Students’ Perspective of Online Medical Education in India during COVID - 19 Pandemic: The need for Rural - Urban Equity

Background: Sudden shifting of medical education to online mode during COVID presented several challenges for teachers and students. It was complicated by differences in resources between rural and urban India. We assessed perception of medical students for online education and difference in these between students of rural and urban areas . Materials and Methods: A cross - sectional pan India online survey was conducted amongst undergraduate medical students. Responses were collected for one week during May 2021. Results: 1125 students from 52 medical colleges responded. 85% of students already had device for online classes. Non - urban students were more affected by network interruptions. 85% students complained of eye p roblems while 71% complained of postural issues. 77% of students did not have practical training, with problem increasing in higher professional years. Interaction with teachers and classmates was another area of concern highlighted by most of the students . Conclusions: Internet connectivity, health issues and practical training are major concerns of medical students for online education. We need to ensure that non - urban residents are not at a disadvantage due to lack of infrastructure in non - urban areas. M edical institutions also need to innovate for two - way interaction between students and teachers

In vitro antioxidant and anti-cancer activities and phytochemical analysis of Commelina benghalensis L. root extracts

Objective: To explore antioxidant potential, anti-cancer activity, and phytochemicals of Commelina benghalensis L. Methods: The roots of Commelina benghalensis were extracted in different solvents (methanol, ethanol, benzene, chloroform, n-hexane) with a range of polarity. Antioxidant activity was evaluated by reducing power assay, DPPH radical scavenging activity and phosphomolybdenum method, cytotoxicity by MTT assay, apoptotic and cell cycle analysis by flow cytometry, migratory and invasive potential by wound scratch assay and invasion assay, respectively, functional groups analysis by FT-IR spectroscopy and phytochemicals by aluminum chloride colorimetric and Folin-Ciocalteu methods. Results: The extracts showed worthy antioxidant potential. The chloroform extract demonstrated the most significant cytotoxic effect on MDA-MB-231 (breast cancer) cell line, induced apoptosis and reduced migratory and invasive potential of MDA-MB-231 cells. Methanol and ethanol extracts presented good yield of total phenolic and total flavonoid contents. The FTIR spectroscopic studies revealed different characteristic peak values with various functional compounds such as alkenes, alkanes, aliphatic amines, aromatics, alkyl halides, carboxylic acid, alcohols, ester, aldehydes and ketones. Conclusions: The results demonstrate the potential use of Commelina benghalensis as a good antioxidant with significant anti-cancer effect.

Silymarin-Laden PVP-Nanocontainers Prepared Via the Electrospraying Technique for Improved Aqueous Solubility and Dissolution Rate

Abstract The aim of the present research was to develop a silymarin-laden PVP-nanocontainer providing ameliorated aqueous solubility and dissolution of the drug. Several silymarin-laden formulations were formed with varying quantities of PVP and SDS via the solvent evaporation method using the electrospraying technique. The influence of the hydrophilic carriers on solubility and dissolution was explored. The solid-state characterization was carried out by particle-size analysis, PXRD, DSC, FTIR and SEM. All of the formulations demonstrated better solubility and dissolution than did silymarin plain powder. Both the SDS and PVP had positive effects on solubility and dissolution of silymarin in the aqueous media. An increased solubility was attained as the drug/PVP ratio was 1/4; however, further increase in PVP did not provide significant improvement. In particular, a nanocontainer formulation prepared with silymarin, PVP and SDS (1/4/0.5, w/w/w) exhibited the best solubility (26432.76 ± 1749.00 μg/mL) and an excellent dissolution (~92 % in 20 min) than did silymarin plain powder. Also, it demonstrated similar dissolution profiles compared to a commercial product; therefore, might be bioequivalent to the commercial product (f 1 = 3 and f 2 = 69). Moreover, cumulative undersize distribution values as represented by X10, X50 and X90 were 201 ± 21.01 nm, 488 ± 36.05 nm and 392 ± 48.10 nm, respectively. The drug existed in the amorphous state in the PVP-nanocontainers with no strong chemical bonding with other excipients. Thus, this formulation might be used for more effective administration of silymarin via the oral route.

