Research Integrity, Governance, and Misconduct in Pakistan: Some Proposed Solutions.

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Use of Social Media and Digital Profile of Physicians: What One Needs to Know?

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Virtual Conference Cannot Replace Physical Meeting: Lessons from COVID-19 Pandemic Online Transformation.

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Challenges of Online Medical Education in Pakistan During COVID-19 Pandemic.

The novel coronavirus (COVID-19) pandemic has adversely affected economy, social life, and educational services all around the globe. Medical colleges and universities are facing challenges to provide quality education to their students during this prolonged period of lockdown. Technologically advanced countries have systems in place for e-learning and online medical education. This is not the case with most of the low-income countries like Pakistan. Here, we describe the challenges being faced by medical faculty members and students in Pakistan while engaging in online medical education during the COVID-19 pandemic. These include lack of faculty training and institutional support, internet connectivity issues, maintaining student engagement, online assessments, and problems with understanding the unique dynamics of online education. A collaborative approach involving all stakeholders, intuitional support, use of free online training resources, and out of box thinking can help overcome these challenges. Key Words: Analysis, E-learning, Coronavirus, Developing countries, Solutions.

Information Overload and Infodemic in the COVID-19 Pandemic.

The world has experienced pandemics worse than the coronavirus disease (COVID-19) which resulted in great loss of life and economy. However, the global effect of this pandemic has been devastating. Billions of people are in lockdown and isolation on six continents around the world. Most have easy access to information due to internet connectivity and electronic media, which has helped share information about the pandemic. However, information overload during the current COVID-19 pandemic has posed a set of challenges not encountered before. There is an "infodemic" in which false news, conspiracy theories, magical cures and racist news are being shared at an alarming rate, with the potential to increase anxiety and stress and even lead to loss of life. This review highlights some of these challenges and suggests general measures to avoid information overload and infodemic in the connected world of 21st century.

Combating Scientific Misconduct: The Role of Focused Workshops in Changing Attitudes Towards Plagiarism.

Introduction Scientific misconduct is a global issue. There is low awareness among health professionals regarding plagiarism, particularly in developing countries, including Pakistan. There is no formal training in the ethical conduct of research or writing for under- and post-graduate students in the majority of medical schools in Pakistan. Internet access to published literature has made plagiarism easy. The aim of this study was to document the effectiveness of focused workshops on reducing scientific misconduct as measured using a modified version of the attitude towards plagiarism questionnaire (ATPQ) assessment tool. Materials and methods A cross-sectional study was conducted with participants of workshops on scientific misconduct. Demographic data were recorded. A modified ATPQ was used as a pre- and post-test for workshop participants. Data were entered in SPSS v20 (IBM< Armonk, NY, US). Frequencies and descriptive statistics were analyzed. An independent sample t-test was run to analyze differences in mean scores on pre-workshop ATPQ and differences in mean scores on post-test scores. Results There were 38 males and 42 females (mean age: 26.2 years) who participated in the workshops and completed the pre- and post-assessments. Most (59; 73.75%) were final-year medical students. One-third (33.8%) of the respondents had neither attended workshops related to ethics in medical research nor published manuscripts in medical journals (32.5%). More than half (55%) admitted witnessing unethical practices in research. There was a significant improvement in attitudes toward plagiarism after attending the workshop (mean difference = 7.18 (6.2), t = 10.32, P < .001). Conclusions Focused workshops on how to detect and avoid scientific misconduct can help increase knowledge and improve attitudes towards plagiarism, as assessed by the modified ATPQ. Students, residents, and faculty members must be trained to conduct ethical medical research and avoid all forms of scientific misconduct.

Thinking Out of the Box: Alternative Career Choices for Young Doctors in Pakistan.

The number of young medical graduates in Pakistan is increasing every year. Most of whom wish to specialize in a particular clinical field. Considering the competition faced for specialty training selection and later on for job placement, it is suggested that these young graduates should explore some alternative careers as well. Opportunities can be availed and decision made based on graduates' personal interest, preference to work in Pakistan or abroad, and availability of suitable employment in local and international hospitals among other factors. Careers in the basic medical sciences, medical education, medical research, medical writing and bioethics can be considered, too. There are very few trained professionals in these fields in Pakistan and once trained, these young doctors will hopefully find rewarding employment.

Exploring the attitudes of medical faculty members and students in Pakistan towards plagiarism: a cross sectional survey.

