[Moodle, a credible alternative pedagogy for teaching medicine in a tropical environment to address large numbers and pandemic situations?] / Moodle, une pédagogie alternative crédible d'enseignement de la médecine en milieu tropical pour répondre aux grands nombres et aux situations de pandémie?

Introduction: Moodle is an interactive online education platform, a true virtual amphitheater, breaking down geographical and space barriers, capable of offering continuous education even in times of war or pandemic. Aim: To show the possible contribution of Moodle in the teaching of medicine in tropical environments to respond to large numbers and pandemic situations. Methodology: It was a cross-sectional and descriptive survey. It was conducted in June 2019 at Joseph KI-ZERBO University of Ouagadougou in Burkina Faso. It consisted of a questionnaire submitted to Master 1 students of medicine and to their teachers. The survey focused on the solutions that students would propose to improve their learning conditions, the role that Moodle could play in improving their learning, as well as the prerequisites to be resolved before adopting Moodle. The respondent rate was 75.6% of the entire promotion. Results: For students Moodle is a good alternative to conventional education. However, prerequisites must be fulfilled such as the donation of computer to each student (90.3%), the availability of a good connection for all (96%), their training prior to the use of Moodle. Students found no harm in their online assessment via Moodle provided it was reliable and verifiable when needed. Teachers in 38% wanted teaching to remain traditional, face to face against 62% who advocated its abandonment in favor of new teaching methods like Moodle provided that the right conditions are in place. Conclusion: Moodle is a credible e-learning that can facilitate the management of large numbers and ensure the continuity of lessons learned in a pandemic situation despite the need for containment. However, it must be a mastered technique, applied on prepared ground.

Miscellaneous nanoaggregates made of beta-CD esters synthesised by an enzymatic pathway.

Various beta-cyclodextrin (beta-CD) fatty esters with different chain lengths (C4-C14) were synthesised by transesterification of beta-cyclodextrin by vinyl fatty ester using thermolysin in DMSO. For each cyclodextrin derivatives, two batches of synthesis were realized. The ability of these derivatives to form nano-organized systems was investigated through the solvent displacement technique. During the formulation step, the effects of the initial concentration of beta-CD fatty esters in the organic phase and that of the final volume of the aqueous non-solvent phase were studied. Except for the beta-CD C4 ester, the transesterified beta-CD derivatives led to measurable nanoparticles. Cryo-electron microscopy images showed a significant morphological variability. Spherical, rod-like or more irregularly-shaped nano-objects were observed with either matricial or lamellar structures. A statistical analysis by a two-way ANOVA was computed for each class of beta-cyclodextrin esters in order to determine the effects of batch and formulation on the final size of nanoparticles.

[Assessing severe maternal anemia and its consequences: the value of a simple examination of the coloration of palpebral conjunctiva]. / Evaluer l'anémie maternelle sévère et ses conséquences: la valeur d'un simple examen de la coloration des conjonctives palpébrales.

The aims of this study were: (1) to investigate the relationship between pre-delivery hemoglobin (Hb) concentration and the outcome of the pregnancy for the mother and child and (2) to assess the extent to which the pallor of the conjunctiva indicates severe anemia in pregnancy (Hb < 7 g/dl). We carried out a prospective study in 1995, in the maternity department of the National Sourô Sanou Hospital (Bobo-Dioulasso, Burkina Faso). Women arriving to give birth at the maternity unit gave verbal consent and underwent a physical examination including the assessment of conjunctiva coloration. Finger-prick blood samples were taken from all the women selected and Hb was determined with a portable hemoglobin meter (HemoCue AB, Sweden). For each woman, information about age, obstetric history, the condition of mother and child at admission and delivery and any post-delivery complications in the first 48 hours was collected before discharge from the maternity unit, 3 to 5 days after the delivery. Women with multiple pregnancies were excluded from the study and 247 women were included overall. Endometriosis was observed in only three cases. Three women died, two due to septic shock. The third woman died from hypovolemic shock. The Hb concentrations of these women were 8 g/dl, 10.2 g/dl and 2.6 g/dl respectively. The mean Hb concentration for our population was 10.1 g/dl (SD = 2.08), with 165 women (67%) having less than 11 g Hb/dl. Forty-one women (17%) had less than 9 g Hb/dl and 16 (6%) had less than 7 g Hb/dl. Severe maternal anemia and pallor of the conjunctiva were significantly associated with pre-term delivery and perinatal death, but not with low birth weight. The sensitivity of the pallor of the conjunctiva for detection of severe maternal anemia was 87%, and its specificity was 88%. We found no evidence that maternal Hb levels of 9 to 10.9 g/dl were associated with a high risk of poor pregnancy outcome for either the mother or the child, although women with such levels of Hb are classed as anemic by the World Health Organization criteria. These results show that poor pregnancy outcome is associated with severe maternal anemia. Examination of the coloration of the conjunctiva is a suitable and affordable screening method for the detection of severe anemia. Mothers with severe anemia present with signs and symptoms of anemia and could therefore be given iron treatment to improve their health. This demonstrates the importance of nutritional intervention during pregnancy.

Stress dependent infection cost of the human malaria agent Plasmodium falciparum on its natural vector Anopheles coluzzii.

Unraveling selective forces that shape vector-parasite interactions has critical implications for malaria control. However, it remains unclear whether Plasmodium infection induces a fitness cost to their natural mosquito vectors. Moreover, environmental conditions are known to affect infection outcome and may impact the effect of infection on mosquito fitness. We investigated in the laboratory the effects of exposition to and infection by field isolates of Plasmodium falciparum on fecundity and survival of a major vector in the field, Anopheles coluzzii under different conditions of access to sugar resources after blood feeding. The results evidenced fitness costs induced by exposition and infection. When sugar was available after blood meal, infected and exposed mosquitoes had either reduced or equal to survival to unexposed mosquitoes while fecundity was either increased or decreased depending on the blood donor. Under strong nutritional stress, survival was reduced for exposed and infected mosquitoes in all assays. We therefore provide here evidence of an environmental-dependant reduced survival in mosquitoes exposed to infection in a natural and one of the most important parasite-mosquito species associations for human malaria transmission.

Effect of hydroxyapatite on the physicochemical characteristics of a gentamicin-loaded monoolein gel intended to treat chronic osteomyelitis.

Many works have demonstrated the real potential of gentamicin-monoolein-water formulations as bioresorbable and sustained-release implants for the local treatment of the chronic osteomyelitis. In order to improve the efficacy of this type of implant, the incorporation of hydroxyapatite, a well-known osteointegrator material, is thought to be an interesting approach. Five formulations incorporating 0, 2.5, 5, 10, and 20% of hydroxyapatite were examined with regard to their physicochemical and in vitro drug release characteristics. The rheological, thermal (differential scanning calorimetric and thermogravimetric diffraction analysis), X-ray diffraction, and dissolution studies have showed that the presence of hydroxyapatite does not dramatically disturb the cubic liquid crystalline structure of the monoolein-water gel and their ability to progressively release the antibiotic. Implant 20% that was capable to release gentamicin sulfate over a period of four weeks without marked burst effect could be used as a more suitable biodegradable delivery system for the local management of chronic osteomyelitis.