Silymarin-laden PVP-PEG polymeric composite for enhanced aqueous solubility and dissolution rate: Preparation and in vitro characterization / 药物分析学报

The aim of this work was to develop, optimize and characterize a silymarin-laden polyvinylpyrrolidone (PVP)-polyethylene glycol (PEG) polymeric composite to resolve low aqueous solubility and dissolution rate problem of the drug. A number of silymarin-laden polymeric formulations were fabricated with different quantities of PVP K-30 and PEG 6000 by the solvent-evaporation method. The effect of PVP K-30 and PEG 6000 on the aqueous solubility and dissolution rate was investigated. The optimized formula-tion and its constituents were characterized using powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) techniques. Both the PEG 6000 and PVP K-30 positively affected the aqueous solubility and dis-solution rate of the drug. In particular, a formulation consisting of silymarin, PVP K-30 and PEG 6000 (0.25/1.5/1.5, w/w/w) furnished the highest solubility (24.3972.95 mg/mL) and an excellent dissolution profile (～100％ in 40 min). The solubility enhancement with this formulation was ～1150-fold as com-pared to plain silymarin powder. Moreover, all the constituents existed in the amorphous state in this silymarin-laden PVP-PEG polymeric composite. Accordingly, this formulation might be a promising tool to administer silymarin with an enhanced effect via the oral route.

Status of Lipid Profile in Hypertensive Patients of A, B, O and AB Blood Groups

Background: Hypertension is the most common illness of circulatory system and is a worldwide health challenge affecting both developed and developing nations. The development of hypertension is a multi-factorial process and the risk factors for its development are many such as genetic factors, obesity, age & sex factors, salt sensitivity, dyslipidemia, hyperinsulinemia & insulin resistance, environmental factors, socio economic imbalances, free radicals/reactive Oxygen species, oxidative stress, blood groups etc. The role of blood groups in the etiology of essential hypertension has long been suspected. Methods: The study design was a cohort study consisting of 15 hypertensive patients of the A, B, AB and O each. Anthropometric parameters such as Blood pressure (SBP/DBP) and Body Mass Index (BMI) and Biochemical parameters such as Blood grouping, Blood Glucose levels, Haemoglobin levels, Lipid profile, which included Triglycerides, Total cholesterol, HDL cholesterol and LDL and VLDL cholesterol, were measured using standardized methods. The various parameters were compared between hypertensives of the various blood groups and statistical analysis was done using SPSS. Mean and SD of each group was calculated, and Unpaired student’s t-test was applied (P < 0.05 considered as significant). Results: When BMI was compared among hypertensive groups we observed significant increased level of BMI in group A as compared to group O hypertensives. (10.36%; P<0.05). While comparing SBP between hypertensive groups we observed significant raised level of SBP in group A as compared to group B (9.38%; P<0.01) and O (10.45%; P<0.01). Similarly, DBP was found to be increased significantly in group A as compared to group B ((5.34%; P<0.05) and O hypertensive patients (5.06%; P<0.001). LDL-C and HDL-C were non-significantly altered in these groups however value of VLDL-C was found increased in group A as compared to group O hypertensives (20.38%; P< 0.05). Conclusion: The study concluded that there is a significantly higher SBP and DBP in the hypertensives of the A blood group as compared to the hypertensives of the B and O blood groups. It also found increased levels of serum triglycerides, total cholesterol, LDL-C, VLDL-C along with decreased levels of HDL-C was in hypertensive patients predominantly in group A and AB hypertensive. The hypertensive patients of A blood group have shown a statistically significant increase in BMI as compared to hypertensives of the other blood groups.

Plant-derived anticancer agents: A green anticancer approach

Cancer is a frightful disease and represents one of the biggest health-care issues for the human race and demands a proactive strategy for cure.Plants are reservoirs for novel chemical entities and provide a promising line for research on cancer.Hitherto,being effective,chemotherapy is accompanied by certain unbearable side effects.Nevertheless,plants and plant derived products is a revolutionizing field as these are Simple,safer,ecofriendly,low-cost,fast,and less toxic as compared with conventional treatment methods.Phytochemicals are selective in their functions and acts specifically on tumor cells without affecting normal cells.Carcinogenesis is complex phenomena that involves many signaling cascades.Phytochemicals are considered suitable candidates for anticancer drug development due to their pleiotropic actions on target events with multiple manners.The research is in progress for developing potential candidates (those can block or slow down the growth of cancer cells without any side effects) from these phytochemicals.Many phytochemicals and their derived analogs have been identified as potential candidates for anticancer therapy.Effort has been made through this comprehensive review to highlight the recent developments and milestones achieved in cancer therapies using phytomolecules with their mechanism of action on nuclear and cellular factors.Furthermore,drags for cancer treatment and their limitations have also been discussed.

