Attitude, perception, and feedback of graduate medical students on teaching-learning methodology in pathology courses: A call for curricular modernization in Morocco.

BACKGROUND: The difficulty of understanding the pathology courses and the student's dissatisfaction with the pathology modules is a universal problem. The principal aim of our survey was to assess the perception and satisfaction of teaching pathology by graduate medical students from nine Moroccan faculties of medicine. MATERIALS AND METHODS: This study was conducted among graduate medical students regarding their preferences in pathology teaching modalities, their satisfaction with the current lecture-based courses, their perception of pathology as a specialty, and their thoughts on whether and how such curricula should be modernized. A qualitative and comparative analysis was performed. The differences in modalities of teaching used were investigated. RESULTS: We received 274 completed surveys from graduate Moroccan medical students. Seventy-five (27.9 %) students were dissatisfied with the actual lecture-based courses. A total of 131 students (48.5%) considered that the methodology of teaching and learning used in their faculty is insufficient for learning, understanding, and memorizing pathology courses. Additionally, 233 students (86.3 %) considered that the curriculum should be modernized. The majority supported the implementation of case reports (74%), hospital-based rotation in the pathology department (68.7%), and virtual slides (60%) as the most preferred didactic methods. CONCLUSIONS: This survey based-study highlighted the limits of the current pathology teaching curriculum in Morocco, insufficiently in line with the aspirations of students. Furthermore, students' responses regarding their knowledge of the pathology laboratory functioning as well as their opinions toward considering pathology as a future career were very surprising, converging toward a huge lack of attractiveness of this discipline.

Evaluation of Antibiograms Interpretation Training Needs of Medical Biology Residents at Ibn Rochd University Hospital.

BACKGROUND: In order to determine domains with the most difficulties and plan a relevant training, the aim of this study was to assess training needs of medical biology residents at the Ibn Rochd University Hospital of Casablanca, concerning antibiograms interpretation. METHODS: A descriptive and comparative study was carried out in February 2022, with two resident groups. The first one included all residents in training in the bacteriology-virology laboratory and having spent at least 2 months. The 2nd one included residents who had validated their course (9 months). Data were collected from collective interviews and a self-administered questionnaire with a qualitative and quantitative grid analysis. RESULTS: Residents expressed needs in the three learning domains (knowledge, know-how, interpersonal skills) but they were low to moderate (scores from 0.2/4 to 2.4/4). Priority topics for training were: interpretation of observed phenotypes (5.85/8), followed by interpretative reading according to EUCAST recommendations (5.05/8). The two groups' responses were similar, except for the know-how domain of natural resistance mechanisms where the needs were greater in G1 (p = 0.008). CONCLUSIONS: In the light of these results, additional training with relevant aims should be planned.

[Imaging appearance of acute disseminated encephalomyelitis: a study of 22 cases]. / Imagerie de l'encéphalomyélite aiguë disséminée: étude de 22 cas.

Acute disseminated encephalomyelitis (ADEM) is a rare cause of encephalitis in adults, characterized by inflammatory lesions in the white substance of the central nervous system (CNS). Initial clinical presentation may mimic severe CNS infection with fever, encephalopathy, seizures, or multiple sclerosis. The purpose of our study was to report the epidemiological, clinical, radiological, therapeutic and evolutionary features of ADEM and to determine the role of MRI sequences in the diagnosis, monitoring and prognosis of this disease. We conducted a retrospective study of the clinical and radiological records of 22 patients with ADEM followed up in the Department of Neurology over a period of 11 years (January 2006- January 2017). These patients underwent medical imaging at the Mohammed V Military Teaching Hospital, de Rabat. The average age of patients was 35 years (12-57 years). A recent infection was found in 31% of patients, while 4% of patients had recently undergone vaccination. Symptoms were dominated by focal neurologic deficit (72%). CT scan was normal in 78%. MRI showed hyperintense subtentorial and supratentorial white substance on FLAIR sequences in 70% of patients, without diffusion restriction in all cases, with enhancement of the lesions in 27% of cases and involvement of the cervical spinal cord in 68% of cases. Clinical and radiological outcome was favorable in all cases.

Evaluation of the Knowledge and Attitudes of Dental Students toward Occupational Blood Exposure Accidents at the End of the Dental Training Program.

AIMS AND OBJECTIVES: This study was conducted to assess knowledge, attitudes, and behavior regarding occupational blood exposure accidents (OBEA) among dental students at the end of the whole dental education program. MATERIALS AND METHODS: The survey was performed using a student self-administered questionnaire during July 2015 in the dental teaching hospital in Rabat. It was conducted on 117 dental students registered in the 5th year. The results were analyzed by SPSS Software, Version 13.0. Univariate analysis was performed by descriptive statistics, and bivariate analysis was used to identify correlations between different variables. RESULTS: Eighty-three students answered the questionnaire (participation rate: 70%). Most participants had incomplete knowledge about the management and the risks of OBEA. Thirty-five participants (42%) experienced at least one occupational exposure to patients' blood. Needle recapping has been the main cause of such injuries (41%). Most accidents occurred, respectively, in the oral surgery (51%) and the restorative dentistry (17%) departments. According to many participants, they had received insufficient education concerning this topic. CONCLUSIONS: More effective education on prevention and management of OBEA is highly recommended to reduce the prevalence of such injuries. Dental schools should set up a local management unit for following and supporting the exposed students.

Moroccan medical students' perceptions of their educational environment.

