Send-up exam performance; a predictor of scores in annual exam for preclinical medical students

One of the criteria for admission in Annual Professional Exam for medical students in Pakistan is to have 75% attendance during the session and the other is to pass Send up exam with 50% marks. To assess the usefulness of send-up exams in predicting the annual marks by comparing their results with annual University examination results for preclinical medical students. A cross sectional analytical study. A total of 173 preclinical students of 1st and 2nd year MBBS passing the First Professional Exam in first attempt were included in the study. Send up result of each student during the year was entered as percentage and compared with percentage total marks of same students in their 1[st] professional exam conducted by the University. Data maintained by Physiology Department was entered and analysed by SPSS 21. Descriptive statistics in the form of numbers and percentages were used and further analyzed using Pearson Correlation and Paired T Test of Significance. The p value of < 0.05 was considered significant. A total of 173 students [81 from 1st Year and 92 from 2nd Year] who had passed the annual exam in first attempt were included in the study. Out of these, 132[76.3%] were females and 41[23.7%] males. All students were within the age group of 18-24 years, mean age being 21.06 years. Mean send-up score in the subject of Physiology was 57.37 [Range=33-78]. Percentage total marks in all subjects [Anatomy, Physiology, Biochemistry] in annual exam had a mean of 69.46 [Range=55-84]. Send-up result in percentage was directly assessed against the percentage marks obtained in annual exam for each student. The send-up marks were significantly related to the marks in the final exam [p=0.01]. The strength of association was same as that for average test marks with annual marks. Girls performed better than boys during the send up [Mean 58.35 Vs 54.21] as well as in the annual exam [Mean 70.12 Vs 67.33]. There was also a difference amongst different classes with 2nd year performing better than first year in both send-up [Mean 58.60 vs 55.98] and annual exams [Median 70.83 vs 67.91]. Send-up results may be good predictors of the academic performance in professional examination in preclinical years in a medical college. Female students perform better than their counterparts during both send-up and annual exams

Glycated hemoglobin [HbA1c]; screening for undiagnosed diabetes in healthy individuals in Sargodha

HbA1c gives an integrated index of glycemia over the entire 120 days life span of red blood cells. Therefore, measuring HbA1c would be appropriate in diagnosing a disease characterized by chronic hyperglycemia and a gradual progression to complications. our primary objective was to evaluate the use of HbA1c as screening test for undiagnosed diabetes [WHO criteria of Fasting plasma glucose [FPG] of >/= 7mmol/l [126mg/dl]] in healthy asymptomatic individuals in Pakistani population. A cross sectional population survey was carried on asymptomatic, healthy individuals without past history of diabetes. Venous blood was obtained to measure fasting plasma glucose [fasting > 8 hours] and Hb A1c. Khan lab Sargodha from July 2013 to March 2014. It was performed by using NycoCard HbA1c in vitro diagnostic medical device for quantitative determination of glycated hemoglobin in whole blood. In our sample size of 775, the lowest HbA1c was found to be 5% and Highest 13.2%. Arithmetic means was 6.7565%, while the median value was 6.2% and standard deviation 1.3323. When using FPG only, the detection rate of diabetes was 32.65% [female, 14.71%; male, 17.94%]. When HbA1c was included as a diagnostic test, the detection rate increased to 40% [female, 18.84%; male, 21.16 %]. An additional 7.6% of participants were diagnosed with diabetes when using HbA1c criteria. ROC [A receiver operating characteristic] curve was used for analysis. At HbA1c cutoff of >/=6.5% it demonstrated sensitivity of 98.02% [95% CI] and specificity of 88.12% [95% CI] for detection of undiagnosed diabetes mellitus in healthy asymptomatic individuals in Pakistani population. Area under the ROC curve was 0.981354 with significance level P [Area=0.5] 0.0001. Our study reveals that HbA1c is a highly specific and convenient alternative to fasting plasma glucose for screening of diabetes mellitus in Pakistani population. A large scale survey should be carried out to set our own national standardizations

Generation of hepatocyte-like cells from human induced pluripotent stem [iPS] cells by co-culturing embryoid body cells with liver non-parenchymal cell line TWNT-1

To generate a homogeneous population of patient-specific hepatocyte-like cells [HLCs] from human iPS cells those show the morphologic and phenotypic properties of primary human hepatocytes. An experimental study. Department of Surgery, Okayama University, Graduate School of Medicine, Japan, from April to December 2011. Human iPS cells were generated and maintained on ES qualified matrigel coated plates supplemented with mTeSR medium or alternatively on mitotically inactivated MEF feeder layer in DMEM/F12 medium containing 20% KOSR, 4ng/ml bFGF-2, 1 x 10-4 M 2-mercaptoethanol, 1 mmol/L NEAA, 2mM L-glutamine and 1% penicillin-streptomycin. iPS cells were differentiated to HLCs by sequential culture using a four step differentiation protocol: [I] Generation of embryoid bodies [EBs] in suspension culture; [II] Induction of definitive endoderm [DE] from 2 days old EBs by growth in human activin-A [100 ng/ml] and basic fibroblasts growth factor [bFGF2] [100 ng/ml] on matrigel coated plates; [III] Induction of hepatic progenitors by co-culture with non-parenchymal human hepatic stellate cell line [TWNT-1]; and [IV] Maturation by culture in dexamethasone. Characterization was performed by RT-PCR and functional assays. The generated HLCs showed microscopically morphological phenotype of human hepatocytes, expressed liverspecific genes [ASGPR, Albumin, AFP, Sox17, Fox A2], secreted human liver-specific proteins such as albumin, synthesized urea and metabolized ammonia. Functional HLCs were generated from human iPS cells, which could be used for autologus hepatocyte transplantation for liver failure and as in vitro model for determining the metabolic and toxicological properties of drug compounds