Molecular Characterization of a MYB Protein from Oryza sativa for its Role in Abiotic Stress Tolerance

ABSTRACT The MYB family represents one of the most abundant classes of transcriptional regulators that perform pivotal role under different developmental processes and abiotic stresses. In present study, a MYB gene from Oryza sativa was selected for functional characterization. Bioinformatics analysis revealed that OsMYB1 cDNA encodes R2-R3 type DNA binding domain consisting of 413 amino acids having size of 44 kDa and pI of 6.24. DNA binding domain containing region was cloned and over-expressed in E. coli. Then, the survival of pGEX-OsMYB1 transformed E. coli cells was compared with control plasmid under different concentrations of NaCl, mannitol, high and low temperature. pGEX-OsMYB1 enhanced the survival of cells at high temperature and salinity. Electrophoretic mobility shift assays (EMSAs) have shown that recombinant OsMYB1 protein was able to bind with DIG labeled probe containing MYB binding site. RT-qPCR analysis revealed high MYB1 expression under wounding, salt, drought and heat stresses in rice. Expression was 23 fold higher in response to wounding demonstrating the worth of OsMYB1 up-regulation in wounding. Intrinsic disorder profile predicted that OsMYB1 exhibits 60% degree of intrinsic disorder proposing that these regions might be involved in DNA binding specificity and protein-protein interaction. The positive response of OsMYB1 suggests that its over-expression in crop plants may help in providing protection to plants to grow under abiotic stresses.

Free Radical Scavenging and Cyto-protective Activity of Ethanolic Extract of Nigella Sativa Seeds

Introduction: Free radicals and the oxidative stress have been implicated in a large number of chronic disorders such as Diabetes mellitus and its late complications, Cardio vascular disease, Arthritis also in some acute conditions such as the hemolytic disease in Glucose 6 Phosphate Dehydrogenase (G 6 PD) deficiency, where free radicals play a direct cytotoxic role causing cellular damage. Various exogenous substances have been found to be of great use for the purpose of scavenging free radicals. These includes micro nutrients such as vitamins eg. Vit C, Vit A etc or other dietary agents polyphenols, flavenols, tannins etc. In traditional medicine certain food items and their extracts are considered useful in combating conditions such as diabetes mellitus, Cardio vascular diseases etc and their long term complications that are caused by oxidative stress. Nigella Sativa seeds are one such condiment used in food in south east, central Asia and middle east and also used in ancient Indian (Ayurveda) and Greeko-arabic (Unani) systems of medicine. Material and Method: The objective of this study is to quantify the free radical scavenging and Cytoprotective effects of ethanolic extract of Nigella Sativa seeds. To measure the free radical scavenging activity DPPH free radical scavenging assay was used. To measure cyto-protective effects of Nigella Sativa seed extract, an AAPH assay was used with the Cyto-protective effect being measured on RBCs (Red blood cells) suspended in PBS buffer. Results: In the DPPH assay the ethanolic extract of Nigella Sativa seeds showed significant free radical scavenging activity. The activity was concentration dependent. Conclusion: In AAPH RBC lysis assay the ethanolic extract of Nigella Sativa seeds did show considerable protective effect against AAPH induced RBC lysis. Once again the activity was concentration dependent.

Fabrication and Characterization of Gliclazide Loaded Microcapsules

This study aimed to formulate, characterize and evaluate the Gliclazide (GLZ) microcapsules prepared with sodium alginate, guar gum and pectin in different ratios by ionotropic-gelation method. The microcapsules were evaluated against different parameters such as particle size and shape, Carr's index, Hausner's ratio, rheological studies and drug release kinetics. Fourier Transform Infra Red (FTIR) and Differential Scanning Calorimetric (DSC) studies demonstrated the absence of any drug - polymers interaction. Promising characteristics were observed in rheological behavior and release kinetics. The size of microcapsules and percentage yield was in the range of 676 to 727 µm and 69 to 77%, respectively. Scanning electron micrographs revealed that microcapsules were discrete, spherical and free flowing. Entrapment efficiency and uniform drug release kinetics were some of the probable characteristics depicting the novel formulation design of Gliclazide microcapsules.