This study aimed to assess students' perceptions of their educational environment in the Faculty of Medicine and Pharmacy of Rabat, Morocco, using the Dundee Ready Educational Environment Measure (DREEM). A cross-sectional survey was conducted in the Faculty of Medicine and Pharmacy of Rabat, Morocco, in which medical students' perceptions of their educational environment were assessed using the DREEM criteria during the 2013-2014 academic years. The DREEM inventory encompasses 50 items divided into five subdomains: perceptions of learning, perceptions of teaching, academic self-perceptions, perceptions of atmosphere, and social self-perceptions. The DREEM has a maximum score of 200, which would correspond to a perfect educational environment. The mean scores (±standard deviation) of students' responses were compared according to their year of study and gender. The responses of 189 postgraduate medical students were included. The mean total DREEM score was 90.8 (45.4%). The mean total scores for five subdomains were 21.2/48 (44.2%), 21.8/44 (49.6%), 13.1/32 (40.9%), 19.0/48 (39.6%), and 15.6/28 (55.7%) respectively. Female students reported higher perceptions of teaching scores than males (P=0.002), and students in their fifth year of study reported significantly higher social self-perceptions scores than those in their fourth year (P=0.03). In this study of the oldest faculty of medicine in Morocco, students perceived the educational environment as having many problems.

[Voluminous mediastinal neurofibroma in a child]. / Volumineux neurofibrome médiastinal chez un enfant.

INTRODUCTION: Neurogenic tumors account for 30% of mediastinal tumors in children. The thoracic region is the most common site for neurofibromas. We report a case of a voluminous neurofibroma in a small girl. CASE: After 8 months of paraplegia, a 4-year-old girl underwent thoracic radiography and computed tomography as well as magnetic resonance imaging of the spine. These revealed a huge mediastinal mass continuing into the vertebral canal and compressing the cord. Histological examination after surgery confirmed the diagnosis of neurofibroma. At the follow-up examination a month later, the paraplegia had resolved. DISCUSSION: Neurofibromas may manifest as solitary tumors or may be one manifestation of neurofibromatosis. In mediastinal neurofibroma, thoracic radiography, and computed tomography can show the tumor, posterior vertebral scalloping, and enlarged neural foramina. MR imaging provides the exact anatomic location, as well as any compression and displacement caused by the tumor. This information is essential for deciding the exact extent of resection. MRI may also be helpful in postoperative management.

Bone turnover markers, anterior pituitary and gonadal hormones, and bone mass evaluation using quantitative computed tomography in ankylosing spondylitis.

The objective of this study was to determine bone mineral density (BMD) distribution in ankylosing spondylitis (AS) using quantitative computed tomography (QCT), to study bone turnover and anterior pituitary and gonadal hormonal axis in AS, and to look for correlations between BMD, bone remodeling markers and gonadal and anterior pituitary hormones. Forty-three male consecutive patients with AS were enrolled prospectively [mean (SD) age of 36.4 (11.3) years (range: 17-67) and mean disease duration of 6.8 (5.2) years (range: 0.4-19)]. Spine BMD was measured in all patients by QCT, and the results were compared to 29 male patients undergoing lumbar CT scan for sciatica. Bone turnover and anterior pituitary and gonadal axis were assessed in 29 patients, and the results were compared to 30 male healthy blood donors. The mean (SD) BMD was 127.7 mg/cm(3) (48.9) (range: 8.8-265.7) and 152.1 (25.3) (range: 34.2-190.4) in patients and controls, respectively (p = 0.018). Patients had lower serum levels of osteocalcin and higher levels of serum testosterone, luteinizing hormone (LH), and prolactin than controls with a significant statistical difference. There was a positive significant statistical correlation between BMD and chest expansion, Schober's test, C7-wall distance, and negative significant statistical correlation with age, disease duration, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), and serum prolactin. No correlation was observed between bone turnover parameters and AS symptomatic and structural severity indexes. BMD is lower with increasing age and late and severe disease. Decreased bone formation with normal resorption and increased levels of serum prolactin may be involved in its pathophysiology.

Lung findings on thoracic high-resolution computed tomography in patients with ankylosing spondylitis. Correlations with disease duration, clinical findings and pulmonary function testing.

The aim of this study was to identify the spectrum of abnormalities revealed on high-resolution computerized tomography (HRCT) in patients with ankylosing spondylitis (AS), to compare findings with those of plain radiography and pulmonary function testing (PFT), and to look for correlations between lung involvement and AS severity. We prospectively studied 55 consecutive patients with a diagnosis of AS according to the modified New York criteria who attended our department over a period of 2 years. All patients had a detailed rheumatological examination and underwent plain chest radiography, chest HRCT and PFT. HRCT revealed abnormalities in 29 patients (52.7%), whereas plain chest radiography was abnormal in only 2. Abnormalities consisted of interstitial lung disease (ILD) ( n=4), apical fibrosis ( n=5), emphysema ( n=5), bronchiectasis ( n=4), ground glass attenuation ( n=2), and non-specific interstitial abnormalities ( n=26). Only apical fibrosis and bronchiectasis were statistically more frequent with increasing disease duration (significant trend chi(2)test, p=0.0029 and 0.028, respectively). PFT showed a restrictive process in 19 patients (34.5%). No correlation was noted between HRCT and PFT, nor with AS symptomatic and structural severity parameters. However, there was a statistically significant correlation between PFT and AS symptomatic and structural severity parameters. In conclusion,: this study confirms that the chest HRCT of patients with AS showed a great number of abnormalities undetectable by standard X-rays. The high incidence of lung abnormalities emphasizes the importance of excluding such a diagnosis in patients with AS even without respiratory symptoms.