A four-Axis-Method to Evaluate a Part of an Undergraduate Medical Students' Curriculum.

Introduction: The evaluation of programs in faculties of medicine enables them to adequately reach their mission objectives, and social responsibilities and to correct their potential lacune. Few publications have described the process of internal evaluation of a program performed by the organizational members. The authors aimed to describe a practical method called the four-axis method to assess curriculum using a practical example. Methods: The authors performed a descriptive study, highlighting the application of a particular method of evaluation of a program called the four-axis method. It consisted of the assessment of the pedagogical alignment [1], teaching techniques and evaluation tests [2], students' viewpoints and needs [3], and the teachers' opinions and needs [4]. To contextualize this method, the authors described a practical experience of the assessment of a multidisciplinary theme (theme 16), which is taught during the second year of medical education. Was performed the evaluation from January 2020 to January 2021. The population studied consisted of the tutors implicated in the teaching of the theme and the students in the second year of medical education who accepted to answer the satisfaction questionnaires. The students and tutors who did not fill out the questionnaires were excluded. No statistical tests were needed because of the descriptive nature of the study. Results: The most relevant results highlighted that 48.4% of the teachers did not systematically use bioclinical cases involving interactions between students; also, 42.4% of the students believed that the teaching sessions didn't introduce practical examples giving rise to interactions between them. Therefore, the 4-axis-based analysis indicated that weaknesses were mostly attributed to the lack of homogeneity in the teaching methods and techniques which showed the teachers' difficulties in integrating clinical data into their teaching so that they can help the students to assimilate the fundamental data. Conclusion: The authors' used a particular approach since it focused both on an objective evaluation of the teaching methods and the evaluation tests and the students' and teachers' viewpoints and needs. The major limitation of this approach was the fact that it could not integrate the educational environment that could impact the students' performances.

Similarities and differences between tutoring and mentoring in medical education.

Supporting medical students involves two broad concepts that are often confused, namely tutoring and mentoring. These approaches, implemented in a heterogeneous way in medical schools, have been the topic of numerous publications. The objective of this update was therefore to define, then clarify, based on a literature review, the common characteristics and the differences between tutoring and mentoring in medical studies.

Epidemiological, clinical and mycological study of dermatomycosis in diabetic patients.

BACKGROUND: Dermatomycosis are fungal infections of the skin and/or phanera, which are often benign but can have an impact on the vital and functional prognosis in diabetic patients. AIM: The aim of our work was to study the epidemiological, clinical and mycological profile of dermatomycosis in diabetic patients. METHODS: This was a retrospective descriptive study carried out in the Parasitology-Mycology Laboratory of Charles-Nicolle Hospital over a three-year period (2016-2018). We collected diabetic patients who were referred for suspected dermatomycosis. RESULTS: Dermatomycosis was confirmed in 799 of the 1007 diabetic patients referred to our laboratory (79.34%) and in 1055 lesions among the 1344 sites sampled (78.50%). Among patients with dermatomycosis, a female predominance was observed with a sex- ratio=0.83. The mean age of the patients was 57.11 [2-82]. The patients with type 2 diabetes were the most affected (86.35%) (p=0.038). The mean duration of lesion progression was 5.0±5.5 years. The most common dermatomycoses were toenail onychomycoses (59.62%), followed by fingernail onychomycoses (15.26%), plantar keratoderma (10.24%), and intertrigo in small skin folds (5.59%). Dermatophytes were the most frequently isolated fungi (80.1%; p<0.001), with predominance of Trichophyton rubrum (78.8%). Candida albicans was the most frequently isolated yeast (11.8%). CONCLUSIONS: Dermatomycosis are common in diabetic patients. Although they are often benign, these fungal infections can engage the functional prognosis or even become life-threatening in case of diabetes. Mycological diagnosis is necessary in case of clinical suspicion in order to confirm the diagnosis, guide the treatment and avoid complications.

