Tag: nevin manimala

Tunis Med. 2025 Aug 1;103(8):969-974. doi: 10.62438/tunismed.v103i8.5623.

ABSTRACT

INTRODUCTION: Role-playing are a subtype of simulation aimed at improving non-technical skills, such as delivering a cancer diagnosis. The use of this pedagogical method in teaching bad news delivery has been growing in recent years. However, data, particularly from Tunisia, on this topic are limited.

AIM: To evaluate learners’ perceptions of the usefulness of role-playing in delivering cancer diagnoses.

METHODS: We conducted a descriptive, cross-sectional study between January and October 2024. We included 4th-year medical students who had completed their gastroenterology rotations at Charles Nicolle Hospital. For each group, we conducted a role-playing session. A questionnaire was distributed to learners before and after the role-playing session to assess whether there was a change in students’ opinions.

RESULTS: We collected data from 61 students. According to the students, the most crucial step for successfully delivering a diagnosis was training doctors in delivering news about serious illnesses. Nearly half of the students (n=34) reported having difficulty communicating with patients or their families. All learners were convinced that simulation plays a major role in medical practice and medical education. Additionally, all students agreed that role-playing sessions are highly suitable for teaching the delivery of bad news, particularly cancer diagnoses. Participation in role-playing sessions allows doctors to understand patients better. The learners’ responses before and after the role-playing session were comparable.

CONCLUSION: Role-playing is a highly effective active learning method for teaching cancer diagnosis delivery. It helps learners approach reality more closely and acquire communication skills with patients and their families.

PMID:41832662 | DOI:10.62438/tunismed.v103i8.5623

Tunis Med. 2025 Aug 1;103(8):961-968. doi: 10.62438/tunismed.v103i8.5651.

ABSTRACT

AIM: To develop procedural documents of three gestures taught in endocrinology and to assess their contribution in the procedural learning of students.

METHODS: Prospective randomized controlled study, comparing a self-learning tool combining a video and a procedural document (PD), with a guided teaching (GT) of a technical gesture by a teacher. The study involved 89 students randomized into: an intervention group (I1;n=47) and a control group (I0;n=42). All the participants had GT regarding blood pressure measurement, thyroid examination, and waist circumference measurement. Then, the GroupI1 received three PD and three videos illustrating the same gestures. A week later, an assessment was performed. Group I0 received the documents after the assessment. The student satisfaction with the two methods was evaluated.

RESULTS: The percentage of students who used PD and videos was comparable between the two groups (68to79% in groupI1 and 76to86% in groupI0, p between0.161and0.827). The mean evaluation score respectively at the thyroid examination station, blood pressure and waist circumference measurement was 8.07±1.28 in groupI1 versus7.94±1.01 in group I0(p=0.634),7.51±1.11versus7.68±0.96(p=0.466) and7.41±1.37versus6.94±1.34(p=0.132). The mean satisfaction score of the two teaching tools was respectively in group I1 versus I0, of (9.38±1.53 and 8.88±1.63; p=0.195), (9.39±1,65 and 9.25±0.76, p=0.658) and (9.43±1.59 and9.24±0.82,p=0.543).The GT satisfaction score was 9.34±1.40 in I1group versus 9.62±0.46 in I0group, p=0.227. The power of the statistical test was less than 10%.

CONCLUSION: The lack of significant difference between the evaluation scores of the two groups could be explained by the low rate of consultation of the educational tools and the small sample size.

PMID:41832661 | DOI:10.62438/tunismed.v103i8.5651

Tunis Med. 2025 Aug 1;103(8):956-960. doi: 10.62438/tunismed.v103i8.5167.

ABSTRACT

Introduction In the emergency department (ED), learning by simulation provides a safe acquisition of procedural skills. This study’s objective was to evaluate the impact of the simulation-based learning on videolaryngoscope (VL) orotracheal intubation (OTI) skills among residents practicing in ED.

METHODS: evaluative, prospective study, including residents practicing in teaching hospitals ED in Tunis. They were novices in direct laryngoscopy. We scheduled a procedural simulation session. Residents were evaluated before and after the session. The primary endpoint was the rate of successful OTI after learning session.

RESULTS: 32 residents were enrolled. The mean age was 28 ± 2.5 years. Gender ratio was 0.18. The mean exercise seniority was 1.53 ± 0.7 years. The rate of successful OTI before and after the training was observed in 4 residents (12.5%) vs 23 (71.8), p=0.689. The average time of OTI was respectively 149.81±108 seconds (sec) vs. 51±96 sec (p<0.001). The rate of esophageal intubation was n (%): 16 (50%) vs 9 (28%) (p=0.49) and the mean number of attempts was 3.81 vs. 1.84 (p<0.001). Intubation time after the session more than 12 sec was an independent factor of intubation failure (Adjusted OR= 3.5, p=0.001 and 95%CI [1.018-10.69]).

CONCLUSION: Learning by simulation in the ED provides residents with a skill that allows complete OTI in less time and a smaller number of attempts. Intubation time is an independent factor predicting intubation failure among doctors learning intubation by VL.

PMID:41832660 | DOI:10.62438/tunismed.v103i8.5167

Tunis Med. 2025 Aug 1;103(8):1087-1091. doi: 10.62438/tunismed.v103i8.5966.

ABSTRACT

INTRODUCTION: Thyroid nodules are a frequent and mostly benign pathology. Failure to recognize a cancer remains a major concern for any physician confronted with this pathology. Fine needle aspiration cytology (FNAC) is the reference examination when managing thyroid nodules. The aim of our study was to evaluate the role of FNAC in determining the histological nature of thyroid nodules.

METHODS: We conducted a cross-sectional, retrospective, and descriptive study, spread over a 5-year period from January 2016 to December 2020, carried out in our Department of Otolaryngology and Head and Neck Surgery.

RESULTS: The median age of the 200 patients was 46 years. Female predominance was evident, with a sex ratio of 0.09. All our patients underwent FNAC followed by surgical excision. FNAC was non diagnostic in 8 cases (4%) and benign in 53 cases (20.50%). It revealed atypia of undetermined significance in 33 cases (16%), a follicular neoplasm in 45 cases (21.50%) and a malignant suspicion in 47 cases (22.50%). FNAC was malignant in 22 cases (10.5%). Pathological examination showed malignancy in 115 cases. FNAC has an overall sensitivity of 84% and a specificity of 71.6% in predicting thyroid nodules diagnosis.

CONCLUSION: Combining clinical and ultrasonographic criteria with cytological results improves the sensitivity of thyroid carcinoma screening.

PMID:41832648 | DOI:10.62438/tunismed.v103i8.5966

Tunis Med. 2025 Aug 1;103(8):1073-1079. doi: 10.62438/tunismed.v103i8.5408.

ABSTRACT

INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, destructive inflammatory rheumatic disease reported in populations of African origin. The aim of this study was to evaluate the epidemiological, clinical and paraclinical data of RA in Guinea with a registry from 2018 – 2022.

METHOD: This was a longitudinal, retrospective study conducted in the rheumatology department of CHU Ignace Deen between January 2018 and December 2022. The diagnosis of RA was based on the ACR and EULAR 2010 criteria.

RESULTS: During the study period we collected 528 cases of RA out of 4213 observations (12.5%). There were 433 (82%) women with an average age of 47.3 years. The average number of painful joints was 8, ranging from 4 to 28, and the average number of swollen joints was 2 (ranging from 2 to 20). Rheumatoid factors were positive in 396 (75%) of cases, while anti-CCP antibodies were positive in 380 (72%) of patients. With DAS28, remission was noted in 53 (10%) of our patients, activity was low in 137 (26%) of cases, moderate in 259 (49%) and high in 79 (15%). Quality of life was assessed by the HAQ score, the mean value of which was 48 out of 60 (range 0 to 60).

CONCLUSION: Rheumatoid arthritis is the most common form of arthritis in Guinea. It mainly affects housewives, with significant functional repercussions.

PMID:41832646 | DOI:10.62438/tunismed.v103i8.5408

Tunis Med. 2025 Aug 1;103(8):1061-1066. doi: 10.62438/tunismed.v103i8.5888.

ABSTRACT

BACKGROUND: Acute pancreatitis (AP) is acute inflammatory process of the pancreas, commonly attributed to biliary or alcoholic causes. Drug-induced AP, although rare, is increasingly recognized as a potential etiology. However, there is limited literature on this topic.

AIM: This study aims to review the epidemiological, clinical, radiological, and management characteristics of drug-induced AP based on data from Tunisian databases.

METHODS: A retrospective study was conducted at the Department of Digestive and Visceral Surgery, spanning five years. Thirteen cases of drug-induced AP out of 1580 admitted patients with AP were analyzed. Data collection included clinical characteristics, diagnosis methods, therapeutic approaches, and outcomes.

RESULTS: We report a series of 13 cases of drug-induced acute pancreatitis (AP). Due to the rarity of this event, our small sample size limits the statistical power of our findings. However, each case provides valuable insight into potential drug associations with AP. The mean age of affected patients was 55.62 years, with a male predominance (77%). Common symptoms included sudden onset epigastric abdominal pain (100% of cases) and elevated lipase levels (92.3%). Implicated medications included captopril (38.5%), atorvastatin (23.1%), azathioprine (23.1%), metformin, and olanzapine (7.7% each). Management involved pain management and proton pump inhibitors, with favorable outcomes in 84% of cases.

CONCLUSION: Drug-induced pancreatitis is a recognized entity requiring multidisciplinary management. Early recognition and reporting of suspected cases are essential for improved pharmacovigilance.

PMID:41832644 | DOI:10.62438/tunismed.v103i8.5888

Tunis Med. 2025 Aug 1;103(8):1050-1060. doi: 10.62438/tunismed.v103i8.5501.

ABSTRACT

INTRODUCTION: The objective of this bibliometric study, spanning half a century of international biomedical research (1970-2019), on “parasitic diseases”, was to describe the editorial profile; methodological and thematic of these scientific publications.

METHODS: The data were collected from the MEDLINE database, through a documentary query based on the descriptor “Parasitic Diseases”, and analyzed according to their main editorial characteristics (types of publication, scientific journals, etc.), methodological (country, parasitic diseases, etc.) and themes (key words), deduced particularly from the fields of its Medical Subjects Heading (MeSH), following a stratification into two periods: A (1970-1994) and B (1995-2019). “Highly Cited” papers were identified through Web of Science.

RESULTS: A total of 337157 publications were identified (A: 110,062; B: 227095) and indexed by 20881 MeSH descriptors (A: 11 817; B: 19640). Published in 6470 scientific journals, these publications particularly covered the specialties of “Infectious Diseases” (37%), “Gastrology/Hepatology” (22%) and “Pediatrics” (20%). Conducted particularly in Brazil (2.6%), these studies were often “retrospective” (2.8%). The descriptor “Intestinal Diseases Parasitic” was the most explored thematic category (2.8%). In addition to “Malaria” (11.3%), the most studied diseases were “Echinococcosis” (2.9%), “Visceral Leishmaniasis” (2.7%) and “Toxoplasmosis” (2.5%). Bibliometric trends were characterized by an increase in “Reviews” (12.4% versus 7.5%), a switch from an “immunology” approach (24261 publications) to another “epidemiology” (70012 articles) and more focus on “Malaria Falciparum”. Only 329 articles were qualified as “Highly Cited” (1‰).

CONCLUSION: The bibliometric profile of international publications on “Parasitic Diseases”, over the last half century, has been characterized by an explosion of synthetic studies, covering a broad spectrum of scientific journals, focused on low- or middle-income countries and centred on malaria.

PMID:41832643 | DOI:10.62438/tunismed.v103i8.5501

Tunis Med. 2025 Aug 1;103(8):1043-1049. doi: 10.62438/tunismed.v103i8.5722.

ABSTRACT

INTRODUCTION: Inappropriate prescriptions (IP) and omission of prescriptions (OP) are sources of adverse events in pediatrics. The pediatric prescription optimization grid (GOPP tool) was developed in the Ivorian pediatric environment for the detection and management of IP and OP. Our aim was to analyze the reliability between pharmacists, when using the GOPP tool for the detection of IP and OP in the Ivorian hospital context.

