This research aimed to determine whether there exists a relationship between the four elements of Keller's ARCS motivation framework and undergraduate students' motivation to learn English as a second language. ARCS' is the acronym for Attention, Relevance, Confidence and Satisfaction. This study employed a quantitative approach and used a survey questionnaire for collecting data from 300 students enrolled in the undergraduate programs in four universities (two public sectors and two private sectors). The questionnaire was adapted from Keller (1987), Loorbach et al. (2015), Instructional Materials Motivation Survey (IMMS) and Wimolmas, (2013). The items were rated on a 5-point Likert Scale. SPSS software (v.23) was used to analyze the data. Demographic/background data was analyzed by running descriptive statistics. Overall, two main statistical analysis tests that are Pearson correlation analysis and Regression analysis were used in this study to determine the relationship among the variables of the study. The findings revealed that there is a significant positive relationship between all of the four factors of the ARCS model (attention, relevance, confidence and satisfaction) and undergraduate students' motivation to learn English as a second language.
A Caucasian man in early 80s was seen in Gastroenterology Clinic, following, referral from the Endocrinology Clinic for concerns for CT Abdomen requested for tiredness and weight loss of three kilograms. The patient also had microcytic picture with low MCV and Ferritin and hypomagnesemia. The CT suggested gross circumferential thickening of the wall of stomach with advice for invasive investigations to further characterise the CT findings. The Endoscopy suggested grossly enlarged rugae in the stomach, and enlarged gastric polyps. Patient was assured no new sinister abnormality. Treatment challenges to consider were to stop acid suppression by prescribing Proton Pump Inhibitors (PPIs) which would lead to stomach ulcers, or to continue with PPIs with sequalae of worsening of hypertrophic gastric folds, enlarged gastric polyps and hypomagnesemia. It would be necessary to consider risk versus benefits in either situation to determine an appropriate treatment plan in the long term. With background of Zollinger-Ellison Syndrome and MEN1 with heterozygous mutation with gastrinoma of the duodenum, and frailty he was advised to continue with Proton Pump Inhibitors with twice weekly correction of Magnesium infusions, and Iron tablets following Multi-disciplinary meeting. doi: https://doi.org/10.12669/pjms.37.4.3984 How to cite this:Zafar M, Muhammad T, Najam-us-Saher, Toqeer M. Hypertrophic Gastric folds with Hypomagnesemia, linking the dots. Pak J Med Sci. 2021;37(4):1237-1240. doi: https://doi.org/10.12669/pjms.37.4.3984 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: Histiocytoses are localized or systemic diseases that can broadly be classified into Langerhans cell histiocytosis and non-Langerhans cell histiocytosis. Juvenile Xanthogranuloma (JXG) belongs to the latter group, which occurs in around 0.5% population younger than 5 years, and presents as solitary or multiple lesions. Here, we present a case of disseminated JXG in an infant with the lesions regressing spontaneously. Case presentation: A 7-month-old boy presented with multiple erythematous nodular lesions over the body excluding limbs for 3 months. Initial laboratory work up was normal. Skin histopathology showed a dermal nodule with sheets of histiocytes exhibiting grooved vesicular nuclei and pale eosinophilic cytoplasm along with touton giant cells. Immunohistochemistry markers further confirmed the diagnosis. Lesions healed completely with symptomatic relief in 1.5 years and no recurrence occurred. Discussion: Disseminated JXG is a benign childhood disorder that can sometimes be associated with internal organs involvement mainly bones, eyes, and brain. Serious complications may follow in case of extracutaneous spread. Most frequently, JXG follows the occurrence of another neoplastic disorder but can sometimes appear de novo. Skin biopsy is required for the diagnosis and better education of the family. Conclusion: JXG in infancy is a rarity in South Asia. Therefore, along with the clinical judgment, clinicians must also get histological confirmation in order to manage this disorder successfully. Close surveillance for multiorgan involvement is also required to avoid any irreversible sequalae.
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