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Objective: To determine the effect of combined supplementation of Pioglitazone and Acacia Honey on blood glucose levels in Streptozotocin-induced type 2 diabetic rats. Study Design: Laboratory-based animal study. Place and Duration of study: Al-Nafees Medical College, in collaboration with the National Institute of Health, Islamabad Pakistan, from Jan 2016 to Jun 2017. Methodology: The study was conducted on 150 male Sprague Dawley rats, divided into five groups with 30 rats. Group-I was the control Group. Groups II-V were given Streptozotocin 65 mg Streptozotocin intraperitoneally to make them diabetic. Group II was diabetic control. Group-III was given acacia honey for three weeks. Group-IV received an intraperitoneal injection of Pioglitazone (oral hypoglycemic) 15 mg/kg body weight per day plus Acacia honey, and Group-V was given Pioglitazone intraperitoneally for the same dose and duration. Fasting blood glucose levels were measured after three weeks of supplementation. Results: After three weeks of supplementation, the blood glucose levels were significantly (p-value

Objectives: To identify improvement in knowledge and attitude of Family Medicine (FM) postgraduate trainees (PGT) towards Palliative care (PC) in order to provide effective care to the patients with advanced disease. Methods: A cross-sectional study was conducted over eight weeks from 1st July till 3rd September 2021 at Family Medicine Department, Aga Khan University Hospital (AKUH). PGT who willingly signed the written informed consent were enrolled in the study. Descriptive analysis, frequencies, proportions and thematic approach were used for data analysis. Data was analyzed using SPSS version 23. Results: FM-PGT were included in the study. Improvement in knowledge was observed in posttest scores along with positive change in their attitude and improved perception of level of confidence for managing PC patients. Overall assessment of PCM was positive. Conclusion: This PCM seems to be a useful tool for PC training in postgraduate medical education (PGME). This highlights some useful aspects for future applications in PC education and training. doi: https://doi.org/10.12669/pjms.39.4.6984 How to cite this: Jabeen I, Usman T, Asad M, Qureshi A, Waqar MA. Evaluation of postgraduate family medicine trainee’s knowledge and attitude following an online Educational Module in Palliative Care: A descriptive study. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6984 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The COVID-19 pandemic has highlighted the important role of telemedicine as a tool for safe healthcare delivery across the world. While its use was more common in the developed world, the developing world has also adopted this strategy. It is important to develop a clear process and contextual guidance for effective use of this strategy for better patient-doctor interaction and its role in teaching/learning of trainees. doi: https://doi.org/10.12669/pjms.37.2.3592 How to cite this:Asad M, Nooresahar, Sabzwari SR. Telemedicine: A New Frontier in Clinical Practice. Pak J Med Sci. 2021;37(2):588-590. doi: https://doi.org/10.12669/pjms.37.2.3592 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: To assess first year MBBS students’ perceptions regardingIntegrated Performance Assessment and its relevance to clinical practice as compared withtraditional OSPEs. Study Design: Cross-sectional observational study. Setting: Al NafeesMedical College, Isra University, Islamabad. Period: Final week of First year MBBS students’professional exam held in November 2013. Methodology: Both interactive and static stationswere developed according to predetermined assessment blueprint. Clinical scenarioswere used as triggers followed by tasks relating to laboratory skills and or relevant physicalexamination on standardized subjects. Two to three tasks were given at each station. Checklistsfor standardized marking of observed stations were also developed. Feedback questionnairewas given to find out overall perception of students regarding this assessment process at theend of examination. The questionnaire comprised of 18 statements to be rated on 5-point Likertscale. Results: Almost all the students agreed that Integrated Performance Assessment wasbetter than traditional OSPEs. 73% of students agreed that stations were well organized and83.4% showed that the time duration for task completion was appropriate. 75% agreed thatstations reflected integration of various disciplines. 64 % were of the opinion that basic scienceknowledge was linked to clinical practice. 72.1% were of the opinion that it involved criticalthinking in clinical context. However, students suggested improving further in organizationand integration of stations. Conclusion: Students perceived IPA as a better tool of assessingapplication of basic science concepts and its clinical relevance in integrated curriculum format.

