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Purpose@#The perception of faculty members about an individually tailored, flexible-length, outcomes-based curriculum for undergraduate medical students was studied. Their opinion about the advantages, disadvantages, and challenges was also noted. This study was done to help educational institutions identify academic and social support and resources required to ensure that graduate competencies are not compromised by a flexible education pathway. @*Methods@#The study was done at the International Medical University, Malaysia, and the University of Lahore, Pakistan. Semi-structured interviews were conducted from 1st August 2021 to 17th March 2022. Demographic information was noted. Themes were identified, and a summary of the information under each theme was created. @*Results@#A total of 24 (14 from Malaysia and 10 from Pakistan) faculty participated. Most agreed that undergraduate medical students can progress (at a differential rate) if they attain the required competencies. Among the major advantages mentioned were that students may graduate faster, learn at a pace comfortable to them, and develop an individualized learning pathway. Several logistical challenges must be overcome. Providing assessments on demand will be difficult. Significant regulatory hurdles were anticipated. Artificial intelligence (AI) can play an important role in creating an individualized learning pathway and supporting time-independent progression. The course may be (slightly) cheaper than a traditional one. @*Conclusion@#This study provides a foundation to further develop and strengthen flexible-length competency-based medical education modules. Further studies are required among educators at other medical schools and in other countries. Online learning and AI will play an important role.
ABSTRACT
Background: Chronic liver disease has remained a major threat to human health. Hepatitis C patients administered combined interferon with ribavirin therapy, and lacking vitamin-D, are susceptible to extra-hepatic manifestations, particularly autoimmune thyroid disorders [AITDs]. The present study was designed to assess the effects of interferon and vitamin D in attaining sustained virological response in autoimmune thyroid disorders
Methods: Seventy-five patients of HCV of age 25-70 years were enrolled and screened at Ganga Ram Hospital Lahore, and 50 age and sex matched healthy individuals served as control. Their sera were separated and estimated for thyroid profile, lipid peroxidation and Vitamin D. Real time HCV PCR was performed with the serum of patients before and after the therapy
Results: Variables of oxidative and inflammatory like malondialdehyde [MDA], interleukin-6 [IL-6] and tumour necrosis factor alpha [TNF-alpha] differed significantly. The levels of MDA [3.68+/-1.14 etamoles/ml], IL-6 [6.80+/-0.79 pg/mI] and TNF-alpha [31.95+/-4.35 pg/ml] were recorded in HCV patients. The thyroid profile of HCV patients showed highly significant differences among the studied groups [FT4 [10.11+/-1.93], FT3 [19.18+/-2.06], and TSH [19.68+/-2.09] pmol/ml]. Higher levels of thyroid antibodies were recorded in HCV patients subjected to interferon therapy. The levels of vitamin D [9.36+/-1.22 etag/ml] in HCV patients differed significantly compared to controls [13.22+/-0.81 etag/ml]
Conclusion: Hepatitis C patients receiving interferon therapy and deficient in vitamin D dysregulate autoimmune response rendering them to develop thyroid disorders
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A multi-centred study was designed to collect dengue epidemiologic data from government and registered private hospitals/clinics and maintained archive of frozen specimens in bio-bank to be used for future dengue epidemic control program, and assess the epidemiology of dengue fever (DF) by evaluating biochemical and oxidative status of patients. ELISA IgM antibodies test was done to confirm DF. From August 2010 to December 2011, 101 confirmed blood samples of DF patients referred to pathology lab of Jinnah Hospital Lahore were subjected to the epidemiologic assessment by evaluating the biochemical and physiological indices and alterations of circulating antioxidants. Clinical features of DF patients and effect of fever on blood components and serum proteins of liver were recorded. The hospital stay in DF, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) showed significant difference. Significant increases in serum alanine amino transferase (ALT) (P=0.000), aspartate amino transferase (AST) (P=0.000), alkaline phosphatase (ALP) (P=0.000), malondialdehyde (MDA) along with significant decreases in total protein (TP) (P=0.000), reduced glutathione (GSH) (P=0.000), superoxide dismutase (SOD), catalase (CAT) (P=0.000), and sialic acid contents (P=0.016) were observed. A positive correlation existed between bound sialic acid levels, liver enzymes and circulating antioxidants (r=0.656, P=0.016). In the present study, alterations of circulating antioxidants in DF suggest that DF might be a metabolic response to an acute, self-limiting tropical viral infection, and a consequence of the viral inflammatory process.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Antioxidants , Metabolism , Biomarkers , Blood , China , Dengue , Classification , Diagnosis , Metabolism , Diagnosis, Differential , Immunoglobulin M , MetabolismABSTRACT
