Apigenin, a natural bioflavonoid, is reported as an anti-diabetic agent since it possesses the ability to inhibit α-glucosidase activity, cause stimulation of insulin action and secretion, manage ROS, and prevent diabetes complications. Apigenin was identified as a new insulin secretagogue that enhances glucose-stimulated insulin secretion and seems like a better antidiabetic drug candidate. Here we explored the insulinotropic mechanism(s) of apigenin in vitro in mice islets and in vivo in diabetic rats. Size-matched pancreatic islets were divided into groups and incubated in the presence or absence of apigenin and agonists or antagonists of major insulin signaling pathways. The secreted insulin was measured by ELISA. The intracellular cAMP was estimated by cAMP acetylation assay. The acute and chronic effects of apigenin were evaluated in diabetic rats. apigenin dose-dependently enhanced insulin secretion in isolated mice islets, and its insulinotropic effect was exerted at high glucose concentrations distinctly different from glibenclamide. Furthermore, apigenin amplified glucose-induced insulin secretion in depolarized and glibenclamide-treated islets. Apigenin showed no effect on intracellular cAMP concentration; however, an additive effect was observed by apigenin in both forskolin and IBMX-induced insulin secretion. Interestingly, H89, a PKA inhibitor, and U0126, a MEK kinase inhibitor, significantly inhibited apigenin-induced insulin secretion; however, no significant effect was observed by using ESI-05, an epac2 inhibitor. Apigenin improved glucose tolerance and increased glucose-stimulated plasma insulin levels in diabetic rats. Apigenin also lowered blood glucose in diabetic rats upon chronic treatment. Apigenin exerts glucose-stimulated insulin secretion by modulating the PKA-MEK kinase signaling cascade independent of K-ATP channels.

Each country of the world has its own health care system to follow, Pakistan has followed the healthcare system designed by British rulers since 1947. Primary healthcare, Secondary Healthcare and tertiary healthcare are the major parts of the defined healthcare system that are been practiced across the country. Pakistan has always participated and encouraged health promotion and delivery participating in Millennium Development Goal (MDG) program, encouraging public private partnership, investing in improvement of human resources and skills, introducing Basic Health Units (BHUs) and Rural Health centers. Though investment and inputs are set at achieving health for all but many weaknesses have slowed down the process of development. Poor governance and monitory policy, political influence and budget allocation issues have made it difficult to provide health on equal basis. The current review is aimed to discuss the strengths and weaknesses of healthcare system of Pakistan.

Objectives: The objectives of this study were focused on finding the influence of excessive mobile phone usage on academic performance of medical students and to find association between excessive mobile phone usage and anxiety in students of a medical University Karachi. Methods: It was a questionnaire based study, three different standardized questionnaires were used to assess the sleep pattern and anxiety, however academic performance were evaluated by their last attempted exam. Results: Excessive mobile phone usage was significantly (p-value = 0.001) associated with disturbed sleep pattern and sleep quality. But we did not had significant results for anxiety and academic performance. Conclusion: Excessive mobile phone use may disturb sleep pattern and quality of sleep but it does not affect academic performance and does not lead to anxiety.

Aim: To evaluates the EQ level in facilitators of government and private medical colleges of Karachi. Study design: Cross sectional Place and duration: Ziauddin Medical College, January-June 2022 Methodology:Facilitators of government and private sector medical institutes particularly lecturers were targeted population. The calculated sample; (n=35/institute) was recruited by simple random technique. The questionnaire regarding demographic data was self-developed however, emotional quotient was assessed by EQ scale. Chi-square test was applied as test of significance. Results: The maturity scale score of females showed that statistically (p-value=0.011) they are emotionally more mature than males. When sensitivity and maturity score were compared between the two institutes (Government or private) their scores were similar and there was no significant difference between sensitivity and maturity scores of government and private sector employees. According to EQ compatibility scoring system scale ,100% male and 100% female scored in the range of extremely high competency category. Conclusion: The emotional quotient analysis showed that females are more sensitive and mature emotionally than males though the emotional intelligence of male and female participants was equal. Emotional sensitivity, maturity and intelligence scores of Government and private sector employees was comparable to each other. Keywords: Emotional quotient, Medical education system, Facilitators, Government and private sector

Aim: Myricetin, a natural bioflavonoid, is reported as an anti-diabetic agent since it possesses the ability to inhibit α-glucosidase activity, stimulate insulin action and secretion, manage ROS, and prevent diabetes complications. Myricetin was identified as a new insulin secretagogue that enhances glucose-stimulated insulin secretion and seems like a better antidiabetic drug candidate. Here, we explored the insulinotropic mechanism(s) of myricetin in vitro in mice islets and in silico. Methods: Size-matched pancreatic islets were divided into groups and incubated in the presence or absence of myricetin and agonists/antagonists of major insulin signaling pathways. The secreted insulin was measured by ELISA. Molecular docking studies were performed with the key player of insulin secretory pathways. Results: Myricetin dose-dependently enhanced insulin secretion in isolated mice islets, and its insulinotropic effect was exerted at high glucose concentrations distinctly different from glibenclamide. Myricetin-induced insulin secretion was significantly inhibited using the diazoxide. Furthermore, myricetin amplified glucose-induced insulin secretion in depolarized and glibenclamide-treated islets. Myricetin showed an additive effect with forskolin- and IBMX-induced insulin secretion. Interestingly, H89, a PKA inhibitor, and MAY0132, an Epac-2 inhibitor, significantly inhibited myricetin-induced insulin secretion. The in silico molecular docking studies further validated these in vitro findings in isolated pancreatic islets. Conclusions: Myricetin, a potential natural insulin secretagogue, amplifies glucose-induced insulin secretion via the cAMP-PKA-Epac-2 signaling pathway.

Background: Healthcare providers may improve healthcare delivery and make it available to more people by combining advanced technologies with high-quality network services. In this regard, telemedicine has improved healthcare providers' ability to provide services for a large number of individuals without their physical presence. Pakistan's healthcare system is a mix of government infrastructure, parastatal healthcare, the private sector, civil society, and charitable contributions. However, unawareness, poor education, lack of skills, lack of resources, and technical issues including internet connectivity, and load shedding have limited the accessibility of the Pakistani population towards advancement in the healthcare industry. Methodology: It was a cross-sectional study conducted at a private tertiary care hospital from April to June 2022 in Karachi. To recruit the study participants, a purposive sampling technique was used. Practicing doctors (n=100), who were aware of telemedicine technology and agreed to participate in the study, were included as study participants. A self-developed proforma was administered to doctors to assess the study's objectives. Results: Out of 100, 64% (n=64) of the participants have no experience working in telemedicine while only 36% have worked with telemedicine for at least one year. When asked about the application of telemedicine technology only 46% of the doctors knew the technology used. While only 42% of the doctors were familiar with the telemedicine tools, including a virtual stethoscope, pulse oximeter, etc. views regarding continue using telemedicine, 26% of the participants having no experience with telemedicine agreed that they would like to use telemedicine, 35% agreed to use telemedicine with improvement whereas 3% of them do not want to use the telemedicine technology. Conclusion: The participants of the current study were aware of telemedicine technology and its advantages. However, despite their agreement, the majority of the doctors emphasized the improvement of the system to deliver better services by using this technology.