Role of Mutation of NOTCH1 gene in development of oral squamous cell carcinoma: a narrative review.

Cancer of the oral cavity has numerous types and, among all, oral squamous cell carcinoma represents >90% of all cancers of the oral area. Oral squamous cell carcinoma arises from the squamous lining of the oral cavity. Across the globe, most commonly it develops in the regions of tongue followed by floor of the mouth, and lower lip. Neurogenic locus notch homolog protein 1 gene has its association with oral squamous cell carcinoma and is known to be associated with both oncogenic and tumour suppressor roles. The current narrative review comprised literature published from 2013 to 2023. It was searched on Google Scholar, PubMed and Google databases. Globally, neurogenic locus notch homolog protein 1 mutations are associated with the development of oral squamous cell carcinoma. Most of the mutations are linked to ligand bind epidermal growth factor-like repeat region of extracellular domain of neurogenic locus notch homolog protein 1. Once activated, the pathway is involved in tumour progression and metastasis. The Asians compared to Caucasians are more affected by neurogenic locus notch homolog protein 1 mutations.

Effectiveness of problem-based learning strategies compared to conventional anatomy teaching approaches.

Objectives: To determine the effectiveness of problem-based learning compared to conventional teaching strategies, and to determine the impact of sub-disciplines of Anatomy on learning outcomes of the subject. METHODS: The cross-sectional, descriptive study was conducted at Bahria University Health Sciences, Karachi, from August to October 2022, and comprised 1st and 2nd year medical students and 1st year dental students of either gender who were being taught by the hybrid method including both conventional and problem-based learning strategies. Data was collected using a questionnaire circulated through Google Forms. It had close-ended questions that were scored on a Likert scale. Anatomy sub-disciplines explored were gross, embryology and histology. Data was analysed using SPSS 23. RESULTS: Of the 251 subjects, 125(49.8%) were males and 126(50.2%) were females. The overall age ranged aged 18- 23 years. There were 115(45.8%) 1st year medical students, 111(44.2%) 2nd year medical students and 25(10%) 1st year dental students. Among 1st year medical students 60(52.17%), among 2nd year medical students 64(57.6%) and among 1st year dental students 14(56%) respondents favoured problem-based learning compared to conventional methodology. Highly significant results were obtained regarding need of topic revision (p<0.001), whether knowledge of conventional teaching method is enough for understanding the clinical scenarios (p=0.017, whether pictures shown during the problem-based learning sessions were enough for understanding anatomy (p=0.035), relevance of questions in oral structured practical examination (p=0.019) and viva (p=0.002). When the participants were asked regarding the anatomy sub-discipline that required revision for comprehensive learning, 72(28.3%) mentioned gross anatomy. CONCLUSIONS: Students considered problem-based learning to be more inducive in enhancing learning compared to conventional teaching.

Clinical assessment of absence of palmaris longus muscle and its association with ethnicity.

OBJECTIVE: To compare two clinical tests used for assessment of absence of palmaris longus, and to determine the prevalence of the absence of palmaris longus among ethnic groups in a cosmopolitan setting. Methods: The cross-sectional descriptive study was conducted at the Bahria University Health Sciences, Karachi, from April 2021 to May 2022, during which forearms belonging to Sindhi, Punjabi and Urdu-speaking ethnic groups were tested. Assessment of presence or absence of palmaris longus was performed using Schaeffer's and Thompson's tests. Agenesis and association of ethnicity and agenesis were compared. Data was analysed using SPSS 23. RESULTS: Of the 250 subjects, 152(60.8%) were females and 98(39.2%) were males. The overall mean age was 20.4±2.23 years (range: 18-23 years). In terms of ethnicity, 100(40%) subjects each were Punjabis and Urdu-speaking, while 50(20%) were Sindhis. The total forearms assessed were 500. The overall agenesis was 186(37.2%). When the two assessment tests were compared, highly significant differences were noted (p<0.000). Overall agenesis was highest among Sindhis 40%, followed by 38% in Punjabis, and 35% in Urdu-speaking. Significant differences were observed when one-sided palmaris longus absence was compared with two-sided absence (p<0.037). Conclusion: Schaeffer's test had more accuracy compared to the Thompson's test in the determination of palmaris longus agenesis. There were variations in terms of agenesis among the ethnic groups.

