The efficacy of a training program for social skills in reducing addictive Internet behaviors among Palestinian university students

Abstract Background: For youth in geopolitically at-risk environments, such as Palestine, the issues related to Internet overuse and addictions are complex. Youth residing in the occupied territories of Palestine as in other highly militarized zones have high levels of environmental stressors (e.g., militarization, poverty, lack of employment opportunities, cultural pressures, etc.) and few chemical or social outlets such as alcohol, intoxicants, and leisure activities. As such, the easily accessible and unrestricted opportunities for stress-reducing social contact of social media can lead easily to excessive and maladaptive Internet use. Therefore, interventions directly aimed at awareness and education on how to manage Internet use are critical for addressing these issues in high risk populations. Aims: The purpose of the current study was to test the efficacy of a time-limited group training program aimed at improving social skills and reducing addictive Internet behaviors among university students. Methods and results: The sample consisted of 30 university students who self-reported high scores on an Internet addiction scale. Participants were randomly assigned to either wait list or treatment group (15 in each condition). Results demonstrated that using a social skills training program over an 8-week period improved the level of social skills and reduced addictive Internet behaviors significantly in those who experienced the intervention when compared with a wait list control group. Conclusions: These findings support the implementation of time limited training programs targeting social skills and addictive patterns of Internet use with university students identified with high levels of Internet addictive behaviors.

Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report

Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.

Rare finding of Eustachian tube calcifications with cone-beam computed tomography

Soft tissue calcification is a pathological condition in which calcium and phosphate salts are deposited in the soft tissue organic matrix. This study presents an unusual calcification noted in the cartilaginous portion of the Eustachian tube. A 67-year-old woman presented for dental treatment, specifically for implant placement, and cone-beam computed tomography (CBCT) was performed. The CBCT scan was reviewed by a board-certified oral and maxillofacial radiologist and revealed incidental findings of 2 distinct calcifications in the cartilaginous portion of the Eustachian tube. To the authors' knowledge, no previous study has reported the diagnosis of Eustachian tube calcification using CBCT. This report describes an uncommon variant of Eustachian tube calcification, which has a significant didactic value because such cases are seldom illustrated either in textbooks or in the literature. This case once again underscores the importance of having CBCT scans evaluated by a board-certified oral and maxillofacial radiologist.

Evaluation of canalis basilaris medianus using cone-beam computed tomography

The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature

The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

Fossa navicularis magna detection on cone-beam computed tomography

Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.

Prevalence of suspected tuberculosis in the Kingdom of Saudi Arabia according to conventional and molecular methods

Although the prevalence of suspected tuberculosis [TB] in the Kingdom of Saudi Arabia remains high, there has been a modest decrease in recent years. In this multi-center cross-sectional study, the prevalence of TB was determined by various techniques with the aim of identifying differences and indicating where there is uniformity in findings. A total of 3404 samples were collected from Saudi TB patients from different regions in Saudi Arabia: Riyadh, Dammam, Jeddah, Madinah, Hail, Qassim, Jazan, and Taif. Different techniques including Ziehl-Neelsen [ZN], Mycobacteria growth indicator tube [MGiT], Lowenstein-Jensen [LJ], and polymerase chain reaction [PCR] were used to screen for the presence of Mycobacterium tuberculosis [MTB]. ZN stain showed that Riyadh and Dammam had the highest prevalence of MTB with 22% and 21%, respectively, while prevalence was lowest in Jazan and Hail with an incidence of 2% and 3%, respectively. MGiT culture showed that Riyadh, Dammam, and Jeddah had the highest prevalence with a rate of 26%, 22%, and 22%, respectively. LJ culture showed the highest prevalence in Riyadh and Dammam with 22% and 21%, respectively. Of all the techniques, the highest detection rate was by PCR which was 10.46% while ZN stain technique was 6.64%, for MGiT culture it was 8.34%, and for LJ culture it was 7.7%. This study is the first in which different methods have been used for detection in the various regions of Saudi Arabia. Collected data are important not only for patients and physicians but for future epidemiological studies to monitor the spread of MTB infection in Saudi Arabia

Parent perceptions of paediatric oncology services at the Eric Williams medical sciences complex, Trinidad and Tobago / Percepciones de madres y padres sobre los servicios de oncología pediátrica en el complejo Eric Williams de ciencias médicas, en Trinidad y Tobago

