Ameliorative Effects of Prolotherapy on Histomorphology of Tibial Articular Cartilage of Chemically Induced Osteoarthritic Knee Joint in a Rat Model

OBJECTIVE

To determine the ameliorative effects of prolotherapy on monosodium iodoacetate (MIA) induced and histomorphological changes in the articular cartilage of tibial condyles at rat knee joint.

STUDY DESIGN

An experimental study. Place and Duration of the Study: Department of Anatomy, Army Medical College Rawalpindi, NUMS, Rawalpindi, from August to November 2021.

METHODOLOGY

Thirty adult male Sprague Dawley rats were divided into three groups, each having 10 rats. Group A was control. Group B was injected with single dose of 1mg MIA intraarticularly in the right knee to induce osteoarthritic changes. Group C was injected with single dose of 1mg MIA intraarticularly, in right knee was followed by 0.1ml Prolotherapy (3ml of 25% dextrose, 2ml of 2% xylocaine, 1ml of injection neurobion, and 1ml of injection methecobal) as intra articular injection at week 2, 6 and 10 in right knee. Rats were sacrificed after one month of the last dose of Prolotherapy. Articular cartilage was collected for gross and histological examination and compared among the groups.

RESULTS

Articular cartilage belonging to control group A was normal. While group B showed statistically significant deterioration in gross appearance (p = 0.001**), reduction in number of chondrocytes (p = 0.005*) and thickness of articular cartilage (p = 0.001**) in comparison to group A. In group C due to prolotherapy statistically significant improvement in gross appearance (p = 0.034*), increase in number of chondrocytes (p = 0.003*), and thickness of articular cartilage (p = 0.001**) was observed as compared to group B.

CONCLUSION

Prolotherapy significantly ameliorates histomorphology of tibial articular cartilage against MIA induced osteoarthritic changes in rat knee joint.

KEY WORDS

Articular cartilage, Knee joint, Monosodium iodoacetate, Osteoarthritis, Prolotherapy.

Ameliorative Effects of Alpha-tocopherol in Carboplatin Induced Toxicity on Histomorphology of Renal Cortex in Rats

OBJECTIVE

To evaluate the histomorphological response of alpha-tocopherol co-administration with carboplatin chemotherapy.

STUDY DESIGN

A laboratory-based experimental study. Place and Duration of the Study: Anatomy Department, Army Medical College / National University of Medical Sciences (NUMS), Rawalpindi, Pakistan, from January to December 2021.

METHODOLOGY

Thirty adult Sprague-Dawley rats were divided into three groups of ten rats each. Control group A received normal diet and water, experimental group B was administered single injection of carboplatin 2.5 mg/Kg intraperitoneally; and experimental group C along with carboplatin injection also received alpha-tocopherol 62.7 mg/Kg daily. At the end of 12 weeks, the euthanasia of animals was done and kidneys were dissected out. Right-sided kidneys were stained with Haematoxylin and Eosin. Micrometry was done to measure the diameters of renal cortical tubules and renal corpuscles.

RESULTS

The proximal and distal tubular and luminal diameter and transvertical diameter of renal corpuscle were increased in group B as compared to control group A. In group C, the proximal and distal tubular diameters were 5.175 ± 0.39 µm and 3.88 ± 0.364 µm, respectively; proximal and distal luminal diameters were 2.67 ± 0.35 µm and 1.64 ± 0.24 µm, respectively and transvertical diameter of renal corpuscle was 12.16 ± 0.870 µm. These values were less than experimental group B and closer to that of control group A.

CONCLUSION

Renal microscopic parameters showed improvement in the group administered with alpha-tocopherol. Therefore, alpha-tocopherol has ameliorative effects on carboplatin-induced renal damage.

KEY WORDS

Alpha-tocopherol, Carboplatin, Renal corpuscle, Tubules.

Faculty Development Initiatives

Teachers have been teaching using traditional strategies and frameworks for generations. Faculty development is a planned activity aimed at improving the performance of departmental faculty members by focusing on the improvement of individual knowledge and skills of faculty in relevant areas.1These skills include teaching, administrative, research, and clinical skills.Continuous medical education is a praiseworthy path to keep the educationist in liaison with the novel trends in their field. Faculty development programs aim to foster excellence and innovation by empowering teachers through innovative teaching methods and sharing evidence-based best practices andexperiences.

Amelioration of Carboplatin-Induced Changes in Rat Renal Cortical Tubulesby Alpha-Tocopherol

