TEAM-BASED LEARNING VS LECTURE-BASED LEARNING IN MEDICAL EDUCATION

Objective: The objective of the study is to determine better mode of learning for medical graduates by comparing team-based learning (TBL) and lecture-based learning methods. Study Design: Comparative analytical study. Place and Duration of Study: Surgical Ward 25 of Endocrine and General surgery, Jinnah Postgraduate Medical Center, Karachi, in April 2019. Methodology: This comparative study was based on the principles of TBL; the control program used the traditional lecture-based approach. Both programs were aimed at investigating the knowledge and performance of the two groups. Thirty surgical interns were included in this study. Two groups were made by random selection of surgical interns, 15 in TBL group and other 15 in traditional teaching group. TBL group (Group A) was given the topic of thyroid diseases for self-study followed by 1 h discussion amongst the group members. Lecture-based group (Group B) was given 1 h powerpoint presentation on similar topic. As the main outcome measures, questionnaire containing twenty best choice questions was given to both groups. Performance of the two groups was checked and results calculated as total, average, and standard deviation. Results: Group A participants’ total score (147) was higher than Group B (131) but the p-value was not found to be significant (0.144). Conclusion: Both forms of learning methods are effective and productive in medical education

The Role of Psychological Capital in Academic Adjustment among University Students

To investigate the potential of psychological capital as a resource for academic adjustment, 511 BBA students were asked to complete two questionnaires, one assessing participants’ psychological capacity, the other academic adjustment. Average grade-point scores were collected at two points in time as an additional measure of academic adjustment. Correlational as well as SEM analyses suggest that psychological capital is a positive resource with a central role in students’ academic adjustment. The study extends knowledge on the impact of psychological capital on positive organizational behavior by generalizing it to higher education

Women Home Based Workers in Rural areas of Pakistan

Home-based work is a “general category of work within the informal or unorganized sector where workers carry out remunerative activities within their homes or in the surrounding areas but not at the premises of an employer”. The women Home-based workers defines as “The Women who work in their own dwelling or home stations. It is the moneymaking activity. The home based work includes the embroidery, handicrafts, stitching, weaving, shoe making, football making, garments, handmade jewelry and decoration piece making etc. The main purpose of this study was to explore awareness among women home based worker about their rights. The study was conducted in District Faisalabad. Multistage sampling technique was used in this study. At first stage, one Tehsil Faisalabad out of five Tehsils was selected by using simple random sampling technique. At second stage 4 union councils including UC-49, UC-157, and UC-274 were selected by using simple purposive sampling technique. At third stage four villages from each union council out of five villages (Chack No- 225 RB, Malkhawala), (Chack No-217 RB, Chakaira), (Chack No-218 RB, Pronkawala) and (Chack No-61 JB, Dharora) were selected purposively. The study was conducted in rural area of District Faisalabad. The sample size of one twenty women was selected by using simple random sampling.  Questionnaire was used as a tool for data collection and collected data were analyzed by using Statistical Package for Social Sciences (SPSS). Results of the study revealed that 61.7% of the respondents were illiterate, about 38.3% of the respondents earned 2501-5000 rupees, the significant majority 86.7% of the respondents belonged to lower class, about one third 40% of the respondents involved in stitching, more than half 51.7% of the respondents worked up to 6 hours per day, the majority 67.5% the of the respondents had muscular pain, and the significant majority 87.5% of the respondents had no awareness about their rights

3D-Bioprinting: A stepping stone towards enhanced medical approaches

In the past few decades, tissue engineering has been seen unprecedented escalation driving the field of artificial tissue and organ construct and brought metamorphosis in regenerative medicine. Prime advancement has been attained through the expansion of novel biomanufacturing approaches to devise and convene cells in three dimensions to fabricate tissue contrive. Accompaniment manufacturing differently known as 3D bioprinting is leading prime innovation in a number of applications in life sciences such as tissue and organ construct, personalized drug dosing, cancer model and heart tissue engineering. Overall, this review summarizes most prevalent bioprinting technologies; including laser-based bioprinting, extrusion bioprinting, injection bioprinting, stereolithography as well as biomaterial such as bioink. It also explores 3D industries, approaches such as Biomimicry, autonomous self-assembly, mini tissues and biomedical applications. Existing challenges that impede clinical mileage of bioprinting are also discussed along with future prospective.Keywords: Bioprinting, tissue engineering, tissue and organ construct, medicinal approac

ROLE OF EXERCISES AND DIETARY INTAKE AS AN INTERVENTION IN WEIGHT REDUCTION

Background: Obesity is now so common within the world’s population that it is beginning to replace under nutrition and infectious disease as the most significant contributor to ill health. Exercise plays significance role with dietary control in weight reduction. The aim of our study is to find out the efficacy of weight reduction interventions and role of exercise. Methods: The study was conducted on 60 participants, subjects or participants were randomly divided. It is an experimental study which was completed in the duration of about six months. The study was based on two groups that are group A (exercise plus dietary) and group B (only dietary) consisting of sixty participants after filling the consent form. Result: Result shows out of these sixty only fifty eight participants completed the study and were observed for four months. Is has been found comparable weight loss relatively fewer in the dietary group Body weight before (80.1±2.7) after (78.1±2.5)and BMI before (32±2) after (30±2) it shows significant results but less significant than group A body weight which was before(78.6±2.6) after(64.0±2.3) and BMI before (33±1) after (39±1). Therefore the results shows that the group A shows more significant outcomes as compare to the other group included in the study. Conclusion: The results shows that (exercise plus dietary) more significant outcomes as compare to the other group included in the study Keywords: Anne Collins, weight reduction, exercises plus dietary, dietary, BMI and body weight

Model-based in silico analysis of the PI3K/Akt pathway: the elucidation of cross-talk between diabetes and breast cancer