Background and Objective: Both Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries. Both of them are blood borne and are transmitted through un-screened blood transfusion, inadequately sterilized needles and equipment. According to WHO’s criteria of endemicity, Pakistan has high disease burden of Hepatitis B and C. The present study was planned to determine the frequency and to identify the risk factors of hepatitis B and C virus in the general community of Farash town. Methods: This descriptive study was carried out in Al Nafees Medical Hospital Lab, from January 2013 to December 2013. Both the genders and all age groups were included in the study. All the patients who fulfilled the inclusion criteria had given a written consent. Data was collected through questionnaire and was analyzed on Statistical Package for Social Sciences (SPSS) version 21. Results: Three-hundred and forty five patients were studied. Among these 92 (27%) were males and 253(73%) were female, 33% of them had hepatitis C, 9% had hepatitis B. History of injections was reported in all of the patients. Visit to community barbers was present in 58.6% and 41% cases of hepatitis B and C. History of dental procedures was obtained in 7(24%) and 15(13%) patients of hepatitis B and C. Conclusion: Major contributors for Hepatitis B and C in Farash town are use of unsterilized therapeutic injections and visit to community barbers. Education of the barbers regarding sterilization may help in reducing the burden of infection in this community.

Student selection for Undergraduate Medical Education Programmes (UGME) is a highly selective process globally. Health care practice requires many attributes like communication skills, professionalism, critical thinking and problem solving in addition to cognitive abilities. This study reports the development and administration of Multiple Mini Interviews (MMI), the descriptive and psychometric properties of the MMI station scores and assesses the validity of MMI stations to ascertain if the stations measured the intended attributes. Nine attributes considered most essential for a successful health care professional were selected. A 5 point rating scale was used to rate each item on the station. The scores were then converted into percentage scores. The mean scores on each MMI station ranged from 27.4% to 80.0%. The reliability of stations using Cronbach's alpha ranged from 0.64 to 0.98. MMI can be used to make reliable and valid decisions to select students with desired non cognitive attributes.

Problem based learning (PBL) is an instructional approach that utilizes problems or cases as a context for students to acquire problem solving skills. It promotes communication skills, active learning, and critical thinking skills. It encourages peer teaching and active participation in a group.It was a cross-sectional study conducted at Al Nafees Medical College, Isra University, Islamabad, in one month duration. This study was conducted on 193 students of both 1st and 2nd year MBBS. Each PBL consists of three sessions, spaced by 2-3 days. In the first session students were provided a PBL case developed by both basic and clinical science faculty. In Session 2 (group discussion), they share, integrate their knowledge with the group and Wrap up (third session), was concluded at the end. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions.Teaching through PBLs greatly improved the problem solving and critical reasoning skills with 60% students of first year and 71% of 2nd year agreeing that the acquisition of knowledge and its application in solving multiple choice questions (MCQs) was greatly improved by these sessions. They observed that their self-directed learning, intrinsic motivation and skills to relate basic concepts with clinical reasoning which involves higher order thinking have greatly enhanced. Students found PBLs as an effective strategy to promote teamwork and critical thinking skills.PBL is an effective method to improve critical thinking and problem solving skills among medical students.

To compare the duration and effects of aqueous methanol Acacia-nilotica leaves extract and glibenclamide as hypoglycaemic and hypolipidaemic activity in diabetic rats.The experimental study was conducted at Shifa International Hospital in collaboration with National Institute of Health, Islamabad, from September 2010 to August 2011.Male Sprague Dawley albino rats were taken and divided into 8 equal groups. Groups I and II were the normal and diabetic control rats. Diabetes mellitus was induced in group II to VIII by administering 110 mg/kg body weight alloxanand at day 4, fasting blood glucose level of200 mg/dl confirmed diabetes. Acacia-nilotica leaves extract was given to group III, IV and V and glibenclamide to group VI to VIII for a period of 1-3 weeks. Blood samples were analysed for lipid profile using enzymatic calorimetric method and serum insulin by enzyme-linked immunosorbent assay on days 0, 7, 14, and 21.There were 64 rats in the study, with 8(12.5%) in each group. Statistically significant decreases in fasting blood glucose, total cholesterol, triglyceride, phospholipids, low density lipoprotein, very low density lipoprotein and an increase in high density lipoprotein and serum insulin levels were observed in diabetic rats compared to diabetic controls after 2 weeks of treatment with plant extract and glibenclamide (p0.05 each).When plant extract and drug treated diabetic rats were compared, a significant difference in the levels of blood glucose, insulin, total cholesterol and triglyceride levels were noted after 2 and 3 weeks of treatment.Acacia-nilotica leaves extract resulted in hypoglycaemic and hypolipidaemic effect in alloxan-induced diabetic rats similar to glibenclamide.

