STUDENT ENGAGEMENT IN VIRTUAL CLASS ROOMS

The impact of COVID-19 pandemic on the education sector throughout the globe resulted in closure of schools, colleges and universities. Consequently, there was a radical shift to e-learning and digital classrooms. Even long before COVID-19, there was already exponential growth and incorporation of technology in the education sector. It may be language apps, virtual tutoring, video conferencing tools, or online learning softwares, a momentous spurt has been noticed in usage of information technology since COVID-19. It is alarming that challenges associated with the transition to online learning would have the greatest impact on students learning capabilities in the midst of this chaos, as the strategies followed by teachers in a conventional classroom differs from those adopted in a virtual classroom. students engagement strategies in a traditional class at the campus differs from a virtual classroom. Basically, student engagement is a measure of how often a student attends to a task, assignment or activity during a class session. Studies clearly indicates positive relationships between student engagement and academic achievement. Engaged learners have demonstrated stronger satisfaction with learning experiences, stronger achievement in courses and increased graduation rates. When it comes to learning, commitment shown by students is affected by the level of motivation, concentration and cognitive aptitude of a learner, as well as the nature of online courses and the decisions of an instructor about his specific facilitation style. Efficient virtual coursework needs much more than "giving a Zoom account to any professor and letting the instructor take his course." Online teachingrequires a deliberate, careful approach to instructional design; particularly at a time when students are transiting at an astounding level following the COVID-19 outbreak. The concept of online learning is absolutely new for many students. Mostly students promoted to colleges from secondary schools are inexperienced and have inculcated habit of being spoon fed during early years. For such students anapproach of online teaching is highly unacceptable. Teachers need to be transparent about the aspirations of students and proactively train students, how to participate in this new landscape of learning. An increasing body of evidence indicates that the biggest obstacle to achieve comparable online learning success rates has been addressing the challenge of fostering the kind of collaboration students interaction and discussion, that are often the trademark for creating excellent teaching and learning environments. While it can be difficult to anticipate any struggle that a student may be e x p e r i e n c i n g w i t h o n l i n e l e a r n i n g , c l e a r communication is the key.

THE FUTURE OF BODY IMPLANTS

There are around 415 million people suffering from diabetes around the globe, and they don't need to get their finger punctured every time their blood sugar is to be monitored or insulin to be delivered, thanks to the magical “Insulin Pumps”. All these tiny machines have is a needle and a small pump, the system is able to monitor the glucose levels, provide information to the pump and then determine the amount of insulin to be injected through the needle. But they have a catch: they're temporary. Within a few days, glucose sensors have to be moved and replaced. And it's not just glucose monitors and insulin pumps that have this problem, but all bodily implants, at different time scales. Plastic prosthetic knees have to be replaced after about 20 years. Other implants, such as those used for cosmetic reasons, can meet the same fate in about 10. That isn't just a nuisance: it can be expensive and risky. This inconvenience happens because of our bodies' immune systems. Honed by several hundred million years of evolution, these defensive fronts have become exceptionally good at identifying foreign objects. Our immune systems boast an impressivearsenal of tools to tackle, intercept, and destroy anything they believe shouldn't be there. But the consequence of this constant surveillance is that our bodies treat helpful implants, like insulin pumps, with the same suspicion as they would a harmful virus or bacteria. As soon as the insulin pump has been implanted in the skin, its presence triggers what's known as a “foreign body response.” This starts with free-floating proteins that stick themselves to the surface of the implant. Those proteins include antibodies, which attempt to neutralize the new object and send out a signal that calls other immune cells to the site to strengthen the attack. Early-responding inflammatory cells, like neutrophils and macrophages, respond to the emergency call. The needle of the pump is labeled as foreign object and attacked with tiny grains that are filled with enzymes, they try t deteriorate the surface of the insulin pump's needle. Macrophages secrete enzymes too, together with nitric oxide radicals, which create a chemical reaction that degrades the object over time. If the macrophages are unable to dispatch the foreign body rapidly, they fuse together, forming a mass of cells called a “giant cell.” At the same time, cells called fibroblasts travel to the site and begin to deposit layers of dense connective tissue. Those enclose the needle that the pump uses to deliver insulin and test for glucose levels. Over time this scaffolding builds up, forming a scar around the implant. The scar functions as an almost impenetrable wall that might start to block vital interactions between the body and the implant. For example, scarring around pacemakers (an electrically charged medical device to control heartbeat) can interrupt the electrical transmission that's crucial for their functioning. With time due to stress and workload, Synthetic knee joints might give out particles that trigger immune cells to come into action and inflame around these fragments. Unfortunately the work of immune system attack might sometime be fatal and endanger life. Research work is underway to trick the immune system into accepting the new devices that are introduced into our bodily tissues. There are implants coated with certain chemicals and drugs that somewhat downplay the response of immune system. Those basically make the implants invisible to the immune system. More implants are being made out of natural materials and in forms that directly mimic issues, so that the body launches a weaker attack than it would if it came across a completely artificial implant. Some medical treatments involve implants designed to regenerate lost or damaged tissues. In those cases, the implant is designed to contain ingredients that will release specific signals, and carefully tailor to bodies' immune reactions. In the future, this way of working alongside the immune system could help develop completely artificial organs, totally integrative prostheses, and self-healing wound therapies. These treatments might one day revolutionize medicine and transform, forever, thebodies we live in.

