Clappboyette1407
Simulation allows learning in action, reflection and feedback. All these factors suggest the positive contribution of the simulation to the development of clinical reasoning. The main assessment tool for standardized testing of this skill is the script matching test.
To assess the impact of teaching through high-fidelity clinical simulation on the clinical reasoning of third-year medical students, while assessing their teaching practices, satisfaction and confidence in the learning they received during this session.
We conducted an evaluative bicentric prospective study that included third-year medical students completing their cardiology internship during the first semester of the academic year 2019-2020 in the cardiology departments of Habib Thameur Hospital and Charles Nicolle Hospital, respectively.
The study included 48 students. The students who participated in this study liked the teaching practices used in the simulation-assisted lessons. Their interest in these practices is validated by the aprocess and improving the quality of care.
Simulation is an innovative pedagogical strategy and a contribution to optimizing the clinical reasoning process and improving the quality of care.
to converge towards a general agreement on the organization and operation of an emergency department.
A participatory approach using the Delphi method was carried out with experts from emergency department staff and teaching hospital managers of Blida (Algeria).In the first round, experts were asked to express their degree of agreement on 30 items of the questionnaire on a seven point Likert scale, this to identify consensual items on the basis of an average rating of at least six. In the second round, the experts were asked to prioritize the consensual items. The experts participated anonymously in the study and any direct meetings between the experts were avoided.
A total of 190 experts participated in the first round, representing an overall participation rate of 77.2%. The first round identified 12 consensual items. Consensus was predictable for some items, such as the important role of the nurse or doctor reception in a emergency department (m = 6.0±1.5), but the response to other items was unexpected. Thus, the proposal that a patient already hospitalized in a required specialty service should never return to the emergency department was not the subject of consensus (m = 5.2±2.2). Correlation of rankings of consensual items by experts was significant but weak (Kendall W = 0.164, p < 10-3).
This study highlights contradictions and inconsistencies resulting from the improvisation that accompanied the birth of the emergency department in the teaching hospital of Blida.Major information and pedagogical efforts are needed to organize a new emergency department.
This study highlights contradictions and inconsistencies resulting from the improvisation that accompanied the birth of the emergency department in the teaching hospital of Blida.Major information and pedagogical efforts are needed to organize a new emergency department.The World Health Organization declared on March 11, 2020 that the COVID-19 epidemic has become a pandemic. In Tunisia, the Ministry of Health has recommended enhanced preventive hygiene measures to contain and limit the spread of the virus. Following the entry of Tunisia into phase 4 of the COVID-19 epidemic, the Tunisian Association of Surgery proposed recommendations related to surgical activity. Surgical emergencies must be treated urgently and without delay. Non-tumor pathologies which require surgery in an elective situation and for which the risk of aggravation or complication is considered low shoud be postponed. For digestive tumor pathology, and apart from complicated forms, neoadjuvant treatment is highly recommended in the context of multidisciplinary concertation staff.Ultraviolet C (UVC) disinfection is an effective technique for inactivating bacteria and viruses, while being non-corrosive to medical equipment. It is therefore very useful for hospitals. However, the handling of this type of radiation without precaution presents a potentially significant danger for the human health. learn more This hazard can manifested immediately or after a long period, by harmful effects ranging from simple erythema to authentic skin cancers. Therefore restrictions should be imposed to control and avoid the risks involved in professional uses. For this reason, the limit values for exposure to UVC radiation have been specified and recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP).Telemedicine has become a privileged mode of medical practice providing medical care while reducing the transmission of Covid-19 among patients, families, and clinicians. The law established in 2018 settled a legal framework for telemedicine in Tunisia. However, thelatterremains not sufficient in itself, as legal issues remain especially delimiting the precise conditions for this exercise and to expose the limits of responsibility of each party involved among its organizers, its health service providers, and its users. Several medico-legal issues may be generated by the practice of telemedicine in Tunisia. Our paper aimed to discuss these medico-legal issues relating to telemedicine in anticipation of its legislation.
To evaluate the outcomes of intracytoplasmic sperm injection (ICSI) cycles when using fresh versus frozen testicular testicular sperm extraction (TESE) samples in non obstructive and obstructive azoospermia in terms of fertilization, cleavage, embryo quality, implantation and clinical pregnancy rates.
A total of one hundred and forty consecutive testicular sperm extraction ICSI cycles were performed at our centre between 2012 and 2018 involving infertile men with obstructive and non-obstructive azoospermia. Fresh TESE samples were used in 56 consecutive ICSI cycles (group 1) and frozen-thawed TESE sperm samples were used in 84 ICSI cycles (group 2).
