Negative faculty role modelling - is it a reflection of deteriorating societal values?

BACKGROUND: Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan. METHODS: This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category. RESULTS: Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels. CONCLUSIONS: In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.

Antifungal activity of green synthesized selenium nanoparticles and their effect on physiological, biochemical, and antioxidant defense system of mango under mango malformation disease.

Plant extract-based green synthesis of nanoparticles is an emerging class of nanotechnology that has revolutionized the entire field of biological sciences. Green synthesized nanoparticles are used as super-growth promoters and antifungal agents. In this study, selenium nanoparticles (SeNPs) were synthesized using Melia azedarach leaves extract as the main reducing and stabilizing agent and characterized by UV-visible spectroscopy, scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray (EDX), and fourier transform infrared spectrometer (FTIR). The green synthesized SeNPs were exogenously applied on Mangifera indica infected with mango malformation disease. The SeNPs at a concentration of 30 µg/mL were found to be the best concentration which enhanced the physiological (chlorophyll and membrane stability index), and biochemical (proline and soluble sugar) parameters. The antioxidant defense system was also explored, and it was reported that green synthesized SeNPs significantly reduced the biotic stress by enhancing enzymatic and non-enzymatic activities. In vitro antifungal activity of SeNPs reported that 300 µg/mL concentration inhibited the Fusarium mangiferae the most. This study is considered the first biocompatible approach to evaluate the potential of green synthesized SeNPs to improve the health of mango malformation-infected plants and effective management strategy to inhibit the growth of F. mangifera.

Patient Safety Awareness Among Dental Students In Lahore, Pakistan: A Multi-Centre Studye.

BACKGROUND: Awareness of key issues associated with patient safety is vital for improving patient care in all fields of medical sciences including dentistry. This study was done to assess awareness among dental undergraduates towards patient safety in different dental institutions of Lahore, Pakistan. METHODS: It was a cross-sectional analytical study conducted at Combined Military Hospital Lahore Medical College & Institute of Dentistry from 1st May to 30th November, 2020. Two hundred third and fourth year BDS students (149 females and 51males; mean age 21.91±1.08) of 4 dental institutions of Lahore, mostly from private institutions (79.5%) completed Awareness of Patient Safety Questionnaire (APSQIII) to assess awareness of patient safety in dental undergraduates. Data was analyzed through SPSS 21. RESULTS: Teaching and learning about patient safety got the highest item scores while "Team functioning" got the highest 6.1 mean domain score. "Professional incompetence as an error cause" got the lowest 3.1 mean score followed by "Disclosure responsibility" (4.3). No significant difference was seen with respect to gender. Fourth year students were found to be more aware about error disclosure and error reporting confidence with statistically significant difference. All reverse coded items were scored in disagreed range by participants. CONCLUSIONS: Despite positive attitudes towards patient safety, lack of awareness was seen in key issues. Incorporation of patient safety in undergraduate curriculum may help in improving patient care and health services.

The blame game- experiences of female residents in obstetrics & gynecology regarding lapses in patient safety.

Objectives: Primary objective was to explore experiences of female residents of Obstetrics and Gynecology (OB/GYN) regarding lapses in patient safety (PS) while secondary objective was to explore factors hampering or favouring improvement of PS in OB/GYN. Methods: In this qualitative narrative study carried out in OB/GYN department of Combined Military Hospital (CMH) Lahore for six months from 1st April to 30th September 2021, six fourth-year residents were asked to write narratives of their personal experiences of medical error (witnessed or committed) in detail and reflect on those experiences, which were then transcribed. Code labels and themes were assigned manually. Interpretation of these themes was done after thematic content analysis. Results: Six, fourth-year female residents with a mean age of 28.6±1.8 participated in the study. Two main themes with sub-themes were identified: 1) Challenges in patient safety (Personal challenges, Workplace challenges, Barriers to PS), 2) Lessons learnt from experiences (Self-improvement and; Promotion of patient safety culture). Heavy workload with long working hours, lack of communication and teamwork, lack of experience and inadequate supervision were major factors involved in PS lapses experienced by residents. Conclusion: Incidents of Patient Safety (PS) lapses had a strong impact on the emotional and professional life of residents. Formal PS training with improvement of working conditions may help promote PS culture.

Effects of Phytogenically Synthesized Bimetallic Ag/ZnO Nanomaterials and Nitrogen-Based Fertilizers on Biochemical and Yield Attributes of Two Wheat Varieties.

