Perception of Medical students regarding lectures

Objective: To assess the interest of medical students in lectures.Methodology: This prospective study was conducted in four different medical colleges of Pakistan from 1st January till 30th March 2015. Total of 600 students were included in this study. Data collection procedure used was questionnaire which contained both open and close ended questions. Written consent was taken from all the participants & permission was taken from the ethical review board of college. SPSS 15 was used to analyze the data.Results: Almost 59% of students in our study consider the lecture as uninteresting tool in medical studies and only 46% consider lecture as essential part of their education during the college timings. Good part of our study is majority of the students managed to reach lecture in time. 77.25% students consider use multimedia helpful during lectures.Conclusion: According to our study, students consider lecture as not very important and uninteresting part of medical education

Perception of Medical students regarding lectures

Objective: To assess the interest of medical students in lectures.Methodology: This prospective study was conducted in four different medical colleges of Pakistan from 1st January till 30th March 2015. Total of 600 students were included in this study. Data collection procedure used was questionnaire which contained both open and close ended questions. Written consent was taken from all the participants & permission was taken from the ethical review board of college. SPSS 15 was used to analyze the data.Results: Almost 59% of students in our study consider the lecture as uninteresting tool in medical studies and only 46% consider lecture as essential part of their education during the college timings. Good part of our study is majority of the students managed to reach lecture in time. 77.25% students consider use multimedia helpful during lectures.Conclusion: According to our study, students consider lecture as not very important and uninteresting part of medical education

Correlation of red cell distribution width with inflammatory markers and its prognostic value in patients with diabetes and coronary artery disease

Background. Recent studies have shown red blood cell distribution width (RDW) as a marker for severity and prognosis in coronary artery disease patients. Other studies have also correlated RDW with diabetes mellitus and inflammation. However, such correlation and prognosis in patients with concomitant coronary artery disease and diabetes after percutaneous intervention remains unclear. Material and methods. Our study group comprised of 730 subjects including 700 patients (cases) and 30 normal subjects (control group). Patients who presented with coronary artery disease were divided into diabetic and non-diabetic groups. All patients had RDW measured at admission and percutaneous intervention was done. Follow-up for adverse events was carried out between 6 to 12 months. Results. RDW was elevated in patients as compared to control group (p < 0.05). RDW correlated well with inflammatory markers including erythrocyte sedimen­tation rate, C-reactive protein, HbA1c, white blood cells and troponin. RDW was higher with more severe atherosclerosis based on SYNTAX and Gensini scores (p < 0.05). Prognosis was found to be worse in patients with high RDW as well as in diabetics. Conclusions. RDW has positive correlation with other inflammatory marker. It may be used as a marker in determining the severity and prognosis in diabetic patients with coronary artery disease

Prognostic significance of serum potassium level for major adverse cardiac events and death in patients with coronary atherosclerotic disease

Introduction: Serum potassium levels have been shown in some animal studies to be associated with theprocess of atherosclerosis. We decided to assess the correlation of serum potassium level in ischemic heart diseasepatients with disease severity and its relationship with prognosis in terms of major acute cardiac events (MACE). Material and methods: This was a cross-sectional cohort study carried out at cardiology department of RehmanMedical Institute, from July 2016 to 31st Aug. 2018 a period of 26 months. 622 patients were included in thestudy. Clinical and angiographic characteristics were assessed based on the serum potassium level. Correlation ofserum potassium level with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX) and Gensini scores was also evaluated. Follow up for MACE was carried out after one year. Results: Mean serum potassium level was 3.93 ± 0.95 (mEq/l) in coronary artery disease patients. Serumpotassium level showed negative correlation with SYNTAX score (r = –0.60, p < 0.05) and Gensini score(r = –0.64, p < 0.05). There was also a significant difference between low and high potassium level in relationto the multi-vessel disease on coronary angiography (p < 0.05). Low potassium level was a good predictor ofadverse outcomes as shown by Kaplan-Meier analysis. Multivariate Cox regression analysis showed that serumpotassium level and diabetes were independent predictors of MACE (p < 0.05). Conclusion: Low serum potassium level is correlated with more severe coronary atherosclerosis. Low potassiumlevels are associated with significantly poor outcomes

Climate change risk perception and adaptation to climate smart agriculture are required to increase wheat production for food security

Climate change poses a serious risk to wheat farmers in many regions of the world. The present study was conducted in the Sialkot District, Punjab, Pakistan, to investigate climate change trends during the past thirty years and to determine farmers’ knowledge and perceptions about climate change. The study also addresses the impacts of climate change on wheat production, current adaptation strategies, and limitations in adaptations to climate-smart agriculture (CSA) through a questionnaire-based survey. The historical weather data from the past thirty years indicated an increase in the mean annual minimum and maximum temperature and a decrease in annual total precipitation. Wheat productivity during the past thirty years showed an increasing trend but it was inconsistent. The respondents’ perception of climate change indicated that the literate farmers and those with broad farming experience were more knowledgeable about the climatic effects on wheat production. However, the survey results showed that the age of the farmers did not affect their perceptions. The current management practices are primarily based on prior experiences (70%) and traditional practices (30%). The standard management practices to increase farm productivity include an increase in fertilizer use (70%), a decrease in manure use (24%), and intercropping or switching to other crop cultivations (60%). The farmers stated that their reasons for limited adaptation to climate smart farm practices (CSFP) were due to their lack of knowledge and skills (86%), lack of modern technologies (74%), economic constraints (78%), politics (86%), and social influences (74%). Based on the survey results, the study suggests that addressing these gaps can increase farm-level wheat productivity to increase resilience. This can be achieved by introducing stateof- the-art farming practices through farmer training and by providing institutional services with a focus on climate-specific farm consultation services, leading to climate-smart agricultural practices for improved food security. Highlights - Literate farmers are more aware of climate change as compared to illiterate farmers. - The farmers emphasized the increase in both the summer and winter temperature. - Rainfall is identified as a major climate threat in the study area. - The farmers identified that the highest impact of climate change occurred during the harvest phase of wheat. - The farmers stated that the limited adoption of climate smart agricultural practices is due to lack of knowledge and technological, economic, and other gaps

Drought Susceptibility Index; a Preferred Criterion in Screening for Tolerance in Soybean

Soybean (Glycine max L.) yield and yield related traits are constrained by drought. Adaptation of soybean to changing environment could be improved by exploitation and introgression of diverse germplasm in breeding program. In present study, the response to drought conditions, especially at flowering stage, was evaluated to determine the potential soybean germplasm for future soybean breeding programs in Pakistan. Field experiment was conducted under two water regimes i.e. well-water and water-limited, to assess the effect of drought in seed yield and yield related traits. Although, drought led to overall reduction of ~15 % in thousand seed weight but still some soybean genotypes performed relatively better under water-limited conditions. These genotypes were also tolerant to drought, with a drought susceptibility index of \u3c 0.5. PCA also explained the pattern of variation existing in soybean germplasm grown under given water regimes i.e. well-water and water-limited conditions. The identified soybean genotypes could be a favorable resource to introduce high yielding soybean in local environment

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability