Ethical and Moral Issues in Undergraduate Medical Education: An Exploratory Study

Background: Ethical and moral values form the basis of the environment in any academic institution. Objectives: This study aimed to explore the ethical and moral issues faced by medical students during their undergraduate medical education in Pakistan. Methods: This qualitative exploratory study was conducted at ABWA Medical College, Faisalabad. It included thirteen semi-structured, one-to-one interviews of volunteering undergraduate medical students of Punjab, Pakistan, from September 2021 to February 2022. The interview invitation was sent electronically to social media groups. Member checking of transcribed interviews was done, and data were analyzed thematically using Atlas-ti software by two independent researchers. Results: Thematic data analysis led to the formation of 28 codes, 13 subthemes, and 3 main themes. Based on the social constructive approach, three main themes were categorized into ethical issues in (1) academic, (2) social, and (3) clinical contexts. Conclusions: The results showed that undergraduate medical students face a myriad of ethical and moral disruptions during their undergraduate study period at medical college. Much awareness about identifying and dealing with such issues is recommended to bring more quality to the program.

Ochratoxicosis in Chicken: Pathological, Biochemical Alterations and Tissue Residues

Ochratoxin A (OTA) exerts nephrotoxic, hepatotoxic and carcinogenic effects in animals and humans. OTA is also responsible to induce oxidative stress and immunosuppression. The presence of OTA as a common contaminant of cereal based food and feed ingredients has been reported from different regions of the World including Pakistan. Keeping in view the toxic significance of OTA, the present study was planned to study the pathological effects of OTA in chicken, with a focus to develop a relationship of pathological alterations associated with age, exposure duration, dietary and tissue/organ ochratoxin levels. Experiments were conducted to induce acute ochratoxicosis in one day old (experiment 1) and 21 day old (experiment 2) broiler chicks by feeding rations containing 0, 1.6, 3.2, and 6.4 mg/kg OTA for 10 days. Chronic ochratoxicosis was induced in day old broiler chicks by feeding 0, 0.05, 0.1, 0.2, 0.4 and 0.8 mg/kg OTA for duration of 21 (experiment 3) and 35 days (experiment 4). Different parameters studied included feed intake, body weight, organ weights, clinical signs, gross and microscopic morphological alterations in different organs/tissues, immunological responses, oxidative stress parameters and OTA tissue residues. Present study concluded that the ochratoxicosis in broiler chicks resulted in the poor feed intake, weight gain and performance of birds, increased mortality and severity of clinical signs in dose dependent manners. OTA feeding in broilers resulted in the suppression of immunological responses and decreased blood and tissue antioxidant potentials. OTA related decrease in antioxidant potential and immunosuppression was directly proportional to the dose and duration of OTA exposure. OTA exposure in older birds resulted in more severe oxidative stress but lesser immunosuppression as compared to birds exposed at young age. Dose related increase and age related development of resistance to the pathological and biochemical alterations were also recorded. Decreased carnosine, anserine and creatine contents of muscles following OTA exposure suggested the production of low nutritional and keeping quality chicken meat. Exposure of OTA both acute and chronic dietary levels resulted in the accumulation of OTA residues in liver, kidney and muscles of the birds although these residues quickly disappear after withdrawal of toxin contaminated diets.