Background A positive association between diabetes and breast cancer has been identified by various epidemiological and clinical studies. However, the possible molecular interactions between the two heterogeneous diseases have not been fully determined yet. There are several underlying mechanisms which may increase the risk of breast cancer in diabetic patients. Introduction In this study, we focused on the role of O-GlcNAc transferase (OGT) enzyme in the regulation of phosphatidylinositol-3 kinase (PI3K) pathway through activation/deactivation of Akt protein. The efficiency of insulin signaling in adipocytes is reduced as a result of OGT overexpression which further attenuates Akt signaling; as a result, the efficiency of insulin signaling is reduced by downregulation of insulin-responsive genes. On the other hand, increased expression of OGT results in Akt activation in breast cancer cells, leading to enhanced cell proliferation and inhibition of the apoptosis. However, the interplay amongst these signaling pathways is still under investigation. Methods In this study, we used Petri nets (PNs) to model and investigate the role of PI3K and OGT pathways, acting as key players in crosstalk between diabetes and breast cancer, resulting in progression of these chronic diseases. Moreover, in silico perturbation experiments were applied on the model to analyze the effects of anti-cancer agents (shRNA and BZX) and anti-diabetic drug (Metformin) on the system. Results Our PN model reflects the alterations in protein expression and behavior and the correlation between breast cancer and diabetes. The analysis proposed two combination therapies to combat breast cancer progression in diabetic patients including combination of OGTmRNA silencing and OGT inhibitor (BZX) as first combination and BZX and Metformin as the second. Conclusion The PN model verified that alterations in O-GlcNAc signaling affect both insulin resistance and breast cancer. Moreover, the combination therapy for breast cancer patients consisting of anti-diabetic drugs such as Metformin along with OGT inhibitors, for example BZX, can produce better treatment regimens

Dengue Fever: A General Perspective

Dengue Fever or commonly known as Dengue, a mosquito-borne arboviral infection has emerged as havoc around the globe. Annually, about 50 million infections are reported, resulting in 22,000 deaths and almost 2.5 billion people are reported living at risk. Dengue infection is caused by Dengue Virus (DENV), which is a member of genus Flavivirus and comprised of ten proteins; three proteins, capsid (C), membrane (M), and envelope (E), play structural role and seven are identified as non-structural that direct DENV replication. Four distinct serotypes: DENV-1, DENV-2, DENV-3 and DENV-4 are transmitted via Aedes mosquitoes. Clinically, Dengue patients can be categorized into three groups according to WHO 2009 revised classification. Typical symptoms of dengue include: extreme fatigue; sudden fever (from 3-7 days), headache, joint, muscle, and back pain; vomiting and diarrhea, appetite loss; skin rash along minor bleeding. Aedes aegypti is geographically distributed in tropical areas and breeds in artificially filled water containers i.e. drums, tyres, flower vases plastic food containers, tin cans, etc. Due to four viral serotypes and non-availability of the model animal for dengue, producing vaccines is a challenging task. Thus, Dengue can be managed using various vector control strategies through physical, chemical and biological means

Integrating depression care within NCD provision in Bangladesh and Pakistan : a qualitative study

Background Co-morbidity of depression with other non-communicable diseases (NCDs) worsens clinical outcomes for both conditions. Low- and middle-income countries need to strengthen mechanisms for detection and management of co-morbid depression within NCDs. The Behavioural Activation for Comorbid Depression in Non-communicable Disease (BEACON) study explored the acceptability and feasibility of integrating a brief depression intervention (behavioural activation, BA) into NCD services in healthcare facilities in Bangladesh and Pakistan. Methods Face-to-face qualitative interviews were conducted with 43 patients and 18 health workers attending or working in NCD centres in four healthcare facilities in Bangladesh and Pakistan, and with three policy makers in each country. The interviews addressed four research questions (1) how NCD care is delivered, (2) how NCD patients experience distress, (3) how depression care is integrated within NCD provision, and (4) the challenges and opportunities for integrating a brief depression intervention into usual NCD care. The data were analysed using framework analysis, organised by capability, opportunity and motivation factors, cross-synthesised across countries and participant groups. Results Patients and health workers described NCD centres as crowded and time pressured, with waiting times as long as five hours, and consultation times as short as five minutes; resulting in some patient frustration. They did not perceive direct links between their distress and their NCD conditions, instead describing worries about family and finance including affordability of NCD services. Health worker and policy maker accounts suggested these NCD centres lacked preparedness for treating depression in the absence of specific guidelines, standard screening tools, recording systems or training. Barriers and drivers to integrating a brief depression intervention reflected capability, opportunity and motivation factors for all participant groups. While generally valuing the purpose, significant challenges included the busy hospital environment, skill deficits and different conceptions of depression. Conclusions Given current resource constraints and priorities, integrating a brief psychological intervention at these NCD centres appears premature. An opportune first step calls for responding to patients’ expressed concerns on service gaps in provisioning steady and affordable NCD care. Acknowledging differences of conceptions of depression and strengthening psychologically informed NCD care will in turn be required before the introduction of a specific psychological intervention such as BA

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A Review on Empirical Approach to Therapeutic Recombinant Protein Production Factories: Applications, Pharmacokinetics and Challenges

Major portion of the proteins in a cell refers to their critical roles in metabolism of the living body. Proteins dysfunction results in the severe disorders which need to be treated in time. For this, respective proteins can be extracted by the external sources and be supplied to the human beings. Such medicinal proteins are known as therapeutic proteins (TPs). This review summarizes some of the key areas about these miracle proteins like their types, classification, production factories, routes of administration, pharmacokinetics, and potential applications. Furthermore, challenges and hurdles faced in getting a potential protein drug, its FDA approval and commercial availability are also highlighted for further research