Omar Habbal

Anatomy Practical Examinations: How Does Student Performance on Computerized Evaluation Compare with the Traditional Format?.

Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the “traditional” method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle™. In this study, we compare student scores between two assessment environments viz. online and traditional environments. We hypothesized that regardless of the examination medium (traditional or online) overall student performance would not be significantly different. For the online medium, radiological images, prosected specimens, and short video clips demonstrating muscle action were first acquired from resources used for teaching during anatomy practical classes. These were optimized for online viewing and then uploaded onto Moodle learning management software. With regards to the traditional format, actual specimens were usually laid out in a circular stream. Identification tags were then attached to specific spots on the specimens and questions asked regarding those identified spots. A cohort of students taking practical examinations in six courses was studied. The courses were divided into three pairs with each pair credit‐weight matched. Each pair consisted of a course where the practical examination was conducted online and the other in the traditional format. There was no significant difference in the mean scores within each course pair. In addition, a significant positive correlation between score in traditional and online formats was found. We conclude that mean grades in anatomy practical examination conducted either online or in the traditional format were comparable. These findings should reassure teachers intending to use either format for their practical examinations. Anat Sci Educ.

Clinical and molecular analysis of Grebe acromesomelic dysplasia in an Omani family

Grebe syndrome is a rare autosomal recessive acromesomelic dysplasia. The syndrome was studied clinically, radiographically, and genetically in an Omani family with four affected children. The affected persons had normal axial skeletons, severely shortened, and deformed limbs with severity increasing in a proximo‐distal gradient, and subluxated joints. The humeri and femora were hypoplastic with distal malformations. The radii/ulnae were shortened and deformed whereas carpal bones were invariably rudimentary or absent. The tibiae appeared rudimentary; fibulae were absent in two children, and some tarsal and metatarsal bones were absent. The proximal and middle phalanges were absent while the distal phalanges were present. The father and mother had short first metacarpal and middle phalynx of the fifth finger and hallux valgus respectively. Transition A1137G and deletion delG1144 mutations in the gene encoding the cartilage‐derived morphogenetic protein‐1 (CDMP‐1) were identified in this family. The A1137G is a silent mutation coding for lysine, whereas the delG1144 predicts a frameshift mutation resulting in a presumable loss of the CDMP‐1 biologically active carboxy‐terminal domain. The affected siblings were homozygous for the delG1144 mutation while parents were heterozygous.

Clinical anatomy and anatomical skills: an innovative course

‘Clinical Anatomy and Anatomical Skills’ is a newly introduced component of the anatomical teaching of medical undergraduates at Sultan Qaboos University. It comes in the final semester of the anatomy course at the end of the BSc (Health Sciences) programme. It aims to refocus, vertically integrate and revise the subject using problem solving plus testing of a variety of clinically relevant skills recorded in a log-book. This gives the appropriate orientation as the student prepares to commence clinical studies in the MD programme. The organization, structure and assessment of the course are explained. The purpose of this report is to re-emphasize the importance of correlating knowledge of basic anatomy and anatomical skills in solving clinical problems. It is hoped that this course will be of interest to other anatomists involved in the training of medical students.

“Between a Rock and a Hard Place” : The discordant views among medical teachers about anatomy content in the undergraduate medical curriculum

The last two decades of medical education have been marked by a persistent push towards curricular reform. Anatomy as a discipline, the unshakable foundation of medical teaching for hundreds of years, has been at the centre of this development. Although it is widely agreed that for doctors to be competent, they need an adequate knowledge of anatomy underpinning medicine, there is much less agreement over the quantity required, and who should decide and define it. Many clinicians feel medical students are being under-trained in this basic medical science before reaching the clinical stages. Professional accreditation boards advocate the reduction of factual information in undergraduate medical courses. Anatomists complain of a progressive erosion of the time allocated to the subject. Caught in the midst of this controversy is the student of anatomy who is left bewildered and confused about what is required from him to become a safe and competent health professional. The way forward might, first, be for medical schools to facilitate discussions between students, anatomy professors, and clinicians to bring these divergent perspectives into alignment. Second, the anatomists need to re-invent themselves in two principal frameworks: first, to present the subject in the context within which it will be utilised by the student, and second to employ the overwhelming learning tool of today, i.e. technology, in their teaching and assessment of the subject.

