Ahmed Yaqinuddin

What is an objective structured practical examination in anatomy

Assessing teaching‐learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The assessment of practical knowledge (three‐dimensional anatomical concepts) involves oral, spot, or objective structured practical examinations (OSPE). Finally, the application of anatomical knowledge to patients is tested mainly through objective structured clinical examinations (OSCE). The major focus of this study is the OSPE. Although many schools challenge students using this tool in practical examinations in the early phase of the curriculum, the true meaning of OSPE is frequently forgotten and it becomes, in reality, a spot examination. This article, for the first time, describes how the concept of the OSPE has evolved and is currently being used to assess the practical domain of anatomical knowledge in a problem‐based curriculum at Alfaisal University College of Medicine. In addition, it describes the main differences from the spot examination, which is normally used in traditional medical curricula. The authors believe that the OSPE remains the most efficient tool to assess the practical aspects of anatomical knowledge in a system where basic knowledge is integrated with the clinical or functional part of anatomy. However, this contention only holds true if the OSPE process revolves around structured objectives. Anat Sci Educ 6: 125–133.

Insights into the potential use of microRNAs as biomarker in cancer

MicroRNAs (miRs) are small non-coding RNAs, which regulate gene expression profiles of several genes. Consequently, miRs control and regulate several vital cellular processes like proliferation, apoptosis, differentiation, etc. Not surprisingly, altered expression of miRs has been linked to cancer development and progression. Recent studies have shown that sufficiently stable miRs can be isolated from the serum and other body fluids of cancer patients. The distinct miR profiles in the cell free circulating fluids of cancer patients have a potential to become a new class of biomarkers to detect and prognosticate cancers. In this review, we first briefly address the biogenesis of miRs and their role in gene regulation. Subsequently, we highlighted the role of miRs in pathogenesis of diseases with an emphasis on cancers. Finally, since, miRs have been shown to be promising circulating biomarkers for cancer detection, we 1) summarize the work done to date and 2) highlight the most significant advances resulting from these studies.

Undergraduate research: An innovative student-centered committee from the Kingdom of Saudi Arabia

Abstract Introduction: Concern has been expressed in recent times whether medical schools have adapted sufficiently to cater for the increasing demand of physician–scientists. Studies have shown that research involvement at the undergraduate level is vital to accommodate this growing need. Enhanced communication skills, improved problem-solving abilities and better future employment opportunities are among the other many benefits of undergraduate research (UR). Herein, we report projects run by a unique student driven undergraduate research committee (URC) at Alfaisal University, Riyadh, Saudi Arabia aimed at providing the future generation of physicians training opportunities for pursuing a research intensive career. Methods: The article describes the unique structure of the URC and provides an in-depth description of the various programs and activities used in promoting students’ research activities. We analyzed students’ perception of URC activities via a questionnaire and analyzed research-output of the first graduating batches through their publication record. Results: Overall, more than 60% of the graduating students were involved in the various research programs offered by the URC and around 50% published in peer-reviewed journals with an average impact factor of 2.4. Conclusions: Research involvement by medical students is an essential need of the twenty-first century and models like URC could provide crucial platform for research training to the new generation of physician–scientists.

Frequent DNA Hypermethylation at the RASSF1A and APC Gene Loci in Prostate Cancer Patients of Pakistani Origin

DNA methylation has emerged as a potentially robust biomarker for prostate cancer (PCa). Since DNA methylomes appear to be disease as well as population specific, we have assessed the DNA methylation status of RASSF1A, APC, and p16 (potential biomarkers of PCa) in Pakistani population. Primary prostate cancer tissues were obtained from 27 formalin-fixed paraffin-embedded blocks (FFPE) of cancer patients who underwent radical prostatectomy and transurethral resection of prostate (TURP) during 2003–2008. As controls, twenty-four benign prostatic FFPE tissues were obtained from patients who underwent TURP for benign prostatic hyperplasia during 2008. DNA was extracted, and methylation-specific PCR was used to assess the methylation status for RASSF1A, APC, and p16 gene promoters. Our results revealed that the RASSF1A promoter was hypermethylated in all the tested cancer samples but was also hypermethylated in 3 out of 24 control tissues. The APC promoter was hypermethylated in 15 out of 27 cancer samples and in none of the control samples. Strikingly, none of the samples showed methylation at the p16 promoter. Our findings suggest that RASSF1A and APC gene promoters are frequently hypermethylated in the Pakistani population and therefore have the potential to develop into universally dependable biomarkers for detecting PCa.

