Medical Undergraduates' Assessment Status Regarding Clinical Neuroanatomy.

The study of Anatomy is essential to the learning of different subjects of medicine. Neuroanatomy is a fundamental part of the Anatomy portion of the undergraduate medical (MBBS) curriculum of different universities of Bangladesh. The clinical relevance of Neuroanatomy is beyond doubt in the context of increasing numbers of cases like stroke, head injury and meningitis in Bangladesh. Contemporary Neuroanatomy books are inclined to a clinically-oriented approach in their presentation. However, there is no organized attempt to analyze these recent trends of highlighting the significance of clinically-oriented approach reflected in the learning pattern or student-assessment in the medical undergraduate courses of Bangladesh. Such analyses can offer an insight into the situation and facilitate teachers and curriculum planners to make necessary modifications. The present study was planned- i) to analyze the Neuroanatomy portion of the recent undergraduate Anatomy written question papers of four public universities of Bangladesh for understanding how clinically relevant knowledge has been assessed in the questions ii) to determine the ability of the medical undergraduates to answer clinically-oriented written questions as compared to their ability to answer non-clinically-oriented questions in Neuroanatomy. It was a comparative study with some descriptive components. For Part-A of the study, all the 'Question-segment's of question (SAQ and MCQ) dealing with Neuroanatomy in all the available First Professional MBBS Exams' Anatomy written question papers of four public universities of Bangladesh of the last five years (2005 to 2009) were identified. The frequency of 'Question-segment's those assessing the ability of the clinically relevant knowledge were determined. It was a descriptive study. For Part-B of the study, total 136 New 3rd year medical undergraduates of one Bangladeshi governmental medical college and one private medical college were taken as participants. The medical undergraduates of each medical college were divided into two equal groups by randomization. One group was given 100 clinically-oriented questions and the other was given 100 non-clinically-oriented questions based on the content of Snell. The scores (frequencies of correct responses) of the two groups were compared using an unpaired 't' test. The frequencies of 'Question-segment's assessing clinically relevant knowledge was 6.14%. The performance of the undergraduates answering clinically-oriented questions was significantly poorer (p=0.01) than answering non-clinically-oriented questions (the mean score being 38.49±10.50 and 45.04±8.48 respectively). Teaching and assessment of Neuroanatomy should be designed in a way to orient medical undergraduates towards more clinically-oriented understanding and performance in Neuroanatomy. The clinically relevant knowledge dealing with Neuroanatomy needs to be addressed with appropriate weighting in the First Professional MBBS written questions of Bangladesh. Necessary changes in the curriculum are also suggested in meeting the above expectations.

Analyses of the Neuroanatomy Portion of the Anatomy Question Papers for Written Summative Assessment at the Medical Undergraduate Level in Bangladesh.

Neuroanatomy is a vital part of the undergraduate medical (MBBS) Anatomy curriculum of different universities of Bangladesh. The teaching-learning and assessment of Neuroanatomy have gone through significant changes in current times in various parts of the world. Neuroanatomy textbooks are supposed to be useful reflectors of these changes and of the present inclinations. The importance of an understanding approach towards Neuroanatomy is beyond doubt. Consequently, the contemporary Neuroanatomy books are inclined more towards an understanding approach in their presentation. However, there has been no organized effort in analysing how such trends are being reflected in the student-assessment in the medical undergraduate courses of Bangladesh. This kind of study can provide useful insight into the present circumstances and assist teachers and curriculum planners in formulating crucial changes. The present study was aimed at analysing the Neuroanatomy written questions of five years' First Professional MBBS Exams regarding content coverage and level of cognitive domain addressed. The study was a descriptive observational one involving qualitative analyses (and quantitation) of questions. All the 'segment's of every item (SAQ and MCQ) dealing with Neuroanatomy in all the available Anatomy written question papers of all the First Professional MBBS Exams of four public universities of Bangladesh of five years (2005 to 2009) were analysed. The frequencies of item- 'segment's dealing with different chapters (or similar parts) of a Neuroanatomy textbook commonly recommended to the medical undergraduate course of the country1 were estimated to determine the content coverage and the item- 'segment's addressing different levels of cognitive domain were identified. The relative coverage of different chapters (or similar parts) of the textbook by Snell1 in the question papers showed considerable differences from the relative proportions of the corresponding chapters (or similar parts) in the book itself. Most (97.64%) of the item-'segment's addressed the recall-level of cognitive domain. The understanding-level was addressed by only 2.36% of 'segment's, but no application-level 'segment' could be identified. The findings of the present research assist teachers, paper- setters and moderators of questions as well as the curriculum planners in integrating the current trends in Neuroanatomy in the respective domains so that pre-clinical undergraduates can be made better prepared for the upcoming years and occupation.

