Comparative assessment of students' performance and perceptions on objective structured practical models in undergraduate pathology teaching

<p><b>INTRODUCTION</b>Assessment is an important factor that drives student learning, as students tend to mainly focus on the material to be assessed. The current practice in teaching pathology extensively applies objective-structured practical examination for the assessment of students. As students will have to deal with real patients during clinical years, it is preferred that students learn and practise via potted specimens and slides instead of picture plates. This study aimed to assess the preferred assesment method of pathology practical exercises.</p><p><b>METHODS</b>This was a cross-sectional survey carried out in two consecutive batches of Phase 2 medical students. Student competency was assessed using both the traditional (TD) (i.e. use of potted specimens and slides) and picture plate (PP) methods. To compare the two assessment methods, we compared the mean scores obtained by the students and examined student perception of the two methods.</p><p><b>RESULTS</b>The mean scores obtained via the PP method were significantly higher than those obtained via the TD method for almost all the components tested.</p><p><b>CONCLUSION</b>We found that students performed significantly better (p < 0.05) when assessed using the PP method instead of the TD method. PP preparations might provide better visuals, thus aiding understanding, than the TD method. The findings of this study are valuable in identifying and improving our current teaching and assessment methods of medical students, in line with advancements in information technology.</p>

Histopathological severity of antral gastritis in relationship to Helicobacter pylori colonisation

The association between Helicobacter pylori (HP) colonisation in gastric antrum and the degree of severity and activity of gastritis and the concomitant relationship with gastric atrophy and intestinal metaplastic changes were studied. A total of 204 pieces of endoscopic biopsy tissues were collected from the outpatient endoscopy unit of New Yangon General Hospital in 1994. Routine Haematoxylin and Eosin stain as well as special stains such as modified Giemsa and Carbol fuchsin stains were used for bacterial identification and quantitative analysis. a significant correlation (P value <0.001) was obtained between density of HP colonisation and severity of gastritis as well as its activity (p value <0.001). However, no significant degree of atrophic changes and intestinal metaplastic changes were noted in these biopsies. a continuation for a better understanding of the pathogenesis of HP and its consequences is necessary.

In-vitro nitric oxide (NO) production of murine cell line and human monocyte-derived macrophages after cytokine stimulation and activation

Nitrite (NO2) and nitrate (NO3) production were determined using J774-murine cell line and human monocyte-derived macrophages after activation of these cells with Interferon gamma (IFN-Y), Lipopolysaccharides (LPS) and Tumor Necrotic Factor a (TNF-alp ) in different concentration and in different combination. Both simple colorimetric assay and chemiluminescence assay were used for comparison. Simple colorimetric assay could detect nitrite produced by J774 cells, only However, with chemiluminescence assay nitrite production by both J774 cells and human monocyte-derived macrophages could be measured. This study was aimed to investigate a possible potent killing mechanism of monocytic cells in infection with intracellular microorganisms, particularly mycobacterium.

Post-mortem histological and dissecting microscopic appearance of the proximal jejunum of Myanmar children

A comparative morphological study of jejunal villi under the dissecting microscope and their histological changes under the light microscope was performed on 100 childhood necropsies from Yangon Children Hospital. they were from a-day-old meonate to twelve-year-old children. Four patterns of villi morphology were observed under the dissecting microscope: finger-like, tongue-like, leave-like and ridge villi. Histologically, inflammatory cells infiltration in the lamina propria and submucosa with vascular congestion of graded severity were observed. There is no correlation between villi morphology and histological changes. Tongue-like and leave-like villi could be regarded as normal for our children. Although histological examination of the post-mortem jejunal materials yields limited value, it could be of supportive or additive value if studied simultaneously with the dissecting microscopy.

