Purpose We hypothesized that low estrogen levels aggravate obesity-related complications. Diet-induced obesity can cause distinct pathologies, including impaired glucose tolerance, inflammation, and organ injury that leads to fatty liver and chronic kidney diseases. To test this hypothesis, ovariectomized (OVX) rats were fed a high-fat style diet (HFSD), and we examined structural changes and inflammatory response in the kidney and liver. Methods Sprague-Dawley female rats were ovariectomized or sham-operated and divided into four groups: sham-operated rats fed a normal diet (ND); ovariectomized rats fed a normal diet (OVX-ND); sham-operated rats fed a HFSD; ovariectomized rats fed a high-fat style diet (OVX-HFSD). Mean blood pressure and fasting blood glucose were measured on weeks 0 and 10. The rats were sacrificed 10 weeks after initiation of ND or HFSD, the kidney and liver were harvested for histological, immunohistochemical and immunofluorescence studies. Results HFSD-fed rats presented a significantly greater adiposity index compared to their ND counterparts. Liver index, fasting blood glucose and mean blood pressure was increased in OVX-HFSD rats compared to HFSD rats at study terminal. Histological and morphometric studies showed focal interstitial mononuclear cell infiltration in the kidney of HFSD rats with mesangial expansion being greater in the OVX-HFSD rats. Both HFSD fed groups showed increased expressions of renal inflammatory markers, namely TNF-alpha, IL-6 and MCP-1, and infiltrating M1 macrophages with some influence of ovarian hormonal status. HFSD-feeding also caused hepatocellular steatosis which was aggravated in ovariectomized rats fed the same diet. Furthermore, hepatocellular ballooning was observed only in the OVX-HFSD rats. Similarly, HFSD-fed rats showed increased expressions of the inflammatory markers and M1 macrophage infiltration in the liver; however, only IL-6 expression was magnified in the OVX-HFSD. Conclusion Our data suggest that some of the structural changes and inflammatory response in the kidney and liver of rats fed a HFSD are exacerbated by ovariectomy.
Objectives: To establish the incidence of “diabetes-related death” (DRD) in children with known and unknown Diabetes Mellitus (DM) dying unexpectedly, and describe post-mortem (PM) biochemistry findings. Patients and Methods: PM reports from the previous 16-year period were reviewed. Cases of DRD were extracted. All available demographic, clinical, and autopsy data including laboratory analyses was retrieved. Results: 9/1376 (0.7%) DRD cases were identified. This was attributed to Diabetic Ketoacidosis in 7 and to Death in Bed Syndrome in 2. 4/9 cases were known diabetic and on insulin; whilst in 5/9 cases the diagnosis of DM was at PM. The mean age was 11.6 years (range 2.5–15). At PM, 4 cases were undernourished. The histology demonstrated pancreatic changes in keeping with DM in 3/9 and unremarkable pancreatic findings in 6/9. 3 cases also had autoimmune thyroiditis (1 also had myocarditis and Armanni-Ebstein nephropathy). Toxicological and biochemical analysis showed raised: β-hydroxybutyrate in 6, ketone bodies in 5 cases and raised HbA1c in 3c. Conclusion: Type 1 DM is an infrequent but yet potentially preventable cause of death in children. Our findings highlight the value of routine biochemical and toxicological analysis in all PM examinations of infants and children dying suddenly and unexpectedly.
Team-based learning (TBL) is relatively new in medical education and has yet to be implemented in Malaysia. The main purpose of TBL is to change the classroom experience from acquiring to applying knowledge in a team. The aim of this study is to identify the student's perception of TBL and the impact on the student's learning in Universiti Sains Islam Malaysia (USIM). The TBL pedagogy was imparted into the teaching of Haematology module among the 3rd year medical students of USIM. Part of the face-to-face teaching sessions (25%) was changed to online learning packages while the tutorial and practical sessions were transformed into readiness assurance tests (RATs) and application exercises. The TBL implementation and the students' performance were observed closely and at the end of the module, a feedback form was distributed to the students (n = 79). Data was analysed using SPSS version 19.0. We found that TBL encouraged students to work more seriously and effectively in teams (93.59%). They are comfortable working in teams and satisfied with the team members' participation (98.72%). They agreed that TBL enhanced their understanding, evidenced by improvement in the tutorial marks (98.72%). TBL also improves their communication skill and self-confidence (84.42%). In general, they preferred the TBL compared to the traditional method (89.61%). Many are not comfortable with online learning and would appreciate more face-toface lecture sessions (52.56%). However, they commented that adequate facilities are required for an effective TBL (94.87%). In conclusion, students' perception and outcome assessment showed promising results and should be considered for implementation.
Membuat keputusan dalam pemilihan kursus adalah penting bagi seorang pelajar. Kesesuaian kerjaya juga haruslah sepadan dengan personaliti pelajar bagi menjamin kepuasan dalam bekerja di samping kejayaan dalam profesion yang diceburi pada masa akan datang. Tujuan kajian ini adalah untuk mengenal pasti sebab-sebab pelajar memilih bidang perubatan, personaliti diri mereka, dan keupayaan kendiri (kesesuaian). Kajian ini merupakan kajian rentas yang melibatkan pelajar perubatan Tahun 3 pra-klinikal di Universiti Sains Islam Malaysia. Soal selidik yang digunakan mengandungi tiga bahagian iaitu data demografik, Inventori Minat Kerjaya Sidek dan sebab-sebab mereka memilih kursus perubatan. Inventori Minat Kerjaya Sidek digunakan untuk mengukur personaliti pelajar dan kesesuaian kerjaya. Seramai 80 orang pelajar yang berumur di antara 20-21 tahun telah menyertai kajian ini dan majoritinya adalah perempuan (n=56, 70.0%). Dapatan kajian menunjukkan seramai 45.7% (n=44) responden memilih kursus perubatan disebabkan 'kesungguhan dan minat', manakala 24.7% (n=20) 'pengaruh ibu bapa' dan 19.8% (n=16) 'untuk membantu masyarakat'. Dalam bidang perubatan, dua trait personaliti yang penting adalah personaliti penyiasat dan personaliti sosial. Seramai 47.5% (n=38) responden mempunyai skor tinggi bagi personaliti penyiasat tetapi hanya 13.8% (n=11) responden mempunyai skor tinggi personaliti sosial. Bagi gabungan kedua-dua personaliti hanya 12.5% (n=10) pelajar mempunyai skor yang tinggi. Kesimpulannya, majoriti pelajar memilih bidang perubatan atas sebab altruistik. Walau bagaimanapun, berdasarkan penilaian personaliti yang telah dilakukan,
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