Objective To assess the extent to which current selection criteria predict success in Sri Lanka's medical schools.Methods The study sample consisted of all students selected to all six medical schools in two consecutive entry cohorts. The aggregate marks of these students at the General Certificate of Education (GCE) Advanced Level examination, the district of entry, admission category, candidate type (school/private) and gender, were identified as entry point variables. Success in medical school was measured in four ways: the ability to pass the first summative examination and the final examination at the first attempt, and obtaining honours in either examination. Multivariate analysis using logistic regression was used to assess the extent to which these entry point factors predict variability in outcome measures.Results Aggregate scores among the 1740 students in the study sample ranged from 212 to 356, with a median of 285. The male:female ratio was 1.4:1. Private candidates (taking the examination for the third time) accounted for 22% of students. Being a school candidate, female and having a higher aggregate score, were the only independent predictors of success for all four outcome measures. The aggregate score alone accounted for only 1-7% of the variation in performance in medical school.Conclusions Marks obtained at the A Level examination (the only academic criterion currently used for selection of medical students in Sri Lanka) is a poor predictor of success in medical school.
BACKGROUNDEncephalitis in children is associated with high rate of morbidity and mortality. Many sporadic cases of encephalitis in children have recently been found to be CSF negative for infective markers. Antibodies against neuronal proteins in CSF are being detected more frequently in such patients and are well responsive to immunotherapy, if timely diagnosed. Anti-N-Methyl-D-Aspartate receptor (anti-NMDA) antibody mediated encephalitis is the most common in children among this group.The objective of this study was to determine the incidence and clinical profile of anti-NMDA antibody mediated encephalitis in children and its early (6-8 weeks) and late (1 year) treatment responses. MATERIALS AND METHODSIt was a descriptive study done in a tertiary care teaching hospital in south India. All children, 3 months to 12 years, presenting as acute encephalopathy, from January 2012 to December 2014 were evaluated and those with CSF anti-NMDA antibody positive children were treated with standard protocol and followed up at 6 weeks, 8 weeks and one year. RESULTSWe had 178 children presented as acute encephalitis during the 3-year period. 18 (10%) children were positive for anti NMDA antibody in CSF. Female gender predominated by 89%. Predominant clinical features were in the descending order, behaviour and psychiatric 89%, speech dysfunction 72 %, movement disorders 56%, seizures 22% and autonomic phenomena 6%. Majority (78%) responded completely to immunotherapy. CONCLUSIONAnti-NMDA receptor encephalitis is not rare in children. In children presenting as acute encephalitis with predominant neuropsychiatric symptoms or if CSF negative for infection, NMDA antibody test in CSF is a must. Prompt diagnosis is important because it is amenable to immunotherapy and longterm prognosis is very good.
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