Challenges of Online Learning Environment Faced by Undergraduate Medical Students During Covid 19 Pandemic

Objective: This study aimed to define the challenges faced by medical students rotating in the orthopedics department and their suggestions regarding improvement during covid-19 pandemic. Study Design: A mixed method cross sectional study design. Place and Duration of Study: It was conducted on 4 and 5 year MBBS students at Shifa college of Medicine with clerkship rotation in the department of orthopedics from 16 March 2020 to 23 August 2021. Materials and Methods: Students were enquired about their comfort levels while using the internet and computer for online sessions. Data was collected through an online questionnaire and analyzed using Google forms. Frequencies, percentages, and standard deviations were calculated for qualitative variables. Results: Out of 147 study participants, 64(43.4%) students strongly agreed that they had no difficulty and were extremely comfortable using internet and computer during covid-19 pandemic. Eighty-five (58%) students used online available reading material shared on Google classrooms and what's app groups. While only 23(16%) agreed to concentrate during online sessions. One hundred and eighteen (80%) agreed with a lesser desire to study for online classes as compared to on campus. Major problems faced by the students during the pandemic included very limited patient centered learning, limited hands-on experience, less interactive sessions, problems with internet connections, technology handling and class timing issues due to time zone differences. Conclusion: We conclude that our students faced lot of challenges during Covid-19 pandemic including internet issues, lack of awareness of technology, distractions because of family, siblings and homely environment and lack of conducive learning environment like learning at bedside. Flexible class timings, multiple breaks, recorded lectures and online interaction of real patients can improve online clinical learning

Studies on two polyherbal formulations (ZPTO and ZTO) for comparison of their antidyslipidemic, antihypertensive and endothelial modulating activities

Background Cardiovascular disorders (CVDs) are the leading cause of disease burden worldwide. Apart from available synthetic drugs used in CVDs, there are many herbal formulations including POL-10 (containing 10 herbs), which have been shown to be effective in animal studies but POL-10 was found to cause tachycardia in rodents as its side effect. This study was designed to modify the composition of POL-10 for better efficacy and/or safety profile in CVDs. Methods To assess the antidyslipidemic, antihypertensive and endothelial modulatory properties of two herbal formulations, (ZPTO and ZTO) containing Z: Zingiber officinalis, P: Piper nigrum, T: Terminalia belerica and O: Orchis mascula, different animal models including, tyloxapol and high fat diet-induced dyslipidemia and spontaneously hypertensive rats (SHR) were used. Effect on endothelial function was studied using isolated tissue bath set up coupled with PowerLab data acquisition system. The antioxidant activity was carried out using DPPH radical-scavenging assay. Results Based on preliminary screening of the ingredients of POL-10 in tyloxapol-induced hyperlipidemic rats, ZPTO and ZTO containing four active ingredients namely; Z, P, T and O were identified for further studies and comparison. In tyloxapol-induced hyperlipidemic rats, both ZPTO and ZTO caused significant reduction in serum triglyceride (TG) and total cholesterol (TC). In high fat diet-fed rats, ZPTO decreased TC, low-density lipoproteins cholesterol (LDL-C) and atherogenic index (AI). ZTO also showed similar effects to those of ZPTO with additional merits being more effective in reducing AI, body weight and more importantly raising high-density lipoproteins. In SHR, both formulations markedly reduced systolic blood pressure, AI and TG levels, ZTO being more potent in reversing endothelial dysfunction while was devoid of cardiac stimulatory effect. In addition, ZTO also reduced LDL-C and improved glucose levels in SHR. In DPPH radical-scavenging activity test, ZTO was also more potent than ZPTO. Conclusion The modified formulation, ZTO was not only found more effective in correcting cardiovascular abnormalities than ZPTO or POL-10 but also it was free from tachycardiac side-effect, which might be observed because of the presence of Piper nigrum in ZPTO

Medical students’ perception toward neurosurgery as a career: a cross-sectional study

