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Saturday, September 29, 2012
Pakistan medical education crisis Medical education in the doldrums... Medical education in Pakistan is going through a serious crisis. With the significance attached to it as a major component of the social sector, one would have expected a little more official concern towards this vital area. Yet different stakeholders are working for their own benefit at the cost of the national healthcare delivery mechanism. The government and its various functionaries, public-sector institutions and the Pakistan Medical and Dental Council (PMDC) - which is responsible for the monitoring and standardisation of medical education - have all apparently lost interest in this regard. It is therefore understandable that people with vested interests have taken over. In the last two years, the PMDC recognised all medical and dental colleges that applied for registration. There was only one exception which, by the looks of it, lacked the 'right' political and financial connections. While we have as many as 92 PMDC-recognised medical colleges in the public and private sectors, the majority of them struggle to meet even the minimal PMDC requirements as regards to faculty, space and facilities. It is also a fact that the PMDC has allowed several of these colleges to increase their induction quota. The least expensive of medical colleges in the private sector charges at least Rs400,000 per student per annum, making it one of those rare businesses in which millions can be earned without having to make a proportionate investment. In terms of faculty, there is an acute shortage of educationists to impart instruction in basic medical sciences such as anatomy, physiology, biochemistry, pharmacology and histology that are taught during the foundation years. There was a proposal to have a shared faculty so that, for example, a professor of anatomy would embark on a teaching tour to various medical colleges. The owners of private medical colleges were quite enthusiastic about the idea but are reluctant to merge colleges. The reason is obvious: by sharing a professor, they stand to cut their salary bill which will increase profits. Public-sector medical colleges are in the same boat. Bolan Medical College in Balochistan is in a pathetic situation, while the newly opened college in Swat has an acute shortage of faculty in all departments. Some colleges in Sindh and Punjab are also faculty-deficient. Dow International Medical College, a public-sector entity charging a massive fee in foreign exchange, allegedly has faculty and facilities only on paper. The situation on the clinical side is not too different either. Clinical teaching is not possible without professionals who are willing to spend time in wards, outpatient departments and emergency rooms. There is hardly any practical training under proper supervision worth its name. During the previous government the then health minister, who was a graduate of Liaquat Medical College at Jamshoro, converted his alma mater into a full-scale medical university. He argued that this would organise medical education along scientific lines in the province. With the Higher Education Commission providing the millions that were needed, the Liaquat University of Health and Medical Sciences came into existence through an executive order, and without any feasibility study having been undertaken. Immediately afterwards, the health minister of Punjab decided to have a medical university in his province. Thus came into existence the Punjab University of Health Sciences. Since then a plethora of medical universities have sprung up across the country.With so many universities one hoped that everybody would have been satisfied, but that is not the case. No studies have been undertaken on what effective change has been brought about by the hundreds of millions that have been spent on these fancy universities. They have started PhD and MPhil programmes but the quality of training and teaching is obvious in departments where faculty members are not qualified to deliver. One of the first things that ought to have been done after all these institutions achieved university status was to convert part-time medical institutions into full-time educational centres. That, however, was never on the agenda. The focus was on construction and purchasing equipment, which could never have had any impact on the basic structure of training. The current government's decision to turn medical colleges in Larkana and Nawabshah into universities is also rooted primarily in politics. There is no valid reason to hope that they will be any different from their predecessors in terms of approach and execution.It is time someone in authority did a serious, sincere and professional audit of the billions issued in grants. Did the grant have any impact on the quality of teaching? Was the money well spent? In terms of postgraduate training, a number of programmes are run by various institutions but are plagued with the same malaise that is the fate of their undergraduate counterparts. The establishment of universities has in fact only exacerbated the situation. Every institution now wants to start some training programme or the other to justify its existence even though most of them have neither the infrastructure nor the human resources for a structured training programme that would produce specialists. Medical curricula and training programmes need to be developed according to the needs of the local