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The National License Examination step 1 (NLE1), which tests basic medical sciences knowledge in Thailand, is considered to be tough and stressful for medical students due to the large amount of content. This study aimed to determine factors influencing the NLE1 score (NLE1S). The NLE1S, academic achievement, and class attendance were obtained officially. Other factors, including study habits, were obtained via a questionnaire, with 81.97% (241/294) being returned. Students were divided into four groups according to the central passing score and Z-score of the NLE1S, including the fail (<52%; n = 13), low-pass (52 to <70%; n = 121), high-pass (70 to <80%; n = 89), and excellent (=80%; n = 18) groups. Men had higher NLE1S (P < 0.001) and comprehensive examination scores (P < 0.001) than women. Students with high motivation to study medicine had higher NLE1S. Daily preparation time (h/day) was lower, but stress was higher, in the fail group. In the excellent group, internet for academic use and achievement of study targets were higher; internet for nonacademic use, instance of absence, and stress were lower; and check-in time was earlier. The NLE1S had strong positive correlations with the comprehensive examination score and academic achievement during preclinical studies. By setting the NLE1S as a dependent variable in multivariate regression analyses, models of significant interactions were observed by setting behavioral factors, the comprehensive examination score, and academic achievement during a regular class as independent variables. Thus exhibiting good study habits and showing good academic performance throughout preclinical studies should be encouraged among students to achieve a good NLE1S.

The relationships among the scores of major subjects taught in the first preclinical year of a Thai medical school, previous academic achievements, and daily life activities are rarely explored. We therefore performed an exploratory study identifying various factors possibly related to the educational scores of these medical students. Questionnaires were sent out to all first preclinical year medical students, with 79.8% being returned (245/307 questionnaires). Positive correlations were revealed between the premedical year grade point average (pre-MD GPA) and anatomy, physiology, and biochemistry scores ("R = 0.664, 0.521, and 0.653, respectively, "P" < 0.001 for all) by Pearson's method. Using multiple linear regression analysis, anatomy scores could be predicted by pre-MD GPA, student satisfaction with anatomy, the percentage of expected reading, monthly earnings, reading after class and near exam time, and duration of sleeping periods near exam time ("R" = 0.773, R[superscript 2] = 0.598, "P" < 0.001). Physiology scores could be estimated by pre-MD GPA, the percentage of expected reading, monthly earnings, and percentage of those who fell asleep during class and near exam time ("R" = 0.722, "R"[superscript 2] = 0.521, "P" < 0.001). Biochemistry scores could be calculated by pre-MD GPA, the percentage of expected reading, motivation to study medicine, student satisfaction with biochemistry, and exam performance expectations ("R" = 0.794, "R"[superscript 2]= 0.630, "P" < 0.001). In conclusion, pre-MD GPA and the percentage of expected reading are factors involved in producing good academic results in the first preclinical year. Anatomy and biochemistry, but not physiology, scores are influenced by satisfaction.

Background: Kisspeptin has a major role in reproductive regulation. Furthermore, it is also involved in metabolic and cardiovascular regulation as well as is a potent vasoconstrictor. This study aimed to: 1) determine correlations between serum kisspeptin levels with obesity/metabolic parameters; 2) compare parameters between non-hypertensive ([non-HT] N.=15) and hypertensive ([HT] N.=15) female subjects; and 3) determine correlations between leptin, systolic blood pressure (SBP) or diastolic blood pressure (DBP) with obesity and metabolic factors., Methods: Clinical parameters and fasting blood and adipose tissue samples were collected from women undergoing open abdominal surgery., Results: Serum kisspeptin was not correlated with obesity parameters but was positively correlated with only SBP (P<0.05). Serum kisspeptin, SBP, DBP, body weight, waist circumference, hip circumference, plasma glucose, plasma insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), and height of visceral adipocytes (VA) were higher but the Quantitative Insulin Sensitivity Check Index (QUICKI) was lower in hypertensive compared to non-hypertensive female subjects (P<0.05). Leptin was positively correlated with obesity and metabolic paramters including area, width, and perimeter of subcutaneous adipocytes, and area, width, height, and perimeter of VA (P<0.05) but was negatively correlated the QUICKI (P<0.001). SBP had positive correlations with insulin, glucose, HOMA-IR, and kisspeptin, but had a negative correlation with QUICKI (P<0.05). DBP had positive correlations with body weight, BMI, waist circumference, hip circumference, insulin, glucose, HOMA-IR, and width of VA (P<0.05), but had a negative correlation with the QUICKI (P<0.05)., Conclusions: Kisspeptin, obesity especially visceral adiposity, and insulin resistance might contribute to increased blood pressure. Further studies are required to reveal the underlying mechanism of kisspeptin on metabolic and cardiovascular regulation.

Kisspeptin, a crucial central regulator of reproduction, has been used as a trigger in in vitro fertilization (IVF) treatment. This study aimed to investigate the roles of kisspeptin in IVF treatment in infertile females ( n  = 30); and in steroidogenesis in human granulosa-like tumor cell line (KGN). In the human study, blood was collected at three time points including (1) the beginning of gonadotropin stimulation (Phase I), (2) around eight days after gonadotropin stimulation (Phase II), and (3) on the day of ovum pick-up (Phase III). Follicular fluid (FF) was collected at Phase III. Serum human chorionic gonadotropin (hCG) was measured 15 days after embryo transfer and fetal heart beats were determined around 42 days of menstrual cycle to classify the subjects into successful and unsuccessful groups. FF kisspeptin levels were higher in successful compared with unsuccessful subjects ( P  < 0.01). Kisspeptin levels were significantly higher in FF than in serum in successful subjects ( P  < 0.05) but were comparable in unsuccessful subjects. Serum kisspeptin was comparable among three phases in the successful group but its levels in Phase III were significantly lower compared with Phase I in the unsuccessful group ( P  < 0.01). Serum kisspeptin in Phase II/III had positive correlations with serum E2 in Phases II and III and the outcomes of IVF/intracytoplasmic sperm injection (ICSI) treatment including serum hCG levels. For the cell experiment ( n  = 3), kisspeptin treatment in the presence of FSH together with IGF-1 enhanced CYP19A1 (aromatase) mRNA expression compared with control. FSH alone increased aromatase concentrations in the supernatant compared with control and kisspeptin at the dose of 10 -2 mmol/L with FSH enhanced aromatase concentrations in the supernatant compared with FSH alone ( P  < 0.001 all). In conclusion, kisspeptin enhanced aromatase expression and secretion and was associated with positive outcomes of IVF/ICSI treatment. Further studies regarding supplementation of kisspeptin could reveal its beneficial effects on IVF/ICSI treatment.