Medical Focus Journal

The Tlemcen Faculty of Medicine's approach to social responsibility: commitments and achievements

2023-11-30T02:29:06+00:00

At a time when healthcare systems around the world, particularly in developing countries, are facing substantial challenges, the social responsibility of medical schools is taking on vital importance. This article looks at the Tlemcen Faculty of Medicine's proactive approach to these challenges, aligned with the ten strategic axes of the Global Consensus on Social Responsibility. It examines the commitments and achievements of our faculty, focusing on two areas: adapting training to the health needs of the population and improving the effectiveness of results-based training adapted to the new roles of health professionals.

These two strategic areas have received particular attention from our faculty, which has been involved in this process since 2012 and has embarked on a process of reflection and action to strengthen this mission. The strategy adopted encompasses a number of initiatives, including the creation of a medical education office, which coincides with a process of curriculum redesign, and a clinical epidemiology unit to strengthen research skills.

Efforts were stepped up in 2014, when we worked to implement a strategy to develop teachers' teaching skills. This led, in 2016, to the introduction of the first Certificate in Medical Pedagogy, which has since trained more than 100 teachers and introduced innovative teaching methods. These methods enable students to engage more effectively with patients and take into account the social determinants of health, while enhancing their public health skills through the problem-based approach and community placements.

An evaluation plan is underway, based on the Kirk Patrick model, to measure the degree of impact of our actions. Preliminary results show that the quality of our teaching and scientific output has improved in recent years.

Research, publication and scientific integrity

2023-12-08T14:47:07+00:00

Le contexte évolutif de la science transforme fortement les modalités d’élaboration et de partage des connaissances. La production massive de données et d’analyses sont employées à grande échelle et ouvrent de nouvelles perspectives pour d’autres avancées [1]. C’est dans ce contexte que l’intégrité scientifique doit être reconsidérée.

Autrefois confondues, les notions d’intégrité scientifique et d’éthique dans la recherche sont intimement liées [2]. L’intégrité scientifique est la conduite intègre et honnête de la recherche. Elle concerne les pratiques, les «règles de l’art», pour exercer cette activité, pendant que l’éthique concerne les questions soulevées par les avancées de la connaissance dans la société [1].

L’intégrité scientifique repose sur la confiance entre équipes de recherche engagées dans un processus éminemment collectif, alors que les écarts à l’intégrité entachent la réputation des personnes, des équipes, voire des universités [1]. Le manquement à ces règles mène à des fraudes telles que la fabrication ou la falsification des données ainsi que le plagiat répréhensible par la loi.

Les grands principes de l’intégrité scientifique adoptés en 2010 dans la Déclaration de Singapour sont au nombre de quatre [3]:

honnêteté dans tous les aspects de la recherche,
conduite responsable de la recherche,
courtoisie et loyauté dans les relations de travail,
bonne gestion de la recherche pour le compte d’un tiers.

En juin 2022, le congrès mondial de l’intégrité scientifique du Cap a choisi le thème de la justice pour favoriser l’intégrité de la recherche dans un monde inégal sous le slogan «Arrêtons la recherche hélicoptère qui consiste à piller des pays sans citer les collaborations», invitant les chercheurs à modifier ces pratiques [4]. En même temps, l’éditorial de Nature a commenté cette déclaration en faisant remarquer que les bénéfices de la collaboration scientifique étaient trop souvent orientés vers les pays les plus riches [5]. La recherche doit produire des résultats exacts, reproductibles et impartiaux, publiés de manière responsable, avec la reconnaissance appropriée de toutes les parties prenantes [4].

A l’issue, 20 recommandations ont été retenues, réunies en cinq groupes [4]

la diversité et l’inclusion comme une voie vers la pratique loyale et l’attribution,
pratiques de la conception à la mise en œuvre,
respect mutuel comme voie vers la confiance,
responsabilité partagée,
reconnaissance des savoirs autochtones et justice.

Face à l’évolution permanente de la science et des pratiques, ainsi qu’à la naissance de nouvelles revues scientifiques dans notre pays, il est temps de rester vigilant sur les recommandations universelles qui se mettent en place. Nos universités ont le devoir d’assurer cette veille dans le cadre de leurs comités d’éthique et d’instaurer des formations adaptées, ainsi que des procédures propres. De leur côté, les chercheurs doivent rester ouverts à ces frémissements et profiter des MOOC qui se développent sur la toile pour se hisser au diapason.

Alors, bon vent à toutes les nouvelles revues et à toutes les publications innovantes et équitables.

Treatment of immune thrombocytopenic purpura in children

2023-12-08T15:22:55+00:00

Immune Thrombocytopenic Purpura (ITP) is a heterogeneous disease that engenders numerous controversies regarding its management in children. These controversies encompass critical considerations, including the identification of cases necessitating immediate treatment and the selection of therapeutic modalities when required. The therapeutic approach to ITP demonstrates a relative consensus and aligns with both national and international recommendations.

This review summarizes the various medications used for the treatment of ITP in different contexts.