OBJECTIVE: To assess the perceptions of parents of children with cancer and to determine level of satisfaction with the paediatric oncology services at the Eric Williams Medical Sciences Complex (EWMSC). DESIGN AND METHODS : Parents of children with cancer were surveyed during the period 12-27 October 2009 as part of a wider needs assessment project using a questionnaire designed to obtain information on their perception of medical, physical and psychosocial resources during the family encounter at the EWMSC. RESULTS: Overall, parents expressed a high level of satisfaction with the quality of delivery of medical and pharmaceutical services which were at no direct cost to the patient. Issues of concern included a lack of a structured clinic appointment system, inadequate patient care assistance on the ward for very young patients and the housing of non-oncology patients in the oncology specialty unit. Apart from their child's illness, fear of job and income loss was a major stressor for parents. CONCLUSION: Medical needs of patients were perceived to be well met, but there was need to address the psychosocial, physical and educational needs of parents.

OBJETIVO: Evaluar las percepciones de madres y padres de niños con cáncer, y determinar el nivel de satisfacción con los servicios de oncología pediátrica del Complejo Eric Williams de Ciencias Médicas (EWMSC). DISEÑO Y MÉTODOS: Se hicieron encuestas a los padres y madres de niños con cáncer, durante el periodo del 12-27 de octubre de 2009, como parte de un proyecto de evaluación de las necesidades. Se diseñó un cuestionario para obtener información acerca de su percepción de los recursos médicos, físicos y psicosociales durante el encuentro de familias en el Complejo Eric Williams de Ciencias Médicas Complejo (EWMSC). RESULTADOS: En general, padres y madres manifestaron un alto nivel de satisfacción con la calidad de los servicios médicos y farmacéuticos sin costo alguno para los pacientes. Los problemas de mayor preocupación incluían la falta de un sistema bien estructurado de citas médicas, atención inadecuada en relación con la asistencia en la sala de los pacientes muy jóvenes, y el alojamiento de los pacientes no oncológicos en la unidad de especialidad de oncología. Aparte de la enfermedad de sus niños, el miedo a perder el trabajo y los ingresos, era una de las causas principales de stress en los padres. CONCLUSIÓN: Las percepciones daban por bien satisfechas las necesidades de los pacientes, pero apuntaban al imperativo de atender las necesidades psicosociales, físicas y educativas de padres y madres.

Assessment of Acute Kidney Injury in Patients Undergoing Elective Coronary Angiography and Percutaneous Coronary Intervention.

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction. Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development, Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN.

Pulmonary Hypertension in Hemodialysis Patients.

Background: Pulmonary hypertension (PH) has been reported to be high among maintenance dialysis patients. There is a paucity of data on the incidence and prevalence of pulmonary hypertension in chronic kidney disease(CKD) in Bangladeshi patients. Materials and Methods: A total 70 CKD patients (male 47,female 23), who were on conservative management and maintenance hemodialysis were studied for the presence of pulmonary hypertension. The variables studied were hypertension, diabetes, duration of dialysis and the hemoglobin, serum creatinine and serum bicarbonate levels. Results: 68.6% of the patients on maintenance hemodialysis had pulmonary hypertension compared to 8.6% of the prediadysis CKD patients. 97.1% of maintenance dialysis patients had anaemia (Hb <10gm/dl) and 42.9% of patients had metabolic acidosis. Conclusion: The incidence of pulmonary hypertension was highest in the hemodialysis group. Significant Pearson’s correlation was found between pulmonary arterial systolic pressure with the duration of hemodialysis, hemoglobin level, serum creatinine, blood sugar and serum bicarbonate level in maintenance hemodialysis patients.

Role of partial splenic arterial embolization for hypersplenism in patients with liver cirrhosis and thrombocytopenia.

Background Hypersplenism is traditionally treated by surgical splenectomy. Transcatheter ablation of splenic parenchyma is an alternative treatment modality. Methods We evaluated the efficacy and safety of partial splenic arterial embolization in 10 patients with chronic liver disease and hypersplenism with thrombocytopenia (platelet count <80,000/μL). Results At six months follow up, median (range) platelet counts (134.5 [71.5-164] × 103/μL) were significantly higher than those before treatment (33.5 [23-39] × 103/μL; p<0.05]). All patients developed post-embolization syndrome. Left-sided pleural effusion and increase in amount or new development of ascites occurred in six and five patients, respectively. Conclusions Our data suggest that partial splenic arterial embolization leads to an increase in platelet count in patients with thrombocytopenia due to chronic liver disease and hypersplenism. However, it is often associated with complications.