people. What we are doing is training doctors to work abroad. Medical students and postgraduate trainees are not exposed to the masses and their afflictions. No wonder we have a very high maternal mortality rate, we have failed to eradicate polio, our neonates are dying, we are unable to save the eyes of young children and our basic health units, rural health centres and taluka hospitals are non-functional. Furthermore, a large number of doctors have no ethical considerations. This is because we initiate programmes without thinking, planning and setting definite goals. The common man and his problems are nowhere in sight when we make decisions. There is a need to form a high-powered committee or commission on medical education to address these issues. Such a commission should justify the need for profit-oriented medical colleges and their role in the country's healthcare system, and examine the role of medical universities in the war against sickness and disease. Dawn
Friday, September 28, 2012
The researchers from the University of Bonn and the Central Institute of Mental Health in Mannheim compared the genetic makeup of the problematic Internet users with that of healthy control individuals. This showed that the 132 subjects are more often carriers of a genetic variation that also plays a major role in nicotine addiction. "What we already know about the nicotinic acetylcholine receptor in the brain is that a mutation on the related gene promotes addictive behavior," explains Dr. Montag. Nicotine from tobacco fits -- just like acetylcholine, which is produced by the body -- like a key into this receptor. Both these neurotransmitters play a significant role in activating the brain's reward system. "It seems that this connection is not only essential for nicotine addiction, but also for Internet addiction," reports the Bonn psychologist. Women more affected by this mutation The actual mutation is on the CHRNA4 gene that changes the genetic makeup for the Alpha 4 subunit on the nicotinic acetylcholine receptor. "Within the group of subjects exhibiting problematic Internet behavior this variant occurs more frequently -- in particular, in women," says Dr. Montag. This finding will have to be validated further because numerous surveys have found that men are more prone to Internet addiction than women. The psychologist assumes, "The sex-specific genetic finding may result from a specific subgroup of Internet dependency, such as the use of social networks or such." Better addiction diagnosis through biological markers Dr. Montag added that studies including more subjects are required to further analyze the connection between this mutation and Internet addiction. "But the current data already shows that there are clear indications for genetic causes of Internet addiction." He added that with the mutation, a biological marker had been found that would allow to characterize online addiction from a neuro-scientific angle. "If such connections are better understood, this will also result in important indications for better therapies," says Dr. Montag
Something for WORLD HEART DAY... The study, carried out in Greece, assessed the effect of four-week oral treatment with 2 g/day of omega-3 fatty acids on the arterial wall properties of cigarette smokers. The results showed that short-term treatment with omega-3 fatty acids improves arterial stiffness and moderates the acute smoking-induced impairment of vascular elastic properties in smokers. "These findings suggest that omega-3 fatty acids inhibit the detrimental effects of smoking on arterial function, which is an independent prognostic marker of cardiovascular risk," said Dr. Gerasimos Siasos, University of Athens Medical School, 1st Department of Cardiology, "Hippokration" Hospital. "The cardioprotective effects of omega-3 fatty acids appear to be due to a synergism between multiple, intricate mechanisms involving anti-inflammatory and anti-atherosclerotic effects. Furthermore, AHA recommends that people without documented history of coronary heart disease should consume a variety of fish (preferably oily -- rich in omega-3 fatty acids) at least twice per week." "The World Heart Federation strongly encourages all smokers to quit," said Dr Kathryn Taubert, Chief Science Officer at the World Heart Federation. "The only way to protect your body from the harmful effects of tobacco is to stop smoking. We encourage all people, both smokers and non-smokers, to eat healthy diets, which includes foods rich in omega-3 fatty acids."
Thursday, September 27, 2012
for those who think we can't do it because we are a PAKISTANI ! it happend it january 2012
ISLAMABAD – Dr Naeem Taj, a surgeon of the Capital Hospital CDA, has earned fame and prestige for the nation by gaining entry into the Guinness Book of World Record by removing 25.5 cm long gallbladder through 1 cm incision.
Dr Naeem after operating 70-year-old patient Rasheeda Bibi at CDA hospital removed 25.5cm long gallbladder from her body. This is the longest ever gallbladder removed laparoscopically in medical history. Guinness Book of World record has awarded Dr Naeem Taj of CDA with the certificate of “world’s longest gallbladder removed through laparoscopy”.
Executive Director Capital Hospital, Dr Saddique Akbar Satti on the occasion said that he was proud of his surgeon Dr Naeem Taj and expected much more on his credit due to his sheer talent.http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/islamabad/10-Jan-2012/pakistani-surgeon-lands-in-guinness-book