Why Corona Virus Spreads so Fast?

Coronaviruses are a family of common viruses that affect mammals and birds and most of the time the strains caused are mild symptoms like a common cold, fever, cough, and runny nose. Given the historic records, there has been cases of diseases every once in a while with strain that were new and were particularly lethal – they could spread through the world quickly and with more concerning outcomes. Prior examples of such diseases would include the SARS epidemic which is not exactly the same as COVID-19 that we're experiencing but some of the same features apply in that it is a corona virus. It is a new strain that we have not experienced before and it's spreading very rapidly. It is empirically understood that our world contains wide range of different viruses and every day since our birth we come into contact with them but we do not develop symptoms because of what's called herd immunity. It means most of us have some level of recognition with our immune system to the common viruses which is why some of us still get sick with colds and influenza. These illnesses tend to not overtake our healthcare system because people don'tget sick all at once and even if so at least they usually do not get sick to a concerning level (easily treatable). The case is different when a new virus such as the one causing COVID-19 right now, appears in the world –and because we have not developed herd immunity to it, it tends to spread very quickly and it takes a while for that herd immunity to catch up. In order to evaluatespecifically how a virus is spreading through the world and affecting populations one needs to look at how quickly or how widespread it already is and also how lethal and fatal it has been. The fact is these two factors don't always go together rather they're independent to one another, coronavirus so far is making a big impact because of how widespread it is due to how easily and how quickly it can spread through our community. As for how lethal it is and how that affects our health care system; the most common symptoms are fever dry cough and tiredness and critical symptoms include difficulty acute respiratory distress syndrome (ARDS) chest pain or pressure and loss of speech or movement. It is to be noted that the timeline of virus spread matters so the WHO has declared COVID-19 a pandemic. This is a public health concept that means a virus or an illness actually that is spreading as separate areas of the world concurrently. It should also be kept in mind that this term “Pandemic” only describes how prevalent and widespread it is, it does not describe how lethal it is. So why is the current virus causing COVID-19 is so good at spreading. As mentioned earlier that since there is no herd immunity and as it spreads, none of us have encountered it before our bodies are not prepared and cannot fight off the virus very quickly. Furthermore, because it's actually not that lethal since 80% of people who suffer from it have either very mild symptoms or no symptoms and even those who go on to develop symptoms can have a very long latent period of up to 10 days where they are contagious. The problem that it is so widespread because 80% of people have no symptoms or are very mild symptoms and can recover easily on their own. 15 percent would probably need hospital care and 5 percent likely needs Intensive Care Unit level critical treatment. Further the most vulnerable population arethe elderly or people who are already sick but the fact that it spreads quickly means that the 5% that needs intensive care will need it very quickly and in a concentrated period of time. This is very different from something like Ebola virus where by the time one will have it and he/she is contagious plus the symptoms were very dramatic and it could be easily determined who has it. In case of COVID-19, most people spend a long time able to pass a virus without either knowing it or with very mild symptoms. Having mentioned that it's almost impossible to completely shut down the spreading of this virus without dramatic measures to contain people in such a highly mobile and globally accessible world. Because we don't know who is sick especially in the earlier parts of the epidemic and that's why we're seeing countries one by one taking really dramatic shutdowns. It is worth mentioning that flu that also puts a percentage of people in critical conditions and leads to death in especially in the vulnerable populations but if we look at flu season around the world it is a six-month period of time. Putting that into perspective the hospitals and personnel; considered limited resources, and the respiratory machines that are needed to support people and the doctors to see them - might be able to support people periodically needing it over a sixmonth period of time. But the case of COVID19 is different, given the fast concentrated spike of critical patients, the systems can get overwhelmed like seen in Italy and China. So the 5% that need critical care might not have the doctor, the ventilator and the infrastructure to help them through the worst of the illness. That's is the reason of spread and lethality of COVID-19 - the delayed response and conjoined with difficulty in containing a virus that spreads quickly through healthy people has been the crux of the problem.