Cyclooxygenase I and II inhibitors distinctly enhance hippocampal- and cortex-dependent cognitive functions in mice

Cyclooxygenase (COX) enzymes are expressed in the brain; however, their role in hippocampus-dependent and cortex-dependent cognitive functions remains to be fully elucidated. The aim of the present study was to comparatively investigate the effects of piroxicam, a selective COX-I inhibitor, and celecoxib, a selective COX‑II inhibitor, on cognitive functions in an AlCl3‑induced neurotoxicity mouse model to understand the specific role of each COX enzyme in the hippocampus and cortex. The AlCl3 (250 mg/kg) was administered to the mice in drinking water and the drugs were administered in feed for 30 days. Assessments of memory, including a Morris water maze, social behavior and nesting behavior were performed in control and treated mice. The RNA expression of the COX enzymes were analyzed using reverse transcription‑quantitative polymerase chain reaction analysis. An ex‑vivo 2,2‑Diphenyl‑1‑picrylhydrazyl assay was performed in the hippocampus and cortex. Following 30 days of treatment with thedrugs, the mice in the celecoxib‑ and piroxicam‑treated groups exhibited enhanced learning (6.84 ± 0.76 and 9.20 ± 1.08, respectively), compared with the AlCl3‑induced neurotoxicity group (21.14 ± 0.76) on the fifth day of the Morris water maze test. Celecoxib treatment improved social affiliation in the AlCl3‑induced neurotoxicity group, the results of which were superior to piroxicam. Piroxicam led to better improvement in nesting score in the AlCl3‑induced neurotoxicity group. Both drugs decreased the expression levels of COX‑I and COX‑II in the hippocampus and cortex, and rescued oxidative stress levels. These findings suggested that each drug distinctly affected cognitive functions, highlighting the distinctive roles of COX-I and COX-II in learning and memory.

Pharmacological effects of Ibuprofen on learning and memory, muscarinic receptors gene expression and APP isoforms level in pre-frontal cortex of AlCl3-induced toxicity mouse model

Aluminium metal (Al) has been implicated in the etiology of many neurodegenerative diseases, most commonly the Alzheimers disease (AD). Al causes biochemical defects by affecting the neurotransmitters level, causes conformational changes in amyloid β protein and increases amyloid accumulation in brain. Aim: This study was aimed at evaluating neuroprotective effect of Ibuprofen (IBU) (25 mg/kg/day for 12 days) in AlCl3-induced (150 mg/kg/day for 12 days) toxicity. Methods: Treated mice were subjected to learning and memory tests. Cholinergic muscarinic receptors (mAChR; M1-M5) and APP isoforms (APP695, APP770 and APP common) gene expression were carried out from the pre-frontal cortex area. Results: Profound effect on learning and memory was observed in IBU treated group along with enhanced expression of M1 mAChR (0.40 ± 0.03; p < 0.01) compared to AlCl3-induced toxicity group (0.05 ± 0.02). Fear memory was improved in IBU treated group (89.68 ± 2.58, p < 0.01) as compared to AlCl3-induced toxicity group (54.58 ± 8.21). Discrimination index in social novelty test in IBU treated group was improved (81.13 ± 8.71; p < 0.05), compared to AlCl3-induced toxicity group (46.28 ± 5.55). Similarly, recognition memory of IBU treated group in novel object recognition test (NOB) was retained (66.85 ± 5.60; p < 0.05) as compared to AlCl3-induced toxicity group (33.06 ± 11.80). Conclusion: IBU demonstrated memory enhancing effect, however, its effect on the APP isoforms expression in pre-frontal cortex needs further studies.

The summer premedical program for matriculating medical students: a student-led initiative

The freshman academic year is one of the most difficult years that a medical student experiences in his/her academic life at a medical school. Freshmen are frequently faced with several challenges, such as adaptation to a new academic environment and its associated different methods of teaching, learning, skills, and assessment. The aim of this study was to describe a 4-wk innovative summer premedical program developed by senior medical students at the College of Medicine, Alfaisal University, in an attempt to improve/smooth the experience(s) of prospective freshmen. This report describes the objectives/strategies/methodologies used to tackle the top three identified freshman challenges, namely, 1) advancement of the academic/scholastic/educational background, 2) the development of college-required skills to succeed and excel in the freshman year, and 3) adaption to the college environment. At the end of the program, a survey was conducted to evaluate the effectiveness of the summer premedical program. Seventy-two students attended this program over the past three summers from 2010 to 2012, and twenty-nine students answered the survey with a response rate of 74.1%. Overall, >90% of the survey respondents reported an improvement in their understanding of basic medical science, integration, presentation skills, medical terminology, and junior-senior relationships. Furthermore, the survey highlighted the need for more focus on skills such as time management, participation in large-group discussions, and use of electronic resources, as >50% of respondents reported no improvement in these areas. In conclusion, this is the first report, to our knowledge, that describes a program developed by senior medical students to improve the experience of freshmen.