Our two groups were comparable concerning epidemiologic characteristics. There were no significant differences between the fresh TESE group and the frozen TESE group in the rates of fertilization, embryo cleavage rate, average number of, rate of tops embryos, blastocyst formation rate, implantation rate and clinical pregnancy rate (32.1% vs. 35.7%; p = 0 ,62). Correlation between clinical pregnancy rate and the type of the injected sperm (motile/ immotile) was not significant (46, 3% vs. 66, 7%; p = 0, 59).
Cryopreservation of testicular sperm seems not to influence ICSI outcomes. Thereby, this alternative is rather efficient in ICSI cycles in azoospermic patients since it may avoid iterative ovarian puncture, especially with non-obstructive azoospermia.
Cryopreservation of testicular sperm seems not to influence ICSI outcomes. Thereby, this alternative is rather efficient in ICSI cycles in azoospermic patients since it may avoid iterative ovarian puncture, especially with non-obstructive azoospermia.
We aimed to determine the prediction of cardiovascular events in patients with hypertension and diabetes using the 10-year Framingham score.
We conducted a cross sectional study in two primary health care centers in Monastir. We included patients with at least one conventional cardiovascular factors. Prediction of cardiovascular event were expressed by median and inter quartile range.
We included 409 patients. Age mean was 64 years (SD 12.3), the sex ratio was 0.44. Patients with type 2 Diabetes were 278 (68%) and 295 had hypertension (72.1%). The global risk prediction at 10 years for cardiovascular diseases was 26.3%, It was 36.6% (26.4-46.8) for tobacco users, 29.7% (18.2-42.5) for patients with hypertension and 29.1 % (18.8-43.3) for those with diabetes. It increased significantly with the number of cardiovascular risk factors. The risk prediction for cardiovascular events, were significantly higher in men than in women (p < 0.01) and in non-controlled patients than in controlled patients (p <0.001). The risk prediction for cardiovascular diseases death was 3.6% (1.3-8.6).
Thirty percent of patients with hypertension or diabetes will develop cardiovascular diseases in 10 years. We suggest renforcing preventive actions to balance cardiovascular risk factors, including hypertension and diabetes.
Thirty percent of patients with hypertension or diabetes will develop cardiovascular diseases in 10 years. We suggest renforcing preventive actions to balance cardiovascular risk factors, including hypertension and diabetes.
Galectin-3 is a new biomarker assumed to reflect fibrogenesis and inflammation. We aimed to investigate the relation of Gal-3 with the severity of coronary artery disease in patients with ST elevation myocardial infarction.
The prospective study enrolled 62 patients with ST elevation myocardial infarction who underwent coronary angiography. The burden of atherosclerosis was assessed by the number of involved vessels, the number of coronary lesions with a stenosis diameter more than 50% and the Gensini score. Gal-3 levels were measured on admission on miniVIDAS (BioMérieux).
The mean age of the patients was 56±11 years old; 93.5% were males. Diabetes, hypertension and hyperlipidemia were respectively 29%, 35.5% and 24.2%. Among patients, 80.6% were active smokers. Mean level of Gal-3was 17±11 ng/ml and didn't differ significantly from the number of involved coronary vessels (p=0.82) and the Gensini score (p=0.4). There was a positive correlation between the number of coronary lesions with a stenosis diameter greater than 50% and Gal-3 (p=0.04).
In patient with ST elevation myocardial infarction we found a positive correlation between the number of coronary stenosis and Gal-3 level.
In patient with ST elevation myocardial infarction we found a positive correlation between the number of coronary stenosis and Gal-3 level.
The current international context considers birth experiences as a focal point for women's health. However, this subject is rarely discussed in Tunisian literature.
Analyze birth experience of a sample of Tunisian women.
Transverse descriptive study. All women who gave birth in the study unit during August 2018 were included. A direct interview was conducted during the first postpartum day. The questionnaire used was developed by a multidisciplinary team and included 55 questions, divided into 4 items. We compared the group of women who described their delivery as physically or psychologically traumatic to the group of women who reported a serene birth experience. A multivariate analysis of variance was used to identify the variables that can influence childbirth experience.
During the study period, 170 women were included with a response rate of 81%. Severe anxiety about delivery was reported by 74.5% (n = 127) of women. Delivery was experienced as a trauma in 48.2% (n = 82) of cases. In the group ofnd societal levels.Immunotherapy in lung cancer has been playing a key role. This role can be explained by the gain in term of survival without progression. The place of the PD-L1 testing is important to know. Because of the multiple clones available and the differrent systems available in pathology labs, it was important to present the last recommendations concerning PD-L1 testing in order to make pathologists and treating doctors aware of the major principles and the different limits.