To consider new hypoglycaemic, anti-hyperlipidaemic and anti-platelet aggregation sources, aqueous methanol extract of Acacia Nilotica (AN) leaves was investigated in streptozotocin induced diabetic rats.Diabetes mellitus was induced in 90 out of 120 male albino rats by administering 50 mg/Kg bodyweight (bw) streptozotocin intraperitonealy, and was confirmed by measuring fasting blood glucose level200 mg/dL on 4th post-induction day. The rats were equally divided into 4 groups, A (normal control), B (diabetic control), C (diabetics rats treated with plant extract) and group D (diabetics rats treated with glyburide). The rats of group C and D were given single dose of 300 mg/Kg bw, AN extract, and 900 microg/Kg bw glyburide respectively for 3 weeks. Blood glucose levels were measured by glucometer, platelet aggregation by DiaMed method, beta-thromboglobulin and insulin by ELISA technique, and lipid components were measured by enzymatic calorimetric method.Significant differences (p0.05) were noticed in blood glucose, serum insulin, platelet aggregation and triglyceride levels in diabetic rats treated with AN extract and glyburide as compared to diabetic controlled rats. A significant difference (p0.05) in beta-thromboglobulin and LDL levels was also noticed in rats treated with glyburide than the diabetic controlled rats. The levels of fasting blood glucose, beta-thromboglobulin and platelet aggregation were significantly reduced (p0.05) in diabetic rats treated with glyburide than AN extract treated rats.Administration of AN leaves extract showed hypoglycaemic and anti-platelet aggregation activity in diabetic rats as that of glyburide.

To determine the effect of estradiol treatment on serum corticosterone levels in Oophorectomized (OVX) female Sprague Dawley rats exposed to chronic restraint stress.Experimental study.Department of Physiology, Army Medical College, Rawalpindi and National Institute of Health, Islamabad, from January to December 2008.A total of 90 female Sprague Dawley rats (age: 90 ± 10 days), were divided into three groups, each having 30 rats. Group-I comprised of healthy control female rats whereas group-II and III were experimental female rats exposed to chronic restraint stress after bilateral Oophorectomy and called estradiol treated and vehicle treated groups. Estradiol treatment of Oophorectomized rats was done once daily for 2 weeks. At the end of experiment, the rats were sacrificed and intracardiac blood sampling was done to measure serum corticosterone levels by enzyme linked immunosorbent assay (ELISA) kit.The restraint stress to estradiol treated rats for 2 weeks revealed that serum corticosterone levels were significantly increased (31.32 ± 5.46 ng/ml, p0.05) as compared to the healthy controls (17.48 ± 4.14 ng/ml).Chronic restraint stress results increases the serum corticosterone levels in Oophorectomized Sprague Dawley rats. Estradiol treatment increases the responsiveness of adrenal cortex of Oophorectomized female rats.

Ogilvie's syndrome (OS), a massive dilation of the colon in the absence of mechanical obstruction, is a rare postsurgical complication. The high mortality rate (normally 15-31% and upto 45% after caecal perforation) explains the seriousness of this clinical situation. Early diagnosis is made by plain abdominal X-ray and CT abdomen. Conservative treatment is usually effective and surgery should be reserved for complicated cases or refractory to conservative treatment. We report a case of 25 years primigravida who developed OS, 24 hours after cesarean section, which was treated by conservative methods.