During the third week of human pregnancy, an embryo transforms from two germinal disc layers of hypoblast and epiblast to three germinal layers of endoderm, mesoderm and ectoderm. Gastrulation is a complex process that includes cellular mobility, morphogenesis and cell signalling, as well as chemical morphogenic gradients, transcription factors and differential gene expression. During gastrulation, many signalling channels coordinate individual cell actions in precise time and location. These channels control cell proliferation, shape, fate and migration to the correct sites. Subsequently, the anteroposterior (AP), dorsoventral (DV) and left-right (LR) body axes are formed before and during gastrulation via these signalling regulation signals. Hence, the anomalies in gastrulation caused by insults to certain molecular pathways manifest as a wide range of body axes-related disorders. This article outlines the formation of body axes during gastrulation and the anomalies as well as the clinical implications.
Movement control order (MCO) was enforced by the Malaysian government on 18th March 2020 due to sudden increase in the cumulative number of COVID-19 cases. University students, including medical students, were among the group of the population which were significantly affected. This study was conducted among medical students in Universiti Putra Malaysia (UPM) to compare the mental health status and coping strategies, between gender and phase of the clinical study related to their quarantine status between 18th March 2020 to 9th June 2020. This was a cross-sectional study involving the undergraduate medical students in UPM in the academic year of 2019/2020 during the MCO. A stratified random sampling method was used; a total of 173 respondents which includes students of Year 1 to Year 5 participated. The study was conducted after five months since the first day of MCO, for one week period of data collection. The mental health status was assessed using Depression, Anxiety and Stress Scale 21-item (DASS-21) questionnaire. Four-point Likert scale was scored to determine the degree of severity. The coping strategies was assessed using Brief-COPE (Coping Orientation to Problems Experienced) in which four-point Likert scale was used as well, and the total marks were grouped into four coping strategies. This study found higher scores of DASS-21 in the non-quarantined group and approach method was considered as a favourable coping strategy in both groups. In the quarantined group, female and clinical students showed higher scores of DASS-21. In the non-quarantined group, clinical students showed a significantly higher score of stress while male students significantly used their humour as coping strategies.
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