Entrance qualifications and student performance in a hybrid problem bases and traditional medical programme

A hybrid problem based learning (PBL) and traditional programme was started at the Trinidad campus of the University of the West Indies in 1989. Analyses were carried out to determine the extent to which the entrance qualifications of the students were related to their performances at the examinations in the Phase I (preclinical and paraclinical) and Phase II (clinical) programmes. Students who were admitted on the basis of their results in the secondary school General Certificate of Examination (GCE), "A" level scored higher at the Phase I, but not at the Phase II, level than those who already had university education. Among the "A" level students, there was positive correlation between the total "A" level scores and the examination marks in the medical programme, particularly at the Phase I level. Futhermore, multiple regression analyses indicated that the grades in "A" level chemistry and, to a lesser extent in biology, had the most influence on performance at the Phase I examinations, with much less influence on performances at the Phase II examinations. These results suggest that good grades at "A" level examination are significant factors, but not the only important ones, that favour high achievement in the initial stages of this type of PBL/traditional medical programme.(AU)

Progress in medical education in the Faculty of Medical Sciences, University of the West Indies: Implementation of problem-based learning at the St Augustine Campus

This paper reviews some of the developmental procedures regarding changes in medical education within the Faculty of Medical Sciences, University of the West Indies. Discussed are some of the constraints experienced in attempting curriculum changes in the established medical school at Mona, Jamaica, as compared with the implementation of a problem-based learning strategy curriculum at the Eric Williams Medical Complex, St Augustine, Trinidad and Tobago. At Mona, integration of disciplines, community-health and other programmes were attempted. However, it was at the Eric Williams Medical Complex, a new school, that the Faculty of Medical Sciences was able to implement a problem-based programme. (AU)

Abnormal thyroid hormone and thyrotropin levels in homozygous sickle cell disease

Male patients with SS disease had significantly lower T3 and higher TSH levels than a comparison group. Stimulation with TRH in 10 male sibling pairs showed highly significant increases in T3 and TSH in both patients and sibling controls although the increase in TSH was significantly greater in SS disease. The interpretation of these findings unclear although the thyroid indices indicate an abnormal pituitary-thyroid axis most consistent with a modest primary thyroid failure

Effects of ackee fruit extracts on bronchomotor tone in rats

The unripe ackee fruit, when eaten, is known to cause serious clinical manifestations, including vomiting, hypoglycaemia and acidosis. The effects, of various extracts from the arilli of the unripe fruit (including hypoglyin-A) on the lungs from rats were examined in an in vitro preparation. All the extracts were found to induce moderately severe broncho-constriction, indicating a possible contribution of these effects to the observed toxicity of ackee (AU)

A re-examination of the mechanism of ackee-induced vomiting sickness

The hypoglycemia seen in ackee poisoning almost certainly results from the presence of hypoglycin A in the aril. However, the mechanism underlying the vomiting and neurologic disorders have not been properly established. We have, in this review, re-established the latter and proposed that the vomiting and neurological features of ackee poisoning probably result from the excitotoxic properties of glutamic and aspartic acids derived directly and indirectly from ackee intake (AU)

Evidence to support the influence of the nucleus accumbens on drug-induced psychopathology

This study was designed to evaluate the hypothesis that the mesolimbic dopamine pathways are involved in the manifestations of psychotic symptoms. Rats were injected with amphetamine (5.0 mg/kg) and apomorphine (1.0 mg/kg) following bilateral lesions of the nucleus accumbens. The results showed high levels of stereotypy following amphetamine administrations in contrast to the low levels seen after the administration of apomorphine. These results, in conjunction with previous experiments involving the globus pallidus, were evaluated in terms of the accumbens' influence on drug-induced psychosis (AU)

Thyroid-gonad relationship in chronic renal failure

Thirty-four men of African origin suffering from chronic renal failure, (CRF) were studied to assess thyroid functions and their relationships to serum testosterone. Significantly lower mean values of T4, T3, testosterone, FT4I and FT3I were observed in CRF patients as compared to those in 23 healthy control subjects. Serum TSH, LH and TBG did not differ significantly whereas T3U and PRL were higher in CRF patients. Mean serum T4, T3U and FT4I values were further reduced in haemodialysed than in nonhaemodialysed patients. Significant positive coefficients of correlation between thyroid hormones and testosterone were observed in CRF patients. Simultaneous decreases in both serum and testosterone in the presence of normal serum TSH, LH and TBG levels suggest dysfunction of the pituitary-thyroid-gonad axis (AU)

Preliminary investigations of the wound-healing properties of a Jamaican folk medicinal plant (justicia pectoralis)

Coumarin was found to be the major component of an acetone extract of the herbaceous plant, justicia pectorials, which is used in folk medicine for the treatment of cuts. Fresh wounds created on Wistar rats and treated with the extracted coumarin, showed attenuated inflammatory process and significantly enhanced wound healing compared with control rats. The use of this plant therefore appears to influence the wound-healing process (AU)

Reproductive toxicity of marihuana smoke a three-generation study in female wistar rats

A three-generation study on the effects of marihuana smoke on female wistar rats was carried out. The mother/parent generation (Gm) and Gf(first generation) were each bred once to give rise to Gf and Gs(second generation) respectively. Reproductive indices studied included oestrous activity, fertility index,gestation of dams, gestation index, gestation survival index, number of pups born alive and pup birth weight. Reproductive toxicity was observed in this study as evidenced from the delayed onset of oestrous activity, frequently occurring oestrous cycles with shortened period of oestrous, reduced fertility index, premature parturition, diminished pup birth weight, reduced litter size as well as gestation survival index. This work shows that when marihuana is inhaled, neither oestrous activity nor ovarian activity is totally suppressed, but it is affected to a significant degree. Influence of marihuana smoke on excitability of uterine smooth muscle, transfer/utilization of nutrients and on hypothalamo-hypophyseal-ovarian axis was proposed to explain its reproductive toxicity. This study bears clinical implications and is useful in the counselling of female marihuana smokers (AU)

