PHARMACOLOGICAL SCREENING FOR ANTI-ARTHRITIC ACTIVITY OF MORINGA OLEIFERA

Objective: The present study was performed to investigate the anti-arthritic activity of ethanolic and aqueous leaf extracts of Moringa oleifera (MO)against formaldehyde-induced arthritis in laboratory rats.Methods: Arthritis was induced in albino Wistar rats by administration of 0.1 ml formaldehyde (2% v/v, sc) into subplantar region of the right hindpaw. Diclofenac sodium (10 mg/kg, i.p.) was used as the standard drug. The ethanolic leaf extracts of MO at doses of 250 and 500 mg/kg and aqueousleaf extract at 500 mg/kg body weight p.o were administered for 10 days. At the end of the study period, changes in paw edema volume, paw thickness,arthritis score, and C-reactive protein (CRP) levels were recorded along with histopathology of knee joints in all groups were studied.Results: There was a significant reduction recorded in paw edema volume, paw thickness, arthritis score, and CRP levels on treatment with diclofenacsodium, ethanolic and aqueous extracts of MO. When compared between the two extracts, aqueous extract in the dose of 500 mg/kg body weight wasfound to be more potent.Conclusion: The results demonstrated significant anti-arthritic activity of ethanolic and aqueous leaf extracts of MO at a dose of 500 mg/kg bodyweight.Keywords: Moringa oleifera, Formaldehyde, Arthritis, C-reactive protein

Evaluative Study Of M.A. Education Programmes Of Teacher Education At Higher Education Level In Pakistan

The study was aimed at evaluating the MA Education Programme of teacher education in Pakistan. Post-graduate teacher’s training institutes in Pakistan grant the Master of Education (MA/M.Ed.), Master of Philosophy (M.Phil) and Doctor of Philosophy (Ph D) post-graduate degrees in the field of education to enhance the careers and accelerate the professional development of educators.  The population of the study was all heads and teachers of education departments of public sector universities and government colleges of education and prospective teachers enrolled in public sector universities and government colleges where the Master degree of Education (MA Education) programme was offered.  The sample of 20 heads of public sector universities and government colleges of education, 56 teacher educators of 10 public sector universities and 10 government colleges of education, and 200 prospective teachers enrolled in public sector universities and government colleges of education departments, where the Master degree of Education (M.A./M.Ed.) was offered in Pakistan, was selected through cluster random sampling.  For the collection of data, three questionnaires - one each for heads of institutions, teacher educators and prospective teachers - were developed. For analysis, chi-square as the contingency test, was applied for identifying the trends from the frequency of responses of each questionnaire item. It was concluded that the teaching faculty of the MA education programme was using a variety of teaching methods according to the nature of objectives, content and students. Evaluation systems for students of the MA education programme were found satisfactory. It is recommended that required changes be introduced in admission criteria, curriculum, duration of degree programme, teaching-practice, research work, rewards and incentives of existing MA Education Programme in Pakistan

Acute phase reactants and lipid profile in acute chest pain presentations: a multimarker approach

Background: Cardiovascular diseases cause more deaths and disability and incur greater economic cost than any other illness in the world. Our objective is to study the biological activity and evaluate the diagnostic and prognostic values of acute phase reactants, high sensitivity C-reactive protein (hsCRP) and ferritin in association with traditional lipid profile, in screening subjects who developed chest pain due to cardiac event as indicated by a positive cardiac troponin I (cTnI) test.Methods: In this hospital-based prospective study, a total of 150 cases (n=150), presented consecutively to the emergency department with symptoms of cardiac ischemia and tested positive for troponin I (enzyme-linked flourescent assay), were compared with an equal number of age and gender matched healthy controls (n=150) for hsCRP (immunoturbidimetric assay), ferritin (immunoturbidimetric assay) and lipid profile (enzymatic colorimetric assay).Results: Median serum hsCRP levels were 2.12 mg/L)±1.79 mg/L) than controls (2.82±significantly elevated in cases (3.57 (p0.05) different between the two groups.Conclusions: hsCRP and ferritin are independent novel predictors for cardiovascular risks and events. Lipid profile demonstrates low specificity in such cases.

