Revealing the significant shortcomings in the learning environment at the three largest medical schools in Syria: what's next?

BACKGROUND: Medical education in Syria still adopts a traditional, teacher-centered curriculum to this day. These elements imply the existence of issues in the learning environment (LE). This study aims to provide the first evaluation of the LE at the largest medical schools in Syria using the DREEM inventory. METHODS: The three largest medical schools in Syria are the ones at Damascus University (DU), University of Aleppo (AU), Tishreen University (TU). The Arabic version of the DREEM questionnaire was used. Students across all years of study except year 1 were approached. Both paper-based and electronic surveys were conducted. RESULTS: A total of 1774 questionnaire forms were completed (DU:941, AU:533, TU: 300). The overall DREEM score at DU, AU, and TU were 100.8 ± 28.7, 101.3 ± 31.7, and 97.8 ± 35.7 respectively with no significant difference (P = 0.254) between the three universities. DREEM subscales concerning Learning, Atmosphere, Academic Self-perception and Social Self-perception had a low score across all universities. Clinical-stage students reported significantly lower perception (P ≤ 0.001) of the LE in comparison to their pre-clinical counterparts across all subscales. CONCLUSIONS: The findings of this study highlight the significant shortcomings of the medical LE in Syria. If not addressed properly, the academic, clinical, and professional competence of the healthcare workforce will continue to deteriorate. Moreover, the negative LE might be a predisposing factor for medical students' exodus. The Syrian medical education system requires leaders who are willing to defy the status quo to achieve a true educational transformation.

Commitment to protective measures during the COVID-19 pandemic in Syria: A nationwide cross-sectional study.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 continues to impose itself on all populations of the world. Given the slow pace of vaccination in the developing world and the absence of effective treatments, adherence to precautionary infection control measures remains the best way to prevent the COVID-19 pandemic from spiraling out of control. In this study, we aim to evaluate the extent to which the Syrian population adheres to these measures and analyze the relationship between demographic variables and adherence. METHODS: This cross-sectional study took place in Syria between January 17 and March 17, 2021. A structured self-administered questionnaire was used to collect the data. The questionnaire was distributed in both electronic and printed versions. Our sample consisted of 7531 individuals. Collected data were analyzed using SPSS v.25. The chi-square test was used to address the correlation between adherence and demographic variables. RESULTS: Of the 10083 reached out, only 8083 responded, and 7531 included in the final analysis with an effective response rate of 74.7%. Of them, 4026 (53.5%) were women, 3984 (52.9%) were single, and 1908 (25.3%) had earned university degrees. 5286 (70.25) were in the high level of adherence category to protective measures. Statistically significant differences were documented when investigating the correlation between commitment to preventive measures and age, sex, marital status, financial status, employment, and educational attainment. Furthermore, those who believed that COVID-19 poses a major risk to them, or society were more committed to preventive measures than those who did not. CONCLUSION: The participants in this study generally showed a high level of adherence to the preventive measures compared to participants in other studies from around the world, with some concerns regarding the sources of information they depend on. Nationwide awareness campaigns should be conducted and focus on maintaining, if not expanding, this level of commitment, which would mitigate the pandemic's impact on Syrian society.

Primary psoas tuberculosis abscess with an iliac bone lytic lesion: a case report.

BACKGROUND: Primary psoas tuberculosis is the presence of "Koch's bacillus'' within the iliopsoas muscle caused by hematogenous or lymphatic seeding from a distant site. Muscular tuberculosis has relatively low prevalence in comparison with other cases of extrapulmonary tuberculosis, which explains the difficulties in establishing the diagnosis. CASE PRESENTATION: In this report, we present a challenging diagnostic case of primary psoas tuberculosis in a 38-year-old middle eastern female from southern Syria. The diagnosis was based on the clinical orientation, the observation of pulmonary lesions on the computed tomography scan, and the necrotic signs in the vicinity of the infected area. Despite the misleading primary false-negative results, the final diagnosis was reached after sufficient repetition of tuberculosis-specific testing. The patient was treated with isoniazid-rifampin-pyrazinamide-ethambutol for 2 months, then isoniazid and rifampin for 7 months, with full recovery in follow-up. CONCLUSIONS: This case highlights the importance of a clinical-based approach in the treatment of patients with psoas abscesses, especially in areas with high tuberculosis prevalence.