Nano-based Masks, Disinfectants and Sanitizers Effectively Combat Covid-19

COVID-19 is an infectious viral disease caused by novel coronavirus to SARS-CoV-2 which emerged from Wuhan, China at the end of year 2019. The World Health Organization (WHO) declared COVID-19 a global pandemic due to highly contagious nature of SARS-CoV-2. Till date COVID-19 has infected and claimed lives of millions of people around the world. The virus is mainly transmitted through droplets from symptomatic patients; however, there are many cases of infection from asymptomatic people, wherein the virus is transmitted even before the symptoms appear. Therefore, it has been strategized to control the spread of virus from one person to another. Moreover, inadequate medical facilities, high cost of treatment and lack of effective medication against novel COVID-19, non-pharmacological interventions (NPIs) can help mitigate the transmission such as wearing face masks, face shields, protective clothing and practicing social distancing. However, these standard protective equipment (PE) are not effective in preventing the spread of coronavirus. Meanwhile, nano-based products are of huge help in effectively preventing COVID-19 outbreak. Face-mask is a cost effective first line of defense against COVID-19 as mask helps prevent the entry of small sized particles. However, commonly used facial masks are incapable of preventing the entry of small sized corona virus, which gets stuck in mask and can live on it for up to 9 days. Moreover, if such mask worn for longer period of time, virus can enter inside the body via mouth and nasal passage. Therefore, masks should be designed such that they are effective, antiviral and comfortable to use. Recently a research showed that nanoceutical N95 mask made with Zinc Oxide nanoflower cotton fabrics were comfortable, washable, porous and light-weight which solved the common problem of carbon dioxide rebreathing and prevented the spread of virus through the pores. Nanotechnology also offers a lot of opportunities for the development of more effective and promising disinfectant systems. In Prague, nano-polymer disinfectants were sprayed on few public vehicles to check its efficiency. It was found that Nano-polymer disinfectant can work for almost 21 days as compared to traditional disinfectants. Moreover, it was also found that copper nanoparticles incorporated disinfectants could be really effective against COVID-19. Coronavirus estimated half-life on stainless steel is 5.6h and on plastics 6.8h therefore copper can be used to inactivate virus. Additionally, the efficiency of hand sanitizers could also be enhanced by introducing nanoparticles like copper, silver, gold, and quaternary ammonium cations (QUATs) due to their antiviral properties. These metals and metal oxides can be used to create a surface coating to protect the body against the covid-19 because they possess the ability to stops the binding of viral proteins with human epithelial cells and leads to the viral protein denaturation. Scaling-up these for commercial use could help in effectively preventing COVID-19 spread. These various available nano-based products help equip people for combating COVID-19. Dr. Humera Kausar Associate Professor Kinnaird College for Women University Lahore, Pakistan

