ADVANCES IN BASIC MEDICAL SCIENCES

Exploring Pakistani Undergraduate Medical Students, Preferences: A Comparative Analysis of Problem Based Learning vs Lecture Based Learning

Sheh Noor — 2024-06-21

Objective

To investigate and compare the preferences of Pakistani undergraduate medical students regarding problem-based learning and lecture-based learning.

Methods

This was a cross-sectional comparative analysis employed with an online Google Docs questionnaire distributed to Pakistani medical students via social media platforms. Utilizing a non-probability convenience sampling technique, participants were enrolled in data collection.

Results

Among the 200 respondents, 29% were from the final year, while 8%,27.5%,26.5%, and 9% were from fourth, third, second, and first professional, respectively. Problem-based learning was favored by 68% of learners and only 32% of students liked lecture-based learning. It was found that 71% of participants expressed the view that PBL resulted in an enhanced understanding of lecture content. As reported by 73.5% of participants, PBL leads to the improvement of the habit of self-learning. Furthermore, 78% of students claimed that PBL leads to a better analytical approach toward problem-solving. In terms of pre-session preparation, 65.5% and in terms of developing competencies 82.5% of students claimed the superiority of PBL over LBL. Regarding the accessibility of resources for facilitating PBL sessions, only 49% of students expressed satisfaction, while 58.5% of the respondents admitted the availability of trained demonstrators for LBL sessions.

Conclusion

The results of this study demonstrate that PBL outperforms LBL in enhancing student competencies. Moreover, these findings indicate a strong preference among students for PBL over LBL. However, it is crucial to address the pressing need for enhancing resources dedicated to conducting PBL sessions.

Understanding the Link Between Consanguineous Marriage and Pathological and Non-pathological Short Stature: A Clinical Investigation

Marya Hameed — 2024-06-21

Objective

To investigate the associations between consanguinity and clinical factors among patients with short stature and to determine whether consanguineous marriage is associated with an increased risk for dysplastic and storage disorders among patients with short stature.

Methods

This study adopted a retrospective cohort design to investigate common features and potential causes of short stature, specifically focusing on skeletal survey findings. Using a convenience sample of 460 patients, 62% of parents reported consanguineous marriage. The participants were evaluated for clinical factors such as pathological short stature, head size abnormalities, and other related conditions. Data was collected from the medical records of a large tertiary care hospital. Statistical analysis was performed using SPSS 26 software.

RESULTS

The median age at presentation was 3 years, with a slight skew towards older ages. Males comprised 62.4% of the participants. Notably, 43% of patients had normal short stature, meaning no underlying cause was identified. The remaining patients had pathological short stature caused by various conditions: Metabolic disorders (16.1%), Storage disorders (13.3%), and Dysplastic disorders (18.5%).

CONCLUSION

The findings suggest that consanguineous marriage is associated with an increased risk for dysplastic and storage disorders. This highlights the need for public health policies and interventions aimed at reducing the prevalence of these conditions in communities where consanguineous marriage is common. Further research is needed to investigate the underlying mechanisms linking consanguineous marriage to health outcomes such as short stature and to develop effective interventions to mitigate the negative impacts of this cultural practice on health.

Lower Calciferol Level In Diabetic People And Their Association With Glycated Haemoglobin

Rizwana Kalsoom — 2024-06-21

Objective

To investigate the relationship between low calciferol levels and glycated hemoglobin in diabetics with normal blood sugar control.

Methods

Vitamin D (calciferol) levels and HbA1c levels were examined in 110 individuals with type 2 diabetes and a control group, ensuring both groups were similar in terms of gender and age. Calciferol (25(OH)D3) level was determined using the method of radioimmunoassay (RIA) and the High-performance liquid chromatography technique (HPLC) was used to determine the glycosylated hemoglobin (HbA1c) level.

Results

Calciferol levels were found low in the test group (type 2 diabetic patients) 18.16 ± 0.85 ng/ml as compared to the control group 24.38 ±2.01ng/ml with (p≤0.000). The calciferol levels were assessed and it was found that they were inversely related to glycated hemoglobin levels in the test group (r (2) = 0.047, linear regression, p ≤ 0.009,). Calciferol levels were also inversely associated with glycated hemoglobin levels in combined analyzed data of test and control groups (p ≤ 0.001, r (2) = 0.079).

Conclusion

The study determined that the calciferol levels were found with decreased frequency in the diabetic group as compared to the control group and it showed that vitamin D levels have a key role in glycemic control in type 2 diabetic patients. These findings support the idea that type 2 diabetic patients may improve their glycemic control by using vitamin D supplementation.