All over the world Hepatitis C virus [HCV] remains to be a main etiological mediator of liver disease. Approximately, 10 million people in Pakistan are diseased with HCV. Pegylated interferon plus ribavirin signifies the gold standard therapy but various side effects may occur. Comparative study. This study was conducted at Jinnah Hospital Lahore from August 2013 to March, 2014. Thirty five patients of hepatitis C virus and Twenty three age and sex-matched clinically apparently healthy individuals were eligible for inclusion in the study at Jinnah Hospital Lahore during the year 2013-2014. 1.0 ml blood sample were taken and subjected to centrifuge at 3000-4000 rpm for 10-15 minutes for the separation of serum. All the analytical work was performed at the Institute of molecular biology and biotechnology [IMBB], and Centre for research in molecular medicine [CRiMM], The University of Lahore-Pakistan. The estimation of AST, ALT, ALP, TP and T.Bilirubin were estimated. The AST level in HCV patients was increases [47.88 +/- 40.49] as compared to the control persons [31.43 +/- 7.31] and statistically significant [0.02<0.05]. Total Protein level in HCV patients was [4.20 +/- 0.61] and in healthy individuals [6.23 +/- 0.51] and statistically significant [0.000<0.05]. MDA level in HCV patients was increases remarkably [8.58 +/- 1.19] and in control persons [1.47 +/- 0.54] and it was statistically significant [0.000<0.05]. There is a relationship between oxidative stress and ALP, ALT, AST and Albumin. The results of the present study confirmed a perfect sketch regarding the circulating biochemical markers and lipid peroxidation [MDA] profile between the studied groups i.e., control and HCV patients with interferon induced Hepatitis C virus infection
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Background: Oxidative stress and antioxidative status caused by hepatitis C therapy plays a significant role in aggravating the disease. A number of reactive oxygen species are responsible for the damaging of cell machinery and ultimately disturbing the homeostasis of the cell
Objectives: To assess enzymatic, non-enzymatic antioxidants and circulating biomarkers in HCV patients receiving interferon therapy
Methods: Study subjects were divided into two groups; patients and controls. The levels of the Thiobarbituric acid reactive substances [TBARS, as a marker of lipid peroxidation], superoxide dismutase [SOD], glutathione [GSH], catalase [CAT] and lipid peroxidation product [MDA] in the serum were estimated
Results: There was statistically difference between patients and healthy controls in levels of CAT[p< 0.000**], SOD[ p< 0.000**], GSH [p< 0.000**] and MDA[p< 0.000**]. Similarly, the levels of ALT [p< 0.048*], AST [p< 0.005*] and ALP [p< 0.000**] were also statistically different between two groups
Conclusion: Imbalanced levels of superoxide dismutase, catalase, reduced glutathione, MDA and serum enzymes [e.g. ALT, AST, ALP] revealed that interferon itself play a crucial rule in disturbing oxidative vs. antioxidative status which ultimately results in tissue damaging. Increased levels of MDA have a significant correlation with disease development during the course of therapy
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Objective: The Urticaria caused by NSAIDs wasstudied for their antioxidant enzyme activity andmalondialdehyde [MDA] concentration
Methodology: Patients were divided into twogroups; group one act as a control and the remaininggroup was urticaria patients. The levels of theThiobarbituric acid reactive substances [TBARS, asa marker of lipid peroxidation], superoxidedismutase [SOD], glutathione [GSH] and catalase[CAT] in the serum were estimated. The enzymaticactivity was estimated and compared with differentcategories of NSAIDs
Results: In present studyCAT, SOD and lipid peroxidation product [MDA]were statistically different from that of healthycontrol and showed significant changes [p< 0.05]while GSH showed a non-significant [p>0.05]value
Conclusion: It is concluded thatantioxidative system of the body is accelerated andshows variations in the patient of Urticaria.Moreover, present study shows the co-ordinatedenzymatic mechanism and the interrelationshipbetween enzymatic activities in allergy