Objective: To determine the effects of carboplatin and alpha-tocopherol co-administration on gross kidney features and renal cortical tubules of carboplatin-treated rats. Study Design: Laboratory-based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College/National University of Medical Sciences Rawalpindi Pakistan, in collaboration with the National Institute of Health (NIH) and Pathology Lab Pak Emirates Rawalpindi Pakistan, from Jan to Dec, 2021. Methodology: Thirty adults "Sprague-Dawley rats" of both genders were used and were divided into three Groups. Group-A was the Control Group. Groups B and C were given injection carboplatin 2.5 mg/kg body weight intraperitoneally on the first day. Group-C was given vitamin E at a dose of 62.7 mg/kg body weight daily via oral gavage starting from the second day of the experiment till the end of 12 weeks. Rats were euthanized at the end, kidneys were dissected, and they were preserved in 10% formalin after gross inspection. Tissue processing and staining were performed. A microscopic study was done to observe proximal and distal tubule necrosis. Results: Thirty adult Sprague Dawley rats, of age 10-12 weeks, and weight 250.0±50.0 grams, were included, there was statistically significant difference in the animal weight difference (p=0.001), length of right kidneys (cm) (p=0.002), width of right kidney (cm) (p= 0.001) and weight of right kidney (gm) (p=0.012) kidneys and relative tissue body weight index (RTBWI) (p = 0.048) of Control Group-A and Experimental Group B and C. Conclusion: Alpha-tocopherol has an ameliorative effect on gross features of rat kidneys..........

Prolotherapy Improves Anatomical and Clinical Outcomes in Monosodium Iodoacetate Induced Model of Osteoarthritis

Objective: To assess the ameliorative effects of Prolotherapy on the pain score of the gait cycle in Monosodium Iodoacetate (MIA) induced osteoarthritis in the rat knee joint. Study Design: Laboratory-based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi in collaboration with the National Institute of Health (NIH), Islamabad and Pathology Lab Pak Emirates Rawalpindi, Pakistan, from Aug to Nov 2021. Methodology: Thirty male Sprague Dawley rats were randomly divided into three groups (n=10 in each group). The control group was Group-A. To induce osteoarthritic changes in Group-B, a single dose of 1mg Monosodium Iodoacetate was injected intra-articularly into the right knee. Group-C received a single dose of 1mg Monosodium Iodoacetate injection in the right knee intra articularly to induce osteoarthritic changes, and was followed by 0.1ml Prolotherapy (3ml of 25% dextrose, 2ml of 2% Xylocaine, 1ml of injection thiamine, and 1ml of injection Methylcobalamin) at 2, 6 and 10 weeks intra articularly into the right knee joint.  Before euthanasia, Pain scoring schemes for gait in rats of all groups were done at 0, 2 and 14 weeks. Results: The present study concluded that prolotherapy improved the gait cycle pain score in experimental group C (p-value 0.001 on the intergroup comparison at two weeks and 14 weeks while p-value 0.001 when compared pain score within the Group C at 0, 2 and 14 weeks). Conclusion: Prolotherapy had ameliorative effects on the pain score of the gait cycle in experimental Group C on Monosodium Iodoacetate......

Agile Management in Health Professions Education with Respect to Waterfall Life Cycle

Objective: To determine the practice of waterfall life cycle functions in the health profession department of medical institutes by keeping in view the demographic factors of health professions managers. Study Design: Cross-sectional survey. Place and Duration of Study: Medical Institutes of Rawalpindi and Islamabad Pakistan, from Feb to Jul 2021. Methodology: 46 managers were taken as a sample through a systematic random sampling technique. A self-developed questionnaire was used, and it contained 21 items. Mean and standard deviation were used to measure the practices of waterfall agile management, and t-test and ANOVA were used to test the effect of gender and experiences. Results: Managers were not fully confident about the practices of water fall life cycle functions in their respective organization (Mean=3.08 ± 1.19). Gender has no significant effect on required analysis (p=0.861); design stage (p=0.625); test (p=0.222); deployment (p=0.718) and development (p=0.432) while monitoring and evaluation had significant effect (p=0.042). Similarly, managers’ experience has significant effect on required analysis (p=0.013); test (p=0.001); deployment (p≤0.001) and development (p=0.002) while it has no significant effect on design stage (p=0.062) and monitoring and evaluation (p=0.060) in medical institutes. Conclusion: Health profession managers were neutral about the practices of the waterfall life cycle of agile management in their respective medical institutes.

Investigation of Insomnia Among Students At The University Level: A Cross-Sectional Analysis

Objective: To investigate the students’ perception of insomnia at the university level and to determine the effects of demographic factors on their perception. Study Design: Cross-sectional study Place and Duration of Study: Department of Education and Department of English, International Islamic University, from Sept 2020 to Feb 2021. Methodology: This study involved twelve hundred and fifty (1250) university students. The insomnia questionnaire was developed after the exploratory factor analysis. Results: The findings of this study revealed that students at the university level suffer from a high rate of insomnia, but they did not take any steps to address it because they had a neutral perception toward the problem. There was no significant effect of semester-term and the type of department with insomnia (p=0.864 and p=0.648). Conclusion: Students were neutral about their insomnia problem at the university level.

