Brain Wave Changes during Cognitive Task Performance in Uncomplicated Diabetic Adults: An Exploratory Study

Introduction: Diabetes mellitus (DM) is a chronic disease associated with cognitive decline and dementia in the elderly population. This exploratory study analysed the brain wave changes during cognitive task performance in working adults with and without type 2 diabetes mellitus (T2DM). MATERIALS AND Methods: The Mini-Mental State Examination was used to screen subject’s cognitive function and quantitative electroencephalography was used to analyse subject’s brain waves at rest and whilst performing the serial seven test. Results: When performing the serial seven test, the diabetic group showed a higher absolute power of theta waves in the left frontal (Fp1, 16.22 ± 3.81 vs 3.75 ± 1.69; p = 0.022) and temporal regions (T3, 24.27 ± 3.69 vs 7.92 ± 2.17; p = 0.045), but lower absolute power of beta waves in both the frontal regions (Fp1, 27.35 ± 3.67 vs 41.14 ± 5.67; p = 0.029; Fp2, 23.01 ± 3.31 vs 39.05 ± 2.64; p = 0.041) and left temporal region (T3, 37.93 ± 4.64 vs 50.94 ± 3.56; p = 0.046) when compared to those of the control group. The diabetic group took longer to complete the task (127.9 ± 8.3 s vs 95.6 ± 5.9 s; p = 0.032) than the control group, despite no statistically significant difference in correct response rates. Diabetes duration was positively correlated with the theta/alpha ratio in the left frontal (Fp1, r = 0.525; p = 0.041) and temporal (T3, r = 0.618; p = 0.037) regions. Conclusions: T2DM may affect cognitive function in patients before clinical manifestation

Time to flip? Feedback from UNIMAS medical students towards implementation of flipped pathology classroom

This study aimed to explore the perception of year two preclinical medical students towards flipped classroom over conventional teaching method through qualitative and quantitative approaches. The study involved 110 year two preclinical medical students at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak from October 2020 to January 2021. Five one-hour pathology lectures were divided into two parts covering different topics of the lecture. The first half hour used conventional teaching, while the second half hour used flipped classroom. Student feedback was collected through a 19-item, self-administered questionnaire comprising 15 quantitative questions in three structured instruments and four qualitative open-ended questions. The score for mean perception of flipped classroom was significantly different according to place of residence while the mean knowledge acquisition score was significantly different among students using different internet sources. In addition, for examination preparation, slightly more than one third preferred traditional classroom. Six aspects of improvement on flipped classroom were identified: learning materials; teaching methods; quality of resource materials; class activity and interaction; choices of topics for flipped classroom; and time, pace, and atmosphere of lessons. Three aspects of significance of flipped classroom were captured, which included facilitating understanding and revision; flexible time, ability to ask and answer; and ability to share, focus and identify mistakes. A flipped classroom shows much potential in medical education. Future studies on feedback from students are needed to improve the flipped classroom to suit the Malaysian context. Keywords: Flipped classroom, Traditional classroom, Medical student, Perception, Pathology

Hb lepore/β0-thalassaemia with α+-thalassaemia interactions, a potential diagnostic pitfall

Haemoglobin (Hb) Lepore is a variant Hb consisting of two α-globin and two δβ-globin chains. In a heterozygote, it is associated with clinical findings of thalassaemia minor, but interactions with other haemoglobinopathies can lead to various clinical phenotypes and pose diagnostic challenges. We reported a pair of siblings from a Malay family, who presented with pallor and hepatosplenomegaly at the ages of 21 months and 14 months old. The red cell indices and peripheral blood smears of both patients showed features of thalassaemia intermedia. Other laboratory investigations of the patients showed conflicting results. However, laboratory investigation results of the parents had led to a presumptive diagnosis of compound heterozygote Hb Lepore/β-thalassaemia and co-inheritance α+-thalassaemia (-α3.7). Hb Lepore has rarely been detected in Southeast Asian countries, particularly in Malaysia. These two cases highlight the importance of family studies for accurate diagnosis, hence appropriate clinical management and genetic counselin