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Objective: To evaluate the diagnostic performance of the polyclonal antibody generated from the subunit surface protein of MRSA for MRSA detection. Methods: The MRSA clinical isolates were identified by the cefoxitin disc diffusion test and confirmed by mecA PCR. The surface protein from the clinical isolates of MRSA was extracted and characterized with hemagglutination and adherence inhibition assays. Polyclonal antibody against the selected protein was produced in mice and then used for Western blot experiments. Results: Four conserved surface protein bands (63, 76, 88, and 114-kDa) were found in each MRSA clinical isolate. Hemagglutination reaction was demonstrated by the subunit 76 and 114-kDa surface protein of MRSA at 1:32 dilution. Such proteins were identified as adhesive molecules in the enterocytes. The sensitivity and specificity of the polyclonal 76-kDa antibody in detecting MRSA were 94.59% and 85.14%, respectively, with the Kappa values fall under the interpretation of substantial agreement (0.752) with the gold standard, suggesting it is useful for MRSA detection. Conclusion: Subunit 76 and 114-kDa surface proteins of MRSA exhibit adhesive properties in mediating MRSA infection. The polyclonal antibody of 76-kDa generated from the surface protein of MRSA could be used as an alternative for the identification of clinical isolates suspected with MRSA infection.

Objective: Online and blended learning methods have experienced rapid growth in higher education due to the COVID-19 pandemic. Our study aimed to compare students’ academic performance between online and blended Clinical Skill Laboratories (CSL) learning in undergraduate medical students. Methods: A total of 101 undergraduate medical students at Maulana Malik Ibrahim State Islamic University, Malang, Indonesia, were enrolled (50 students from the academic year 2020 [group 1: online CSL]; 51 students from the academic year 2020 [group 2: blended CSL]). The main outcome was students’ academic performance collected from the Objective Structured Clinical Examination (OSCE) score. Additionally, students also completed an evaluation questionnaire to assess the quality of the learning scheme. Results: Both groups agreed that CSL is an important subject and clinical video demonstration is useful for their OSCE preparation. However, students who received online learning felt that online CSL was ineffective and scored lower in the OSCE compared to the blended CSL. Qualitative data also supported these findings. Conclusion: Blended learning provides more value than online learning in terms of teaching clinical skills for undergraduate medical students. Additionally, online CSL may not be sufficient for medical students to attain critical skills.

Purpose: To evaluate the short-term effects of intravitreal ranibizumab (IVR) injection on visual and structural changes in diabetic macular edema (DME). Patients and methods: A retrospective study including 108 eyes of 74 patients with DME in which IVR injection was conducted three times at one-month intervals. Retinal and choroidal layers, as well as the subretinal fluid area, were measured at baseline and during 3 months of treatment. The correlation between structural changes and visual acuity was investigated. Results: In general, most of the retinal layers tended to decrease after treatment. Resolution of subretinal fluid remained relatively superior in predicting the outcome of ranibizumab injection. In addition, we found that reduction of photoreceptor layer (PRL) thickness provided the best estimation of visual acuity gain. Conclusion: Neural recovery in PRL is associated with better visual improvement. Individual retinal segmentation would be beneficial for monitoring and evaluating ranibizumab treatment in DME. Resumen: Objetivo: Evaluar los efectos a corto plazo de la inyección intravítrea de ranibizumab (IVR) sobre los cambios visuales y estructurales en el edema macular diabético.Pacientes y métodos: Estudio retrospectivo que incluyó 108 ojos de 74 pacientes con edema macular diabético en los que se inyectó tres veces IVR 3 veces con intervalos de un mes. Las capas retinal y coroidea, así como el área de líquido subretiniano, se midieron al inicio del estudio y durante 3 meses de tratamiento. Se investigó la correlación entre los cambios estructurales y la agudeza visual. Resultados: En general, la mayoría de las capas de la retina tendieron a disminuir después del tratamiento. La resolución del líquido subretiniano siguió siendo relativamente superior para predecir el resultado de la inyección de ranibizumab. Además, encontramos que la reducción del grosor de la capa de fotorreceptores tuvo la mejor estimación de la ganancia de agudeza visual. Conclusión: La recuperación neural de de la capa de fotorreceptores se asocia con una mejor mejora visual. La segmentación individual de la retina sería beneficiosa para monitorear y evaluar el tratamiento con ranibizumab en el edema macular diabético.

Objective: Pediatric glaucoma is a rare disease that is potentially more severe than adult glaucoma because it is more challenging to diagnose and more difficult to treat. The segmented retinal layer has been shown to have excellent capability in assessing adult glaucoma. However, there is limited information regarding the benefits of spectral domain-optical coherence tomography (SD-OCT) in children. Thus, our study aims to investigate the role of circumpapillary (cp) OCT analysis in examining pediatric glaucoma and characterizing the changes in the fellow eyes of glaucomatous children. Methods: SD-OCT was used to investigate the optic nerve head (ONH) and retinal morphology of 18 patients with pediatric glaucoma and 14 matched healthy controls. Results: As predicted, pediatric patients with glaucoma had a wider disk diameter, cup diameter, and cup-to-disk ratio (CDR). Pediatric glaucoma also resulted in a thinner retinal nerve fiber layer (RNFL), ganglion cell layer – inner plexiform layer (GCL-IPL), photoreceptor layer – retinal pigment epithelium (PRL-RPE), and total retinal layer (TRL). Similarly, these observations were found in the fellow eyes of glaucomatous children. Our finding also indicated that cpRNFL, GC-IPL, and PRL-RPE thickness were useful for the early identification of pediatric glaucoma. Conclusion: In conclusion, SD-OCT could be implemented in managing glaucoma in young children. Moreover, retinal layer damage at the corresponding locations of the fellow eye is similarly detected in the glaucomatous eye.