Effect of Injection Botox in Masseter Muscle on Morphometric Measurements of The Mandible in Sprague Dawley Rats

Objective: To study the effects of injection botox in masseter muscle on the morphometric measurement of underlying mandible and total body weight change in Sprague Dawley rats.Study Design: Laboratory-based experimental study. Place and Duration of Study: Anatomy Department, Army Medical College, Rawalpindi, with collaboration with Military Hospital, Rawalpindi and National Institute of Health (NIH), Islamabad, from Jun to Aug 2020. Methodology: Female sprague dawley rats, 10 weeks of age, weighing 200-250 gm were selected. They were housed in separate cages in animal house of NIH under standard laboratory conditions and received regular diet and water ad libitum. Animals were divided into three groups. Group-A served as control while group B and C were experimental groups. Group-B was sham injected whilst group-C was injected by injection botox in left masseter muscle. Initial and final weights of the rats were recorded. All the rats were sacrificed after completion of experimental period. Weight of left mandibles was recorded. All the specimens of mandibles were cleaned and the mandibular length, condylar head length and width were measured by Vernier caliper. Result: Total 30 sprague dawley rats were included in the study. Injection botox decreased the morphometric measurements of the mandible in experimental group-C when compared with control group-A and sham group-B with the statistically significant result (p<0.001).

Using Pensieve: Guiding and Evaluating a Learning Session on Reflections

The objectives of this study were to guide students on reflective essay writing, evaluate their understanding and explore the immediate impact of a well-designed session on learning of students. A 1.5-hour learning session was designed following Gagne's nine events of instruction and conducted on final year MBBS students to guide them on reflective practice and its significance. The session was evaluated by a self-designed, structured questionnaire given as a pre-test and post-test. Of 158 students, self-scoring of reflective essay, by hand raising method, revealed that nearly 60% students were critical reflectors, 30% were reflectors and 10% were non-reflectors. Five out of nine questions showed a significant effect (p <0.001) in two-tailed t-test. This learning session led to a significant improvement in understanding of students regarding role of reflective practice in modifying their future behaviour, and its role in making them a better professional. Key Words: Learning, Reflections, Satisfaction, Feedback, Written, Educational assessment, Medical students.

Time to move from past to future by making present creative: A Scoping review

Creativity is one of the tools in the toolkit of modern day learners. Scientific progress cannot be accomplished without developing creative capacities of individuals. The Muslim countries, despite their historical achievement in different creative and innovative discoveries and positive encouragement by Islam towards creativity, have paradoxically gone down from their position. Creativity is one of the priorities of modern age due to its role in the progress of humanity and future. The education system is spoon-feeding our learners and killing creativity. The main aim of the current scoping review is to summarise and disseminate research findings pertaining to the evidence on the definition of the concept of creativity, its importance in education, role of teachers and learners in making creativity a part of their educational endeavours, and their implications. Moreover, it provides a broad and detailed outline of the topic and exploring more general questions rather than providing answer to limited questions. It will help to determine how important it is to foster creativity as educators.

IRON DEPOSITION IN THE GROWTH PLATE OF LONG BONES OF THE OFFSPRING WHEN GIVEN DURING PREGNANCY IN RAT MODEL

Objective: To evaluate histologically the deposition of iron in the epiphyseal cartilage of offspring’s of dams given iron supplementation during pregnancy and lactation in rat model. Study Design: Laboratory based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi and National Institute of Health (NIH) Islamabad, from Mar to Nov 2016. Methodology: In this study, 16 female and 4 male adult rats were chosen for breading. After confirmation of pregnancy, pregnant rats were separated in two groups. One group was given oral iron supplementation for four weeks till delivery and half of the pups fed by mothers who were given iron during lactation. The other group was kept on normal lab diet. Deposition of iron in the epiphyseal cartilage of newborn rats after four weeks was evaluated histologically in pups. Results: Iron deposition was maximum in group C i.e. 1.30 ± 0.48; in group B it was 0.20 ± 0.44. Statistically significant iron deposition (p<0.001) was observed in the growth plate of off springs when mothers were given iron supplements during pregnancy and lactation. Conclusion: Present study proves that injudicious iron supplementation through pregnancy results in deposition of iron in epiphyseal growth plate of the fetus and it can have damaging effects on bones of fetus.

EFFECTS OF NOISE STRESS ON THYROID STIMULATING HORMONE IN ADULT RATS

Objective: To determine the effect of noise stress on Thyroid Stimulating Hormone in adult rats. Study Design: Laboratory-based experimental study. Place and Duration of Study: Department of Anatomy Army Medical College, Rawalpindi in collaboration with National Institute of Health, Islamabad, from Jan to Dec 2020. Methodology: A total of 30 adult Sprague Dawley rats were distributed into three groups as ten rats/group. Group A served as the control group, rats in group B were exposed to 100 dB noise for continuous 4 hours/day for four months, and the rats in group C were exposed to 100 dB noise for continuous 6 hours/day for four months. At the end of the study, serum samples were collected from the rats’ tail veins. Thyroid-stimulating hormone levels were compared among the groups. Results: At the start of the study, mean serum thyroid stimulating hormone level of control group A rats was 0.34 ± 0.15 µIU/ml. Mean serum thyroid stimulating hormone level of experimental groups B and C rats at the start of the study was 0.46 ± 0.18 µIU/ml and 0.41 ± 0.14 µIU/ml, respectively Mean serum thyroid stimulating hormone of rats did not differ statistically significantly between the group p=0.26, By the end of study mean serum thyroid stimulating hormone level of control group. A rats was 0.6 ± 0.2 µIU/ml. Mean serum thyroid stimulating hormone levels of experimental groups B and C rats at the end of the study were 1.32 ± 0.35 µIU/ml and 1.86 ± 0.67 µIU/ml, respectively.......