Morphometric, Histological Variations in the Placenta of Normotensive and Pregnancy Induced Hypertensive Mothers

Falak Naz — 2024-06-21

Objective

To study the macroscopic and microscopic alterations in placenta of pre-eclamptic mother using combination of morphometric and histological analysis.

Methods

This was a retrospective cohort study carried out among pregnant women. The duration of this study was 6 months in a clinical setting of Khyber Teaching Hospital and Anatomy Department of Khyber Medical College Peshawar from the duration of Jan 2021 to 31 Dec 2021. A total of 50 freshly delivered normal normotensive (control group) and 50 pregnancy-induced hypertensives (PIH) mothers (test group) of age limit 18-40 years were examined both grossly and histologically for placenta. Data was collected and analyzed by SPSS version 21.

Result

On gross examination, the morphometric parameters were significantly decreased in test group. Histological study showed the fibrinoid necrosis. Endothelial proliferation and calcification in the present study. The numbers of cotyledons were the same in the control (normotensive) and test (hypertensive) groups.

Conclusion

The study provided valuable insights into the histological and morphometric differences in the placenta of the test and control group. The observed placental variations in the test group were seen as significantly different from the control and it may influence fetal health and the pathophysiology of this condition in pregnant women. It will be more valuable if there are further studies on molecular and genetics having direct implications on these changes and further clinical management among PIH mothers.

The Effect of Vitamin E on Glucose Levels in Diabetic Mice

Saadia Rashid — 2024-06-21

Objective

To evaluate the blood glucose levels in diabetic mice treated with vitamin and those who were untreated.

Methods

It was an Experimental study. This study was conducted in the Anatomy Department of the Army Medical College, from November 2009 to November 2010 in cooperation with (NIH) National Institute of Health, Islamabad. Three groups of thirty mature female BALB/C mice were randomly selected. Group A acted as the study control. Streptozotocin (STZ) was administered intraperitoneally to Group B to cause diabetes. STZ was administered intravenously to Group C, and they had a diet high in Vitamin E (alphatocopherol). All Group’s Serum glucose levels were monitored using a glucometer at the beginning of the trial, after 72 hours following STZ injection, and then after 12 weeks.

Results

There is a considerable change in blood glucose levels between the diabetic group (Group B) and a diabetic group treated with Vitamin E (Group C) respectively. When compared to experimental Group B, Group C’s blood glucose level dropped significantly.

Conclusion

Vitamin E treatment for diabetic mice may have a significant impact on lowering blood glucose levels through the use of antioxidant therapy.

Previous Mode of Education and Future Learning Style Preferences among Medical students: A Cross-Sectional Study

Aqsa Saleem — 2024-06-21

Objective

To find the association of different learning styles with gender and previous mode of education among 1^st and 2^nd year medical students at a private medical college in Lahore, Pakistan.

Method

A cross-sectional study was conducted on 1^st and 2^nd year MBBS students of Shalamar Medical & Dental College. Data was collected using a validated questionnaire comprising 44 questions in four domains, active/reflective, visual/verbal, sequential/global, and sensitive/intuitive.

Results

The total number of participating students was 297, 132 were male and 165 were female. We found that students mostly preferred the active learning style over reflective and sequential over global, sensitive over intuitive, and visual over verbal. We also found that the previous mode of education was significantly associated with active/reflective and sensitive/intuitive.

Conclusion

Most of the students preferred visual overactive, sensitive, and sequential learning styles. The previous mode of education strongly impacts the preference for learning styles in professional academic careers. By adapting the previous mode of education of the majority of students in future institutions, the outcomes of academic scores and conceptual learning can be improved, which is vital to make a good doctor.

Functional Outcome of Cemented Primary Total Hip Arthroplasty

Farmanullah Khan — 2024-06-21

Objective

To determine the efficacy of cemented primary total hip replacement in patients with end-stage hip disease.

Methods

The study was conducted at Khyber Teaching Hospital Peshawar, Pakistan, from March 2022 to January 2024. The study involved 50 males and 23 females and aged 40-80 years, who underwent cemented total hip arthroplasty for end-stage hip diseases. The participants underwent a thorough history, physical examination, and Harris hip score to evaluate their functional ability. All arthroplasties were performed through a modified Hardinge lateral approach using a cemented total hip prosthesis under spinal anesthesia. The patients were mobilized with crutches on the first postoperative day and received intravenous antibiotics for 3 days. The Harris hip score was monitored at 3 months postoperatively and analyzed using SPSS-23 and paired T-test keeping a p-value of ≤ 0.05 as significant.

