Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 2).

BACKGROUND: The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. AIM: The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. METHODS: This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. RESULTS: The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates, two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. CONCLUSION: The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities, and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1).

BACKGROUND: The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country. AIM: The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face. METHODS: This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges. RESULTS: The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates (UAE), two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait, and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education, particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges. CONCLUSION: The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Nutrition and health education intervention for student volunteers: topic-wise assessment of impact using a non-parametric test.

OBJECTIVE: To assess the impact of a classroom-based nutrition and health education intervention among student community volunteers in improving their knowledge on individual topics. DESIGN: Prospective follow-up study. Topic-wise knowledge change among student volunteers on individual topics (twenty-one questions related to nutrition and health, eight questions related to infectious diseases and two questions related to obesity and hypertension) pertaining to nutrition and health was evaluated at baseline and after intervention, using the McNemar test. SETTING: Six different colleges affiliated to Osmania University, Andhra Pradesh, India. SUBJECTS: Six hundred and eighty-seven student volunteers under the National Service Scheme, of both genders, average age 19 years. RESULTS: A significant mean improvement of 11.36 (sd 8.49, P < 0.001) was observed in the overall nutrition and health knowledge scores of the student volunteers after the education intervention. The McNemar test showed that knowledge on individual topics related to energy, proteins, fats, adolescent phase, obesity, some lifestyle diseases and infectious diseases improved significantly (P < 0.01). No significant (P > 0.05) improvement was observed in knowledge on the nutritional content of milk and sprouted grams, hypertension, HIV/AIDS, ELISA and malaria. CONCLUSIONS: Topics on which our educational intervention could not bring about significant knowledge improvement have been identified and suitable modifications can be carried out to strengthen them.

Nutrition education for student community volunteers: a comparative study of two different communication methods.

BACKGROUND: Nutrition education for student volunteers can enhance their skills, and they can act as change agents in the community. There is a dearth of data from India on the effectiveness of different communication tools in providing nutrition education to student volunteers. OBJECTIVE: This study aims to examine the comparative effectiveness of two different methods of communication--lectures in the classroom aided by print material, and a televised version of a local folk-dance form--for providing nutrition education to student community volunteers in a South Indian state. METHODS: Interventions were conducted during two mega-camps of student volunteers (camps 1 and 2) with 70 and 137 participants, respectively. Their knowledge levels were tested at baseline. Camp 1 received the lecture intervention and camp 2 the televised folk-dance intervention. Knowledge scores were measured before and after the intervention in each camp, and the two camps were compared for significant improvements in knowledge. RESULTS: At baseline, the knowledge levels of students in both camps were comparable. Significant improvement in knowledge was observed in both camps after intervention (p < .05). Although there was no significant difference between the camps in improvement in knowledge, a significant difference was observed when only the positive increments (improvement over baseline) were compared. CONCLUSIONS: The televised version of the folk-dance form was better in bringing about positive increment.

Food safety knowledge, attitudes and practices of mothers: findings from focus group studies in South India.

In India, most of the diarrhoeal deaths among children (<5 years) are attributed to food and water contamination. Mothers are usually the final line of defence against food borne illnesses. Thus, the role of mothers in ensuring food safety at homes is well accepted. There are hardly any studies in India to understand their knowledge, attitudes and practices on food safety. The present study was an attempt in this direction. A total of 32 Focus Group Discussions were carried out with mothers of children <5 years in 16 districts from all the four South Indian states. The findings reveal that food safety awareness and practices are good among mothers perhaps due to the Indian food ethos passed on to them through generations. Home cooked foods are considered to be safer than prepared foods bought from outside. Many mothers were aware of the common food adulterants but do not bother to complain or take action. There is a need to create enabling environment with improved access to potable water, sanitation and cooking fuel. Spreading awareness about checking food labels and reporting to the health authorities in case of food poisoning or adulteration is also the need of the hour. The Anganwadi Centres can be the focal points for imparting food safety education to the mothers.

Dietary habits and effect of two different educational tools on nutrition knowledge of school going adolescent girls in Hyderabad, India.