Fabrication, physicochemical characterization and preliminary efficacy evaluation of a W/O/W multiple emulsion loaded with 5% green tea extract

Complex multiple emulsions have an excellent ability to fill large volumes of functional cosmetic agents. This study was aimed to encapsulate large volume of green tea in classical multiple emulsion and to compare its stability with a multiple emulsion without green tea extract. Multiple emulsions were developed using Cetyl dimethicone copolyol as lipophilic emulsifier and classic polysorbate-80 as hydrophilic emulsifier. Multiple emulsions were evaluated for various physicochemical aspects like conductivity, pH, microscopic analysis, rheology and these characteristics were followed for a period of 30 days in different storage conditions. In vitro and in vivo skin protection tests were also performed for both kinds of multiple emulsions i.e. with active (MeA) and without active (MeB). Both formulations showed comparable characteristics regarding various physicochemical characteristics in different storage conditions. Rheological analysis showed that formulations showed pseudo plastic behavior upon continuous shear stress. Results of in vitro and in vivo skin protection data have revealed that the active formulation has comparable skin protection effects to that of control formulation. It was presumed that stable multiple emulsions could be a promising choice for topical application of green tea but multiple emulsions presented in this study need improvement in the formula, concluded on the basis of pH, conductivity and apparent viscosity data.

Emulsões múltiplas complexas possuem excelente habilidade de agregar grandes quantidades de agentes cosméticos funcionais. Este estudo teve por objetivo encapsular grandes volumes de chá verde em uma emulsão múltipla clássica e comparar sua estabilidade com a emulsão múltipla sem o extrato do chá verde. Emulsões múltiplas são desenvolvidas usando cetil dimeticona copoliol como emulsificante lipofílico e o clássico polissorbato-80 como emulsificante hidrofílico. As emulsões múltiplas foram avaliadas por meio de vários aspectos fisico-químicos como condutividade, pH, análise microscópica e reologia. Estas características foram observadas por um período de 30 dias sob diferentes condições de armazenamento. Testes de proteção da pele in vivo e in vitro foram realizados para ambos os tipos de emulsões testadas, i.e. com o ativo em estudo (MeA) e sem ativo (MeB). Ambas as formulações apresentaram características comparáveis no que diz respeito aos diferentes fatores físico-químicos avaliados sob diferentes condições de armazenamento. A análise reológica mostrou que as formulações apresentaram comportamento pseudo-plástico sob contínuo estresse de cisalhamento. Os resultados dos testes in vivo e in vitro sobre a proteção da pele revelaram que a formulação ativa promoveu efeitos comparáveis à formulação controle. Nossos dados mostraram que emulsões múltiplas estáveis poderiam ser escolhas promissoras para a aplicação tópica do chá verde. Entretanto, a fórmula das emulsões múltiplas apresentadas neste estudo precisam ser melhoradas no que diz respeito ao pH, condutividade e viscosidade aparente.

Study of parameters to ensure quality control in histopathology reporting: A meta-analysis at a tertiary care center.

Context : When surgical pathology reports are dispatched to patients and clinicians, sometimes they are discovered to have errors, and it is a common practice for the pathologists to issue amended reports. Measuring the rate at which surgical pathology reports are amended can be used as a tool for assuring quality control in histopathology. Aim : The aim of this study was determine the parameters that can be used as an assessment tool to minimize errors in histopathology. Materials and Methods : This study was carried out at a major histopathology center. The duration of this study was from January 2001 through January 2011(ten years). Following parameters were looked for: Interpretational errors, permanent and frozen section correlation, intradepartmental consultation and cases sent for second opinion, cases brought in tissue committee meetings, audits, and cases discussed in hospital meetings. Results : A total of 28,1931 surgical pathology cases were signed out during the ten-year period. On these, addendums were issued on 5730 cases (2.0%). Additional report issued on 3521 (1.3%). Addendum/corrected report issued for 2209 cases, which was 0.7%, representing the true interpretational error. And out of this number, a second opinion was taken for 5980 cases, and 78 were sent abroad for second opinion. Conclusion : Review by a second pathologist is a strong tool to minimize errors in surgical pathology reporting. This may be done prior to or after the report is dispatched and the case is discussed in the hospital for treatment purposes. This analysis concludes that true interpretational error occurred only in 0.7% of cases, which is an attribute to the strong peer review in the department.

