Current trends in undergraduate medical and dental research: a picture from Pakistan

Abstract BACKGROUND: Initiatives taken over the last few years have led us to the day when most of the medical and dental institutions in the developed countries have established a strong research culture at undergraduate level but the situation is quite the contrary in Pakistan. This study was carried out to investigate the current trends in undergraduate medical and dental research and to highlight the research barriers. METHODS: A cross-sectional study was conducted at six medical and dental colleges of Rawalpindi and Islamabad. A structured questionnaire was used to collect data from 300 students. Results were recorded as percentages. Findings of current survey were compared with those of already reported in literature using chi-square test. RESULTS: Out of 300 students, 206 (68.7%) students had already participated in research as principal researcher, co-researcher or as a research volunteer. Internet was most effective method of publicity of research opportunities reported by 74% of students. Only 36.7% students reported the presence of student research office at their institute. Accessibility to medical and dental journals and availability of research funds were reported by 77.2% and 13.4% of students, respectively. Lack of funding and academic overload were two main research barriers reported by 92.6% and 91.9% of students, respectively. CONCLUSION: The fraction of medical and dental students who are confident that they can plan, conduct and write a research study has increased over last four years. There is an improvement in the availability of research promoting activities but the number of research barriers is still hi

POSTMODERN CRITIQUE OF MISSIONARIES’ HISTORIOGRAPHY (A Case Study of the Civilization of Southern Africa)

Southern Africa is unique in its culture and civilization. Its history of last four centuries is the most important and interesting one for the historians of Africa as well as researchers. In colonial period identity, political consciousness and new social order of southern African people were based on the western colonialists and missionaries’ representations and models. Both groups, missionaries and colonialists, view the region from the same angle because of their similar instrumental approach. Their prejudices and biases towards southern Africa lean towards Western superiority and African inferiority for material and spiritual exploitation. They claimed superiority of Christianity over southern African religious traditions and they also condemned it as superstitious and heathen. The missionaries’ historical texts are primary source of modern consistent historiography of southern Africa and they collaborated with European colonialists. However they presented southern African people, uncultured, and barbarians, as a rationale of imperialism. Their understanding of the internal dynamics of southern African history primarily formed the perspectives of colonialism; it is demand of postcolonial era to cure the curse of the misperceptions and to understand nature of religious traditions, culture and civilization of southern Africa. After the demise of colonialism revisionist trend, among the historians of southern Africa, became popular to retell the story of the civilization of the region. This study consists of postmodern critique of missionaries’ historiography of southern Africa. In the light of revisionism it would be possible to draw the real picture of southern Africa and to formulate new principles of historiography of the continent.</p

Pattern recognition using genetic programming for classification of diabetes and modulation data

The field of science whose goal is to assign each input object to one of the given set of categories is called pattern recognition. A standard pattern recognition system can be divided into two main components, feature extraction and pattern classification. During the process of feature extraction, the information relevant to the problem is extracted from raw data, prepared as features and passed to a classifier for assignment of a label. Generally, the extracted feature vector has fairly large number of dimensions, from the order of hundreds to thousands, increasing the computational complexity significantly. Feature generation is introduced to handle this problem which filters out the unwanted features. The functionality of feature generation has become very important in modern pattern recognition systems as it not only reduces the dimensions of the data but also increases the classification accuracy. A genetic programming (GP) based framework has been utilised in this thesis for feature generation. GP is a process based on the biological evolution of features in which combination of original features are evolved. The stronger features propagate in this evolution while weaker features are discarded. The process of evolution is optimised in a way to improve the discriminatory power of features in every new generation. The final features generated have more discriminatory power than the original features, making the job of classifier easier. One of the main problems in GP is a tendency towards suboptimal-convergence. In this thesis, the response of features for each input instance which gives insight into strengths and weaknesses of features is used to avoid suboptimal-convergence. The strengths and weaknesses are utilised to find the right partners during crossover operation which not only helps to avoid suboptimal-convergence but also makes the evolution more effective. In order to thoroughly examine the capabilities of GP for feature generation and to cover different scenarios, different combinations of GP are designed. Each combination of GP differs in the way, the capability of the features to solve the problem (the fitness function) is evaluated. In this research Fisher criterion, Support Vector Machine and Artificial Neural Network have been used to evaluate the fitness function for binary classification problems while K-nearest neighbour classifier has been used for fitness evaluation of multi-class classification problems. Two Real world classification problems (diabetes detection and modulation classification) are used to evaluate the performance of GP for feature generation. These two problems belong to two different categories; diabetes detection is a binary classification problem while modulation classification is a multi-class classification problem. The application of GP for both the problems helps to evaluate the performance of GP for both categories. A series of experiments are conducted to evaluate and compare the results obtained using GP. The results demonstrate the superiority of GP generated features compared to features generated by conventional methods

Beneficial Effects of Artocarpus Lakoocha Extracts in Rat Models Suffering from Atherosclerosis