Perception of peer teaching on learning anatomy: A qualitative study

The aim of this study was to identify the effectiveness of peer-assisted learning while giving presentation on assigned anatomy topics in class by medical students for enhancement of their learning and communication skills. Sixty top performing students were selected for the study. They were given assigned topics related to anatomy to be presented in the class after taking their consent. The duration of the study was 32 weeks. At the completion of the projects by the students, each of them was interviewed for three to five minutes; the questions were very precise and few in number and were then analysed. Focus group discussions were conducted from the rest of the class who were the audience and enjoyed the activity. The study showed that by conducting such an activity among medical students their knowledge about the subject, communication and teaching skills and confidence are enhanced. It is a fun activity for them and can be added in the routine timetable for its beneficial outcomes.

PROPHYLACTIC EFFECT OF COENZYME Q10 ON GROSS PARAMETERS OF RAT TESTIS EXPOSED TO MOSQUITO COIL SMOKE INHALATION

Objective: To determine the toxic effect of mosquito coil smoke inhalation on gross parameters of rat testis and explore the protective effect of Coenzyme Q10on testicular toxicity profile. Study Design: Laboratory-based experimental study. Place and Duration of Study: Department of Anatomy Army Medical College, Rawalpindi in collaboration with National Institute of Health, Islamabad, from Jan 2020 to Dec 2020. Methodology: This study was carried out among 30 male Sprague Dawley rats, distributed into three groups as 10 rats/group; group A served as control group, rats in group B were exposed to allethrin-based mosquito coil smoke 4hours/day for 12 weeks. Rats in group C were administered Coenzyme Q10 (10 mg/kg/day) via oral gavage for 12 weeks along with mosquito coil smoke exposure. At the end of study, gross parameters of body weight gain, testicular weight and volume, and relative tissue body weight index of testis were compared among groups. Results: Rats exposed to mosquito coil smoke alone showed significantly less weight gain (p<0.001)), testicular weight (p<0.001), volume (p<0.001), and relative tissue body weight index (p<0.001) as compared to control group. Rats administered Coenzyme Q10 along with mosquito coil smoke exposure exhibited significantly higher weight gain (p<0.001), testicular weight (p<0.001), volume (p<0.001) and relative tissue body weight index (p<0.001) as compared to rats exposed to mosquito coil smoke alone. Conclusion: Long-term inhalation of allethrin-based mosquito coil smoke caused testicular atrophy among rats, as evident by reduced testicular weight, volume and relative tissue body weight index. Whereas, prophylactic oral administration of Coenzyme......................

REMODELED SOCIO-CULTURAL AND ACADEMIC E-LEARNING

Panacea erupted by COVID-19 outbreak has transformed our personal and political perspectives, on priorities and mode of lives, around the world. On March 11, 2020, WHO declaring it as a pandemic followed by nation wide smart lockdown and implementation of social distancing, has remodeled our sociocultural and academic norms.To our interest, it has encouraged medical colleges of our country to take a giant leap from a traditional face-to-face instruction to online learning. Though sudden, massive, and unplanned transition it might be, this not only changed mode of curricular delivery, but uncovered opportunity of grooming ourselves to Millennial expectations. Initially, our digital recluse faculty had to learn basics of computer to become digital refugees. Later, they successfully adapted themselves as digital immigrants to teach a digital native generation!

PREVALENCE OF OBESITY IN AFFLUENT SCHOOL CHILDREN IN MULTAN

Objective: The objective of this study was to determine the prevalence of obesity in affluent school children in Multan. Study design:  Cross sectional study Place and Duration of study: Three private schools of Multan selected at random; willing to participate in the study. The study was carried out from 15 May 2015 to 15 November 2015. Results: In our study, 37.58% (n=62) children were between 5-7 years and 62.42% (n=103) were between 8-10 years of age, mean +SD was calculated as 7.79+1.47 years, 73.94% (n=122) were males and 26.06% (n=43) were females. Mean values of basic characteristics of the patients were calculated as 2.14+1.21 as birth order, 33.18+8.25(kg) for weight, 130.15+8.81(cm) and 1.30+0.08(m) for height and 19.40+3.26 (kg/m^2) for BMI. Prevalence of obesity in affluent school children in Multan was calculated as 43.03% (n=71). Conclusion: We concluded that the prevalence of obesity in affluent school children in Multan is very higher. Low physical activity and sedentary lifestyle are potential risk factors for obesity in children which may be modified and persistence of obesity may be avoided.