The immune response to coitus and conception.

It is well recognized that cells or tissues exchanged between genetically dissimilar members of the same species will be destroyed by a specific immune response. This process of destruction is initiated by the expression of histocompatibility antigens on the surface of the donor cells which provoke a reaction by the immune system of the recipient. Successful reproduction even through a fundamental process is thought to expose the female to significant antigenic challenge. Numerous hypotheses have been proposed to account for the survival of the semiallogeneic conceptus, although the immunological consequences of coitus are frequently ignored. The possible immunosuppressive role of seminal plasma in normal reproduction is clearly of great clinical importance. Its exclusion from the in vitro fertilization techniques of human reproduction may partially account for the high failure rates associated with this form of assisted reproduction. Its presence in the normal ejaculate may explain the vulnerability of the female reproductive tract to virally inducted neoplasms and be a relevant factor in the etiology of the acquired immune deficiency syndrome.

The Golden Age of Medieval Islamic Toxicology

Abstract The science of toxicology has a long history, and early Islamic researchers were among the most illustrious in the field. The etymology of two words, “toxin” and “bezoar,” dates back to Islamic antiquity and further establishes the importance of toxicology to countries flourishing at the time Numerous Islamic scientists were experts in the field of toxicology and had described poisons and antidotes in their literature. Ibn Uthal, an early chemist and well known as a skilled toxicologist, conducted systematic studies on antidotes and poisons. Jāber-ibn-Hayyān, Ibn Wahshia and Imād al-Din Mahmud ibn-Mas’ud Shirāzi were among the most famous scientists who worked in this field. Different aspects of poisons, including their identity and constituents, ways of identifying poison types and methods of detoxification, chemistry, pharmacology, and pharmacokinetics are all topics which were noted by these medieval Islamic toxicologists. They also took into account ethical issues and were critical of the opinions of earlier scientists. In addition to treatment, they were very cognizant of the prevention of poisoning. Different pharmacological interventions and antidotes have been suggested for the management of poisons that are not well known in modern toxicology, including scorpion and other reptiles, stings, scabies, oleander poisoning, etc. Studying treatises and manuscripts from toxicologists of the medieval Islamic era can help in the development of new ideas for the prevention and treatment of poisonings. Designing appropriate methods to examine the experiences of toxicologists from the medieval Islamic era may lead to the discovery of new and possibly more effective treatments for poisoning.

Altered blood cytokines, CD4 T cells, NK and neutrophils in patients with obstructive sleep apnea

BACKGROUND There are contradictory reports on the effects of obstructive sleep apnea (OSA) on the immune system. In order to clarify the effect of OSA on the different components of the immune system, we studied the association of OSA with changes in cytokine and chemokine levels, proliferative patterns of CD4 and CD8 T lymphocytes as well as NK cells ex vivo and neutrophil functions. METHODS We investigated the association of OSA with potential alterations in 14 Th1/Th2 and inflammatory cytokines and chemokines, CD4 and CD8 T cells, NK cells, and the NADPH oxidase activation and phagocytic functions in neutrophils. RESULTS Our results suggest that the increase in CD4 T cell frequency in OSA is associated with an increased expression of the nuclear protein Ki67 (p<0.05; power>0.8), and is correlated with the levels of IL-1β (p<0.05; power>0.8). The levels of IL-1β as well as IL-6 showed a potential increase, while the levels of IFN-γ (p<0.05; power>0.8) and the ratio IFN-γ/IL-4 in the blood were possibly decreased in OSA. Additionally, we observed a potential increase in the expression of Ki67 in CD8hi and CD8lo NK cells (p<0.05; power>0.8). Our results also suggest that neutrophils have a decreased capacity to phagocytose bacteria and activate NADPH oxidase in OSA patients (p<0.05; power>0.8). CONCLUSION OSA may be associated with inflammatory and pro-Th2 immune responses, an increased proliferative potential of NK and CD4 T cells and a decreased capacity of neutrophils to phagocytose bacteria and produce ROS.