Anatomical insight into the variable terminal branching pattern of brachial artery: A narrative review.

Blood to the arm is mainly supplied by the brachial artery, which arises at the termination point of the axillary artery at the level of inferior margin of the teres major muscle. The artery ends by dividing into two terminal branches: radial and ulnar. The bifurcation normally takes place at the cubital fossa or around a finger's width below elbow at the level of the neck of the radius bone. For the current narrative review, literature published from 2016 to 2022 was searched on PubMed, Google and Google Scholar databases. Across the globe, variation in terminal branching pattern of the brachial artery was observed. In most cadavers, higher termination was observed in the right upper limb. The variability can have adverse effects on the diagnostic, therapeutic and interventional procedures. As such, awareness of the varying anatomical location of the branches is essential for medical practitioners to avoid procedural errors and misdiagnosis.

Anatomical aberration of palmaris longus agenesis muscle through clinical examination in relation to gender and hand dominance.

OBJECTIVE: To determine the frequency of agenesis of palmaris longus muscle and its association with gender and hand dominance. METHODS: The cross-sectional descriptive study was conducted at the Bahria University Medical and Dental College, Karachi, from March 2021 to November 2021, and comprised medical students of either gender from 1st, 2nd and 3rd year of studies. Clinical examination of palmaris longus was done by using the classic Schaeffer's test, and it was confirmed using the Thompson's test. The agenesis of palmaris longus muscle and its association with gender and hand dominance was also tested. Data was analysed using SPSS 23. RESULTS: Of the 200 participants, 114(57%) were female and 86(43%) were male. The overall age range was 18-23 years. Of the total, 195(97.5%) subjects were right hand dominant and 5(2.5%) were left hand dominant. Agenesis was found in 67(33.5%) subjects with no significant difference in terms of gender or hand dominance (p>0.05). Statistically significant difference (p=0.01) was found related to bilateral agenesis. CONCLUSIONS: Bilateral agenesis was found significantly more in females compared to the males, while palmaris longus agenesis and hand dominance had no significant association.

Online mentoring of medical students during COVID-19 pandemic: Another new normal.

Objectives: To determine the impact of online mentoring sessions on the students during the pandemic time. Methods: The cross-sectional descriptive study was conducted at Bahria University Medical and Dental College, Karachi. The total study duration was 5 months from March 2021 to July 2021. Quantitative research design was used. Categorical data was scored on a three point Likert scale (1= 'Disagree', 2= 'Neutral' and 3= 'Agree'). Frequencies and percentages were calculated to determine the impact of online mentoring. Results: Sixty two percent of 2nd year MBBS students were of the opinion that online mentoring was helpful as compared to 58% 1st year and 50% 3rd year students. Students were anxious while sharing their issues online. A total of 61.66% were eager to have classes on campus as compared to online as learning difficulties were felt in 70%, 77% and 81% of 1st, 2nd and 3rd year classes respectively. Of the 1st year 39%, 2nd year 46% and 3rd year 32% showed relief after the mentoring session but were in favor of face to face sessions. Technical issues were faced by 54% 1st year, 66% 2nd year and 64% 3rd year students. Conclusion: The study suggested that students were overall satisfied with the online mentoring sessions. They do have certain apprehensions like privacy and confidentiality issues but on the whole, they considered this medium as being a powerful one in times of the pandemic.

Association of fetal hydrocephalus with other embryological anomalies: A prenatal ultrasound-based study.