CHALLENGES OF E-LEARNING FACED BY MEDICAL TEACHERS AND STUDENTS DURING COVID-19 PANDEMIC

Objective: To explore perceptions of medical students and faculty, regarding challenges of e-learning they faced, during COVID-19 pandemic. Study Design: Mixed method study (Quantitative and Qualitative - Phenomenological approach). Place and Duration of Study: Army Medical College Pakistan, from Apr 2020 to Sep 2020. Methodology: A self-made questionnaire, having both qualitative and quantitative elements, was developed after interviews of participants. It was pilot tested, finalized and sent via Google forms. Total 318 students and 6 faculty members responded, data was transcribed verbatim, themes were identified, and qualitative inductive content analysis of participants‟ reports was done. Results: Twenty-seven subthemes were identified by analyzing students‟ and faculty perceptions. They were grouped under five major themes, namely, communicational, technological, institutional, related to educators and students. Conclusion: Despite limiting factors like communication gap, digital refugee faculty teaching digital native students, limited technical support, digital divide and unplanned curricular delivery, e-learning was found to be beneficial in terms of flexibility in timings, improving learners‟ self-efficacy, faculty transformation and gradual acceptance. Moreover, it provided opportunity for hybrid e-curriculum development.

Effect of Platelet-rich Plasma on Mankin Scoring in Chemically-induced Animal Model of Osteoarthritis

OBJECTIVE

To evaluate the effects of platelet-rich plasma injection on histological changes of osteoarthritis using the modified Mankin score in monoiodoacetate-induced rat knee model.

STUDY DESIGN

Laboratory-based experimental study.

PLACE AND DURATION OF STUDY

Department of Anatomy, Army Medical College, Rawalpindi and National Institute of Health (NIH), Islamabad from March to May 2018.

METHODOLOGY

Thirty-two pathogen-free male rats aged 3-4 months were selected and divided into two groups with 8 and 24 animals, respectively. Groups A was used as control. Experimental group B was further subgrouped as B1, B2 and B3 with 8 animals, in each subgroup. Monoiodoacetate solution was injected into the articular cavity of the right knee joint of all the animals in group B. Both the control (A) and experimental group B1 were sacrificed after 2 weeks of MIA injection, for observing the histological changes in the articular cartilage. Group B2 received a single injection of platelet rich plasma (PRP) while group B3 was reared as such. Both groups were sacrificed after 4 weeks of intra-articular administration of PRP. Articular cartilage was collected, processed and stained with hematoxylin and eosin (H and E) and toludine blue (T.B). Routine histological study was done and Mankin score was calculated to determine the grade of arthritis. SPSS Version 21 was used for the statistical analysis and p-value was considered significant at the cut-off value of 0.05.

RESULTS

The mean Mankin score of group B3 (9.37) was significantly higher than that of group B2 (7.37, p=0.003).

CONCLUSION

Platelet-rich plasma treatment controls the histological changes of chemically-induced osteoarthritis in rat knee.

Platelet-rich Plasma-induced Inhibition of Chondrocyte Apoptosis Directly Affects Cartilage Thickness in Osteoarthritis

Abstract

The search for minimally invasive treatment of osteoarthritis has led to the development of biological options such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone marrow aspirate concentrates. This research was conducted to study the outcomes of PRP administration in the chemical-induced model of osteoarthritis in rat knee.

Methods and results

Two milligrams of monoiodoacetate (MIA) was used for the induction of arthritis in the right knee of 16 rats. Autologous PRP was prepared by double centrifugation, which was then administered in the arthritic knee of eight rats. This group was labeled as the treated group (A) while the rest were counted as the non-treated group (B). Chondrocyte count and uncalcified cartilage thickness were morphometrically assessed on hematoxylin and eosin (H&E) stained slides, and it was noted that treated group A had a higher chondrocyte count and more cartilage height as compared to non-treated group B. Intergroup comparison was done between the treated group (A) and non-treated group (B) using the independent t-test. P-values were found to be statistically significant for these parameters.

Conclusion

This study thus concluded that PRP had induced an inhibitory effect on the apoptosis of chondrocytes, which, in turn, prevented the loss of cartilage height by inhibiting matrix loss.

Effect of Autologous Platelet-rich Plasma on Appearance of Tenocytes at Injured Achilles Tendon Entheses in Rabbits

OBJECTIVE

To determine the effects of autologous platelet-rich plasma on appearance of tenocytes at injured Achilles tendon entheses in rabbits.

STUDY DESIGN

Laboratory-based experimental study.

PLACE AND DURATION OF STUDY

Department of Anatomy and Pathology, Army Medical College, Rawalpindi, in collaboration with National Institute of Health, Islamabad, from March to May, 2018.

METHODOLOGY

Forty healthy male, 4-6 months old New Zealand white rabbits, weighing 2000-2500 gm, were randomly divided into four equal groups A, B, C and D. Group A served as control, while B, C and D were experimental groups. Injury was surgically induced at left Achilles tendon entheses of experimental groups, which were treated with injections of autologous platelet-rich plasma, at the time of induction of injury in group C and two weeks after injury in group D, while no treatment was given in group B. Animals were euthanised at the end of 12 weeks. Specimens were taken and processed for histological observations. Bonar's modified score was used to assess the appearance of tenocytes. SPSS version 21 was used for statistical analysis. Chi-square test was applied and p-value of <0.05 was taken as significant.

RESULTS

Experimental group B showed marked deterioration in Bonar's score as compared to the control group A. The scores were significantly improved in treatment groups C and D as compared to group B.

CONCLUSION

Injection of autologous platelet-rich plasma effectively improved the Bonar's modified score for appearance of tenocytes at injured entheses, 12 weeks after injury.