Presentation Pattern of Histology and Illustrations in the Histology Text Books Commonly Used by the Medical Undergraduates of Bangladesh.

The teaching-learning and assessment of cell and histology have gone through remarkable changes in recent times. Histology text books recommended by renowned medical institutions should be good reflectors of these changes and the present trends. Cell and histology is categorically visual in nature. So, their presentation in text books is likely to show rational and meaningful use of illustrations. From July 2007 to June 2008, this descriptive observational study was done to analyze the presentation pattern of illustrations in two histology text books commonly recommended for the medical undergraduates of Bangladesh through: a) estimating the relative weights given to (i.e., proportions of printed area allotted to) illustrations and text; b) determining the frequencies of 12 'form's of illustration-defining each 'form' on the basis of how it has been created and how it looks like and c) determining the frequencies of 3 'categories' of illustration-on the basis of their utility as teaching-learning and assessment tools. Illustrations have been found to be allotted more than half of the printed area in the two books together. Regarding the 'form' of illustrations, 'schematic diagram and three-dimensional diagram' has the highest mean frequency (30.11%) and followed by 'photomicrograph - routine stain - high power' (17.56%). More than 90% of the illustrations could be categorized either as 'practically the best tool for the purpose' (70.21%) or as 'a complementary tool to another tool' (21.05%) for using in teaching-learning and assessment. By incorporating the findings of the present study with the present-day ideas and trends in cell and histology education in the renowned institutions of the world and with the understanding of the science of medical education, guidelines can be formulated for improving the methods of teaching and assessment in cell and histology for the medical undergraduates of Bangladesh.

Effect of fenugreek seeds on the fasting blood glucose level in the streptozotocin induced diabetic rats.

In this experiment defatted Trigonella foenumgraecum (fenugreek seeds/methi seeds) has used as the antidiabetogenic herbal medicine. The experiment was carried out in Bangabandhu Sheikh Mujib Medical University and BIRDEM from 1996 to 1998 on a total of 58 Long Evans rats of either sex. They were 50-60 days young rats with average body weight 72-174 gm. Among the total, 10 rats were treated with only vehicle called as non-diabetic control rats, 48 rats were treated with Streptozotocin (STZ) at a dose of 90 mg in 1 ml of citrate buffer solution per kg body weight, among which 20 were diabetics. Ten (1 died, 1 escaped) diabetic rats were again treated with fenugreek called as Fenugreek-treated diabetic rats and the rest 10 diabetic rats were called as diabetic control rats. The change in the mean fasting blood glucose (FBG) level in different groups of rat from day 5 from streptozotocin injection were higher in diabetic control group and in fenugreek-treated diabetic group than in non diabetic control group. The FBG level on day 13 the mean in non-diabetic control group was 5.21 mmol/L. In diabetic control group and in fenugreek-treated diabetic group the mean FBG level were 24.33 mmol/L and 9.89 mmol/L respectively. So, from this experiment it may be concluded that fenugreek decreases the FBG level considerably by improving diabetes mellitus.

Large retinal ganglion cells that form independent, regular mosaics in the bufonoid frogs Bufo marinus and Litoria moorei.

Population-based methods were used to study labeled retinal ganglion cells from the cane toad Bufo marinus and the treefrog Litoria moorei, two visually competent bufonoid neobatrachians with contrasting habitats. In both, cells with large somata and thick dendrites formed distinct types with independent mosaics. The alpha(a), alpha(ab), and alpha(c) mosaics of Bufo in all major respects resembled those of ranids, studied previously, and could be provisionally matched to the same functional classes. As in other frogs, some alpha(a) cells were displaced and many alpha-cells of all types were asymmetric, but within each type all variants belonged to one mosaic. Nearest-neighbor analyses and spatial correlograms confirmed that all three mosaics were regular and independent. In Litoria, monostratified alpha(a) cells were not found. Instead, two bistratified types were present, distinguished individually by soma size and dendritic caliber and collectively by membership of independent mosaics: the larger (approximately 0.8% of all ganglion cells) was termed alpha1(ab) and the smaller (approximately 2.2%) alpha2ab. An alpha(c) cell type was also present, although too inconstantly labeled for mosaic analysis. Nearest-neighbor analyses and spatial correlograms confirmed that the two alpha(ab) mosaics were regular and independent. Densities, proportions, soma sizes, and mosaic statistics are tabulated for each species. The emergence of a consensus pattern of alpha-cell types in fishes and frogs, from which this treefrog partly diverges, offers new possibilities for studying correlations between function, phylogeny, ecology, and neuronal form.

