OBJECTIVE: To identify the stressors related to academic online teaching and the change in social... more OBJECTIVE: To identify the stressors related to academic online teaching and the change in social norms during the pandemic and to assess their psychological impact on the medical students. METHODS: A web based, descriptive cross-sectional study was conducted at Hazrat Bari Imam Sarkar Medical and Dental College, Islamabad Pakistan over a period of 4 months using an Online questionnaire via Google forms based on Depression Anxiety Stress Scales (DASS21) scale comprising of 21 questions which address the depression, anxiety, and stress related questions. The modified questionnaire also contained open ended questions along with a short questionnaire based on 3 points Likert scale. RESULTS: Total of 305 subjects participated. Mean (±SD) severity score for Depression, anxiety and stress was 2.02± 1.3, 1.76±1.25 and 1.66±1.15 respectively. Highly significant positive correlation was observed between depression and stress score of subjects and history of COVID-19 infection in an acquain...
Objective: The study was to assess the knowledge and attitude of medical students and young medic... more Objective: The study was to assess the knowledge and attitude of medical students and young medical college teachers regarding Genetic Risk Testing for Premature Coronary Artery Disease. Study Design: Cross Sectional Descriptive study. Setting: Azad Jammu and Kashmir Medical College, Muzaffarabad and Combined Military Hospital Muzaffarabad. Period: September, 2019 to December, 2019. Material & Methods: A self-completion online questionnaire was sent to collect the data from 298 medical students and 70 young medical college teachers (<45 years) at Azad Jammu & Kashmir Medical College, Muzaffarabad, Pakistan and Combined Military Hospital Muzaffarabad. The questionnaire contained questions related to the knowledge and attitudes of the participants towards genetic risk testing along with their views regarding direct to consumer genetic tests for PCAD versus genetic tests involving consultation with a cardiologist before opting for such tests. Results: A total of 250 medical student...
Objective: The students and teachers are major stakeholders whenever there is a change in the cur... more Objective: The students and teachers are major stakeholders whenever there is a change in the curriculum. Objective of the study was to assess the views of Third Year MBBS students and college teachers involved in teaching Third Year MBBS class regarding the inclusion of special pathology to the already cumbersome course content. Methods: It was a cross-sectional descriptive study carried out over a period of eight months from April, 2019 to December, 2019.An online questionnaire was used to collect the data from 110 third year MBBS students and 35 medical college teachers involved in teaching the third year MBBS class at HBS Medical & Dental College, Islamabad, Pakistan. The questionnaire contained open ended questions along with a short questionnaire based on 3-point Likert scale for a semi-quantitative analysis. The open ended responses in the interviews were assessed using Mayring’s qualitative context analysis. The similar comments were bundled up as the comments were sequentia...
Integrative genomics may help in the identification of novel biological pathways in the pathogene... more Integrative genomics may help in the identification of novel biological pathways in the pathogenesis of CAD. Objectives: To find out the association of 5 Cytokine SNPs and 13 CAD SNPs gene risk scores with serum cytokine levels in Premature Coronary Artery Disease (PCAD). To identify the direct and indirect protein interactions of the 13 CAD risk genes and the 5 cytokine genes in PCAD. Study Design: Case-control study. Setting: Army Medical College, in association with University College London (UCL), London, United Kingdom (UK). Materials and Methods: 340 PCAD patients and 310 age and sex matched controls were recruited. Serum IL18, TNFA, IL6 and IL10 levels were measured using ELISA (Invitrogen). The SNPs were genotyped using TAQMAN and KASPar assays. Data analysis was done using standard SPSS software version-21 (SPSS Inc, Chicago, Illinois, USA). The proteinprotein interaction (PPI) network was generated using STRING version 9.0, Genemania and I-Tessar web. Results: The patients of PCAD had mean ± SD age of 42 ± 3.80 years consisting of 329 males and 11 females. The 5 SNP cytokine gene risk score correlated significantly with the serum IL-18, IL-6, TNF-alpha, IL-18: IL-10 and TNF-alpha: IL-10 ratios (p<0.01). The 13 CAD SNP gene risk score also correlated significantly with the serum IL-18, TNF-alpha, IL-18: IL-10 and TNF-alpha: IL-10 ratios but not with serum IL-6 levels. IL-6 works in close interaction with IL-6R, STAT3 and NFKB1. While MRAS, MIA3 and SORT1 interact with each other CXCL-12 mediates its actions by interacting with IL-18, JAK-2 and CCR4. LPA interacts closely with APOB and LPL acts via interaction with APOA4 and APOA5. Conclusion: The correlation between gene risk scores and serum cytokine levels can aid in the analysis of complex networks to understand the pathogenesis of PCAD.
Pro- and anti-inflammatory cytokines play a significant role in early atherosclerosis. Linkage di... more Pro- and anti-inflammatory cytokines play a significant role in early atherosclerosis. Linkage disequilibrium patterns differ between ethnic groups pointing toward the need to develop population-specific gene risk scores. Our objective was to investigate the role of a cytokine gene score in the risk prediction of premature coronary artery disease (PCAD). A case-control study was performed at the National University of Sciences and Technology (NUST) in collaboration with the Cardiovascular Genetics Institute, University College London, United Kingdom. Three hundred forty subjects with >70% stenosis in at least one coronary vessel on angiography were labeled as PCAD cases and compared with 310 angio-negative controls. Genotyping of the rs187238 (interleukin [IL]-18), rs1800795 (IL-6), rs1800629 (tumor necrosis factor [TNF]-alpha), rs1800871 (IL-10), and rs1946519 (IL-18) SNPs was performed using KASPar and TaqMan assays. The odds ratio for cytokine gene score was significantly high...
Objective: To determine the cut-off values for serum Prostate Specific Antigen and Gleason score ... more Objective: To determine the cut-off values for serum Prostate Specific Antigen and Gleason score for predicting bone metastasis of Prostate cancer. Methodology: This diagnostic accuracy study was conducted in Pakistan Institute of Medical Sciences (PIMS), Islamabad from 2015 to 2018. 330 patients of Prostate cancer were enrolled in the study. Prostate Specific Antigen (PSA) and Gleason Scores (GS) were determined using commercially available ELECSYS® assays in the Modular Analytics E170 (Roche Diagnostics) and histopathology respectively. Tc99m methylene diphosphonate (MDP) was used to perform the Bone scan. Any correlation between these variables was nvestigated to determine a cut-off value for PSA and GS. Results: Out of the total 330 patients included in the sample, BS was positive for metastasis in 186 (56.4%) patients and negative in 144 (43.6%) patients. Amongst these 186 positive patients, 5 (2.7%) had PSA < 20 ng/ml, 174 (93.5%) had PSA between 20 and 90 ng/ml, and 9 (4.8...
OBJECTIVE: To identify the stressors related to academic online teaching and the change in social... more OBJECTIVE: To identify the stressors related to academic online teaching and the change in social norms during the pandemic and to assess their psychological impact on the medical students. METHODS: A web based, descriptive cross-sectional study was conducted at Hazrat Bari Imam Sarkar Medical and Dental College, Islamabad Pakistan over a period of 4 months using an Online questionnaire via Google forms based on Depression Anxiety Stress Scales (DASS21) scale comprising of 21 questions which address the depression, anxiety, and stress related questions. The modified questionnaire also contained open ended questions along with a short questionnaire based on 3 points Likert scale. RESULTS: Total of 305 subjects participated. Mean (±SD) severity score for Depression, anxiety and stress was 2.02± 1.3, 1.76±1.25 and 1.66±1.15 respectively. Highly significant positive correlation was observed between depression and stress score of subjects and history of COVID-19 infection in an acquain...
Objective: The study was to assess the knowledge and attitude of medical students and young medic... more Objective: The study was to assess the knowledge and attitude of medical students and young medical college teachers regarding Genetic Risk Testing for Premature Coronary Artery Disease. Study Design: Cross Sectional Descriptive study. Setting: Azad Jammu and Kashmir Medical College, Muzaffarabad and Combined Military Hospital Muzaffarabad. Period: September, 2019 to December, 2019. Material & Methods: A self-completion online questionnaire was sent to collect the data from 298 medical students and 70 young medical college teachers (<45 years) at Azad Jammu & Kashmir Medical College, Muzaffarabad, Pakistan and Combined Military Hospital Muzaffarabad. The questionnaire contained questions related to the knowledge and attitudes of the participants towards genetic risk testing along with their views regarding direct to consumer genetic tests for PCAD versus genetic tests involving consultation with a cardiologist before opting for such tests. Results: A total of 250 medical student...
Objective: The students and teachers are major stakeholders whenever there is a change in the cur... more Objective: The students and teachers are major stakeholders whenever there is a change in the curriculum. Objective of the study was to assess the views of Third Year MBBS students and college teachers involved in teaching Third Year MBBS class regarding the inclusion of special pathology to the already cumbersome course content. Methods: It was a cross-sectional descriptive study carried out over a period of eight months from April, 2019 to December, 2019.An online questionnaire was used to collect the data from 110 third year MBBS students and 35 medical college teachers involved in teaching the third year MBBS class at HBS Medical & Dental College, Islamabad, Pakistan. The questionnaire contained open ended questions along with a short questionnaire based on 3-point Likert scale for a semi-quantitative analysis. The open ended responses in the interviews were assessed using Mayring’s qualitative context analysis. The similar comments were bundled up as the comments were sequentia...
Integrative genomics may help in the identification of novel biological pathways in the pathogene... more Integrative genomics may help in the identification of novel biological pathways in the pathogenesis of CAD. Objectives: To find out the association of 5 Cytokine SNPs and 13 CAD SNPs gene risk scores with serum cytokine levels in Premature Coronary Artery Disease (PCAD). To identify the direct and indirect protein interactions of the 13 CAD risk genes and the 5 cytokine genes in PCAD. Study Design: Case-control study. Setting: Army Medical College, in association with University College London (UCL), London, United Kingdom (UK). Materials and Methods: 340 PCAD patients and 310 age and sex matched controls were recruited. Serum IL18, TNFA, IL6 and IL10 levels were measured using ELISA (Invitrogen). The SNPs were genotyped using TAQMAN and KASPar assays. Data analysis was done using standard SPSS software version-21 (SPSS Inc, Chicago, Illinois, USA). The proteinprotein interaction (PPI) network was generated using STRING version 9.0, Genemania and I-Tessar web. Results: The patients of PCAD had mean ± SD age of 42 ± 3.80 years consisting of 329 males and 11 females. The 5 SNP cytokine gene risk score correlated significantly with the serum IL-18, IL-6, TNF-alpha, IL-18: IL-10 and TNF-alpha: IL-10 ratios (p<0.01). The 13 CAD SNP gene risk score also correlated significantly with the serum IL-18, TNF-alpha, IL-18: IL-10 and TNF-alpha: IL-10 ratios but not with serum IL-6 levels. IL-6 works in close interaction with IL-6R, STAT3 and NFKB1. While MRAS, MIA3 and SORT1 interact with each other CXCL-12 mediates its actions by interacting with IL-18, JAK-2 and CCR4. LPA interacts closely with APOB and LPL acts via interaction with APOA4 and APOA5. Conclusion: The correlation between gene risk scores and serum cytokine levels can aid in the analysis of complex networks to understand the pathogenesis of PCAD.
Pro- and anti-inflammatory cytokines play a significant role in early atherosclerosis. Linkage di... more Pro- and anti-inflammatory cytokines play a significant role in early atherosclerosis. Linkage disequilibrium patterns differ between ethnic groups pointing toward the need to develop population-specific gene risk scores. Our objective was to investigate the role of a cytokine gene score in the risk prediction of premature coronary artery disease (PCAD). A case-control study was performed at the National University of Sciences and Technology (NUST) in collaboration with the Cardiovascular Genetics Institute, University College London, United Kingdom. Three hundred forty subjects with >70% stenosis in at least one coronary vessel on angiography were labeled as PCAD cases and compared with 310 angio-negative controls. Genotyping of the rs187238 (interleukin [IL]-18), rs1800795 (IL-6), rs1800629 (tumor necrosis factor [TNF]-alpha), rs1800871 (IL-10), and rs1946519 (IL-18) SNPs was performed using KASPar and TaqMan assays. The odds ratio for cytokine gene score was significantly high...
Objective: To determine the cut-off values for serum Prostate Specific Antigen and Gleason score ... more Objective: To determine the cut-off values for serum Prostate Specific Antigen and Gleason score for predicting bone metastasis of Prostate cancer. Methodology: This diagnostic accuracy study was conducted in Pakistan Institute of Medical Sciences (PIMS), Islamabad from 2015 to 2018. 330 patients of Prostate cancer were enrolled in the study. Prostate Specific Antigen (PSA) and Gleason Scores (GS) were determined using commercially available ELECSYS® assays in the Modular Analytics E170 (Roche Diagnostics) and histopathology respectively. Tc99m methylene diphosphonate (MDP) was used to perform the Bone scan. Any correlation between these variables was nvestigated to determine a cut-off value for PSA and GS. Results: Out of the total 330 patients included in the sample, BS was positive for metastasis in 186 (56.4%) patients and negative in 144 (43.6%) patients. Amongst these 186 positive patients, 5 (2.7%) had PSA < 20 ng/ml, 174 (93.5%) had PSA between 20 and 90 ng/ml, and 9 (4.8...
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