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This article explores practices regarding community–based activities (CBAs) of the undergraduate outcome–based integrated curriculum in medical colleges of twin cities (Rawalpindi–Islamabad) of Pakistan. The study identifies gaps and recommendations for implementing community–oriented and community–based medical education (COME & CBME) at the undergraduate level in Pakistan. The analysis shows that the lack of learning outcomes, assessment strategies, and supervisory structure hindered any improvement in the CBAs. The dominance of the clinical faculty and the Community Medicine faculty's limited motivation were identified as significant challenges hindering advancement in the CBME. The regulatory authority was proposed to combat pre–clinical versus clinical dilemmas and interdisciplinary and interprofessional issues, including multi–sectoral and community engagement challenges faced by the COME in Pakistan. Keywords: Community–Oriented, Medical Education, Undergraduate, Community–Based, Twin Cities, Pakistan DOI: 10.7176/JEP/15-6-10 Publication date: May 30th 2024

Environmental selection of antibiotic resistance genes (ARGs) is considered to be caused by antibiotic or metal residues, frequently used in livestock. In this study we examined three commercial poultry farms to correlate the co-occurrence patterns of antibiotic and metal residues to the presence of ARGs. We quantified 283 ARGs, 12 mobile genetic elements (MGEs), 49 targeted antibiotics, 7 heavy metals and sequenced 16S rRNA genes. The abundance and type of ARG were significantly enriched in manure while soil harbored the most diverse bacterial community. Procrustes analysis displayed significant correlations between ARGs/MGEs and the microbiome. Cadmium (Cd), arsenic (As), zinc (Zn), copper (Cu) and lead (Pb) were responsible for a majority of positive correlations to ARGs when compared to antibiotics. Integrons and transposons co-occurred with ARGs corresponding to 9 classes of antibiotics, especially Class1 integrase intI-1LC. Redundancy analysis (RDA) and Variance partitioning analysis (VPA) showed that antibiotics, metals, MGEs and bacteria explain solely 0.7%, 5.7%, 12.4%, and 21.9% of variances of ARGs in the microbial community, respectively. These results suggested that bacterial composition and horizontal gene transfer were the major factors shaping the composition of ARGs; Metals had a bigger effect on ARG profile than detected antibiotics in this study.

Micropollutants have become of great concern, because of their disrupting effects on the structure and function of microbial communities. However, little is known about the relative importance of trace micropollutants on the aquatic prokaryotic communities as compared to the traditional physico-chemical characteristics, especially at different spatial dimensions. Here, we investigated free-living (FL) and particle-associated (PA) prokaryotic communities in a subtropical water reservoir, China, across seasons at horizontal (surface water) and vertical (depth-profile) scales by using 16S rRNA gene amplicon sequencing. Our results showed that the shared variances of physico-chemicals and micropollutants explained majority of the spatial variations in prokaryotic communities, suggesting a strong joint effect of the two abiotic categories on reservoir prokaryotic communities. Micropollutants appeared to exert strong independent influence on the core sub-communities (i.e., abundant and wide-spread taxa) than on the satellite (i.e., less abundant and narrow-range taxa) counterparts. The pure effect of micropollutants on both core and satellite sub-communities from FL and PA fractions was similar to 1.5 folds greater than that of physico-chemical factors at the horizontal scale, whereas an opposite effect was observed at the vertical scale. Moreover, eight micropollutants including anti-fungal agents, antibiotics, bisphenol analogues, stimulant and UV-filter were identified as the major disrupting compounds with strong associations with core taxa of typical freshwater prokaryotes. Altogether, we concluded that the ecological disrupting effects of micropollutants on prokaryotic communities may vary along horizontal and vertical dimensions in freshwater ecosystems.

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) were investigated in eleven edible fish species (5 herbivorous and 6 carnivorous) collected from the River Chenab, Pakistan, during 2007–2009. Total OCP and PCB concentrations (ng g− 1 wet weight, ww) ranged between 13–107 (mean: 38) and 3.1–93.7 (mean: 20) for five herbivorous fish species and 21.6–365 (mean: 148) and 2.5–108 (mean: 30) for six carnivorous species, respectively. The trends of detected organochlorine pesticides (OCPs) in fish samples were: DDTs > PCBs > chlordanes > HCHs. The mean concentration(s) (ng g− 1 ww) of OCPs were relatively higher in all fish species collected near industrial areas followed by urban and agricultural areas. Risk assessment of OCPs and PCBs indicated that fish intake may pose health risk to humans with a consumption rate of > 8 g/person/day. The hazardous ratios for the 50th and 95th percentile data of OCPs and PCBs in fish exceeded the value of 1, suggesting that the daily exposure to OCPs and PCBs yield a lifetime cancer risk greater than 1 in 10,000.