Wheat is the most important staple food worldwide, but wheat cultivation faces challenges from high food demand. Fertilizers are already in use to cope with the demand; however, more unconventional techniques may be required to enhance the efficiency of wheat cultivation. Nanotechnology offers one potential technique for improving plant growth and production by providing stimulating agents to the crop. In this study, plant-derived Ag/ZnO nanomaterials were characterized using UV-Vis spectroscopy, SEM, EDX, FTIR, and XRD methods. Various concentrations of phytogenically synthesized Ag/ZnO nanomaterials (20, 40, 60, and 80 ppm) and nitrogen-based fertilizers (urea and ammonium sulphate 50 and 100 mg/L) were applied to wheat varieties (Galaxy-13 and Pak-13). The results obtained from this research showed that application of 60 ppm Ag/ZnO nanomaterials with nitrogenous fertilizers (50 and 100 mg/L) were more effective in improving biochemistry and increasing yield of wheat plants by reducing enzymatic and non-enzymatic antioxidants (proline content, soluble sugar content, malondialdehyde, total phenolic content, total flavonoid content, superoxide dismutase, peroxidase, and catalase); and significantly increasing the protein content, number of grains per pot, spike length, 100-grain weight, grain yield per pot, and harvest index of both wheat varieties, compared to untreated plants. These findings allow us to propose Ag/ZnO nanomaterial formulation as a promising growth- and productivity-improvement strategy for wheat cultivation.

Exogenous Application of Green Titanium Dioxide Nanoparticles (TiO2 NPs) to Improve the Germination, Physiochemical, and Yield Parameters of Wheat Plants under Salinity Stress.

Agriculture is the backbone of every developing country. Among various crops, wheat (Triticum aestivum L.) belongs to the family Poaceae and is the most important staple food crop of various countries. Different biotic (viruses, bacteria and fungi) and abiotic stresses (water logging, drought and salinity) adversely affect the qualitative and quantitative attributes of wheat. Among these stresses, salinity stress is a very important limiting factor affecting the morphological, physiological, biochemical attributes and grain yield of wheat. This research work was carried out to evaluate the influence of phytosynthesized TiO2 NPs on the germination, physiochemical, and yield attributes of wheat varieties in response to salinity. TiO2 NPs were synthesized using TiO2 salt and a Buddleja asiatica plant extract as a reducing and capping agent. Various concentrations of TiO2 nanoparticles (20, 40, 60 and 80 mg/L) and salt solutions (NaCl) (100 and 150 mM) were used. A total of 20 mg/L and 40 mg/L improve germination attributes, osmotic and water potential, carotenoid, total phenolic, and flavonoid content, soluble sugar and proteins, proline and amino acid content, superoxide dismutase activity, and reduce malondialdhehyde (MDA) content at both levels of salinity. These two concentrations also improved the yield attributes of wheat varieties at both salinity levels. The best results were observed at 40 mg/L of TiO2 NPs at both salinity levels. However, the highest concentrations (60 and 80 mg/L) of TiO2 NPs showed negative effects on germination, physiochemical and yield characteristics and causes stress in both wheat varieties under control irrigation conditions and salinity stress. Therefore, in conclusion, the findings of this research are that the foliar application of TiO2 NPs can help to improve tolerance against salinity stress in plants.

Biogenic Silver Nanoparticles as a Stress Alleviator in Plants: A Mechanistic Overview.

Currently, the growth and yield of crops are restrained due to an increase in the occurrence of ecological stresses globally. Biogenic generation of nanomaterials is an important step in the development of environmentally friendly procedures in the nanotechnology field. Silver-based nanomaterials are significant because of their physical, chemical, and biological features along with their plentiful applications. In addition to useful microbes, the green synthesized Ag nanomaterials are considered to be an ecologically friendly and environmentally biocompatible method for the enhancement of crop yield by easing stresses. In the recent decade, due to regular droughts, infrequent precipitation, salinity, and increased temperature, the climate alternation has changed certain ecological systems. As a result of these environmental changes, crop yield has decreased worldwide. The role of biogenic Ag nanomaterials in enhancing methylglyoxal detoxification, antioxidant defense mechanisms, and generating tolerance to stresses-induced ROS injury has been methodically explained in plants over the past ten years. However, certain studies regarding stress tolerance and metal-based nanomaterials have been directed, but the particulars of silver nanomaterials arbitrated stresses tolerance have not been well-reviewed. Henceforth, there is a need to have a good understanding of plant responses during stressful conditions and to practice the combined literature to enhance tolerance for crops by utilization of Ag nanoparticles. This review article illustrates the mechanistic approach that biogenic Ag nanomaterials in plants adopt to alleviate stresses. Moreover, we have appraised the most significant activities by exogenous use of Ag nanomaterials for improving plant tolerance to salt, low and high temperature, and drought stresses.

Plant-Based Bimetallic Silver-Zinc Oxide Nanoparticles: A Comprehensive Perspective of Synthesis, Biomedical Applications, and Future Trends.