Executive Functioning Processes in Simple and Complex Theory of Mind Tasks

Using a multimethod-multimodal approach, this study compared the contributions of executive function (EF) abilities (Go No-Go, Visual Search, 2-Back task, and Task Switching) to narrative comprehension tasks (False Belief, Strange Stories, Self-Reported Theory of Mind Inventory [TOMI-SR]) and a narrative production task (interpersonal decentering) in a sample of young adults. Separate regression models were conducted for each theory of mind (ToM) measure with EF measures as predictor variables and empirically selected demographic variables controlled. As expected, in this college student sample (N = 110), False Belief demonstrated a ceiling effect and was not associated with any EF ability. Task Switching and 2-Back accounted for significant variance in Strange Stories. No EF task significantly predicted performance on TOMI-SR or interpersonal decentering. Both story comprehension tasks (False Belief and Strange Stories) were significantly associated, but these tasks were not correlated with either self-reported ToM or interpersonal decentering. Several unanticipated demographic associations were found; having more siblings and English proficiency accounted for significant variability in Strange Stories; education, presence or absence of self-disclosed autism diagnosis and mental health diagnosis explained a large portion of variance in TOMI-SR; interpersonal decentering maturity differed significantly between cisgender men and cisgender women. Lastly, interpersonal decentering number of interactions demonstrated an advantage for individuals without diagnosed or suspected autism diagnosis. This study raises critical concerns regarding measurement method error variance and variability of task demands in explaining cognitive mechanisms relevant to social cognitive processes

Enhancing cognitive engagement of pre-clinical undergraduate medical students via video cases and interactive quizzes in problem-based learning

Background: Problem-based learning (PBL) is one of the main pedagogical approaches utilized in the undergraduate medical education (UGME) program at a private medical college in Karachi, Pakistan. Video-enhanced cases and formative assessments were introduced at the end of PBL sessions to evaluate their effectiveness in enhancing student engagement.Methods: A mixed methods study was conducted with Year 2 medical students (n=102; divided into 11 groups) and faculty (n=11) facilitating the PBL process. Of the 10 PBL cases, five were converted to video-enhanced cases and five were kept as paper-based, “traditional” cases. “Micro” videos were used to introduce clinical scenarios, augmented by a set of guided questions related to the scenario. In addition, a formative quiz was conducted to assess concepts at the end of video-enhanced PBL sessions. At the end of a module, students and facilitators completed an online survey regarding this modified learning experience, and this was followed by a focus group discussion with the PBL facilitators.Results: More than two-thirds (71%) of the students and all facilitators preferred video-enhanced over paper-based cases. Seventy-nine percent of the students agreed that this method increased peer-peer and peer-facilitator engagement, while 66% (n=68) of the students and 81% (n=9) of the faculty agreed that the end of PBL formative assessment activity would support the Universal Design for Learning framework.Conclusion: Video-enhanced PBL used during the introduction of the case and formative assessment activities at the end of the PBL sessions improved student engagement and contributed positively to the discussions and their understanding

Online assessment in undergraduate medical education: Challenges and solutions from a LMIC university

Background and objectives: The Covid-19 pandemic has caused large-scale disruption in almost all educational programs across the world. Planning and rapid implementation of assessment through an online format presents the next set of novel challenges that must be addressed by academic administrations across the globe.Methods: This cross-sectional study was conducted between March to August 2020 at the Aga Khan University Medical College. Two hundred medical students of year 1 and 2 participated in the study. We describe the planning, processes, and outcomes of online assessments using video communication platforms conducted at a private university in Pakistan. Standardized protocols were written and piloted, extensive training of student, proctors and staff for preparation and conduct of online assessments were developed. Feedback was recorded after each session and suggestions were incorporated in subsequent high-stakes assessments.Results: A total of three pilot assessments were conducted to identify issues and process refinement. Commercially available lockdown browser and ZOOM were used in the first pilot; 80% of the class was unable to launch lockdown browser and laptops required repeated reload/reboot. For the second pilot assessment, University\u27s VLE page & MS Teams was trailed. Issues with internet connectivity, VLE page slowdown, and suboptimal recording feature in MS Teams were identified. For the final pilot assessment, phased launching of VLE page with single test item per page was implemented with success. The students reported that attempting the online exam on VLE with ZOOM support was user friendly. Ninety percent of the class was supportive of the continuing with the online assessments.Conclusion: In order to device an effective protocol for e-assessments conducting multiple trial runs, and incorporating feedback from all stakeholders is a necessity

Evaluating Safety And Efficiency Of Chemotherapy Among Patients With Advanced Colorectal Cancer

