LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

Carnitine deficiency in epileptic children treated with a diversity of anti-epileptic regimens

Abstract Background Carnitine deficiency is relatively common in epileptic patients. The risk factors reported include the combination of valproic acid with other antiepileptic drugs (AEDs), young age, multiple neurologic disabilities, non-ambulatory status, and being underweight. Objectives To study the level of carnitine deficiency and its associated risk factors among a group of children with idiopathic epilepsy treated with different AEDs. Patients and methods Fifty children with idiopathic epilepsy and 40 age-matched controls were enrolled. For all, serum carnitine level was measured by enzyme-linked immune sorbent assay (ELISA). Results The mean carnitine level was lower in cases compared to controls (p = 0.04). Patients receiving monotherapy treatment had a high percentage of carnitine deficiency compared to controls (p = 0.04). Patients receiving valproate with other AEDs had a lower level of carnitine compared to controls (p = 0.03). The age of the patients, the duration of treatment, and the doses of different AEDs were not risk factors for carnitine deficiency. Conclusions Carnitine deficiency is common in our population, and the use of valproate with other AEDs is considered the most important risk factor for it in epileptic children

The Possible Improving Effects of γ-Irradiated and/or Extruded Soy Flour on Hypercholesterolemic Rats

Hypercholesterolemia is serious conditions that can cause fatal complications without careful management. Among the dietary supplementation with functional food, soybeans possess variety of antioxidant compounds that may lower incidence of hypercholesterolemia and degenerative cardiovascular disease. Thus, the purpose of this study is to determine the effect of gammairradiated and/or extruded soy flour on hypercholesterolemic rats. Processing of soy flour by γ-irradiation and/or extrusion reduced the amount of antinutritional factors such as tannin and trypsin inhibitor and resulted in different changes in the total amino acids and fatty acid contents. The animals maintained on the HCD showed remarkable decrease in the level of HDL-C associated with significant increase in the values of serum total lipid, total cholesterol, triglyceride, LDL-C, vLDL-C and the risk ratio in addition to serum concentration of urea, creatinine and uric acid in comparison with those of the control group. However, dietary supplementation of raw and treated soy flour resulted in reduction in the bad changes induced by HCD in the above mentioned parameters. In conclusion, treated soy flour supplementation in diet of rats pointed out to its hypocholesterolemic effect and its ability to improve lipid profile and kidney function of hypercholesterolemic rats

Photoperiodic Modulation in Immune and Reproductive Systems in Japanese Quails (<i>Coturnix japonica</i>): A Morphometric Perspective

The present study was designed to elucidate a relationship between lymphoid organs and reproductive activity in male Japanese quails (Coturnix japonica) bred in a temperate region of Pakistan (30.3753° N, 69.3451° E) in response to photoperiodic changes. The research focused primarily on the relative morphological changes in primary (thymus and bursa of Fabricius) and secondary (spleen) lymphoid organs with respect to seasonal variations in the histomorphometry of testicular tissue. For this purpose, a comparable number of clinically healthy Japanese quails were exsanguinated during active (April–May), regressive (September–October) and inactive (January–February) reproductive phases. Following an extensive gross measurement of lymphoid and reproductive organs, a histomorphometric analysis was performed on sampled tissues by employing ImageJ® software. Blood was collected for hormonal and leukocytic analysis. One-way ANOVA was used for statistical comparison. Testes had the highest parenchymal development in the active phase (80.66 ± 21.22 µm) and the lowest in the inactive phase (27.80 ± 7.22 µm). Conversely, a percentage change was evident in the sizes of primary (bursa: 61.5%, thymus: 46.9%) and secondary (spleen: 23.9%) lymphoid organs during inactive and active reproductive phases. This study demonstrated that a physiological trade-off is imperative between immune and reproductive systems for optimum survivability and reproductive performance