OBJECTIVES: To assess dietary habits and nutrition knowledge levels of the adolescent girls from different schools and to study the efficacy of two different nutrition education tools in improving their nutrition knowledge in the classroom setting. DESIGN: Purposive sampling technique was adapted for selecting the subjects in the study. SETTING: Four secondary schools in Hyderabad, India. SUBJECTS: In total, 164 adolescent girls belonging to eighth grade. INTERVENTIONS: Two interventions (Intervention-1. Traditional method using print media such as folders leaflets and charts; Intervetion-2. Audio-visual CD) were carried out in a classroom setting for the experimental group. RESULTS: FFQ data on dietary consumption of adolescent girls revealed more consumption of aerated drinks, bakery items, fast foods and less consumption of millets irrespective of their socio-economic conditions. However, consumption of vegetables, green leafy vegetables and fruits was moderate. A significant improvement in the nutrition related knowledge was observed among the experimental group after interventions-1 and -2 as compared to the baseline data. However, no significant difference in the improvement of nutrition knowledge levels was observed with the second intervention over the first intervention as already the children in the experimental group gained knowledge through print media. CONCLUSIONS: Education on ill effects of aerated drinks, fast foods and the importance of nutrition during the adolescent phase should be emphasized in future programmes.

Evaluation of the Food and Agriculture Organization's global school-based nutrition education initiative, Feeding Minds, Fighting Hunger (FMFH), in schools of Hyderabad, India.

OBJECTIVE: To assess the efficacy of the Food and Agriculture Organization's global school-based nutrition education initiative, Feeding Minds, Fighting Hunger (FMFH), in improving nutrition-related knowledge levels of schoolchildren. DESIGN: Adopting the cluster randomisation technique, five schools each in experimental and control groups were randomly chosen from the member schools of a voluntary organisation. Repeated measures of knowledge levels were carried out at three points in time to assess pre-, post-intervention and retention of knowledge gained during the intervention. Children from experimental schools were given nutrition education by teachers in the classroom setting using FMFH material. SUBJECTS/SETTINGS: Schoolchildren (n=358 in the control group and n=312 in the experimental group) of grades VIII and IX from schools in Hyderabad, India. RESULTS: The classroom-based intervention resulted in a significant improvement (P<0.01) in nutrition knowledge levels of schoolchildren in the experimental group. Significant improvement in knowledge was also observed in the control group. The effect size indicated that the improvement in knowledge levels of schoolchildren in experimental schools over control schools was medium (d=0.40), indicating the efficacy of the FMFH programme in improving nutrition-related knowledge. No significant decrease (P>0.05) in knowledge levels was observed after 2 months, indicating retention of the knowledge acquired through the intervention. CONCLUSION: The FMFH programme provides an opportunity for schoolchildren to learn more about nutrition through their teachers in a classroom setting if the lesson plans are adapted to the local circumstances. Furthermore, it has the potential to make nutrition education interactive, effective and sustainable.

Action of Hygrophila auriculata against streptozotocin-induced oxidative stress.

Hygrophila auriculata (K. Schum.) Heine (Family: Acanthaceae) is a wild herb widely used in 'Ayurveda' as 'Rasayana' drug for treatment of various disorders. Treatment of diabetic rats with aerial parts of Hygrophila auriculata extract (HAEt, 100 and 250 mg/kg body weight) for 3 weeks showed significant reduction in blood glucose, thiobarbituric acid reactive substances (TBARS) and hydroperoxide in both liver and kidney. The treatment with HAEt significantly increased the glutathione (GSH), glutathione peroxidase (GPx), glutathione S-transferase (GST) and catalase (CAT) in the drug-treated group, which is comparable to the control group. HAEt and glibenclamide-treated rats also showed decreased lipid peroxidation that is associated with increased activity of superoxide dismutase (SOD) and catalase. The ability of HAEt on tissue lipid peroxidation and antioxidant status in diabetic animals has not been studied before. The result of this study thus shows that HAEt possesses significant antidiabetic activity along with potent antioxidant potential in diabetic conditions.

Plasma antioxidant vitamins and lipid peroxidation products in pregnancy induced hypertension.

It has been suggested that antioxidant systems are impaired in pregnancy induced hypertension and hence patients are exposed to oxidative stress. In order to investigate the relationship between lipid peroxidation and certain antioxidant parameters in blood of pregnancy induced hypertension (PIH) cases, 25 normotensive and 23 PIH samples were studied. In the present study, thiobarbituric acid reactive substances showed a tendency to increase, however the increase remained statistically insignificant. Plasma ascorbic acid level remained unaltered and Vitamin E showed a tendency to increase in the study group. The findings implicate oxidative stress in the disease and cite the biochemical rationale for clinical trials of antioxidants to prevent and treat pregnancy induced hypertension.

Plasma antioxidant vitamins in brain tumors.

