ADVANCES IN BASIC MEDICAL SCIENCES

Elucidating Genomic Variation and Evolutionary Dynamics of Local Dengue Virus In Host And Vector

2026-02-17T04:47:55+00:00

OBJECTIVE

To evaluate the evolutionary dynamics and genomic variation of DENV, specifically the Capsid precursor membrane (CprM) gene, in both the mosquito vector Aedes aegypti and human hosts.

METHODOLOGY

Aedes aegypti was molecularly identified using the Cytochrome C oxidase (COI) gene, and mosquito collection sites were mapped using geographic information systems. The Vector (Aedes aegypti) samples and Host (Human) Samples were tested for dengue virus presence using PCR amplification that targets the CprM gene, which, when present, generates a 510 bp fragment. To understand the evolutionary dynamics, nucleotide sequences of the Capsid Precursor Membrane (CprM) gene were retrieved from the NCBI database for mosquito-derived (32 sequences) and human serum–derived (40 sequences) samples, aligned using MEGA11 to identify conserved regions. Maximum Likelihood-constructed phylogenetic trees revealed evolutionary links between Dengue virus strains.

RESULTS

Strong purifying selection acting on the CprM gene was found by selection pressure analysis with the Global MG94xREV model and DataMonkey, with a low dN/dS ratio. Regions of high genetic diversity were identified through Shannon entropy analysis, indicating adaptive evolution. The Integer Neighbour-Joining (NJ) Network provided a clear visualisation of the genetic relationships, demonstrating that the viruses have both host-specific and shared lineages.

CONCLUSIONS

We discovered conserved and diversified genomic regions by phylogenetic analysis and molecular identification, revealing adaptive evolution and purifying selection. These findings enhance our understanding of DENV adaptation in hosts and vectors, informing targeted preventive measures.

The Clinical Case Sandwich: An Innovative Lecture Delivery Model to Enhance Student Engagement in Preclinical Pathology

2026-05-25T14:06:18+00:00

OBJECTIVE: To explore students’ perceptions of a modified pathology lecture format in which each session opened with a clinical case and returned to the same case at the end, named as the “Clinical Case Sandwich” technique.

METHODOLOGY: A cross-sectional mixed-methods study was conducted at the College of Medicine, Gulf Medical University, Ajman, UAE, after one academic year of pathology teaching using this format within a system-based modular curriculum. Forty-three Higher Diploma in Preclinical Sciences students completed a validated questionnaire. Thirteen 5-point Likert-scale items assessed engagement, clinical and examination relevance, learning impact, and satisfaction. Two open-ended questions captured students’ comments. Quantitative data were summarised using descriptive statistics and displayed through frequency plots and a heat map. Free-text responses were reviewed to identify recurring ideas, and Word-It-Out word-cloud software was used to visually summarise commonly occurring terms.

RESULTS: Responses were strongly positive. Eighty-two percent agreed that the cases improved engagement, 95% felt the approach would help them in their clinical years, and 86% believed it would support examination performance. Overall, 83% reported satisfaction and 93% recommended adoption by other faculty. Qualitative comments suggested that the format made lectures more interactive, clinically meaningful, and easier to follow, with the opening case creating curiosity and the closing discussion consolidating learning.

CONCLUSION: Opening and closing pathology lectures with a clinical case was well received and was perceived to strengthen student engagement, understanding, and clinical relevance. This simple lecture modification may help preclinical students connect pathology mechanisms with clinical reasoning.

Micronutrients Imbalance in Tuberculosis: A Comparative Study of Zinc and Copper in Multidrug Resistant and Drug-Sensitive Pulmonary Tuberculosis

2026-06-06T05:42:13+00:00

OBJECTIVE
To evaluate the differences in serum copper, zinc levels and Cu/Zn ratio between individuals who have multi-drug resistant pulmonary tuberculosis and those with drug-sensitive Tuberculosis.

METHODOLOGY
The confirmed cases of TB- DS (group A) and TB-MDR (group B) were compared cross-sectionally. Venous blood samples were collected under aseptic conditions, and copper & zinc levels were measured in serum by atomic absorption spectrophotometry. Statistical analysis was performed to assess differences between the two groups.

RESULTS
A statistically notable decrease (P < 0.001) was observed in the serum zinc levels in group B as compared to group A. The Cu/Zn ratio was increased in group B (1.09) compared to group A (0.71). The difference in the case of serum copper among the groups was not significant.

CONCLUSION
Patients with TB- MDR exhibited significantly lower zinc levels and a higher Cu/Zn ratio than drug-sensitive TB patients, reflecting impaired antioxidant status.