Abstract Background This study aims to access the perspective of medical students toward practicing neurosurgery after MBBS and also to identify factors responsible for low affinity among medical students in pursuing neurosurgery as a career. In this cross-sectional study, medical students were surveyed via pre-tested questionnaire, with a four-point Likert scale to determine their influence on student’s consideration of neurosurgery as a career. Data analysis was performed using SPSS software. Results The survey was completed by 185 students out of which 56.2% students considered neurosurgery as a career. Although more than 90% students acknowledged that neurosurgery training is too prolonged and it can also impede family life but huge prestige and income is attached to neurosurgery, 35.7% students shared that neurosurgery exposure and teaching is not adequate enough for them in order to have a positive influence toward neurosurgery as a career. Conclusion Additional studies are required to further explore how participation in a formal neurosurgery experience can alter medical students’ perceptions and influences their consideration of neurosurgery as career choice

Promoting green behavior through ethical leadership: A model of green human resource management and environmental knowledge

Purpose: This paper aims to investigate the influence of supervisor's ethical leadership style on subordinates' green or pro-environmental work behavior in the presence of green human resource management (GHRM) as a mediator and environmental knowledge as a moderator. Design/methodology/approach: A questionnaire-based was distributed to 427 supervisor–subordinate dyads working in various Pakistani organizations. Structural equation modeling was used to determine the mechanisms and boundary conditions in the relationship between supervisor's ethical leadership style and subordinates' green behavior. Findings: Structural equation modeling supported a partial mediating role of GHRM in the influence of ethical leadership on green work behavior. Further, the findings revealed that employee's environmental knowledge can magnify the indirect impact of ethical leadership, via GHRM, on green behavior. Research limitations/implications: Cross-sectional survey data are typically associated with common method bias. To counter this bias, we collected data from dual sources, namely, supervisors and their subordinates. The research findings have implications in deepening the understanding of the impact of ethical leadership in improving environmental performance of the organization. Originality/value: This is the first study that utilizes multi-sourced data to examine the mediating role of GHRM and the moderating role of environmental knowledge in the relationship between ethical leadership and green behavior at work

Infantile Spasms: Clinical profile and treatment outcomes

Background and Objective: Infantile spasm (IS) is one of the severe epileptic encephalopathies which affect children in early two years of life. Our objective was to determine the clinical profile, etiology and outcome of treatment in children with infantile spasms attending tertiary care hospital at Karachi, Pakistan. Methods: This is retrospective study of 36 patients out of 94 registered as IS, aged three months to two years, managed and followed up at Aga Khan University Hospital, Karachi, from 2010 to 2015. Data of all children with IS was collected from case record. Details including clinical observations, lab investigations, anti-epileptic medications and treatment outcome was collected and analyzed. Patients who received treatment for six weeks to document response were included. The treatment response was categorized as complete response, partial response (\u3e50% improvement) and no response. Data was analyzed on SPSS using descriptive statistics. Results: Thirty-six patients (38.29%) with IS fulfilled eligibility criteria. The mean ± SD age at presentation was 4.6±2.1 months. Male to female ratio was 2:1. Consanguinity and developmental motor delay was observed in 66.6% and 89% respectively. Symptomatic etiology was predominant (61%) and hypoxic ischemic insult (32%) was the commonest underlying cause. EEG and MRI were diagnostic tools whereas metabolic studies were not helpful. Multiple antiepileptic drugs were used for seizure control and vigabatrin was the most frequently used (88%) drug. Short term treatment response was not different in idiopathic or symptomatic infantile spasms. Conclusion: Majority of patients had symptomatic infantile spasms and generalized tonic clonic along with myoclonic jerks were predominant seizure types. EEG and MRI were diagnostic in most of cases. Multiple AEDs were required to control seizures and VGB was most common drug (88%) used. Treatment outcome was not different in idiopathic and symptomatic groups