Srikumar Chakravarthi ¹, P. Thanikachalam ¹, H. S. Nagaraja ², David Low Wee Yang ³, Nadeem Irfan Bukhari ³

Affiliations
1 Department of Pathology, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, MY
2 Department of Physiology, Faculty of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, MY
3 Faculty of Pharmacy; International Medical University, Bukit Jalil, 57000 Kuala Lumpur, MY

Abstract

The cytoplasmic expression of Ki-67, a nuclear protein that appears primarily during the proliferative phases of the cell cycle was studied in benign tumours of the prostate gland. Archival prostatic tissue from 39 patients with nodular hyperplasia and no prior or subsequent prostatic carcinoma that have been obtained through transurethral prostatectomy (TURP) procedure, were used in this study. The proliferative index was assessed by calculating the number of actively proliferating cells in the H&E sections in varied histologic patterns like hyperplastic epithelium, proliferating stroma, normal glands and normal stroma. The nuclear protein Ki- 67 was analyzed by immunohistochemistry for determining the cytoplasmic positivity of the tumour cells. The proliferative index in the hyperplastic tissues was higher, indicating an increased activity of cellular proliferation, compared with the normal tissues, which was highly significant (p<0.01). Out of 39 cases of prostatic tissue, 25 (64 %) showed positivity for Ki-67 expression. Pearson's correlation test was applied to and showed significant association (p<0.05) between the intensity of Ki-67 expression with proliferative index. Comparisons of proliferative indices between the normal cells and tumour cells showed significant correlation, strongly suggesting the higher cell proliferation in the benign lesions. Enhanced expression of Ki-67 by the tumour cells suggests a growth imbalance in favour of cell proliferation that might ultimately promote prostatic hyperplasia.

Keywords

Prostate, Mitosis, Ki-67, Nodular Hyperplasia

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Srikumar Chakravarthi ¹, H. S. Nagaraja ¹, John Paul Judson ¹

Affiliations
1 Dept. of Pathology, Faculty of Medicine, 2Dept. of Human Biology, Intn. Medical University, MY

Abstract

This study was done to explore the challenges of problem-based learning (PBL) in medical education and to propose a framework with implications for practice and learning. The paper uses a total of 24 undergraduate medical students divided into 3 groups who participated in the focus group discussions. A quantitative instrument was used as triangulation to gather data on 18 statements through Likert scale ratings. In addition, semi-structured interviews were conducted with 6 medical PBL facilitators. Quotes from the participants are used to support the key themes and issues that have emerged from the data. Quantitative data are used to support certain important issues. The successful development of PBL will depend on re-establishing the strategic direction of PBL within a certain context, evaluating the social and learning structures associated with power distribution, and providing non-routine rigorous educational systems to enhance learning.

Keywords

Problem Based Learning (PBL), Medical Education, Focus Group Discussion, Malaysia

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