CANCER INSIGHT: HALLMARKS AND THERAPEUTIC STRATEGIES

Cancer metastasis is a complex, multistep process responsible for > 90% of cancer-related deaths. Cancer is the second leading cause of death globally and about 8.8 million people worldwide died from cancer (Liver (788 000), Lung (1.69 million) Colorectal (774 000), Stomach (754 000), Breast (571 000)) in 20151. That is nearly 1 in 6 of all global deaths. Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervix and stomach cancer are the most common among women. During metastasis, the primary tumor seeds pioneer cells that move out, invade adjacent tissues, and then travel to distant sites where they may succeed in founding new colonies called secondary tumors . In the last few decades, a rich and complex body of knowledge has been generated in cancer, revealing cancer to be a disease involving dynamic changes in the genome. In 2000, Douglas Hanahan and Robert A. Weinberg reported six hallmarks of cancer. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks are genome instability, which generates the genetic diversity that expedites their acquisition, and inflammation. Cancer Initiation, detachment and organ-specific affinity of cancer cells to host cells in terms of the above mentioned hallmarks helped devise new potential therapies. To date, five cancer treatment modalities have been defined. Currently available cancer treatments include the traditional surgery (Cryosurgery, Lasers,Hyperthermia), radiotherapy (External Beam Radiation Therapy, Internal Radiation Therapy), and conventional chemotherapy (Oral, Intravenous (IV), Injection, Intrathecal, Intraperitoneal (IP), Intraarterial (IA), Topical), approaches and have been extended with two new modalities in recent decades: molecularly targeted therapy (MTT) ( Small -molecule drugs, antibodies ) and immunotherapy Monoclonal antibodies,, Adoptive cell transfer, Cytokines, Treatment Vaccines, Bacillus Calmette-Guérin (BCG)). The most important goal of targeted therapy or more advanced immune-based strategies is to eradicate cancer cells more specifically than traditional theraphies while maintaining an acceptable level of side effects and quality of life. Unfortunately, the newly developed targeted agents or techniques show a similar incidence and severity of toxicities as traditional cytotoxic agents do. With a full clarity of mechanism, cancer prognosis and treatment will become a rational science. It's a dream that one day the patchwork quilt of major fields like cell biology, genetics, histopathology, biochemistry, immunology, pharmacology and physics will detect and identify all stages of cancer progression and will be able to prevent incipient cancers from developing and will cure preexisting cancers.

Coordination Difficulties in the Management of Operation Theatre in Children Hospital Lahore.

An operation theatre is any facility within a hospital domain where the surgical procedures are carried out in a strict sterile cosmos. Management of the operation theatre requires the coordination of humane and material resources in such a way that surgery can be performed safely, efficiently and cost effectively.Objective: To identify the difficulties in coordination of operating room management and find out their solutions for better patient outcomes. Methods: This descriptive study was conducted in Main Operation Theatre of Children Hospital and Institute of Child Health Lahore. Data was collected by using Convenient Sampling Technique. This was a hospital-based study in which staff members of both genders were included. The study population divided into four strata; doctors (surgeons and anesthetists), nurses, operation theatre technicians and anesthesia technicians. A total of 51 cases were observed and checked by a checklist about coordination diffculties in the management of operation theatre. Results: A total of 51 cases were studied to determine the difficulties in management of operation theatre. 25.22% cases showed difficulty in proper management of Operation Theater. This result showed that there are still some difficulties like insufficient and old equipments, absence of proper sterilization, lack of proper leadership, work overload, no quality check of equipments, no teaching program, and unpunctuality of staff, improper timing and organization in the operation theater. Conclusions: There are many difficulties in management of operation theatre regarding staff members, equipments, timings and sterilization. A proper leadership and organization can sort out these problems.

Kojic Acid: A Comprehensive Review

Due to the emerging nature of kojic acid, current project was conducted to introduce the abilities in details. KA is produced industrially by Aspergillus species in aerobic fermentation. Its structure was identified as 5-hydroxymethyl-pyrone. The KA plays an important role in determining certain chemical and physical properties it possesses. KA has different applications in various fields. It is broadly utilized in cosmetics, medicine, food, agriculture, chemical and other industries. These days kojic acid performs a vital function in cosmetics specically skin care products because it enhances the capability to prevent UV radiation it extensively utilized in whitening creams and lotions because of its anti tyrosinase activity. Kojic acid keeps getting hold on attention because of its economic potential as an anti-inflammatory and analgesic agent in the medical field. KA is utilized as an anti-bacterial agent in food industry & because of its antioxidant activity it is utilized as an antibrowning agent for agriculture products. Due to various uses of organic molecules the demand for kojic acid has rapidly increased. It also has some drawbacks, such as the KA is highly unstable upon exposure air and sunlight it changes its color and the other drawback is cytotoxicity which may be overcome by way of the formation of kojic acid peptides which are more stable.

