Perceptions of cadaveric dissection in anatomy teaching

Background: Anatomy professors world over are lamenting about medical students' lack of interest in dissections and its diminishing utilisation in medical studies. The objective of our study was to find out the reasons why some of the Pakistani medical students were avoiding dissections. Method: We conducted this study in 5 medical colleges of Pakistan from Dec 2010–Oct 2011. Questionnaires were prepared and administered to more than 500 Pakistani medical students, at least 6 months after their first cadaver dissecting session. Mostly 1 st and 2 nd year medical students participated in this study. Result: Around 43% students have actually performed dissections in some form, whereas around 57% had never touched the cadaver. Further evaluation of these results revealed that out of 57% of students, 45% avoided dissection due to bad smell of formaldehyde, 37% due to moral/ethical grounds, 22% due to low motivation and respect of human body, 19.4% due to anxiety, 18.6% due to religious reason, 16% due to fear, asthma and emotional reaction, 9.4% due to toxic chemical, 8.6% due to laziness and 7% due to nightmares. Conclusion: In spite of availability of required number of cadavers in all 5 medical colleges and a clear realisation amongst the students that dissecting cadaver is an effective way of learning anatomy; majority of students were not very keen and had therefore not performed dissection even once. Keywords: Anatomy, dissection, cadaver, questionnaire, medical student, formaldehyde

Anaemia: the neglected feale health problem in developing countries

Background: Anaemia is arguably the biggest female health problems in developing countries. The world is still to fully fathom the extent and gravity of the problem. This problem aggravates particularly during and after pregnancies due to increased nutritional demands and inadequate iron supply and is therefore more widespread in parous segments of female population. Objective of this study was to determine prevalence of anaemia in apparently healthy parous female population of Abbottabad and investigate underlying causes. Methods: This descriptive, cross-sectional study was conducted from October 2001 to March 2011 in Abbottabad. Women reporting for various surgical procedures were investigated for anaemia by obtaining history through a structured performa, specifically designed to identify the underlying causes. Sixteen thousand women of child bearing age [20–40 years] were included in the study; 14, 800 with history of at least one pregnancy and remaining with no previous pregnancy. Haemoglobin [Hb] was measured using haematology analyser Sysmex [KX21]. Results: Of the screened women, 60% were found anaemic [Hb <12 g/dl] 10% of which were severely anaemic [Hb <6 g/dl]. Anaemia was related to socio-demographic and obstetric history characteristics. The prevalence of anaemia was significantly lower in women who used iron supplements during their pregnancies. Lactating mothers not making up for the iron deficiencies during pregnancies usually carried their anaemia postpartum and beyond. Lower gaps between pregnancies also contributed significantly to the problem. Conclusion: Prevalence and severity of anaemia in reproductive age females reporting to surgical units were found to be exceptionally high. Frequency of anaemia in the parous females of relatively affluent city of Abbotabad indicates that anaemia may be on the rise in developing countries. Addressing pregnancy related anaemia and nutritional deficiencies through intake of supplements on regular basis in women before and between pregnancies is essential. Keywords: Anaemia, Reproductive age, nutritional deficiency, parous, Lactation

Comparative therapeutic response to pegylated interferon plus ribavirin versus interferon alpha-2b in chronic hepatitis C patients

Hepatitis C is an epidemic worldwide since discovery in 1989. Conventional interferon alpha-2b plus Ribavirin therapy was started in 1998 but over all sustained viral response [SVR] rates are much below the desired rates to eradicate the diseases and stopping its epidemic. This study was conducted to access the therapeutic and cost-effectiveness of long acting pegylated interferon alpha-2b plus Ribavirin therapy verses conventional interferon alpha-2b plus Ribavirin. This comparative study was done at PAF Hospital Shorkot Cantt from July 2005 to July 2008. One hundred anti-HCV positive patients were selected randomly for the study according to willingness due to cost affordability of the patients for conventional interferon. Group-A was labelled as pegylated interferon alpha-2b plus Ribavirin group, and Group-B interferon alpha-2b plus Ribavirin group. Both groups were given treatment for 24 weeks. Early virological response [EVR] was accessed at 12 weeks of treatment. Sustained virological response [SVR] in both the groups was done at 24[th] week during the treatment and 6 monthly after treatment for 2 years. Initially non-responders and relapsed patients within 2 years of treatment were re-treated for 24 weeks with the same treatment. In both groups nonresponders and relapsed patients were labelled as resistant patients. Both groups were followed with same protocol for 2 years. Out of 100 patients included in the study, 34% were females and 66% were males. Group-A patients over all showed 94% SVR as compare to 80% in Group-B in 2 year follow-up. Group-A showed 6% resistant patients as compare to Group-B [20%]. Conventional interferons were better tolerated. Higher incidence of side-effects was seen in Group-A. Pegylated interferon plus Ribavirin showed 94% SVR in 2 years. Pegylated interferon plus Ribavirin is the treatment of choice

Comparison of lipid profile and apoprotein in sedentary workers and those involved in regular exercise

One of the important effects of exercise on human body is on the metabolic system especially on lipids; elevated lipids and lipoprotein are risk factors for coronary heart disease. This case-control study was conducted to compare the lipid profile and apo-protein B levels in sedentary workers and subjects involved in regular exercise. The study was conducted at Women Medical College Abbottabad, from July 2004 to January 2005. Subjects were civilians and army men involved in regular exercise for more than 6 months duration [test group] and sedentary workers [control group]. The age, body weight, height, waist hip ratio and other related findings were recorded on a special proforma. Fasting blood samples were taken and were analyzed for lipid profile and apoprotein B levels. Statistical analysis was done by the Chi square and the Student t tests and level of significance was recorded. The subjects comprised 29 army men, 24 civilians and 39 sedentary workers. Significant differences were found between the control and test groups for WHR, total cholesterol, HDL, LDL, Triglycerides, Apo B, and Cholesterol/HDL ratio; in addition the civilian group also showed significant differences from the control group in BMI values. Although LDL levels were lower in army than sedentary group, the difference was statistically nonsignificant. Significant differences were found between the army and civilian groups in age, HDL, Triglycerides and Apo B values. Long term aerobic exercise has beneficial effects in decreasing Apo- protein B levels, LDL levels and total cholesterol /HDL ratio. Exercise habits should be encouraged in general population to decrease the cardiovascular disease risk