The Mizan meta-memory and meta-concentration scale for students (MMSS): a test of its psychometric validity in a sample of university students

BACKGROUND

Predisposing factors for metacognitive dysfunctions are common in university students. However, there is currently no valid questionnaire instrument designed to assess metacognitive aspects including meta-memory and meta-concentration in students. To address this need, the present study investigated the psychometric validity of a brief questionnaire, the Mizan meta-memory and meta-concentration scale for students (MMSS) in university students.

MATERIALS AND METHODS

A cross-sectional study with simple random sampling was conducted among students (n = 383, age = 18-35, body mass index = 21.2 ± 3.4 kg/m2) of Mizan-Tepi University, Ethiopia. MMSS, a socio-demographics questionnaire, and the Epworth sleepiness scale (ESS) were employed.

RESULTS

No ceiling/floor effect was seen for the MMSS global and its sub-scale scores. Confirmatory factor analysis showed that a 2-Factor model had excellent fit. Both, the comparative Fit Index (CFI) and goodness of fit index were above 0.95, while both the standardized root mean square residual and root mean square error of approximation (RMSEA) were less than 0.05, while χ2/df was less than 3 and PClose was 0.31. The 2-Factor MMSS model had adequate configural, metric, scalar, and strict invariances across gender groups as determined by a CFI > .95, RMSEA<.05, χ2/df < 3, non-significant Δχ2 and/or ΔCFI≤.01. Good internal consistency (Cronbach's alpha = 0.84, 0.80 and McDonald's Omega =0.84, 0.82) was found for both subscales of the MMSS. No correlations between the MMSS scores and ESS score favored its divergent validity.

CONCLUSION

The MMSS was found to have favorable psychometric validity for assessing meta-memory and meta-concentration among university students.

Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

Purpose

To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders.

Methods

This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions.

Results

Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis.

Conclusions

Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

In vitro antifungal activity of cassia fistula extracts against fluconazole resistant strains of Candida species from HIV patients

BACKGROUND

Candida species is the fourth common cause of blood stream infections all over the world which is life threatening. Invasive candidiasis leads to increased mortality and morbidity especially in immunosuppressed. The antifungal resistance pattern in high-risk patients is major concern.

PURPOSE

The present study was to access the anticandidal activity of leaves, bark and seeds of Cassia fistula against fluconazole resistant Candida species, C. albicans, C. glabrata, C. krusei, C. tropicalis, C. kefyr and C. parapsilosis isolated from HIV patients. The predominant phytochemical component responsible for fungicidal activity was to be accessed.

MATERIAL AND METHODS

Ethanol, chloroform, petroleum ether and aqueous extracts of leaves, bark and seeds of C. fistula linn. was evaluated against Microbial type culture collection (MTCC) Candida strains and 21 fluconazole resistant clinical isolates. Antifungal activity was evaluated by agar diffusion and broth dilution techniques. The active phytochemical component present in the ethanol extract of seeds was accessed by high performance thin layer chromatography. The docking study was done with lanosterol 14-alpha demethylase, the azole drug target with the predominant phytochemical from the extract having antifungal activity.

RESULTS

All the extracts of C. fistula showed excellent anticandidal activity. Ethanol extract of C. fistula seed exhibited the most inhibitory activity. C. krusei and C. parapsilosis were the most inhibited and C. kefyr was the least inhibited species. The predominant phytochemical active component of the ethanol extract of seed was gallic acid. Gallic acid showed excellent binding with lanosterol 14-alpha demethylase.

CONCLUSION

The present study reports the antifungal activity of various extracts of Cassia fistula for the first time against fluconazole resistant Candida isolates. We can conclude that the polyphenolic compound gallic acid is a potent natural antifungal agent. Further research is needed to assess the pharmacokinetic property.

Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART.

Sleep disturbances and memory impairment among pregnant women consuming khat: An under-recognized problem

Khat (Catha edulis) is a evergreen flowering shrub that is cultivated at high altitudes, especially in East Africa and the southwest of the Arabian Peninsula. The plant contains alkaloids, of which cathinone and cathine have structural similarity and pharmacological action similar to amphetamines. The leaves are, therefore, consumed in some regions as a psychoactive stimulant due to cultural beliefs and misperceptions on the health benefits of khat consumption. This resulted in a growing prevalence of khat consumption among pregnant women. The myriad of physiological changes associated with pregnancy impairs sleep and memory. Moreover, khat has also been shown to have adverse effects on memory and sleep. Therefore, its use during pregnancy may further aggravate those impairments. The purpose of this mini-review is to summarize the changes in sleep and memory during pregnancy and the evidence supporting a relationship between khat consumption and neurocognitive deficits and sleep dysfunctions. The misperceptions of beneficial effects of khat, the high prevalence of consumption among pregnant women, and the possibility of under-reporting of khat abuse do necessitate the development of alternative methodologies to identify cases of unreported khat abuse in pregnant women. It is proposed that screening for sleep problems and memory deficits may help identify under-reported cases of khat abuse in pregnant women.

In vivo absorption studies of insulin from an oral delivery system

Alginate microspheres prepared by an emulsion-based process were loaded with insulin by a remote loading process. We observed that the time of exposure, pH of the remote loading medium, and beta-cyclodextrin complexation of insulin influenced drug loading. In vivo absorption studies of insulin from optimized microspheres were carried out in diabetic albino rats. Serum sugar levels on administration of multiple oral doses of the microspheres and a radioimmunoassay for serum insulin indicated absorption of insulin from the gastrointestinal region. This process could be utilized for the development of an oral insulin delivery system.