The Integrated Clinical Anatomy Program at Alfaisal University: An Innovative Model of Teaching Clinically Applied Functional Anatomy in a Hybrid Curriculum.

Anatomy has historically been a cornerstone in medical education regardless of specialty. It is essential for physicians to be able to perform a variety of tasks, including performing invasive procedures, examining radiological images, performing a physical examination of a patient, etc. Medical students have to be prepared for such tasks, and we can assist this by changing the way that we educate students in medical schools. Thus, newer medical curricula need to be designed according to needs of future physicians. In this report, we describe a unique program called the Integrated Clinical Anatomy Program (ICAP). The ICAP was developed at the College of Medicine of Alfaisal University in the Kingdom of Saudi Arabia. Here, we describe the unique features of this program, including the structure and facilities of the Anatomy Resource Center. The Anatomy Resource Center plays a pivotal role in engaging the students for faculty-directed structured laboratory sessions as well as peer-assisted uniform student-centered learning. The ICAP has shown great promise, as reflected by early results from a nationwide progress test. Students from all years of the Alfaisal University medical school scored significantly higher than the national average on the anatomy and physiology component of the nationwide progress test examination, with P values of 0.0179 and 0.0015, respectively. We believe that the ICAP can be used as a model for teaching clinically applied functional anatomy to medical students in a hybrid curriculum around the world.

An innovative approach to inculcate analytical and non-analytical clinical reasoning among medical students

Physiological concepts are often poorly understood with students ‘knowing’ but not ‘understanding’ (Berlucchi & Di Benedetta 2000). Therefore with respect to oxygen delivery and hypoxaemia we have used images of Thomas the Tank Engine delivering coal to improve comprehension (Cosgrove et al. 2006). To evaluate the process we presented two 30-minute lectures to Year One Medical Students. The control lecture was a conventional presentation; the study lecture contained additional images of Thomas the Tank Engine. LREC approval was unnecessary; HiT Entertainment-UK granted permission to use the imagery. Students were randomised into four groups (A n1⁄4 73, B n1⁄4 56, C n1⁄4 59, D n1⁄4 53). Groups A and B received the control lecture, while C and D the study lecture. Groups A and C undertook a pre-lecture MCQ to assess background knowledge. All students completed a postlecture MCQ and qualitative evaluation of the lecture. Evaluation scores (out of 20 for the MCQs) were collected using an ARS-KEEpad system and compared using the Mann– Whitney U-test. A p-value 0.05 was regarded as significant. The post-lecture MCQ scores failed to demonstrate any evidence of gender stereotyping or priming (A vs. B, p1⁄4 0.6 and C vs. D, p1⁄4 0.4.) Both lectures significantly improved postlecture MCQ scores (p5 0.001.) Group A had a significantly higher pre-lecture MCQ score compared to group C (median 16 vs. 12, p5 0.001); there was no difference post-lecture between A and C (median 18 vs. 17, p1⁄4 0.4). Qualitatively the imagery also made the lecture significantly more organised (p1⁄4 0.006), interesting and stimulating (p5 0.001) and improved understanding (p5 0.001.) At 6 months there was no significant difference in MCQ scores (p1⁄4 0.4). Groups A and B had the same median MCQ score at 6 months as group A pre-lecture MCQ (p1⁄4 0.9). Groups C and D had a significantly higher median MCQ score at 6 months compared to group-C prelecture (p5 0.001). In conclusion, analogous imagery significantly improved aspects of understanding hypoxaemia and in students with lower levels of background knowledge, the imagery allowed them to attain knowledge levels similar to their peers and minimised knowledge decline-ratio at 6 months. Thus compared to a didactic lecture, imagery of Thomas the Tank Engine delivering coal can provide an improved structure for lecture delivery and knowledge retention, assisting medical students in engagement with learning and understanding the processes of oxygen delivery and hypoxaemia. The improvement in scores post-lecture can also assist the lecturers (both registered with the General Medical Council) in their revalidation process.