Plasma levels of vitamins A, E and C were analyzed in 102 patients with different types of brain tumors. A follow-up study was done with 27 postoperative patients. On comparison with plasma from normal individuals, vitamin A and E were decreased, but the decrease was statistically insignificant. Vitamin C levels remained in the normal range. In a comparative study of preoperative and postoperative cases, plasma vitamin A levels in postoperative glioma patients were significantly higher than those in the pre-operative state. There was no significant difference in the plasma level of vitamins C and E. The results of the present study suggest that the plasma antioxidant vitamins are not altered effectively in brain tumor cases.

Primary hypertrophic colonopathy.

We report a 45-year-old man and a 60-year-old woman who presented with features of intermittent intestinal obstruction. Barium enema revealed narrowing at the pelvic-rectal junction in the man, and from the pelvic colon to the anal verge in the woman. Histology of the resected sections showed marked hypertrophy of the muscularis propria in both cases, with normal mucosa, submucosa and myenteric plexus. Both patients are asymptomatic at 4 years' and 2 years' follow up. This entity of primary hypertrophic colonopathy may be a variant of primary visceral myopathy.

Role of antioxidant enzymes in brain tumours.

Erythrocyte antioxidant enzymes were analysed in 100 patients with intracranial neoplasm and in 47 controls. There was a significant decrease in RBC glutathione reductase (GRx) and superoxide dismutase (SOD) activity in most types of brain tumor cases. Patients with acoustic neurinoma showed a significant reduction in selenium-dependent glutathione peroxidase (Se-GPx) activity. A decrease in catalase (CT) activity was seen in most of the brain tumor patients but remained statistically insignificant when compared to controls. A significant increase in plasma ceruloplasmin concentration was observed in patients with glioma. These enzymes were also studied in 27 post-treatment cases. GRx activity returned to normal levels in these patients. RBC SOD and plasma ceruloplasmin levels showed a tendency to return to normal. Hence, a marked decrease in the antioxidant enzymes may have a role in the genesis of considerable oxidative stress in patients with brain tumors.

Primary melanocarcinoma of stomach.

Melanomas of the gastrointestinal tract are infrequent. Among primary melanomas, melanoma of the stomach is a rarity. We report a patient with primary melanocarcinoma of the stomach.

Marked perisplenitis in gastric carcinoma.

We report a patient with gastric carcinoma with marked perisplentis, on gross appearance resembling secondary deposit. On sectioning, the spleen showed a solitary metastasis in the red pulp.

Respiratory effects of occupational exposure to asbestos.

Ventilatory capacities of 73 Libyan men working in the Asbestos-Cement Pipe factory in Jenzur, a residential area near Tripoli, Libya and those of 73 age-matched healthy Libyan men unexposed to asbestos were determined. The mean values of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) for men unexposed to asbestos were 3.89 +/- 0.084 and 3.64 +/- 0.082 liters respectively. The respective values for men exposed to asbestos were 3.62 +/- 0.082 and 3.29 +/- 0.097 liters. Thus, there has been a significant decrease in the ventilatory function of the men exposed to asbestos as compared with age-matched unexposed counterparts.

Oxytocin induces intimate behaviors.

After decades of classic research on its secretion from the neurohypophysis and its potential effects in the uterus and the gland, oxytocin has, in the last 15 years, been proven to be centrally distributed neuropeptide with a broad spectrum of behavioral effects. Of particular interest are reports of potent effects of oxytocin on many reproductive and social behaviors such as maternal behavior, female sexual receptivity (lordosis), penile erection, male mounting behavior and side by side contact. The nonapeptides promote a large number of key behavioral interactions between conspecifics than any other class of neuropeptides. Nonapeptides may trigger the appropriate intraspecific affiliative behavior under broad range of reproductive and social conditions.

Blood pressure levels in diabetes mellitus.

Levels of fasting plasma glucose, body mass index, serum total lipids, serum total cholesterol, serum triglycerides and blood pressure of 177 Libyan diabetic patients were determined. The respective mean values were 212.4 +/- 5.6 mg/dl, 26.6 +/- 0.45 kg/m2, 825.7 +/- 20.5 mg/dl, 176.4 mg/dl, 144 +/- 5.8 mg/dl and 135.3 +/- 1.7/83 +/- 0.89 mm Hg. The mean levels of all variables except plasma glucose are significantly higher in the female patients than their male counterparts. Correlations were present between blood pressure levels and age/body mass index/serum total lipids. There was a significant correlation between systolic pressure levels and the duration of diabetes. Serum cholesterol and serum triglyceride levels correlated with diastolic blood pressure levels only.