BackgroundFew studies have explored factors affecting preference of medical students towards general practice as a career choice. We conducted a survey in Karachi across various public and private sector medical colleges to examine factors associated with students’ general practice career aspirations in Karachi, Pakistan.MethodsFrom January to March 2018, we distributed a 21-item questionnaire to final year medical students in eight medical schools. The survey asked students about their top three career preferences from 19 specialty fields, their demographics and their career priorities. Multivariable logistic regression was used to determine the effect of each item.ResultsA total of 1400 responses were obtained. The top five specialty fields chosen by students with their numbers were: internal medicine, 898 (64.2%); general practice, 337 (24.1%); pediatrics, 449 (32.1%); surgery, 380 (27.2%); and emergency medicine, 243 (17.4%). The “intent to inherit existing practice” and “other academic or professional experiences prior to medical school” had a positive association with choosing general practice while “having a physician parent’’ had a negative association among the medical students demographics after adjusting for other covariates in the multivariable logistic regression. Medical students who ranked “clinical diagnostic reasoning”, “community-oriented practice”, “involvement in preventive medicine”, and “frequent patient communication” as highly important were more likely to choose general practice, whereas, “access to advanced medical fields”, “mastering advanced procedures”, and “depth rather than breadth of practice” were less likely to be associated with general practice aspiration.ConclusionThe study’s results depicted limited interest of family medicine as a career option in graduating students, and pointed out the factors that likely influence the choice of general practice as a career are clinical diagnostic reasoning, community-oriented practice and preventive medicine.

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The grave reality of the global climate crisis has become evident in Pakistan this year, with torrential rains and flooding, which have resulted in a third of the country being under water. Over 33 million people have been since displaced, and consequently, are vulnerable to a plethora of diseases, including malaria, dengue, and a multitude of respiratory and skin disorders.Since 2010, Pakistan has experienced dengue epidemics following the monsoon season, with over 16,580 confirmed cases in the city of Lahore in the year 2010 alone [1] . This year, all 4 provinces of Pakistan, namely, Sindh, Punjab, Balochistan, and Khyber Pakhtunkhwa, have reported an increase in the number of diagnosed dengue cases, pointing toward the biggest outbreak yet. The disease characterized by flu-like symptoms appearing 7 days after infection, can be managed with appropriate and timely testing, which reduces its case fatality rate to <1% [2] .The dengue virus (DENV) has 4 variants and belongs to the Flaviviridae family. Its vectors, the Aedes aegypti and Aedes albopictus mosquito, had a spike in population not only due to the current rapid environmental changes but also, due to the stagnant water pools all over the landscape of Pakistan, which serve as the perfect breeding ground for the larvae. Recently, the situation has become more alarming, with the appearance of Aedes vitattus for the first time in the country, according to a renowned virologist at COMSATS University [3] .Tomatidine (TO), a novel steroidal alkaloid, has been shown to be efficacious against DENV, both in the early and late stages of infection. TO has been found to control the expression of the cellular protein activating transcription factor 4 (ATF4). However, this protein is not solely responsible for the observed antiviral effect [4] . In trials conducted on rats, TO has been found to reduce the uptake of dietary cholesterol in the liver by forming Research registration unique identifying number (UIN)None.