Assessment of Awareness About Biomedical Waste Among Doctors and Nurses of Children Hospital Lahore

Bio Medical waste refers to any type of waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research purposes pertaining to or in the fabrication or testing of biologicals. Objective: To assess the awareness about bio-medical waste management among Doctors and Nurses of Children Hospital. Methods: Descriptive study was conducted in Children's Hospital and Institute of Child Health Lahore. Convenient Sampling Technique was applied to gather data. This was a hospital-based study in which staff members of both genders were included. The study population divided into two strata and these strata consisted of doctors and nurses. A total of 139 staff members were involved out of which there were 77 doctors, 62 nurses. Their responses checked by a Performa about problems in the management of biomedical waste. Results: The result showed that majority (62%) staff members had knowledge about bio-medical waste. The remaining staff had very basic knowledge about bio-medical waste. Conclusions: The awareness about BMW management among Children's Hospital Operation theater staff is satisfactory. But still, they need to improve their knowledge to ensure more patient safety by organizing seminars, workshops.

Susceptibility of Aedes Aegypti Against Various Insecticides in Lahore, Pakistan

Dengue fever is an arbo-viral infection, widespread all over the world. In 21th Century, there is no safe affordable and effective vaccine accessible yet; vector control is that most effective method for the control of the disease Objective: To determine the susceptibility status of wild and laboratory strains larvae and adults of Aedes aegypti against different group of insecticides in Lahore city. Method: From Lahore sites, larvae were collected where insecticides used for wild strain at high frequency and quantity. The Insectary of National Institute of Malaria Research and Training (NIMRT), Lahore, Pakistan, adults and larvae were collected for laboratory strain.The laboratory strains for larvae bioassays were used. The mosquitoes populations indoor and outdoor collected in 2009, hatched from larvae into adults insectary in Lahore, Pakistan. During this study, four major insecticides groups are used which include Pyrethroids (Deltamethrine 2.5% SC), Neonicotenoids (Imidacloprid 5% SC), Phenyl-pyrazoles (Fipronil 2.5% EC) and Organophosphates dichlorvos (DDVP 50% EC). For data analysis, Minitab statistical software (Version 13.20) used for data expressed as mean ± S.E.M from bioassays. By using EPA Probit, LC was estimated with 95% confidence. The 50 statistically significant p value was <= 0.05. For comparing the concentrations of insecticides, Duncan's multiple range tests was used with significant difference (5% level) using at New Costat. Results: Different location of Lahore samples, Imidacloprid the most toxic to Aedes aegypti's wild strains on the other hand while Fipronil was also active for wild larval samples. Deltamethrine showed least activity against both adults and larval strains. The susceptibility of the eld strains was lower than laboratory strains; resistant ratio varies from insecticide to insecticide. In reporting results, mosquitos' population was resistance because of infrequent and incomplete coverage. Conclusions: This study concluded that Pyrethroids and agriculture pest control play role in indirect growth of insecticides' classes. Based on this study it is suggested that by using new strategies to prevent and delay in growth of insecticides will helpful in Lahore, city, Pakistan.

Assessment Of Knowledge Regarding The Dietary Practices Among Osteoarthritis Patients

Osteoarthritis (OA) is a major public health issue, as it results in chronic pain, reduces physical function, and diminishes the quality of life. Awareness related to osteoarthritis is needed to improve the condition. Objective: To fnd out the knowledge regarding the dietary practices among osteoarthritis patients, visiting Sir Ganga Ram Hospital, Lahore. Methods: A cross-sectional study was conducted at Orthopedic and OPD Departments of the Sir Ganga Ram Hospital, Lahore, for 4 months. The data were collected through a pretested questionnaire from 100 osteoarthritis patients using the non-probability convenient sampling technique. Data were tabulated and analyzed with the help of SPSS version 24.0. Frequencies were calculated, and the Pearson chi-square test was applied. Results: The analysis revealed a significant association between level of education, knowledge regarding the dietary practices and progression of the disease. Conclusions: Based on the current study results, patient's level of education had significant association with knowledge, dietary practices, and joints pain and progression of disease among osteoarthritis patients. Majority of patients due to low knowledge about osteoarthritis have poor dietary practices.