Long-Term Effects of Kratom (Mitragyna speciosa) Use

@#Introduction: Kratom or (Mitragyna speciosa) leaves are consumed as a folk remedy and opioid substitute in the Southeast Asian region. There is still a lack of information about the long-term or toxic-causing effects of kratom use. Methods: A total of thirteen regular kratom users, with long-term (>20 twenty years) kratom use history were recruited for this cross-sectional pilot study. Respondents were required to undergo a blood-test and laboratory anaysis was conducted to determine the mitragynine content in an acquired street sample of kratom. Results: The regular, longterm consumption of brewed kratom decoction did not cause any significant alterations in haematological, kidney, liver, thyroid, inflammatory and gastrointestinal analytes in a cohort of kratom users who had no history of substance misuse. However, those who had a higher intake (>3 glasses per day) of kratom exhibited higher lipid values (except for HDL-cholesterol), and a moderate elevation of homocysteine level. Conclusion: Long-term (>20 years with a daily intake of ≥87.54mg of mitragynine) kratom consumption was not associated with altered biochemical levels, although prolonged and heavy use (>3 glasses daily) may result in cardiovascular risks. The latter finding, however, requires further investigation.

Medical student's perception to different types of set induction in anatomy lectures / 대한해부학회지

Set induction refers to the process of using a thought-provoking statement, interesting fact, or an audio-visual stimulus at the beginning of lecture to gain student's attention and give an overview about the lecture topic. In the present study, students were introduced to three types of set induction namely narratives, food-based analogies and humor-based images or activities at the beginning of anatomy lecture and their response to it is collected and analyzed. The objective of the study is to estimate the difference in a questionnaire-based perception score between the three different types of set induction; estimate sex differences in the questionnaire-based perception score. Students rated the validated, 7-item perception questionnaire using a 5-point Likert scale. Students felt that food-based analogies and humor-based images were more interesting, motivated them to participate in lecture-discussion than the narrative set induction. The familiarity of set induction varied between all the three different types of set induction. There was no significant difference in the perception of different types of set induction between male and female undergraduate students. Based on the student's feedback, it could also serve as a memory aid and ease the students learning experience. Majority of students responded positively to the use of set induction and recommended for its use in future classes.

Socio-demographic Characteristics, Kratom Use and Quality of Life (QoL) of Regular Kratom (Mitragyna speciosa Korth.) Users

Abstract@#Introduction: Kratom which is a tropical plant use as traditional remedy in rural areas of Malaysia and Thailand has recently been a research focus worldwide due to its potential as substitution therapy for opioid addiction. However, data on its effect on the quality of life of kratom users is scarce. This study aimed to describe the socio-demographic and history of kratom use as well as assessing the quality of life and its associated factors in Malaysian kratom users. Methods: This cross-sectional survey recruited 150 kratom users and they were administered with socio-demographic and substance history questionnaires, the World Health Organization Quality of Life- BREF (WHOQOL-BREF) to assess quality of life and the Kratom Dependence Scale (KDS) to assess severity of kratom dependence. Results: Respondents were all males with mean age of 34.4 years old (SD= 11.2). Sixty-percent of respondents use kratom > 6 years (mean duration = 8.5 years, SD= 5.3) while 55% (n=83/150) used >3 glasses of kratom daily. Duration of kratom use, quantity of kratom use and severity of kratom dependence were not associated with all the domains of quality of life except severe kratom dependence users had significant lower physical quality of life score when compared to that of users with mild to moderately severe kratom dependence. Conclusion: Based on our study, kratom consumption does not cause impairment in quality of life of kratom users except for severe kratom dependence which may cause deterioration in physical well-being of users.

The influence of learning style in understanding analogies and 2D animations in embryology course / 대한해부학회지

Undergraduate students struggle to comprehend embryology because of its dynamic nature. Studies have recommended using a combination of teaching methods to match the student's learning style. But there has been no study to describe the effect of such teaching strategy over the different types of learners. In the present study, an attempt has been made to teach embryology using the combination of analogies and simple 2D animations made with Microsoft powerpoint software. The objective of the study is to estimate the difference in academic improvement and perception scale between the different types of learners after introducing analogies and 2D animation in a lecture environment. Based on Visual, Aural, Read/Write, and Kinesthetic (VARK) scoring system the learners were grouped into unimodal and multimodal learners. There was significant improvement in post-test score among the unimodal (P < 0.001) and multimodal learners (P < 0.001). When the post-test score was compared between the two groups, the multimodal learners performed better the unimodal learners (P=0.018). But there was no difference in the perception of animations and analogies and long-term assessment between the groups. The multimodal learners performed better than unimodal learners in short term recollection, but in long term retention of knowledge the varied learning style didn't influence its outcome.

Microsurgical Treatment of Sporadic and von Hippel-Lindau Disease Associated Spinal Hemangioblastomas: A Single-Institution Experience

STUDY DESIGN: Retrospective cohort study. PURPOSE: To examine the clinical profile and surgical complications in patients with spinal hemangioblastomas and to evaluate the long-term outcome in them. OVERVIEW OF LITERATURE: Although considered to be histologically benign, hemangioblastomas may cause significant neurological deficits. The proportion of spinal hemangioblastomas associated with von Hippel–Lindau (VHL) disease has been estimated be 13%–59%. Preoperative neurological function correlates with postoperative neurological status. Studies have shown no difference in outcomes between sporadic and VHL-associated spinal hemangioblastomas. METHODS: This retrospective study included 14 consecutive patients treated for spinal hemangioblastomas at our institute between January 2000 and June 2013. The mean follow-up period was 5 years. Magnetic resonance imaging of the complete neuraxis was performed in all cases, and preoperative embolization was performed in two cases. RESULTS: In total, 14 patients underwent 18 surgeries, of which 15 were for spinal hemangioblastomas. Of all the patients, 86% had motor weakness and 79% presented with sensory disturbances. Preoperative McCormick functional grades were grade I in 7 (50%), grade II in 3 (21%), and grade III in 4 (29%) patients; 50% patients were diagnosed with VHL disease. All patients underwent complete resection of the tumor. Eight patients experienced deterioration in their neurological status in the immediate postoperative period; among them, five had gradual improvement. At 5-year follow-up, 11 (78.57%) patients showed good functional outcomes. CONCLUSIONS: Microsurgical excision of spinal hemangioblastomas can cause postoperative morbidity, mainly in the form of neurological deterioration. Almost half of our patients had deterioration in the McCormick grade in the immediate postoperative period. However, a complete microsurgical excision can result in good long-term functional outcomes, as most of the immediate postoperative neurological deterioration in our patients was reversible. There was no difference in the long-term functional outcomes between sporadic and VHL-associated spinal hemangioblastomas.