A preliminary study of CD4+ T-lymphocyte count in tuberculosis patients

We evaluated the CD4+ T cell count in tuberculosis patients, whether it may be a supportive indicator reflecting the immune status of the patient. A total of 55 patients and 50 controls were included. Patients were within the age range of 19-65 years with a mean of 42.836 + or - 16.24 SD. These included 43 male and 12 female subjects with pulmonary and extrapulmonary tuberculosis. Age and sex matched subjects were included as controls. CD4+ T-lymphocyte count was determined manually with Coulter Manual CD4 Count Kit. A significant reduction in mean CD4 count against control subjects was observed (p=0.004, d.f. 103). A correlation coefficient of 0.546 was observed between CD4 count and percentage of differential lymphocyte count from the peripheral blood. the results indicate that measurement of CD4 count using above method is worthwhile for tuberculosis patients as an adjunct to clinical parameters for the assessment of the immune status of the patient.

Effect of adenosine triphosphate (ATP)-induced macrophage cell death (apoptosis) on mycobacterium viability and production of nitric oxide (NO)

The effect of ATP-induced macrophage cell death (apoptosis) on mycobacterium viability and production of nitric oxide was studied. Murine monocytic cell line (J774) and human monocyte - derived macrophages were stimulated to die by apoptosis following treatment with aTP in different concentrations. The morphological feature of cell death was examined by fluorescence light microscopy to determine if macrophage apoptosis or necrosis had occurred. It was then confirmed by DNA-gel analysis. The viability of mycobacteria (BCG) was determined by 3(H)-uridine incorporation and the release of nitric oxide (N)) was quantified by Greiss reagent assay. The murine cell line (J774) and human monocyte-derived macrophages were shown to die rapidly within one hour by apoptosis following treatment with ATP (3mM), resulting in a 40-60 per cent reduction in bacterial viability. A high level of NO release was associated with the death of murine cell line although it was not in human macrophages. the results suggest that the release of nitric oxide is not associated with the triggering of macrophage cell death by apoptosis. Thus, there might be two different pathways in control of intracellular mycobacterial infection by macrophages.

The phytohemagglutinin (PHA)-induced peripheral lymphocyte blastogenic response in cancer patients

The in vitro blastogenic response of peripheral bolld lymphocytes was determined in 50 patients with various types of malignancies by quantitation of phytohaemagglutinin PHA-induced tritiated thymidine uptake. PHA-induced blastogenic response was impaired in patients with malignancy more so in patients with squamous cell carcinoma in whom there was an inverse correlation with the stage of the tumor and the reduction. No correlation was seen in patients with adenocarcinoma, lymphoma or sarcoma. these data indicate that PHA-induced blastogenic respoonse is a potentially useful assay for the detection of immunocompromized persons especially in patients suffering from squamous cell carcinoma.

The peripheral lymphocyte mitogenic responses of apparently healthy Myanmar blood donors

The responses of peripheral lymphocytes to mitogens namely, phytohemagglutinin (PHA) and lipopolysaccharide (LPS) were determined in 50 apparently healthy blood donors. The stimulation indexes of PHA and LPS of male and female donos were calculated. Though there was a singificant difference (p < 0.001) between the sexes to PHA response, no significant difference was found in LPS response. Also the mitogen responses had no correlation with the age and the number of T and B lymphocytes in the peripheral blood.

Clinicopathological study of post russell's viper bite renal failure patients

Six patients returning due to various symptoms between 2 months to 11 months after recovering from acute renal failure following Russell's viper bite were investigated. Urine RE, C & S, Blood urea, electrolyte, creatinine, cholesterol, serum protein, were estimated. Ultrasound abdomen and renogram were performed. Renal biopsy was performed if suggestive of renal involvement. Autopsied tissue from four patients in the acute stage were included. Biopsy was taken from five patients with nocturia of 2-4 times. Three patients with proteinuria, (trace to ++). One patient with hypertension of 170/100 mm Hg discovered 8 months after recovery. The glomerular changes consisted of mild degrees of glomerular necrosis. Fluid collection and adhesion between the glomeruli and the Bowman's capsule were seen in all the cases but more marked in the ones who expired. Ballooning of the capillary loops with thickening of the basement membrane were seen only in three biopsied cases who presented with proteinuria and nocturia. Mild to moderate tubular degeneration was noted in all the cases. Interstitial fibrosis occurred in two of the biopsied cases presenting with nocturia. Thus changes in both the glomeruli and tubules and interstitium persist even after 11 months following Russell's bite and may manifest as nocturia, proteinuria and occasionally hypertension.