A comparison of the objective structured clinical examination results across campuses of the University of the West Indies (2001 and 2002) / Una Comparación del Examen Clínico Objetivo Estructurado Resultados en los Campus de la Universidad de West Indies (2001 y 2002)

OBJECTIVE: To compare the performance of medical students in the Objective Structured Clinical Examination (OSCE) of thefinal MBBS Examination across the four campuses of The University of the West Indies, over a two-year period DESIGN AND METHODS: All final examination results of the Medicine and Therapeutics OSCE were collectedfrom the Faculty of Medical Science at the four campuses of The University of the West Indies and analyzed using both parametric (t-tests and ANOVAs) and non-parametric tests (chi-squared tests). RESULTS: Results indicated that students achieved significantly higher mean scores in the 2002 examination than in 2001 (t = 3.85, df = 415, p = 0.000). There were no significant differences between campuses with regards to the mean corrected score in 2001. Also in 2001, in adult stations, all campuses achieved significantly higher scores than Jamaica. However, in Jamaica, mean child health station scores were significantly higher than all other campuses and, the mean score in Trinidad and Tobago was higher than the Bahamas and Barbados. In 2002, all other campuses achieved significantly higher scores than Trinidad and Tobago and females performed significantly better than males with regards to overall mean scores (t = 2.814, df = 189, p = 0.005). Also in 2002, Barbados achieved significantly higher mean corrected scores than Trinidad and Tobago (F = 4.649, df = 3191; p = 0.004) and Barbados and Trinidad and Tobago both obtained significantly higher mean child health station scores than Jamaica. CONCLUSIONS: The important conclusion from this study is that the OSCE scores in Medicine and Therapeutics are generally uniform across the four campuses of the University, thereby confirming the consistency of the approach to teaching and helping to validate the efficacy and veracity of the medical graduate being produced by The University of the West Indies

Objetivo: Comparar el rendimiento académico de los estudiantes de medicina en el examen clínico objetivo estructurado del examen final de MBBS, en los cuatro campus de La Universidad de West Indies, en un período de dos años. Diseño y métodos: Se recopilaron todos los resultados del examen final de ECOE de Medicina y Terapéutica de la Facultad de Ciencias Médicas, en los cuatro campus de la Universidad de West Indies. Los datos fueron analizados usando tanto tests paramétricos (tests t y ANOVAs) como tests no paramétricos (tests de chi-quadrado). Resultados: Los resultados indicaron que los estudiantes alcanzaron puntuaciones significativamente más altas en el examen del 2001 que en el del 2002 (t = 3.85, df = 415, p = .000). No hubo diferencias significativas entre los distintos campus con respecto a los resultados corregidos promedios 2001. También en 2001, en las unidades asistenciales de adultos, todos los campus lograron resultados significativamente más altos que Jamaica. Sin embargo, en Jamaica, los resultados promedios de las unidades pediátricas fueron significativamente más altos que en todos los otros campus, y el resultado promedio en Trinidad y Tobago fue más alto que en Bahamas y Barbados. En 2002, todos los otros campus lograron resultados significativamente más altos que Trinidad y Tobago, y las mujeres obtuvieron rendimientos significativamente mejores que los de los hombres, con respecto a los resultados promedios generales (t = 2.814, df = 189, p = .005). También en 2002, Barbados alcanzó resultados corregidos promedios significativamente más altos que Trinidad y Tobago (F = 4.649, df = 3,191; p = .004), mientras que Barbados así como Trinidad y Tobago, obtuvieron resultados significativamente más altos en la unidades pediátricas, en comparación con Jamaica. Conclusiones: La conclusión principal de este estudio es que los resultados del OSCE en Medicina y Terapéutica son generalmente uniformes en los cuatro campus de la Universidad, confirmando de ese modo la solidez del enfoque de la enseñanza, y contribuyendo a validar la eficacia y calidad del graduado de medicina egresado de la Universidad de West Indies.

Immune status with empyema thoracis.