AIM: Evaluating safety and efficacy of chemotherapy among metastatic colorectal cancer patients The cultural, social, and religious differences in parenting and child-parent relationships in families make parenthood a sensitive domain for the research study. Accordingly, the changing nature of families, culture, and gender discrimination influence or affect parenting styles and parent-child relationships. The current study explored the conceptual understanding of parenthood, such as beliefs, views, expectations, and parental well-being in Indian families, especially in the states of Tamil Nadu, Kerala, and Gujarat. The participants were nine parents living together and with children the age range between eighteen and thirty-five. The parents’ age ranged from 41 to 63 (M = 50.8 years, SD = 6.05) (Mother’s age M = 48.7 years, SD = 6.04; Fathers’ age M = 52.9 years, SD = 5.28). They were selected based on purposive sampling. The method had an exploratory and qualitative design with multiple case studies. The researcher conducted in-depth, open-ended, semi-structured interviews using the online platform Google Meet and Zoom and face-to-face meetings. The interview transcriptions were analyzed using Braun and Clarke's inductive thematic analysis. The resulting six themes were: Objectives: Primary objective: To determine objective response rate of MCRC patients with chemotherapeutic regimen assessed as complete/ partial response/ stable/ progressive disease according to RECIST version 1.1. to evaluate the efficacy of chemotherapeutic regimen with in terms of objective response in accordance with response evaluation criteria in solid tumors RECIST version1.1. Secondary objective: To asses patient’s performance status using ECOG scale and to estimate percentage of all grade toxicities in accordance with CTCAE version 4.03. MATERIAL AND METHODS: It is a retrospective single centered empirical study conducted at the medical record department of oncology at a tertiary hospital for the duration of 6 months. CONCLUSION: MCRC is one of the major cause of death globally as the treatment involves complexities alongside much complications with chemotherapy are seen together with better outcomes. Entire data comprises of 109 subjects diagnosed with MCRC recorded in this retrospective study among which the no. of Male patients were 80 and Female patients were 29. The information extracted from the above data was that male subjects of age group between 50-70Y were more effected with colorectal cancer than female subjects of age group 40-70Y and patient specific treatment response rates were determined. The study revealed efficacy of chemotherapeutic regimen was found more with capox (capecitabine) and it came out as the most trending treatment among folfox (fluorouracil, oxaliplatin) and folfirinox (fluorouracil, irinotecan, oxaliplatin and capox is widely preferred by oncologists. Study revealed that among 109 patients with mcrc, the patients of age group 40- 70Y were more effected with repeatedly occurring adverse events of chemotherapy using CTCAE and determining the patient activity status

Oral Health Status Among Pregnant Women Attending Gynae OPD of Tertiary Care Hospital in Rawalpindi

Objective: The objectives of this study were to determine the oral health status and treatment needs using DMFT & CPITN indices in pregnant women attending Gynae OPD of tertiary care Hospital in Rawalpindi, to Determine Association of Oral health status using DMFT and CPITN with socioeconomic status and to determine oral health status of various trimesters of pregnancy Materials and methods: An analytical cross-sectional study was carried out to assess the oral health status and treatment needs among pregnant women at Tertiary Care Hospital, Rawalpindi from April’ 2020 to September’ 2020. Consecutive sampling was used to select the study participants. An adaptive version of WHO questionnaire was used. Results were presented in the form of frequency tables. Chi square test of statistics was applied to assess the association between categorical DMFT and CPITN with the sociodemographic characteristics of the participating females. Results: The mean DMFT score pregnant females was 2.41 + 2.30 and were belonged to a middle socioeconomic status 43.8% (n=173). About 61.8% (n=244) of participants had DMFT total score 1-7. Whereas, majority of the participants were reported bleeding gums on probing 30.6% (n=121) on assessment by CPITN. The participating pregnant females also depicted the worsening of periodontal tissues (P=0.00) and dentition status (P=0.02). Socioeconomic status was not significantly associated with dentition (P=0.39) and periodontal status (P=0.69). Conclusion: The study revealed that oral health status was deteriorated during pregnancy. Education and gestational period were strong indicator for oral health status among pregnant women. Bleeding gums were reported in majority of participants during second trimester of pregnancy. Socioeconomic status was not significantly associated with oral health status by CPITN and DMFT score

A PROSPECTIVE OBSERVATIONAL STUDY ON THE ASSESSMENT OF POTENTIAL DRUG-DRUG INTERACTIONS AND MANAGEMENT OF POST-COMPLICATIONS IN STROKE PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL

Objective: The objective of the study is to determine the occurrence, frequency, and severity of significant drug-drug interactions in stroke patients, with an emphasis on post complications and their symptomatic management. Methods: A prospective observational study was carried out for 6 mo at Osmania General Hospital, a Tertiary Care Teaching Hospital. The prescriptions taken by stroke patients throughout their hospital stay were analyzed for possible interactions using-Micromedex-2 (Thomson Reuters) × 2.0. Results: A total of 130 prescriptions was analyzed in the study in which 141 drug-drug interactions were found with a male predominance of 85.4%. The majority of interactions were of moderate severity (74.46%) and pharmacokinetics (67.37%) in nature. Among the clinical consequences, decreased atorvastatin efficacy (49.10%) was found to be the highest. The class of drugs most commonly involved in drug-drug interactions was found to be anti-epileptics and statins. 60.15% of the study population were identified with one complication, among which seizures account for 15% of patients. All the complications allied with the condition were treated with drug classes in the study population. Conclusion: This study highlighted the exigency for screening prescriptions of cerebrovascular accident patients for potential drug-drug interactions (pDDIs). Brain edema and seizure were the most accountable complications identified in the study population. The early detection of these problems can improve stroke outcomes and can reduce the mortality or disability rate