Objective. The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods. The Attitudes Toward Plagiarism questionnaire (ATP) was modified and distributed among 550 medical students and 130 faculty members in 7 medical colleges of Lahore and Rawalpindi. Data was entered in the SPSS v.20 and descriptive statistics were analyzed. The questionnaire was validated by principal axis factoring analysis. Results. Response rate was 93% and 73%, respectively. Principal axis factoring analysis confirmed one factor structure of ATP in the present sample. It had an acceptable Cronbach's alpha value of 0.73. There were 421 medical students (218 (52%) female, 46% 3rd year MBBS students, mean age of 20.93 ± 1.4 years) and 95 faculty members (54.7% female, mean age 34.5 ± 8.9 years). One fifth of the students (19.7%) trained in medical writing (19.7%), research ethics (25.2%) or were currently involved in medical writing (17.6%). Most of the faculty members were demonstrators (66) or assistant professors (20) with work experience between 1 and 10 years. Most of them had trained in medical writing (68), research ethics (64) and were currently involved in medical writing (64). Medical students and faculty members had a mean score of 43.21 (7.1) and 48.4 (5.9) respectively on ATP. Most of the respondents did not consider that they worked in a plagiarism free environment and reported that self-plagiarism should not be punishable in the same way as plagiarism. Opinion regarding leniency in punishment of younger researchers who were just learning medical writing was divided. Conclusions. The general attitudes of Pakistani medical faculty members and medical students as assessed by ATP were positive. We propose training in medical writing and research ethics as part of the under and post graduate medical curriculum.

Levels of inflammatory markers and their correlation with dyslipidemia in diabetics.

OBJECTIVE: To measure the levels of inflammatory markers (serum ferritin and high sensitivity C-reactive protein) and dyslipidemia in diabetics and to find a correlation between these inflammatory markers and dyslipidemia. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, from March 2007 to February 2008. METHODOLOGY: The study included 30 known type-2 diabetic patients randomly inducted from diabetic clinics of Rawalpindi. Healthy volunteers (n=30) having blood glucose less than 6 mmol/L were inducted as the comparison group. Fasting blood samples of diabetics and controls were analyzed for glucose, glycated hemoglobin (HbA1c), lipid profile, high sensitivity C-reactive protein (hs-CRP) and serum ferritin. RESULTS: The diabetic subjects had significantly higher levels of glucose, HbA1c, total cholesterol, LDL cholesterol, triglycerides, hs-CRP and ferritin as compared to normal subjects (p<0.001), while the level of HDL cholesterol was significantly lower in diabetics (p<0.001). Furthermore, a significant positive correlation was found between the inflammatory markers, hs-CRP and ferritin, and the parameters of dyslipidemia i.e. total cholesterol, LDL cholesterol and triglycerides (p<0.001 r=0.72) except for HDL cholesterol, which had an insignificant negative correlation with the inflammatory markers (p>0.05 r=-0.10). CONCLUSION: Low-grade inflammation exists in Diabetes mellitus and it is positively related with dyslipidemia (except for HDL cholesterol) in diabetics.

Traumatic spinal cord injuries at a tertiary care rehabilitation institute in Pakistan.

OBJECTIVE: To identify the epidemiological pattern of traumatic spinal cord injuries (SCI) presenting at a rehabilitation institute of a developing country. METHODS: Eighty three patients of traumatic SCI admitted at Armed Forces Institute of Rehabilitation Medicine in 2006 fulfilling the inclusion criteria were enrolled. Detailed clinical evaluation and radiological assessment was done along with identification of mechanism of injury, mode of evacuation and presence of associated injuries. Data analysis was done in January 2007 and results were compiled and analyzed using SPSS 13. RESULTS: There were 68 (81.9%) males and 15 (18.1%) females. Mean age was 28.3 +/- 12.4 years. Majority of the patients were in their second decade 43 (51.8%) years. Ambulance evacuation was carried out in only 18 (22.2%) patients and none received any spinal trauma first aid and log roll at the injury site. Most of the patients were paraplegics 49 (71.1%), 48 (57.8%) had complete injury and 43 (51.8%) spinal fixation. Fracture dislocation was the predominant vertebral column injury in 25 patients. Associated injuries and problems were present in 49.4% patients. CONCLUSION: Epidemiology of SCI in a developing country has unique epidemiological features and problems, which is different from a developed country. This was to be considered while formulating a plan for SCI management and rehabilitation. There is a dire need to establish a SCI registry in Pakistan, in order to improve the spinal trauma evacuation protocols and develop spinal rehabilitation centers.