OBJECTIVE: To evaluate the humoral and cell mediated immune status of children with empyema thoracis. METHODS: Serum IgG, IgA, IgM, Complement C3 assay and cell mediated immunity (CMI) tests were performed in 33 patients of empyema thoracis, and 14 healthy age matched controls. RESULTS: The mean serum IgG and IgA levels in empyema thoracis and its subgroups were significantly raised as compared to controls. The overall values of IgG and IgA were 104% (p<0.001) and 114% (p<0.01) of normal mean, respectively. The mean serum IgM and complement C3 levels did not differ significantly in both the groups. The frequency of negative skin reaction to purified protein derivative (PPD) was significantly higher in children with empyema thoracis as compared to controls (p<0.05). The mean absolute lymphocyte count (ALC) was significantly decreased and serum adenosine deaminase (ADA) activity was significantly raised in empyema thoracis in comparison to controls. The overall ALC was 76.1% (p<0.01) and serum ADA activity was 169.4% (p<0.001) of normal mean, respectively. No significant differences were observed in the mean levels of immunoglobulins, complement C3 and CMI tests between pyothorax and pyopneumothorax and pleural fluid culture positive and negative cases. CONCLUSIONS: Thus, both humoral and cell mediated immunity were affected in empyema thoracis patients. However, CMI demonstrated more pronounced change in comparison to humoral immunity.

Acute respiratory disorders in the newborn at the Mount Hope Women's Hospital, Trinidad

This retrospective study was undertaken to determine the incidence of acute respiratory disorders (ARD) in newborns delivered at the Mount Hope Women's Hospital (MHWH) from January 1 to December 31, 1994. The study also examined the relationships between incidence rate of ARD and maternal and neonatal parameters. Hyaline membrane disease (HMD), transient tachypnoea of the newborn (TTN), meconium aspiration syndrome (MAS), persistent fetal circulation (PFC) and pulmonary infection (PI) were identified as ARDs among 5062 live newborns using standard diagnostic criteria. Overall, 174/5062 neonates were diagnosed with ARD to give an incidence of 3.4 (104 males and 70 females). The most common ARD was PI (39) followed by HMD (29). The incidence of ARD in preterm infants was 20.6 (100/486) and 1.1 (48/4363) in term neonates. Hyaline membrane disease occurred mainly in the preterm and low birthweight babies. Transient tachypnoea of the newborn and PI were found in all gestational age groups. Asphyxia was present in 10.9 (19/174) at five minutes of age. It was more common in babies who developed HMD and PFC. Forty-one per cent (71/174) of babies with ARD required assisted ventilation. There were 58/174 (33) deaths. More than a half of those ventilated died (39/71 or 55); 2/3 of those with airleaks and all those with intraventricular haemorrhage died. Mortality was significantly associated with asphyxia at both one and five minutes of age. There was significantly greater mortality among neonates with HMD as compared to the other ARDs

Invasive pulmonary aspergillosis complicating chronic obstructive pulmonary disease in an immunocompetent patient.

Immunocompromised individuals are susceptible to pulmonary aspergillus infection, but invasive aspergillus infection is extremely rare in the presence of normal immunity. We report a case of invasive aspergillosis in an immunocompetent 63-year-old male with chronic obstructive pulmonary disease (COPD). Patients with COPD may be at risk for developing pulmonary aspergillus infection, which should be considered as a diagnostic possibility in patients with unresolving pulmonary infection.

Zinc, magnesium and gamma glutamyltransferase levels in human seminal fluid

The purpose of this study was to determine the levels of Zn, Mg and Gamma- GT in seminal fluids as an indirect method for the evaluation of the excretory function of the prostate gland. Seminal fluid specimens were collected from 167 Jordanian males referred for infertility investigation. Descriptive seminal fluid analyses were performed on all samples according to WHO standards, and were divided into four groups: normospermia [n=70]; oligospermia [n=50], azoospermia [n=22] and asthenospermia [n=25]. Zn and Mg were determined in the seminal plasma of each group by atomic absorption spectrophotometery and Gamma-GT was determined by enzymatic method. Compared with the other groups, oligospermic group had the highest proportion of specimens with abnormal liquefaction [26.0%] and leukocyte counts [32.0%]. Both oligospermic and asthenospermic groups had comparable sperm motility, which was lower than that in normospermia [p < 0.05]. The mean levels of Gamma-GT and Mg in oligospermia were significantly lower than that in all other groups. The mean Zn levels in oligospermia and azoospermia were lower than that in the other two groups. Significant positive correlation was observed between Gamma-GT, Zn and Mg in all four groups. The mean levels of Gamma-GT, Zn and Mg correlated positively with sperm count and motility only in the normospermic group. The presence of a high ratio of leukocytes in association with decreased levels of Zn, Mg and Gamma-GT in oligospermia, suggests disturbed function of the prostate gland, most probably due to infection. Measurement of these parameters may shed some light on the treatment and management of oligospermic infertile men