Corticosteroids and intravenous immunoglobulins (IVIG) are the most commonly used drugs for newly diagnosed ITP. In refractory cases, second-line treatment is proposed, using a heterogeneous therapeutic arsenal composed of various molecules such as rituximab, immunosuppressive agents like cyclosporine A, azathioprine, mycophenolate and TPO receptor agonists. Moreover, one of the recently developed compounds, fostamatinib, characterized by its mechanism of action in inhibiting the signaling pathway of Fc receptors on immunoglobulin fragments (FcγR) through the targeting of the spleen tyrosine kinase (Syk), has obtained regulatory approval for market release in the United States of America.
Simultaneously with these therapeutic advancements, new inquiries have arisen, such as the placement of each medication within the ITP management algorithm and the need for predictive biomarkers of response to customize treatment for patients and enhance their care.

Weight-loss diets: Descriptive study in the West of Algeria

2023-12-09T22:25:41+00:00

Introduction: New dietary strategies such as slimming diets have emerged to prevent metabolic diseases such as overweight and obesity, and this alternative has become popular and widely adopted in recent years. Nevertheless, several scientific studies carried out on weight-loss diets have shown that they can present health risks due to deficiencies in the vitamins and trace elements needed for the body to function properly. Objective: The aim of this study is to establish the current state of the population's knowledge of weight-loss diets in Western Algeria. Methodology: This was a cross-sectional descriptive study carried out over a period of 2 months using a questionnaire. The data collected were analyzed and processed using the following software: Google Forms and Microsoft Excel 2013. Results and discussion: Out of a total of 398 participants ,61% of the participants did not suffer from any disease ,71% of the population had a high body mass index ,the study showed that 89% of the participants had already followed a weight loss diet ,the diet of 65% of the population was unbalanced, the habit of snacking between meals was observed in 64% of the population; during the weight loss diet, 69% of the population avoided sugary drinks, the feeling of being deprived was very noticeable during the diet as well as fatigue.Conclusion: A healthy, varied diet combined with physical activity is the key to a balanced diet and good health, and it is important to point out that healthcare professionals must provide support and guidance to help people avoid the risks associated with weight-loss diets.

Key words: State of play, Dieting, overweight, obesity, Western Algeria.

Detection of prohibited substances in food supplements commercialized in Algeria

2023-11-30T02:42:29+00:00

Food supplements as defined in European regulations are foodstuffs whose purpose is to supplement the normal diet. The composition of these supplements is regulated in Europe. Indeed, the list of nutrients (vitamins, minerals, etc.), substances for nutritional or physiological purposes as well as additives authorized in the formulation of food supplements are well regulated by European regulations. In addition, food supplements are not considered as drugs, must not contain pharmacologically active ingredients and are not intended to prevent or cure a disease. However, counterfeits may occur in order to improve their effect or their conservation by fraudulently using prohibited substances. Indeed, we were able to determine the presence of Para-, methyl hydroxybenzoate (methyl paraben E 218), prohibited for use in Europe in food supplements, in a gel used as a gastric dressing. This additive was not mentioned on the labeling of the analyzed product. We were also able to determine the presence of Tadalafil, a drug called phosphodiesterase type 5 inhibitor which is used in the treatment of erectile dysfunction, in an aphrodisiac preparation made with honey. The consequences of these fraudulent practices can be very serious on the health of consumers, particularly if they have underlying pathologies. The extraction of the samples was carried out by QUECHERS method, and the analysis was carried out by gas chromatography mass spectrometry and liquid chromatography coupled with UV detector with diode arrays.

Identification of addictive products seized and consumed by drug traffickers during the COVID-19 pandemic

2023-11-29T17:51:32+00:00

Introduction : The trafficking and diversion of illicit substances remain a concern throughout the world given the disastrous consequences of this scourge on social, health and economic life. This work aims to study the impact of the COVID-19 pandemic on the epidemiological profile of drug seizure and consumption in northern Tunisia. Methods : This is a retrospective study on the illicit products seized by the narcotics brigade from subjects in charge of drug trafficking (associated or not with consumption) during the year 2020, as well as the results toxicological analysis of urine samples recovered from the same suspects. . Immunochemical methods were used to identify the nature of the products seized and consumed, gas phase chromatography coupled with mass spectrometry allows the confirmation of the results. Results: 2239 subjects in charge of circulation and/or consumption were collected with a clear male predominance (95%), the mean age was 29 ± 8.9 years; 91.2% were single and 75.2% were daily workers. The most frequent product (80.3%) and the most consumed (93.63%) was cannabis followed by MDMA 6.3%, benzodiazepines 3.2%, trihexyphenidyl 3%. Polydependence was observed in 2.35% of cases with the cannabis/MDMA association (60%). Urinalysis showed 1446 (64.6%) samples positive for cannabis (60.4%) and MDMA (1.2%). The emergence of the consumption of new synthetic drugs was strongly suspected. Conclusion : The COVID-19 pandemic has considerably modified the data relating to sales, traffic, prices and even drug consumption habits, indeed the recurring confinements and the cessation of maritime and land transport have pushed traffickers to create new distribution network thus favoring the availability of cannabis to the detriment of other drugs

Rupture spontanée rénale gauche avec hémorragie massive d’origine non traumatique avec un hématome péri-rénal géant chez un patient infecté par le COVID-19, à propos d’un cas

2023-12-11T14:53:46+00:00

We report a spontaneous left renal massive hemorrhagic suffusion in a 65-year-old COVID-19 contaminated patient requiring an emergency salvage nephrectomy.