Large retinal ganglion cells in the pipid frog Xenopus laevis form independent, regular mosaics resembling those of teleost fishes.

Population-based studies of retinal neurons have helped to reveal their natural types in mammals and teleost fishes. In this, the first such study in a frog, labeled ganglion cells of the mesobatrachian Xenopus laevis were examined in flatmounts. Cells with large somata and thick dendrites could be divided into three mosaic-forming types, each with its own characteristic stratification pattern. These are named alpha a, alpha ab, and alpha c, following a scheme recently used for teleosts. Cells of the alpha a mosaic (approximately 0.4% of all ganglion cells) had very large somata and trees, arborizing diffusely within sublamina a (the most sclerad). Their distal dendrites were sparsely branched but achieved consistent coverage by intersecting those of their neighbors. Displaced and orthotopic cells belonged to the same mosaic, as did cells with symmetric and asymmetric trees. Cells of the alpha ab mosaic (approximately 1.2%) had large somata, somewhat smaller trees that appeared bistratified at low magnification, and dendrites that branched extensively. Their distal dendrites arborized throughout sublamina b and the vitread part of a, tessellating with their neighbors. All were orthotopic; most were symmetric. Cells of the alpha c mosaic (approximately 0.5%) had large somata and very large, sparse, flat, overlapping trees, predominantly in sublamina c. All were orthotopic; some were asymmetric. Nearest-neighbor analyses and spatial correlograms confirmed that each mosaic was regular and independent, and that spacings were reduced in juvenile frogs. Densities, proportions, sizes, and mosaic statistics are tabulated for all three types, which are compared with types defined previously by size and symmetry in Xenopus and potentially homologous mosaic-forming types in teleosts. Our results reveal strong organizational similarities between the large ganglion cells of teleosts and frogs. They also demonstrate the value of introducing mosaic analysis at an early stage to help identify characters that are useful markers for natural types and that distinguish between within-type and between-type variation in neuronal populations.

Large retinal ganglion cells that form independent, regular mosaics in the ranid frogs Rana esculenta and Rana pipiens.

Population-based studies of ganglion cells in retinal flatmounts have helped to reveal some of their natural types in mammals, teleost fish and, recently, the aquatic mesobatrachian frog Xenopus laevis. Here, ganglion cells of the semiterrestrial neobatrachian frogs Rana esculenta and Rana pipiens have been studied similarly. Ganglion cells with large somata and thick dendrites could again be divided into three mosaic-forming types with distinctive stratification patterns. Cell dimensions correlated inversely with density, being smallest in the visual streak. Cells of the alpha a mosaic (< 0.2% of all ganglion cells) had the largest somata at each location (often displaced) and their trees were confined to one shallow plane within sublamina a of the inner plexiform layer. In regions of high regularity, many trees were symmetric. Elsewhere, asymmetric, irregular trees predominated and their dendrites, although sparsely branched, achieved consistent coverage by intersecting in complex ways. Cells of the alpha ab mosaic were more numerous (approximately 0.7%) and had large somata, smaller (but still large) trees, and dendrites that branched extensively in two separate shallow planes in sublaminae a and b. The subtrees did not always match in symmetry, and each subtree tessellated independently with its neighbors. Cells of the alpha c mosaic (approximately 0.1%) had large, orthotopic somata and large, sparse trees (often asymmetric and irregular) close to the ganglion cell layer. Nearest-neighbor analyses and spatial correlograms confirmed that each mosaic was regular and independent. Densities, proportions, sizes, and mosaic statistics are tabulated for all three types, which are compared with types defined by size and symmetry in R. pipiens, by discriminant analysis in R. temporaria, by physiological response in both, and by mosaic analysis in Xenopus and several teleosts. The variable stratification of these otherwise similar types across species is consistent with other evidence that stratification may be determined, in part, by functional interactions.