Management of a primary retroperitoneal hydatid cyst ruptured in the abdominal wall: A case report.

INTRODUCTION: Hydatid disease is a global zoonosis. Any organ of the human body can be involved. Single or multiple locations are reported. However, retroperitoneal hydatid cysts are uncommon. Furthermore, parietal complications are rarely reported in literature. Therefore, the management of hydatid cysts ruptured in the abdominal wall remains challenging. PRESENTATION OF CASE: In this case report, we aim to describe our experience in treating a primary retroperitoneal hydatid cyst with rupture into abdominal wall in an 87-year-old woman who presented with a 15-centimeter mass of the right flank. Hydatid serology test was positive. An abdominal CT scan showed a 20-centimeter cystic mass of retroperitoneum extended to the abdominal wall with several septa within and enhanced thick wall. The patient underwent a surgical elective drainage with perioperative antiparasitic chemotherapy. Follow-up showed no recurrence. DISCUSSION: Primary retroperitoneal hydatid cyst with parietal complications is scarce and barely described in literature. We performed a review of the recent relevant literature that deals with this subject. None of the hydatid cysts reported in 55 cases was located in retroperitoneum. The top seven countries of origin are located in Mediterranean region except for India. Imaging is compulsory for the diagnosis along with patient's history, physical examination and hydatid serology. The treatment is surgical and must be must be covered by antiparasitic chemotherapy. CONCLUSION: Primary retroperitoneal hydatid cyst extended to the abdominal wall remains a rare and challenging diagnosis that must be considered in endemic countries.

Progress and impact of the publications of the Faculty of Medicine of Tunis: A 55 years study.

BACKGROUND: Over the past few years, efforts have been made to ensure that the teachers of the Faculty of Medicine of Tunis (FMT) cite their affiliation to the FMT and the University of Tunis El Manar in addition to their hospital institutions and their research structure in their publications. AIMS: In this study, we proposed to evaluate the FMT's membership in the publications of its teachers, to identify the different types of publications and to estimate the real number. METHODS: In this bibliometric cross-sectional study, we retrieved the FMT publications indexed in medline/pubmed database (1964-June2019). We have chosen the keywords corresponding to the publications of group1 (referenced FMT) and group2 (referenced FMT or annexed hospital-university institutions). Next, we calculated the rate of group1 on group2 and sorted the different types of items in group2. Finally, We estimated, after randomization, the actual number of FMT publications for a 99% confidence interval (99% CI). RESULTS: For groups 1 and 2, 1477 and 5194 publications were retrieved, respectively. The FMT membership rate averaged 28% ranging from 4% (1990-2010) to 44% (2011-2019). Of the FMT publications, 30% were free of charge and 55% were original articles. After a draw for 300 group2 publications, the estimated number of total FMT publications was between 4519 and 4934 for a 99% CI. CONCLUSIONS: It is essential to mention its affiliation to «the Faculty of Medicine of Tunis¼ and to «the University of Tunis El Manar¼ in order to improve the visibility and ranking of our two academic institutions.

Avian mite bites acquired from pigeons: Report of three cases and review of the literature.

BACKGROUND: Skin lesions caused by avian mite bites are uncommon and often misdiagnosed. They are usually caused by bites from avian mites that have infested domestic poultry or birds nesting in or near human habitation. We report three cases of human skin lesions from avian mites infesting pigeons. OBSERVATIONS: Three persons working in the same place developed similar skin pruritic papules simultaneously. The diagnosis remained unknown until Dermanyssus gallinae (chicken mite) was found on the computer's table of the three individuals workplace, situated near a window where pigeons used to live. Antihistaminic treatment was carried out with a skin disinfestation. In two cases, symptoms resolved after one week of treatment. In the third case, corticosteroids were needed. CONCLUSIONS: Avian mite bites skin lesions can remain unrecognized or misdiagnosed. Inquiry about contact with pigeons or poultry may be helpful in patients with nonspecific skin lesions.