Factors such as age, gender, marital status, interest and motivation to enter medical school, learning resources, study time and the transportation used have been shown to significantly affect medical student's cumulative GPA as a whole batch as well as when they are tested for gender.

Although much has been reported on the in vitro interaction of Chlamydia trachomatis with cells derived from the female genital tract, little is known of its interaction with male genital tract epithelium. The aim of this work was to investigate the effect of C. trachomatis serovar E on immortalized normal human urethral epithelial cells and on immortalized normal adult human prostate epithelial cells with regard to chlamydial growth and secretion of cytokines. After infection, these epithelial cells were assessed for their support of chlamydial growth in comparison with HeLa cells, and cytokine levels in cell culture supernatants were determined by ELISA. Although the male-derived epithelial cells supported growth of chlamydiae, the best growth was seen in HeLa cells. In contrast to prostate epithelial cells, the urethral epithelial cells released much larger quantities of interleukin 1a (IL-1a) following infection, whereas both IL-6 and IL-8 were produced in larger quantities by infected prostate cells. At 7 days post-infection, HeLa cells consistently produced large quantities of all three cytokines. In conclusion, the male-derived cell lines were shown to support the invasion of C. trachomatis and initiate a proinflammatory response to infection. From in vitro studies the suggestion that high levels of IL-6 could be a possible marker for chlamydial prostatitis is confirmed. Although not as marked a change, it is also suggested that higher IL-8 levels could be associated more with infection of the prostate than the urethra. Differential cytokine production by different male-derived epithelial cells could help determine the site of chlamydial infection and help in the study of pathogenesis. INTRODUCTIONChlamydia trachomatis causes the most prevalent sexually transmitted bacterial infection as it affects more than 90 million people annually worldwide (Norman, 2002). In males, C. trachomatis may cause different urogenital infections, ranging from lower to upper genital tract diseases. This bacterium has been found to be responsible for more than 50 % of all organisms causing nongonococcal urethritis (Bakare et al., 2002;Falk et al., 2004), and around 50 % of all cases of chronic prostatitis caused by infectious agents (Skerk et al., 2004). Moreover, a potential association between C. trachomatis infection and benign prostatic hypertrophy (BPH) has been established (Corradi et al., 1996;Toth et al., 2000). A high prevalence of asymptomatic persistent C. trachomatis infection among infertile couples has also been reported (Idahl et al., 2004), and although the effect of this bacterium on male fertility is still controversial, possibilities include an effect on semen parameters or sperm function (Hosseinzadeh et al., 2001;Segnini et al., 2003;Idahl et al., 2004).C. trachomatis is a Gram-negative bacterium that lives as an obligate intracellular parasite within the host cell. This bacterium has a unique developmental cycle in which the organism is present in two main forms, the elementary body (EB), which is the ext...

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Results demonstrate that feedback on students' clinical performance is often not forthcoming and when offered it is deficient and fails to concentrate on the development of different clinical skills. This highlights the critical challenges that need to be addressed by teachers, medical education unit and all hospital departments in order to enhance giving effective and structured feedback to medical students during clerkships. Results also raise the extreme need for the establishment and enhancement of a culture that supports feedback among all levels of clinical supervisors.