Protective Effect of Commercial Green Tea on Ibuprofen-Induced Glomerular Atrophy in Kidney of Adult Rat

OBJECTIVE

To determine the effect of commercial green tea on ibuprofen-induced glomerular atrophy in kidney of adult rat by using transvertical glomerular diameter as the determining parameter.

STUDY DESIGN

Laboratory-based experimental study.

PLACE AND DURATION OF STUDY

Department of Anatomy, Army Medical College Rawalpindi in collaboration with National Institute of Health (NIH) Islamabad from December 2016 to January 2017.

METHODOLOGY

Thirty Sprague-dawley rats, males and females, were selected and divided into three groups. Each group comprised of 10 animals. Group A was used as control. Group B was given ibuprofen 120 mg/kg bodyweight/day. Group C received extract of Lipton green tea 1 ml/100 mg bodyweight/day in addition to ibuprofen 120 mg/kg. The dose was administered once daily for a period of 9 weeks. Animals were sacrificed 24 hours after administration of last dose. Kidney tissue was processed and stained with H&E. Routine histological study was performed. Change in transvertical glomerular diameter was taken as the defining parameter for determining glomerular atrophy. SPSS version 22 was the tool used for statistical analysis. P-value <0.05 was considered significant.

RESULTS

Transvertical glomerular diameter (TVGD) was significantly decreased in both experimental groups B (76.15 +1.85 µm) and C (89.59 +1.87 µm) in comparison with control group A (94.27 +1.82 µm). However, the difference in TVGD between both experimental groups was also significant, asserting the ameliorative effect of green tea against glomerular damage.

CONCLUSION

Ibuprofen caused glomerular atrophy but administration of green tea along with ibuprofen protected against significant reduction in glomerular diameter, thus preventing atrophy.

Diagnostic accuracy study of internal assessment using receiver operator characteristic curve analysis

OBJECTIVE

To assess whether internal assessment as a part of continuous assessment links to the outcome of the final summative assessment.

METHODS

The diagnostic accuracy study was conducted at Army Medical College, Rawalpindi, Pakistan, from November 2015 to July 2016, and comprised medical students of 2nd year. Different teaching methods used were interactive lectures, case-based sessions, demonstrations, small group discussions, skill lab and practicals. Other confounding factors were not considered. Receiver operator characteristic curve was computed to determine diagnostic accuracy of internal assessment for the prediction of examination results..

RESULTS

Out of 202 students, 122 (60.4%) were male and 80 (39.6%) were female with an overall mean age of 20.05±0.69 years. Total marks of 2nd professional examination and internal assessment were normally distributed with mean values of 131.71±19.81 and 36.18±8.03 respectively. The cut-off value was 27.5 and at this value, sensitivity was 100% and specificity was 91%.

CONCLUSIONS

Diagnostic power of internal assessment to identify students who may fail in professional examination was significantly high.

Effects of Iron Administration on the Diameter of Cells of Growth Cartilage of Rat Pups During Pregnancy

OBJECTIVE

To determine the effect of oral iron administration on pregnant rats on the diameter of cells of growth plate of rat pups.

STUDY DESIGN

Experimental study.

PLACE AND DURATION OF STUDY

Anatomy Department, Army Medical College, Rawalpindi in collaboration with National Institute of Health (NIH), Islamabad from March to November 2016.

METHODOLOGY

Group Acontaining 8 pregnant rats was control group, and group B containing same number of pregnant rats was the study group. Control group Awas on standard diet throughout pregnancy. Iron was given to the experimental group B for 21 days (throughout pregnancy) in the form of syrup 0.5ml daily (2.75 mg of elemental iron) given in water. Rat infants were born via spontaneous vaginal delivery. Inclusion criteria for infants was pups born at term which were active and taking feed. Femur from each rat infant of right side was removed for the growth plate investigation. Processing, embedding and staining with Hematoxylin and Eosin, Perl's stain for histological study was done. The cell diameter in hypertrophy and proliferative zone was evaluated. Mean values of the diameter of chondrocytes in both the zones of growth cartilage of femur were measured.

RESULTS

Diameter of the cells in hypertrophy and proliferative zones was considerably decreased in group B as compared to group A.

CONCLUSION

Administration of iron during pregnancy with normal iron status can disturb growth of the rat infant through its accumulation in the epiphyseal plate of femur. The cell diameter of the hypertrophy and proliferative zones was markedly reduced in iron administered group as compared to the control group.

Effect of skill laboratory training on academic performance of medical students

OBJECTIVE

To observe the effect of skill lab training on academic performance of final year medical students in terms of marks obtained in long case, short case, objective structured clinical examination and viva.

METHODS

The cross-sectional comparative study was conducted at Army Medical College, Rawalpindi from February to April 2015. Two batches of final year MBBS were recruited for the study. Batch 1 received conventional training, and Batch 2 received skill lab training. The performance of students was assessed by comparing the marks obtained in long case, short case, objective structured clinical examination and viva. Data was analysed using SPSS 23.