Impact of Community Outreach Placements on Social Accountability and Cultural Competence among Medical Students at Rehman Medical College, Peshawar

2026-06-06T05:39:51+00:00

OBJECTIVE: To evaluate medical students’ perceptions regarding the impact of community outreach placements on cultural competence, social accountability, and educational development at Rehman Medical College, Peshawar.

METHODOLOGY: A cross-sectional study was conducted among 103 undergraduate medical students using a self-developed structured questionnaire based on a 5-point Likert scale. The questionnaire explored multiple thematic domains related to outreach-based learning. Data were analysed using IBM SPSS Statistics version 26. Pearson’s chi-square test was applied to assess associations between demographic variables and student perceptions.

RESULTS: Students reported positive perceptions regarding cultural competence (mean = 2.08), social accountability (mean = 1.94), and clinical and communication skills (mean = 1.85), with a lower mean score referring to stronger agreement. Students aged 23-25 years demonstrated significantly higher agreement regarding improvement in history taking and patient examination skills (p = 0.007) and communication skills (p = 0.003), whereas gender-based differences were not statistically significant. Participants also identified gaps in undergraduate curricula related to underserved populations and community-oriented learning.

CONCLUSION: Community outreach placements were perceived as valuable educational experiences that promote cultural awareness, social accountability, and practical learning among medical students. Incorporating structured community-based placements into undergraduate medical curricula may help foster socially responsive and culturally sensitive future physicians.

Assessment of Vision-Related Quality of Life in Patients with Vision Impairment Aged 30 Years and Above at Saidu Teaching Hospital, Swat, Khyber Pakhtunkhwa Pakistan: A Cross-Sectional Study

2026-04-30T05:07:27+00:00

OBJECTIVE: To evaluate vision-related quality of life (VRQOL) of people with VI and identify the association of demographic, physical and psychosocial factors to VRQOL.

METHODOLOGY: A cross-sectional study was conducted to assess VRQOL in people with VI aged 30 years and above visiting the Ophthalmology department at Saidu Teaching Hospital, Swat (STHS). A total of 450 participants were involved consecutively; a validated tool, NEIVFQ-25, was used to evaluate VRQOL. Correlation, chi-square, and linear regression were used to assess the associations between VI, demographic characteristics, and the accomplishment of routine activities, with p <0.05 considered statistically significant.

RESULTS: The mean age of the sample was 58.5 years, with 54.2% female. Participants with occupation “labourer”, 10 years of education, having profound VI with visual acuity (VA) =1.3 or blindness (VA>1.3 log MAR) had significantly (p <0.05) low VRQOL scores. In comparison, participants aged 51 to 60 years had lower VRQOL scores for driving and tasks such as focusing on distant objects, with a p <0.05.

CONCLUSION: A significant impact on VRQOL was observed in people with VI. The findings can be helpful for patients and clinicians in understanding the effects of VI and devising a suitable and culturally acceptable rehabilitative strategy to improve VRQOL and, hence, the standard of living.

Hepatoprotective Effect of Aqueous Neem Leaf Extract Against Erythromycin-Induced Changes in Albino Wistar Rats

2026-06-09T13:36:42+00:00

OBJECTIVE: To evaluate the hepatoprotective activity of aqueous Neem leaf extract on Erythromycin-induced loss in hepatocyte count of albino Wistar rats.

METHODOLOGY: Eighty male albino Wistar rats were included in the experiment and divided into four groups. Group A was an untreated control. Group B received Erythromycin alone, while Group C received both Erythromycin and aqueous neem leaf extract. Group D was treated only with neem extract. The body weight of each rat was measured at the start of the study and at the end of the experiment. At the end of the 14-day treatment period, animals were sacrificed, and their livers were collected, weighed, and prepared for further processing.

RESULTS: Group A maintained a normal hepatocyte count (16.13 ± 0.44), consistent with intact liver tissue. A noticeable reduction was observed in Group B (8.94 ± 0.43), indicating significant hepatocellular loss following liver injury. In Group C, hepatocyte count increased to 11.63 ± 0.46, suggesting partial restoration of hepatic tissue. Group D showed a hepatocyte count of 15.76 ± 0.35, which was comparable to the control group and may indicate a protective effect with preservation of normal liver morphology.

CONCLUSION: Histopathological assessment showed marked differences among groups. Group B exhibited reduced hepatocyte count with disrupted liver architecture, congestion, and hemorrhagic changes, while Group C showed near-normal recovery with mild residual alterations. Groups A and D maintained normal hepatocyte count and liver histology. These findings suggest that aqueous neem leaf extract may protect against erythromycin-induced hepatotoxicity by preserving hepatocyte integrity and supporting normal liver structure.