Clinico-epidemiological pattern of cutaneous leishmaniasis in armed forces personnel fighting war against terrorism in Khyber Pakhtunkhwa Province and FATA regions

Cutaneous leishmaniasis [CL] is endemic in various regions of Khyber Pakhtunkhwa [KPK] province and Federally Administered Areas [FATA]. Troops deployed in these regions are at an increased risk of acquiring the disease as compared to the native population. To determine clinical and epidemiological pattern of CL in armed forces personnel serving in endemic areas of CL in KPK and FATA. This observational/descriptive study was conducted at CMH, Peshawar from January, 2010 to June, 2010. All patients of any age reporting in skin outdoor with clinical diagnosis of CL were enrolled in the study and all were subjected to skin slit smears for Leishman-Donovan [LD] bodies and skin biopsies were also taken in all cases to observe histopathological features. Patients in whom clinical diagnosis was not supported by laboratory diagnosis, were excluded. Clinical and epidemiological data was recorded and finally analyzed by using descriptive statistics. Out of 172 initially enrolled cases, 2 were excluded from the study as their clinical diagnosis was not supported by laboratory findings. All patients were young males [deployed armed forces personnel]. Their ages ranged from 18 to 43 [mean age: 27.4 years]. Number of lesions ranged from 1-11. Multiple lesions were seen in 41.2% cases only. Size of lesions ranged from 1-13 cm. 70.6% of lesions were seen on upper and lower limbs followed by head and neck region 27.6%, and trunk and abdomen 1.8%. Morphological patterns seen were crusted plaques, psoriasiform plaques, nonhealing ulcers, erythematous infiltrated nodules and papules. Majority of the cases were from the regular army units deployed in the areas in recent past [71.8%] as compared to 28.2% of native troops of Frontier Corps [FC]: 3% deployment of regular troops against 0.5% of FC troops. CL is common in soldiers serving in KPK province and FATA regions of Pakistan. Armed forces personnel who moved from central Punjab and deployed in these areas for operations against terrorists are at much higher risk of acquiring the disease as compared to the native troops. This risk can be decreased by implementing effective precautionary measures and education of the soldiers

EDTA contamination in laboratory specimens-effect of an awareness campaign

To measure the effects of awareness campaign on the frequency of EDTA contamination. A cohort study. The study was carried out in Combined Military Hospital, Peshawar, from October to December 2008. A cohort of 200 doctors, nurses and paramedical staff involved in sample collection for laboratory investigations were selected for this three phased study. In all samples with plasma potassium level>6.0 mmol/L, plasma Ca++ was measured for one month before, during and after a campaign of correct filling order of sample tubes for two weeks. Renal function test and LDH were also measured to rule out chronic renal failure and in-vitro haemolysis, respectively. Fisher's exact test was used for comparison of frequency of hyperkalemia. There was a significant decrease [75%, p<0.01] in the cases of spurious hyperkalaemia and hypocalcaemia. EDTA contamination is a common and important source of pre-analytical error which can be prevented to some extent by education of medical and nursing staff

Multiple pulses improve electroporation efficiency in Agrobacterium tumefaciens

Electroporation entails brief, high intensity pulse to create transient pores in the cell membrane to facilitate the entry of exogenous macromolecules, which may otherwise be excluded. Removal of the external field leads to the resealing of the membrane electropores permitting the survival of the electrically stimulated recipient cells. Using this technique foreign deoxyribonucleic acid (DNA) has been successfully introduced into many cell types both from prokaryotes and eukaryotes. Increase in pulse voltage and length beyond a critical limit has been reported to decrease transformation efficiency, hence in this study we have investigated another strategy i.e. increase in the number of pulses at constant high voltage and pulse duration. Commonly used Agrobacterium strains LBA4404 and EHA101 and binary vector pCAMBIA1301 were used. Transformants were selected on a combination of hygromycin and kanamycin, and confirmed by polymerase chain reaction (PCR) and restriction analysis. Increase in the number of pulses was found to show a significant and linear increase in transformation efficiency.

Adverse effects of smoking in the flyers of Pakistan air force

This study was carried out to assess the adverse effects of smoking on pilots at PAF Base Sargodha. 73 Aircrew were included in the study. 28 pilots, 28/73 [38.35%] were found to be smokers. 57% of pilots reported high frequency of upper respiratory tract problems per year. 100% reported altered taste sensation. 78% reported dyspepsia/heartburn. The study recommends that all aircrew who smoke must quit smoking as it affects almost all body systems