The universal emphasis on the study of green nanotechnology has led to biologically harmless uses of wide-ranged nanomaterials. Nanotechnology deals with the production of nanosized particles with regular morphology and properties. Various researches have been directed on nanomaterial synthesis by physical, chemical, and biological means. Understanding the safety of both environment and in vivo, a biogenic approach particularly plant-derived synthesis is the best strategy. Silver-zinc oxide nanoparticles are most effective. Moreover, these engineered nanomaterials via morphological modifications attain improved performance in antimicrobial, biomedical, environmental, and therapeutic applications. This article evaluates manufacturing strategies for silver-zinc oxide nanoparticles via plant-derived means along with highlighting their broad range of uses in bionanotechnology.

Responses of bimetallic Ag/ZnO alloy nanoparticles and urea on morphological and physiological attributes of wheat.

Wheat (Triticum aestivum L.) is the most important staple food crop globally. According to economic survey 2018-19, agriculture sector of Pakistan grew by 0.85%, with wheat accounting for 8.9% of agriculture and 1.6% of GDP, and its production fell short of the target by 4.9%. Wheat requires beneficial ties to improve its efficiency with the help of modern technology. Nanotechnology modifies conventional agricultural practices as these are stimulating agents for plant growth. Green bimetallic Ag/ZnO alloy nanoparticles (NPs) synthesised from salts reduced by Moringa oleifera and characterised by UV-visible spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy are studied herein. Different concentrations of urea and Ag/ZnO alloy NPs were applied exogenously to wheat plants (Pakistan-13 and Galaxy13). A significant effect of 100 mg/L urea and 75 ppm Ag/ZnO alloy NPs was observed on the morphology of wheat, with a maximum increase of 58% plant length, 85% leaf area, 89% plant fresh weight and 76% plant dried weight. In physiological parameters, relative water content and membrane stability index have shown maximum increases of 39% and 77%, while chlorophyll a, b, and total chlorophyll content (TCC) showed maximum increases of 92%, 71%, and 84% respectively. Evidence of the morpho-physiological responses of urea and green synthesised alloy NPs on wheat varieties are reported on.

Perceptions Of Medical Students About The Educational Environment At The Start And End Of Obstetrics And Gynaecology Rotation And Its Impact On Career Choice.

BACKGROUND: The educational environment can influence students' learning and their attitudes towards various medical specialties, thus affecting their career choices. This study aimed to compare perceptions of medical students about educational environment at the start and end of Obstetrics and Gynaecology (O&G) rotation and to assess if these perceptions influenced their career choices. METHODS: This was a Comparative analytical study carried out in the Obstetrics and Gynaecology Department, Combined Military Hospital Lahore Medical College from 1st February to 30th July 2019. Eighty-eight final year MBBS students (60 females and 28 males; average age 22±1.2 years) completed validated Dundee Ready Education Environment Measure (DREEM) questionnaire at the start and end of three weeks of O&G clinical rotation. Two questions were added post rotation to assess impact of their perceptions on career choice. Data was analysed through SPSS version 21 using independent sample t-test. RESULTS: Mean total DREEM score was 126.68±14.17 and 127.49±15.31 out of a maximum of 200 pre and post rotation (p-value 0.001). The sub-scale which improved significantly (p-value 0.010) was Perception of Environment with average scores of 27.88±4.63 and 28.25±4.64 pre and post rotation. Majority of female students (78.7%) felt motivated for choosing O&G as a career after this rotation. CONCLUSION: Final-year medical students perceived the learning environment to be positive. Clinical rotation helped in improving their perception about O&G learning environment and helped female students get more inclined to choose this specialty as a career.

Angular Pregnancy: An Eccentric Implantation Within Uterine Cavity.

Angular ectopic is a rare form of ectopic pregnancy which is diagnosed as intrauterine pregnancy on ultrasound but may rupture in second trimester leading to maternal mortality. We present a case of a 32-year-old primigravida who presented at 18 weeks gestation to the emergency department of national hospital Lahore with complaint of dizziness, sweating and epigastric pain for one hour. She had an episode of diarrhoea and vomiting at hospital followed by rapidly increased abdominal distension and signs of hypovolemic shock. Urgent ultrasound suggested rupture of posterior uterine wall and massive hemoperitoneum. An urgent laparotomy was done. Uterus was perforated by pregnancy posteriorly. baby was inside the sac and alive. But died soon after birth. Uterus was repaired in two layers. Stepwise devascularization of uterus was done due to continuous bleeding. 6 units whole blood 6 FFP were transfused. The abnormal location of this pregnancy makes it antenatal diagnosis difficult. A high index of suspicion is needed in pregnant women presenting in shock even when intrauterine location of pregnancy is diagnosed in first trimester.