Objective: To determine the incidence of fetal hydrocephalus in pregnant women and to identify the association of fetal hydrocephalus with other embryological anomalies. Methods: This comparative cross-sectional study was conducted on 36 pregnant women at a private ultrasound clinic in Karachi over a period of eight months. The participants were divided into age groups, 21-30 years and 31-40 years. Toshiba APLIO 300 ultrasound machine was used to assess fetal age by measuring biparietal diameter (BPD) and femur length, whereas atrium of lateral ventricle was measured to diagnose fetal hydrocephalus. Results: Twenty-two cases of fetal hydrocephalus were observed in maternal age of 21-30 years with a p-value of 0.011. Severe dilatation of ≥15mm was observed in 85.7% cases in age group of 31-40 years. Cranial anomalies were found in 20 cases with significant results while extracranial anomalies were observed in cases of severe dilatation only. Hydrocephalus was prevalent in male fetuses and was observed in 30 (83.33%) fetuses. Conclusion: Most cases of fetal hydrocephalus were observed in women of younger age (p=0.011). Fetal hydrocephalus of severe type exhibiting ventricular dilatation >15mm was observed in fetuses of male gender.

Prevalence of agenesis of palmaris longus in male and female genders on clinical examination - a review.

Palmaris longus is a muscle that is located in the anterior compartment of the forearm. Among the muscles belonging to the flexor compartment of forearm, palmaris longus is located at the most superficial position and that is why it is easy to access. It exhibits high variability and its prevalence ranges between 1.5% and 63.9%. The knowledge of prevalence of agenesis of palmaris longus is essential both in terms of updating anatomical information and also for physicians, radiologists, physiotherapists and surgeons. The surgeons must know about the variability as it may be beneficial while they plan surgeries involving the palmaris muscle as a graft. The current narrative review was planned to highlight the variability pattern of palmaris longus muscle in terms of prevalence, gender and laterality. Palmaris longus agenesis is more common in females and on the left side. Besides, unilateral agenesis is more common compared to bilateral agenesis.

Prevalence, triggers and presentation of migraine among the college and university students: Review of the available literature.

Migraine is a type of headache associated with causing disability. It is considered the third main cause of disability among individuals aged <50 years. Environment around us does play an essential role in triggering the symptoms of migraine. The painful episodes can be prevented by adopting certain lifestyle changes, affecting the daily life activities of students. In the current narrative review, literature was searched on Google, Google Scholar and PubMed databases from 2015 to 2020. Migraine pain was found to be prevalent at different severity levels among college and university students, being more common in the females compared to the males. Identifying triggers is an essential feature in identifying and thus preventing the severity of migraine. As the disease affects the quality of life of students, it is essential to create more awareness so that students may approach physicians and maintain undisturbed focus on their academics.

Distinctive morphometric measurement of frontal sinuses among the female ethnic populations living in Karachi.

OBJECTIVES: To determine uniqueness of frontal air sinuses in female ethnic populations living in Karachi. METHODS: The cross-sectional descriptive study was conducted at the Radiology Department of Jinnah Postgraduate Medical Centre, Karachi, from November 2018 to April 2019, and comprised adult females who were divided into four equal ethnic groups. Frontal sinus X-ray radiography was done using the Water's view. Width, height and area of the right and left frontal sinuses were measured. The radiographs were saved in photograph format and measurements were done using RadiAnt DICOM software. Measurements of height, width and area were noted. Data was analysed using SPSS 23. RESULTS: There were 108 females; 27(25%) in each of the four groups. The overall mean age was 35.14±8.68 years. Variability in terms of width, height and area were noted in both right and left frontal air sinuses (p<0.001). CONCLUSIONS: The width, height and area of right and left frontal sinuses showed variability among female ethnic groups living in Karachi.

Anthropological significance of sexual dimorphism and the unique structural anatomy of the frontal sinuses: Review of the available literature.

Frontal sinuses have unique anatomical features that are distinct to every individual. Radiographic measurement of the frontal sinus is becoming popular in identifying deceased persons in cases where soft tissue remains are not found such as in cases of mass explosions and natural disasters. The aim of this review article is to highlight the significance of employing the method of radiography of frontal sinuses in the process of identification of human bodies. With the use of Pubmed, Medline and Embase, articles on frontal sinus anthropological significance were analyzed from 2015 till 2018. Sexual dimorphism was evident between the two genders. The dimensions are bigger for the males as compared to the females. The left sinus has bigger dimensions as compared to the right frontal air sinus. The reliable use of the radiographic technique is a simple and cost effective method of knowing identity even when the body is severely decomposed.