regeneration partially through regulation of CDK9. These findings can help elucidate the pathway responsible for GABA related liver regeneration

The effect of N-acetyl cysteine on H2O2 mediated oxidative stress in Whartonʼs jelly derived mesenchymal stem cells

Background: Hypoxic stress is a crucial factor for retaining the cell survival in injured tissue. Overcoming this issue is the key for successful cellular regenerative therapy. Therefore the purpose of this study was to investigate whether the in-vitro pretreatment of Whartonʼs Jelly (WJ) derived Mesenchymal stem cells (WJ-MSCs) with an antioxidant, namely N-acetylcysteine (NAC), can improve the efficacy of WJ-MSCs for transplantation purpose.Methods: WJ-MSCs were cultured with or without NAC at different concentrations (0.1mM, 1mM and 10mM). To simulate oxidative stress conditions, cultures were exposed to hydrogen peroxide (H2O2) 100 µM for 1 hour. Cytoprotective effect of NAC was evaluated by determining cell injury, viability, and proliferation. The oxidative stress is assessed by measuring the activity of glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and malodialdehyde (MDA).Results: Pretreatment of WJ-MSCs with NAC increased their viability and proliferation in concentration-dependent manner. Furthermore, 10 mM NAC significantly reduced the H2O2 induced oxidative stress by enhancing the activity of GSH, SOD, and CAT and reduced the level of MDAConclusion: The study results indicate that NAC may abrogate H2O2 induced oxidative-stress of WJ-MSCs. This study provides basis to explore NAC effect on WJ-MSCs survival without cytotoxicity

Medical Professionalism... Need of the Day

Abstract: The pledge taken by healthcare professionals to fulfill the needs of the people across-the-board and to abide the rules and regulation while practicing medicine is the essence of medical professionalism. with growing involvement of different technological forces and industries related to health care sector, the traditional ways of practicing medicine have changed and so does the relationship between doctor and patients. It is therefore important to educate our students, the new concepts of practicing medicine and making them aware with the principles of medical professionalism. It is important to note that the practice of medical professionalism shall not be limited to the seminaries rather than disseminated everywhere in the health care vicinities

A take on social wellbeing attributes by first year medical students

Objective: To compare awareness about concept of social wellness in male and female first year medical students. Methods: It was a cross sectional, questionnaire based study conducted from February till December 2010. Responses on aspects of social wellness were rated never, sometimes, mostly and always from lowest to highest (1-4); evaluated as frequency, proportion and percentages by PASW (Predictive analysis software) version 18. Chisquare test was applied for comparison of social wellness in both genders; results to be declared significant with pvalue \u3c0.05. Results: Overall score for social well being of females (20.24±4.50) was higher than male medical students (18.66±4.76; p\u3c0.0001). Majority of the female respondents believed that they exhibit fairness and justice in public dealing (p\u3c0.004), had a good network of close friends and family (p\u3c0 001), were prompt at helping batch fellows (p \u3c0.004), participated in group discussions (p \u3c0.004), followed dynamics of communication (p\u3c0.05) and were better at solving problems (p\u3c0.01) as compared to the male respondents. Conclusion: The scores highlighted a better interaction of females with the social environment

Body mass index or body fat! which is a better obesity scale for Pakistani population?

Ojective: To compare two methods of classifying obesity based on body mass index and body fat percentage.Methods: The cross-sectional study was conducted from November 2012 to August 2013 at Jinnah Postgraduate Medical Centre, Karachi. Male and female volunteers between the ages 15-65 years were selected using simple random sampling. They were classified into different groups for body mass index and body fat percentage measured through bioelectrical impedance scale. The subjects were sub-grouped into underweight, normal weight, overweight and obese. SPSS 11 was used for statistical analysis.Results: The mean age of the 828 healthy volunteers was 25.67±10.10 years. A total of 552 (66.6%) subjects had a higher body fatpercentage and were misclassified by body mass index. Only 276 (33.3%) subjects had body fat percentage values corresponding to the body mass index classification. The difference in terms of categorising obesity was highly significant (p\u3c0.001). Both body mass index and body fat percentage showed positive correlation with age (r=0.144; p=0.001) (r=0.261; p=0.001) and weight (r=0.578; p=0.001) (r=0.444; p=0.001) respectively. Moreover body fat percentage showed a significant positive association with gender (r=0.109; p=0.027) whereas BMI did not.Conclusions: Body fat percentage should be incorporated for a better understanding as well as categorising of obesity

Teaching shock pathophysiology by flipped classroom: Views and perspectives

Flipped classroom (FCR) is an active learning pedagogical method in which the students prepare prior to class using different modalities, for example, reading materials and videos, and afterward spend the time in class discussing the content and reinforcing the concepts. We chose to replace one problem-based case on Shock with flipped-style teaching in the respiration circulation module of a private medical university. Our objective was to use the clinical presentation of Shock to open a window to interrelate basic science concepts of cardiovascular physiology and pathology. It aimed to merge the case-based discussion with small-group discussions in the form of FCR activity. The qualitative study gives an overview of comments of facilitators, observers, and leadership of the Department and University obtained during focus group discussions and in-depth interviews. Thematic analysis of responses emphasized the importance of FCR as an effective teaching learning modality, which can be made more effective by careful selection of topic and provision of facilities to support technology-enhanced learning. The discussions with facilitators, observers, and leadership revealed its usefulness through student\u27s engagement and increased participation to build learning of the key concepts. Student satisfaction in these activities can be enhanced by construction of knowledge acquired in non-face-to-face component with substantial pre-reading materials, videos, peer discussions, quizzes, and prompt feedback