Protein energy malnutrition is associated with cerebral atrophy which may be detrimental to intellectual development. The aim ofthis study was to document the anatomical abnormalities which lead to the appearance of cerebral atrophy using magnetic resonance imaging (MRI) in the acute stage of kwashiorkor and to monitor changes during nutritional rehabilitation.Twelve children aged 6 to 37 months requiring admission to hospital for the treatment of kwashiorkor were studied. The children were evaluated clinically, biochemicaily, and by MRI of their brains on admission and 30 and 90 days later. Brain shrinkage was present in every child on admission. White and grey matter appeared equaliy affected and the myelination was normal for age. At 90 days, the cerebral changes had resolved in nine and improved substantially in the remainder, by which time serum proteins and weight for age were within the normal range. The findings of this study suggest that brain shrinkage associated with kwashiorkor reverses rapidly with nutritional rehabilitation.
A 12-month development programme, the IP, effectively addressed generic learning skills deficiencies present in academically-at-risk students entering medical school.
The present study explored the nature and frequency of physiology naïve beliefs by investigating novices' understanding of the respiratory system. Previous studies have shown considerable misconceptions related to physiology but focused mostly on specific physiological processes of normal respiration. Little is known about novices' broader understanding of breathing in a clinical context. Our study hypothesized that naïve beliefs could hamper participants' ability to understand the interrelatedness of respiratory structures and functions related to breathing during a clinical complication. The study entailed both quantitative and qualitative foci. A two-tier test was designed and administered to 211 first-year medical students. Participants were asked to choose the correct answer out of a set of four options and to substantiate their choices. Questions were purposefully left open to elicit a wide range of responses. Statistical analysis (SPSS) was done to evaluate the frequency of naïve beliefs. Thematic analysis was used to determine themes within the raw data. The majority of participants selected incorrect answers in the multiple-choice question part of the questionnaire. Results from the thematic analysis yielded a considerable range of naïve beliefs about gas exchange, foundational physics, airflow, anatomic structures, and breathing pathways. An awareness of the existence of such naive beliefs in respiratory physiology will allow educators to address them in their teaching and thereby prevent naïve beliefs transforming into misconceptions.
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