Results

Most hip involvement was right, with 62% being right hip involvement. Hip pain was the main complaint. The Harris Hip Score was 10-32, with a mean value of 16.50±4.83 preoperatively while postoperatively, in the 3rd month, it was 86.34±9.84 with a p-value of <0.00001 which is significant. The Harris hip score was good to excellent at 82%, fair at 12%, and poor in 5% of cases in 3rd month postoperatively. Complications included skin surgical site infections and dislocations.

Conclusion:

Cemented total hip arthroplasty is a safe and successful treatment for end-stage hip joint diseases, providing patients with the possibility of regaining mobility, reducing discomfort, and improving quality of life with minimum risk of complications.

The Circadian Code: Deciphering the Role of Blood Groups in Sleep Pattern

Jamshed Warsi — 2024-06-21

Objective

To establish the relationship between blood groups and sleep, establish the interference that differences in blood groups have on circadian rhythms, and specifically establish and analyze sleep patterns among blood groups.

Methods

A cross-sectional study was conducted in the Department of Physiology from March 2023 to June 2023, with a sample size of 381 male participants within the age range of 18–24 years. Blood grouping was performed, and a valid questionnaire (PSQI) was employed to determine the quality of sleep.

Results

Among 381 participants, 118 (30.97%) were having good sleep and 263 (69.03%) were suffering from bad sleep. According to the PSQI questionnaire, 54 (14.17%), 114 (29.92%), 32 (8.39%), and 63 (16.53%) were in the A, B, AB, and O blood groups, respectively, and had bad sleep. Furthermore, 234 (61.41%) and 29 (7.61%) were in the in the Rh+ and Rh-blood groups, respectively, and had bad sleep. The highest frequency of bad sleep was found in B+ blood group 105 (27.55%).

Conclusion

Conclusively the highest frequency of bad sleep was found in blood group B and RH⁺.

Hyperuricemia in Acute Coronary Syndrome Patients at Tertiary Care Hospital Peshawar.

Shabina Shafiullah — 2024-06-21

Objective

To investigate the affiliation between elevated uric acid and acute coronary syndrome.

Methods

This descriptive cross-sectional study was conducted over twelve months from June 2022 to May 2023 in the Cardiac Care Unit (CCU) and Pathology Laboratory of Kuwait Teaching Hospital. 201 patients were included, determined using the WHO sample size calculator. Inclusion criteria were patients with typical ischemic chest pain indicative of ACS, irrespective of gender and age, who were willing to participate. Data were collected using a structured preform questionnaire covering demographics, medical history, clinical presentation, and diagnostic findings. Key data included patient age, gender, history of hypertension, diabetes, hyperlipidemia, smoking status, family history of coronary artery disease, and symptoms at presentation. ACS was classified into STEMI, NSTEMI, or Unstable Angina based on ECG and troponin-I levels. Serum uric acid levels were measured after an eight-hour fasting period. Data were entered into Microsoft Excel and analyzed using SPSS version 25, employing descriptive statistics and Chi-square tests, with a p-value of <0.05 considered significant.

Results

A total 201 study participants were enrolled (average age: 57.5 years), with 99 (49%) males. Diabetes mellitus was found in 88 (44% of patients) and hypertension in 83 (41%). In 73 (36%) of the patients, hyperuricemia was seen. Males were more likely to have hyperuricemia (75%) than females 60 (59%), and diabetics were more likely to have it (80%) than hypertensive people 59 (71%). The overall incidence of hyperuricemia in ACS patients was 52%.

Conclusion

Our findings demonstrate the high prevalence of hyperuricemia in persons diagnosed with acute coronary syndrome. Routine monitoring and surveillance of blood uric acid levels in the general population appears to be a viable technique for proactively identifying and addressing anomalies promptly.

Revolutionizing Histopathology: Utilizing Large Language Model for Report Interpretation and Medical Education

Sadia Yaseen — 2024-06-21

The arrival of large language models like Open AI’s ChatGPT, Microsoft’s Copilot and Google’s Gemini AI heralds a revolutionary era in various medical fields including the interpretation of histopathology reports. Histopathology is a foundation in diagnostic medicine which traditionally depends on the skill of a histopathologist to interpret cytology and tissue biopsies. However, a fusion of large language models (artificial intelligence) has enhanced diagnostic accuracy and lessened the workload burden on pathologists especially in human resource-constrained setups. This editorial explores the merits and demerits of integrating large language models for interpreting histopathology reports supported by evidence.