RESULTS

Of the 335 subjects, 168(50.1%) were male and 167(49.9%) were female students with a mean age of 21.79±1.02 years. Batch 1 had 151(45%) students and Batch 2 had 184(55%). Batch 2 got significantly higher marks in long case, short case and objective structured clinical examination (p<0.05 each). Viva result was not found to be related to training (p>0.05).

CONCLUSIONS

Acquisition of clinical skills significantly improved when medial students were trained in skill laboratories.

Role of Skill Laboratory Training in Medical Education - Students&rsquo; Perspective

OBJECTIVE

To evaluate the perceptions of medical students regarding their training utilizing facilities provided in the skill laboratory of a public sector medical college.

STUDY DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Army Medical College, Rawalpindi, from October to December 2014.

METHODOLOGY

Students of final year MBBS who had underwent skill laboratory training were recruited through convenience purposive sampling. Students not exposed to skill laboratory training were excluded. Data collection tool was a questionnaire having 23 questions with responses on Likert Scale as strongly disagree, disagree, agree and strongly agree coded as 1, 2, 3 and 4, respectively. Data was analysed on SPSS version 22.

RESULTS

There were 78 (57%) male and 59 (43%) female students out of 137, with mean age of 22.59 &plusmn;0.74 years. The response rate was 68.5%. Cronbach&#039;s Alpha test was 0.84 showing high reliability. The mean of sum of all the 23 items was 63.85 &plusmn;8.71, whereas item means was 2.78 &plusmn;0.38, reflecting a high inclination of students towards skill laboratory training. Frequency of students responding in favour of skill laboratory training was significantly high (p &lt; 0.05).

CONCLUSION

Medical students perceived skill laboratory training as a favoured learning strategy as compared to practising on real patients for acquisition of various aspects of clinical skills, knowledge and attitude.

Effectiveness of Case-Based Learning During Small Groups Sessions at Army Medical College

A pragmatic and sequential mixed method study was conducted at Army Medical College, from October to December 2014 to determine medical students' perceptions regarding effectiveness of small groups during the CBL(case-based learning) sessions. Tutorial Group Effectiveness Instrument (TGEI) was used after written and informed consent. Free text comments about CBL were invited from the respondents and common ones, and were tabulated. The mean scores were calculated and compared among different subgroups of respondents using appropriate independent sample t-test. Content analysis of qualitative segment was done. Ap-value of less than 0.05 was taken as statistically significant. The analysis of qualitative and quantitative variables was integrated in the final interpretation phase to draw conclusion. The average age of the participants was 19.33 ±0.657 years. The difference in scores was statistically insignificant for cognitive (p = 0.537), motivational (p = 0.868), and demotivational (p = 0.125) effectiveness between males and females. Insignificant difference was also observed for qualification of the overall group productivity among male and female students (p = 0.162), and exposed and non-exposed groups (p = 0.272). The perceptions of overwhelming number of participants were in favour of small group discussion as a component of CBL.

Role of vitamin E in preventing arteriohyalinization in kidneys of streptozotocin induced diabetic mice

OBJECTIVE

To evaluate the role of vitamin E on the arteriolar hyalinisation in kidneys of diabetic mice.

METHODS

The laboratory-based randomised control trial was conducted at the Department of Anatomy, Army Medical College, Rawalpindi, in collaboration with National Institute of Health, Islamabad, from November 2009 to November 2010. Adult female BALB/C mice were randomly divided into three groups. Group A served as control group. Group B was made diabetic by the intraperitoneal injection of streptozotocin. Group C received streptozotocin injection and was fed with vitamin E (alphatocopherol) supplemented diet. After 12 weeks,the animals were sacrificed and their kidneys were removed for histomorphological study. SPSS 16 was used for statistical analysis.

RESULTS

Diabetes caused significant histomorphological changes in arteriole of kidneys of Experimental Group B compared to Control Group A (p>0.05), but these changes were prevented in Group C. In experimental group B, 2(20%) animals had arteriolar hyalinisation of score 1, while score 2 was revealed in 8(80%) animals. Experimental group C showed no hyalinisation in any arteriole.

CONCLUSIONS

Vitamin E prevents the arteriohyalinization in kidneys of mice with STZ induced diabetes.

Role of nicotine and camellia sinensis on the developing femur of chick

OBJECTIVE

To study the harmful effects of nicotine on the developing femur of chick and to observe the role of antioxidant camellia sinensis in the prevention of these effects.

METHODS

The experimental study was conducted at Army Medical College, Rawalpindi, from November 2, 2011, to November 1, 2012, and comprised fresh fertilised eggs of Fayoumi species at zero hour of incubation of Fayoumi species. The eggs were divided into four equal groups. Control group G1 was given normal saline; G2 was given green tea extract; G3 was given 0.0001% nicotine solution; and G4 was given both 0.0001% nicotine solution and green tea extract. First exposure was at 48 hours of incubation and second at 48 hours of hatching (post-natal dose).At the age of one month, the chicks were sacrifised. The length of the femurs was measured with the help of measuring scale by keeping the ruler between greater trochanter and the lateral condyle. SPSS 16 was used for statistical analysis.

RESULTS

The four groups had 10 eggs each. G3 and G4 showed decreased growth compared to G1 and G2 (p<0.05). In G4, better growth was noticed compared to G3 (p<0.05), but its growth was less in comparison with G1 and G2(p>0.05).