Saving Lives and Protecting Futures Through an Urgent Tackling of Cervical Cancer in Pakistan

2026-02-17T08:09:23+00:00

Despite being one of the most preventable malignancies, cervical cancer is nevertheless a significant public health issue in Pakistan, where an estimated 5,000 to 7,000 new cases occur annually. The actual burden is likely to be higher due to the prevalent poor cancer registries and underreporting. It is estimated that around 60% of the diagnosed women die from the disease, because the majority of the cases are diagnosed at advanced stages, when treatment is less effective. The cervical cancer primarily affects women between the ages of 15 and 55, which causes severe social and economic issues and stigmas for the families. The major barriers in the management of cervical cancer are lack of awareness, cultural taboos surrounding reproductive health, absence of national screening and HPV vaccination programs, and limited healthcare infrastructure in Pakistan. In addition, rural women encounter significant barriers to accessing healthcare. Despite being preventable through human papillomavirus (HPV) vaccination and early detection, cervical cancer continues to claim lives unnecessarily across Pakistan.

Overuse of Benzodiazepines for Generalized Anxiety Disorder: A Growing Concern in Pakistan

2026-02-17T05:58:51+00:00

Generalised anxiety disorder (GAD) affects a significant proportion of the global population, and its treatment may presuppose the use of drugs as well as psychotherapy. Traditionally, benzodiazepines (BZDs) were prescribed to relieve anxiety symptoms in the short run because of the rapid onset of action. Nevertheless, evidence shows that their overuse, particularly in countries like Pakistan, is causing grave concerns relating to dependence, cognitive and negative social impacts.

Although the recommended guidelines favour selective serotonin reuptake inhibitors (SSRIs) or cognitive-behavioural therapy as first-line treatments and emphasise that benzodiazepines should be used carefully and for a limited period in the management of GAD [1, 2]. Recent research found that a significant proportion of benzodiazepine users continue prescribed treatment beyond recommended guidelines, which puts them at risk of dependence and withdrawal [3].

The problem in Pakistan is worsened by the cultural stigma of mental health, lack of access to special psychiatric treatment, and absence of strict prescription monitoring, which all contribute to the increasing cases of abuse and adverse events [4]. The easy access to benzodiazepines in local pharmacies without a prescription is another factor contributing to the problem.

The solution to benzodiazepine overuse is complex and should consider three aspects: better education of physicians on the evidence-based methods of anxiety management, greater regulatory control, and more awareness of the dangers of long-term use of benzodiazepines among the population. The use of benzodiazepines can be minimised by incorporating mental health in primary care and encouraging non-pharmacological treatment options.

To sum up, although benzodiazepines still play a useful role in addressing the symptoms of anxiety in the short term, their excessive use in Pakistan, especially to manage GAD, poses a serious public health challenge that needs to be addressed immediately.

The Education short communication. ENGAGING STRATIGY OF TEACHING ANATOMY

2026-04-22T15:36:13+00:00

Anatomy form the basis for the practice of medicine. The knowledge of anatomy is required for medical and surgical specialization diagnosing imaging surgical procedures. Rehabilitation and bodily restoration process. Technical and anatomical language must be known for pharmacology, Pathology, Physiology and Forensic Medicine Patient assessment and surgical and therapeutic procedure. There are different methods adapted since long. The most important method includes the dissection of human cadavers. During pandemic of Covid 19 remote modalities were adapted. Students and teacher were trained; online classes were started that all were interactive. Online examination was also conducted and showed satisfactory results.

The Anatomy is the corner stone of the curriculum of the basic medical sciences in medical institute all over the world.1 The Anatomy is defined as branch of Biology dealing with the structures of organisms 2.

Since anatomy is a vast subject, it is divided into different sub disciplines.

General anatomy
Gross anatomy including systemic and regional 3
Microscopic anatomy or histology
Development anatomy or embryology
Neuro anatomy
Clinical and applied anatomy 4
Forensic anatomy
Radiological anatomy and, Surface anatomy is not less important as it provide information about structures that may be observed or palpated beneath the skin. Clinical anatomy is most important as it correlate the bodily structures to function important in the practice of medicine and dentistry and allied health sciences. It incorporates the regional and systemic approach to study anatomy.

The Recent trends in Anatomy education demand great emphasis on conceptual understanding of the discipline leading to better knowledge of procedure skills and problems solving ability. However, strategy should be to keep the balance between conceptual learning and procedural skill. To achieve the purpose, the infrastructure is being improved. Other teaching aids are also used for crystal clear concept.