Thyroid function in dengue fever, meningitis, encephalitis, poliomyelitis and other febrile conditions

Thyroid function was studied by estimating serum thyroxine (T4), triodothyronine (T3) and thyrotropin (TSH) in 52 patients suffering from dengue fever, bacterial meningitis, viral encephalitis, paralytic poliomyelitis and other febrile illnesses. Mean serum concentrations of total T4 and T3 were significantly lower in all patients except those suffering from poliomyelitis. Serum TSH was significantly low in dengue fever and pyrexia of unknown origin (PUO). Though the TSH levels were also low in patients with bacterial meningitis and encephalitis, the differences were not statistically significant. Decreases in serum T4, T3 and FT1 in severe illnesses as compared to normal subjects may signify a state of secondary hypothyroidism of a functional type. It will be erroneous to say that decreases in T4 and T3 in systemic illnesses is entirely an adaptive or protective process to maintain metabolic rate. The possible value of thyroid hormone replacement therapy in these illnesses needs further investigations. (AU)

In vitro human placental perfusion studies cholinergic activity in normal subjects and in toxaemia of pregnancy

The present study was designed to investigate acetylcholine (ACh) concentration in normal and toxaemic placentae. The perfusate from placental lobules was collected at different time intervals and analysed, by bioassay, for ACh. The results showed that ACh concentration was time-dependent, attaining its highest value by 90 minutes (74.465 ñ 0.76 10-9 g/ min/g), which was maintained for up to 180 minutes placentae. Similar observations were made in the toxaemic samples, but the values were significantly lower, when compared to the control group (44.36 ñ 1.54 10-9g/min/gt at 90 minutes). This study demonstrated active secretion of Ach by the placentae and the occurrence of low ACh concentration in toxeamia. It is postulated that low ACh could probably interfere with local transport mechanism and account for low birth weights in toxaemia.(AU)

Long-term effects of marihuana smoke on uterine contractility and tumour development in rats

The present investigation considered the role of acute and chronic marihuana smoking, as well as crude extracts of marihuana (ME), on uterine contractions and tumour development. The contractions and the electrical activity were recorded on isolated superfused rats' uteri. Enhanced spontaneous activity and contractile responses were observed following exposure to marihuana smoke. Atropine failed to block contractile responses with ME following chronic smoke exposure. It is suggested that ME contains both contractile and relaxing properties. Chronic exposure to marihuana smoke resulted in appearance of various tumours in 50 percent of experimental animals. This study suggested far-reaching consequences on reproductive activity following chronic use of marihuana (AU)

Common psychological illnesses in the elderly

The elderly are especially prone to psychological illness. Cognitive impairment increases with age and as this is a primary symptom of many common disorders, it constitutes a major health problem. The elderly also frequently become depressed and have the highest suicide rate of all age groups. Given the increasing numbers of elderly persons in the population, the primary care physician must assume the reponsibility of evaluating, diagnosing and initiating psychiatric treatment with an emphasis on early and accurate diagnosis, and the detection of underlying causes, many of which are reversible (AU)

Thyroid-gonad relationship in bronchial asthma

Serum concentrations of thyroxine (T4), triodothyronine (T3), thyrotropin (TSH), T3 uptake (T3U), free thyroxine (FT4I) and free triodothyronine (FT3I) indices and testosterone (T) were studied by radioimmunoassays to elucidiate thyroid-gonad relationships in 30 men of African origin with bronchial asthma. In asthmatic subjects, (i) there were decreases (p<0.001) in both serum T3, FT3I and T levels;(ii) significant increases (p<0.001) in T3U were not associated with changes in serum T4 and FT4I, indicating an abnormality in thyroid-binding globulins (TBG); and is concluded that the hypophyseal-thyroid-gonadal axis may be set at a lower level in asthmatic patients (AU)

Socio-economic status and lung function in Jamaican children

A study was carried out in Afro-Jamaican children of both sexes, 6 to 15 years of age, to examine the role of socio-economic status on various pneometric tests such as forced vital capacity (FVC), mid-expiratory flow rate (MEFR 0.2-1.2), mean transit time (MTT), peak expiratory flow rate (PEFR), forced expiratory volume (FEV 1.0) and FEV 1.0 percent. Based on the annual income of the parents, the children were subdivided into 3 groups (I,II,III). Statistical analysis of the data revealed significant differences in all pulmonary function tests in children >10 years of age in both sexes and in all the groups, except PEFR in girls and MEFR 0.2-1.2 in boys <10 years of age in group II. The girls belonging to the same groups had higher values for all lung functions except significantly lower values of MTT. The study suggests differences in both central and peripheral airway function, with poorer function in the lower income group children who may be more susceptible to subclinical infections, probably due to malnutrition. The lower lung function in boys was attributed inter alia to lower mean values of height and weight than in girls (AU)

Insulin release pattern after blockade of catecholamine synthesis with alpha-methyl tyrosine in vivo

Insulin release pattern in vivo was studied using 30 control rats and 30 rats treated with alpha-methyl tyrosine to block catecholamine synthesis in vivo four days before the time of investigation. The drug treated animals exhibited higher fasting insulin levels, and also the phase insulin release after the B cell was challenged with a glucose load was significantly higher in these animals than occurred in the controls. This observation implies that the B cell is modulated by the sympathetic nervous system in its function and the insulin release would vary according to the emotional state of the individual. (AU)