CONCLUSIONS

Camellia sinensis antioxidant property helped to neutralise the oxidative injury by the use of nicotine, but was unable to recover it fully.

Factors associated with stress among medical students

OBJECTIVE

To determine the probable factors responsible for stress among undergraduate medical students.

METHODS

The qualitative descriptive study was conducted at a public-sector medical college in Islamabad, Pakistan, from January to April 2014. Self-administered open-ended questionnaires were used to collect data from first year medical students in order to study the factors associated with the new environment.

RESULTS

There were 115 students in the study with a mean age of 19±6.76 years. Overall, 35(30.4%) students had mild to moderate physical problems, 20(17.4%) had severe physical problems and 60(52.2%) did not have any physical problem. Average stress score was 19.6±6.76. Major elements responsible for stress identified were environmental factors, new college environment, student abuse, tough study routines and personal factors.

CONCLUSIONS

Majority of undergraduate students experienced stress due to both academic and emotional factors.

Higher stress scores for female medical students measured by the Kessler Psychological Distress Scale (K10) in Pakistan

The aim of this study was to determine the stress level of medical students and the relationship between stress and academic year. A cross-sectional, descriptive study was conducted at an undergraduate medical school with a five-year curriculum, in Pakistan, from January 2014 to April 2014. Medical students in the first four years were included in the study. The Kessler Psychological Distress Scale (K10), a self-administered questionnaire, was distributed to the students. A total of 445 medical students completed the questionnaire. The average stress score was 19.61 (SD=6.76) with a range from 10 to 43. Stress was experienced by 169 students (41.7%). The scores of female students were higher than scores of males, indicating a higher stress level (P=0.011). The relationship between stress and academic year was insignificant (P=0.392).

Role of dissection in light of students' perceptions

OBJECTIVE

To observe students' perception of gross anatomy dissection.

METHODS

The qualitative study comprised second year medical students of Army Medical College, Rawalpindi, and was conducted in July, 2013. Data was collected over three weeks through quota sampling. Focus group discussions were held with four groups having 15 students each.The sessions were audio-recorded which were transcribed and interpreted.

RESULTS

On the basis of FGDs, four themes were identified: Prossected specimen as an introductory teaching tool; emotional reaction on specimen handling; practical concerns during specimen handling; and experience of learning anatomy. Trends were identified within these broader themes.

CONCLUSION

There were differences in terms of attitudes and dissection hall experiences of medical students connected with the learning.

Effect of monosodium glutamate on the serum estrogen and progesterone levels in female rat and prevention of this effect with diltiazem

BACKGROUND

Glutamate is found in a wide variety of foods. It induces the uterine fibroid in the rats by increasing the levels of estradiol. Diltiazem is an effective preventive medication. This study was conducted to analyse the effect of monosodium glutamate on the serum estrogen and progesterone levels in adult Sprague Dawley rat and its prevention with diltiazem.

METHODS

This Laboratory based randomized controlled trial was conducted in the department of Anatomy, Army Medical College, Rawalpindi in collaboration with National Institute of Health (NIH), Islamabad from 9th April to 23rd April 2012. In this experimental study, 30 adult female Sprague Dawley rats of average weight of 500 g were randomly assigned into three groups. The experimental group B was given 0.08 mg/kg of monosodium glutamate (MSG) orally and experimental group C was given 0.08 mg/kg of MSG and 10 mg/kg of diltiazem in distilled water orally for 14 days. The control group (A) received only laboratory diet. Using intracardiac route 5 ml blood was taken from each animal for hormonal assay.

RESULTS

Hormone assay of the serum in the experimental group B showed increase in serum estrogen and progesterone levels as compared to the group A and there was minor increase in the hormonal levels in group C.

CONCLUSION

MSG causes increase in the serum estrogen and progesterone levels in adult female rats and diltiazem prevents this effect.

The role of folic acid in prevention of neural tube defects caused by high dose progesterone

AIM

To describe the effect of high dose progesterone (HDP) alone, or in combination with folic acid (FA), on occurrence of neural tube defects (NTDs) in chick embryo.

MATERIAL AND METHODS

60 Fertile, specific eggs of Fyoumi species of chick were selected at zero hr of incubation. They were incubated at 37.5 °C and 75% relative humidity until the embryos reached stage eight of development. At this stage the eggs were divided into four groups consisting of 15 eggs/group. The 1st group was incubated without any operation. The 2nd group was injected with physiological saline. The 3rd and 4th groups were injected with HDP (20x physiologic dose of progesterone) and HDP with supplement of 5 micrograms/embryo of FA, respectively. After 48 hrs of incubation, all embryos were reviewed for the presence of NTDs under light microscopy.

RESULTS

None of the eggs in the control, and saline injection groups showed NTDs, whereas 75 % (9/12) of the embryos in the 3rd group, and 58.3 % (7/12) of the chick embryos in 4th group showed NTDs.

CONCLUSION

Exogenous progesterone at levels twenty times above its physiologic range in chick embryos causes NTDs. FA supplementation decreases the frequency of NTDs but does not abolish them.