Objective: To evaluate the anti-inflammatory effects of A. lakoocha extracts by utilizing the rat models with induced hyperlipidemia.Methodology: Twenty-four well-fed rats (Wistar breed), were selected for the current study, weighing average 150-250 grams each and divided into three groups; GROUP I served as healthy control group, fed with normal diet composed of carbohydrates, proteins and fats. Group II were hyperlipidemic rats, with atherosclerosis, and considered as disease group. They were fed with high fat diet. Group III rats were fed with extracts of A. lakoocha, extending from day 20 up to day 60 of this experiment.Results In the disease group, significantly decreased (P &lt; 0.001) expression levels of IL-5 were found in (14.76 ± 2.65) compared with control group (26.54 ± 3.98). IN the group treated with A. lakoocha extracts (22.01 ± 4.53) significantly enhanced (P &lt; 0.01) the expression levels of IL-5 were observed. In addition, plasma IL-6 levels were significantly enhanced (P &lt; 0.05) in the disease group (44.19 ± 10.90) compared with the control group (32.59 ± 4.51). Treatment of rats with A. lakoocha extract (20.22 ± 2.75) caused significant reduction (P &lt; 0.001) in the expression levels of IL-6 as compared with the disease group. Significantly raised (P &lt; 0.01) expression levels of TNF-α within the disease group (31.78 ± 4.71) compared with the control group (23.34 ± 2.25) group. Moreover, A. lakoocha extracts (24.60 ± 4.26) significantly reduced (P &lt; 0.05) the expression of TNF-α levels, compared with the disease group. &nbsp;Conclusion: Current study demonstrates that A. lakoocha extracts significant protective and anti-inflammatory properties in selected rat models, subsequently leading to atherosclerosis. The present study highlighted the down-regulation of inflammatory cytokines such as IL-6, TNF-α, IL-6 and NF-кB, while simultaneously up-regulating the plasma levels of IL-15, in rat models treated with extracts of A. lakoocha

Spectrum of Complications in Children with Moderate to Severe DKA Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital

Background: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome. Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU). Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences &amp; The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value. Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%. Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation. Key words: complications, DKA severity, children, PICU

Spectrum of Complications in Children with Moderate to Severe DKA Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital

Background: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome. Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU). Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences &amp; The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value. Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%. Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation. Key words: complications, DKA severity, children, PICU

Clinical outcome of tetanus based on dakar tetanus severity score in paediatric intensive care unit of a tertiary care hospital

Objective: To evaluate the validity of  Dakar scoring system in predicting the outcome of tetanus in children of post neonatal age. Method: A prospective single center study conducted at ICU (Intensive Care Unit) of –removed for blind review-- 131 children with diagnosis of tetanus from January 2020 to June 2021 by analyzing demographic and clinical parameters. Results: Mean age of children was 8.11 ± 3.45 years with male predominance 91(69.5%). Major proportion of children were in range of 5-10 years comprising 65(50%). Period of onset of spasm was &lt; 2 days in 92(70%) that correlate well with shorter incubation period (p-value &lt;0.001). Mean duration of ICU stay was (18.81 ± 11.73) days. Only 14(10.7%) received three doses of vaccination but no one received booster dose. In majority of patients trauma due to road traffic accident 86(65.6%) was the predisposing factor followed by ear discharge 31(23.7%) and other causes 14(10.7%). Out of 131 patients 104(79.3%) received mechanical ventilation because of disease severity. Regarding outcome mild cases 2(1.5%), moderate 61(46.6%) and severe were 68(51.9%) according to Dakar scoring system and out of these severe cases 18(13.7%) expired (p-value &lt; 0.001). However, 53(40.4%) discharged, 50(38.1%) shifted out to other wards after stabilization and 10(7.6%) left against medical advice. (p-value 0.001) Conclusion: Dakar scoring system correlates well with disease severity and should be adopted to aid clinical triage and management as with effective and appropriate treatment patients can have good prognosis. However, preventive aspects should be emphasized regarding booster dose of tetanus. Keywords: Tetanus, Outcome, Dakar scoring syste

Comparative geospatial approach for agricultural crops identification in interfluvial plain - A case study of Sahiwal district, Pakistan

Agricultural crop cover identification is a major issue and time-consuming effort to verify the crop type through surveys of the individual field or using prehistoric methods. To establish the scenario of crop identification, the stage of crop provides diverse spatial information about the variety of crops due to its spectral changes. The main aim of this study was to the identify the crop types and their behavior using remote sensing and geographical information system-based approach. Moreover, two main methods were applied to the Sentinel-2 satellite data in which one is random forest based supervised classification and another was Normalize Difference Vegetation Index (NDVI) density estimation method through the google earth engine to procure the data in time-efficient way. This study also established the comparison between classified and vegetation index based seasonal compositional datasets for wheat, cotton, maize, and fodder crops. Study discussed the best fit technique for crops identification in the light of observed methods. Furthermore, the vegetation index ranges by the zonal statistics of the field samples were established according to crop precision. Results showed that -22.94, -43.72, 20.61, and 32.49 % dissimilarities existed in wheat, fodder, cotton, and maize results respectively, after comparison of both techniques. Although, the accuracy assessment was performed on the classified dataset for validation of results by confusion matrix accuracy assessment process using field sample data. Moreover, the vegetation index was used to evaluate crop land surface temperature to estimate the crop growth stage valuation that revealed noticeably enthralling outcomes. The results determined that the classified accuracies of wheat, cotton, maize and fodder were 84, 80, 81 and 71 % respectively. This study also revealed that the random forest classifier has used more features and information potentially during the classifier trainings but vegetation index just implies the limited number of features such as crop growing status

Ataxic Variant Of Guillain Barre Syndrome: A Case Report

A 17-year-old girl was admitted after acute onset of unsteady gait succeeding acute gastroenteritis. Neurological examination reported normal power in all four limbs, impaired finger-nose, heel-shin tests, areflexia and ataxic gait. We eliminated other diseases with cerebellar symptoms; for example, Wernicke encephalopathy, multiple sclerosis, cerebellar vascular disease , encephalitis in the brain stem and cerebellum. Blood serum collected from the patient during the acute phase showed no anti-ganglioside antibodies. As the patient presented with evident cerebellar ataxia without muscle weakness, ophthalmoplegia or proprioceptive sensory disruption a diagnosis of ataxic form of Guillain-Barré syndrome (GBS) after nerve conduction studies. Though ataxic GBS is not a settled impression, we should have to give heed to the potential existence of such a scarce GBS variant