METHODS: A cross-sectional study with a descriptive aim was carried out. The treatments of 881 patients were analyzed using the GOPP tool by clinical pharmacists (reference group) for the detection of IP and OP. Thirty (30) cases with at least 1 IP or OP were selected. These cases were also examined independently using GOPP tool by ten (10) pharmacists and interns (evaluator group) having no prior experience with this tool. Inter-user reliability for PI and OP detection using the GOPP tool was determined using the kappa (κ) test of agreement.

RESULT: The selected cases concerned patients with a median age of 25.5 months. The numbers of PI lines and OP detected by pharmacists in the “reference” group were 50 and 6, respectively. The median levels of agreement for PI and OP detection were judged as very good (Kappa=0.92) and good (Kappa=0.77), respectively.

CONCLUSION: The GOPP tool is a reliable tool for the detection of PI and OP by pharmacists working in the Ivorian hospital context. Its use is relevant in routine for the pharmaceutical analysis of prescriptions in pediatric departments in Côte d’Ivoire.

PMID:41832642 | DOI:10.62438/tunismed.v103i8.5722

Tunis Med. 2025 Aug 1;103(8):1033-1038. doi: 10.62438/tunismed.v103i8.5375.

ABSTRACT

INTRODUCTION: By 2030, non-communicable diseases (NCDs) are expected to overtake all other causes of death in Africa. The prevalence of NCDs and related risk factors are influenced by gender and socioeconomic disparities.

AIM: Thus, this study aimed to determine the impact of socio-economic and demographic factors on non-communicable diseases in Morocco.

METHODS: Cross-sectional data were analysed from 4766 adults who participated in the 2017 STEPS survey in Morocco. Data collection included assessment of behavioural and biochemical risk factors. The Kolmogorov-Smirnov, Chi-square and the Kruskal-Wallis tests were performed.

RESULTS: There was a significant difference between genders in NCDs. Men had higher rates of tobacco and alcohol use (21.2%, 13.9%, respectively, with a p <0.001)), while women had higher obesity prevalence (31.2% (p <0.001)). Individuals with no formal education showed the highest prevalence of hypertension (38.9%), diabetes (10.1%), and obesity (27.9%) compared to those having primary education or more. Adults aged 70 years or older showed higher prevalence of hypertension and diabetes than the other age groups.

CONCLUSION: Morocco has a high prevalence of NCDs. The incidence of NCDs is significantly associated with sociodemographic and behavioral factors. A multisectoral and integrated strategy, focusing on sociodemographic and behavioral factors is necessary to prevent and control NCDs.

PMID:41832640 | DOI:10.62438/tunismed.v103i8.5375

Tunis Med. 2025 Aug 1;103(8):1024-1032. doi: 10.62438/tunismed.v103i8.5969.

ABSTRACT

Indonesia ministry of health data shows that 21.7% of the population has anemia, with a prevalence of 26.4% in the 5-14-year age group and 18.4% in the 15-24-year age group (Hb <12.0 g/dL). The Health Belief Model (HBM) is used to identify lifestyle patterns of anemic students and their risks to academic achievement.

AIMS: This study examines the relationship between hemoglobin levels and academic achievement and assesses the relationship between the HBM construct and anemia.

METHODOLOGY: This study is a cross-sectional study with a sample of 80 grade VIII students at SMP Negeri 1 Lhokseumawe. This study examines the relationship between hemoglobin levels and academic achievement and assesses the relationship between the HBM construct and anemia.

RESULTS: Chi-square test showed a significant relationship (p<0.05) between anemia and academic achievement, where students with normal hemoglobin levels had better achievements than those with anemia.

CONCLUSIONS: These findings confirm the impact of anemia on academic achievement, highlighting the importance of iron for brain function, concentration, and intelligence. The limited correlation of most HBM constructs with anemia suggests low student awareness, thus educational interventions are needed to improve preventive behavior.

PMID:41832639 | DOI:10.62438/tunismed.v103i8.5969