Value of routine long bone radiographs in management of babies with a positive VDRL at the Mount Hope Women's Hospital

This retrospective study examined the records of 44 mothers and 44 babies with a positive blood VDRL test and/or who showed symptoms of congenital syphilis at the Mount Hope Women's Hospital (MHWH), Trinidad, between June 1, 1996 and September 30, 1998. Long bone radiographs of 40/44 (91) babies were assessed independently by two radiologists for signs of congenital syphilis and the data were analysed using frequency tables. Of the 44 mothers in the study, 34 (77) were VDRL positive and the rest were either negative or unknown. Maternal age ranged from 14 to 39 years and most (92) had antenatal care. Fourteen of the 34 (41) VDRL positive mothers received treatment antenatally. All mothers were asymptomatic and none had any clinical features of syphilis. In 35/44 babies, the VDRL test was positive and in nine, the test was either negative or unknown. Twenty-six of the babies had signs suggestive of congenital syphilis and in 12, (46) long bone radiographs revealed changes compatible with the diagnosis of congenital syphilis. Radiographic abnormalities were present only in infants with VDRL titres > 1:8

Ant allergy in Benha district Qualyobia governorate, Egypt

Individuals from Banha City and some adjacent villages were presented with various degrees of skin allergy. Children spending the night sleeping on the floor were suffered from generalized lymphadenopathy with or without fever. The patients were successfully treated with carbolic acid [1:25]. Oral anti-histamine [H1] and systemic antibiotics were indicated in the complicated cases. In the concrete houses of the patients, a huge number of the large ants [mainly Catagliphus bicolar] were found. Spreading or burning dried leaves of camphor tree proved to be effective against the ants. Discussion also focused on the medical importance of ants

Effect of pregnancy on plasma lipid concentration in Trinidadian women. Result of a pilot study

In Trinidad and Tobago, cardiovascular disease and Type 2 diabetes mellitus are important causes of morbidity and mortality, and birth weight is significantly less than reference standards. Lower birth weight is associated with increased risk of these diseases. Variation in birth weight is due, in part, to deposition of adipose tissue in the foetus during the last trimester at the same time that maternal plasma triacylglycerol (TAG) increases. We conducted a pilot cross-sectional analysis of maternal plasma lipid status and birth weight in healthy, non-pregnant, primigravida Trinidadian women. Non-pregnant and pregnant women, in their second and third trimesters, and at term, were recruited at random from an antenatal clinic. Adult and umbilical cord plasma TAG, non-esterified fatty acids (NEFA) and phosphatidylcholine (PC) concentrations were determined from gas chromatographic analysis of fatty acids. Maternal height, weight, skinfold thickness and infant birth weight were measured. The infants born to Afro-Trinidadian and Indo-Trinidadian women were of low to normal birth weight (medians 3.07 and 3.22 kg, respectively). At term, plasma TAG concentration was approximately two fold (p < 0.05) greater than for non-pregnant women. The increment between 30-34 weeks was 1.5 to 1.9 fold lower than reported in other populations. There was a strong relationship (r = 0.8771, p = 0.019) between maternal and cord plasma TAG and NEFA, but not PC concentrations. There was no significant relationship between maternal TAG concentration at term and birth weight. The result suggests an impaired ability to increase plasma TAG concentrations during late gestation.

Fifty years of clinical examinations at the University of the West Indies

The University of the West Indies was founded at Mona, Jamaica, in 1948. After fifty-two years, the format of the final Bachelor of Medicine clinical examination in Medicine and Therapeutics has been radically revised. The change from the traditional to an evidence-based, objective structured clinical examination (OSCE) was undertaken in November/December 2000. Assessment drives learning and both the methods chosen for assessment and the manner in which they are applied determine how students learn. The philosophical underpinnings of the change in format are discussed in this paper.