Please wait...


Majbar MA, Majbar Y, Benkabbou A, Amrani L, Bougtab A, Mohsine R, Souadka A.

Background: The learning environment is one of the most influential factors in training of medical residents. The Dutch Residency Educational Climate Test (D-RECT) is one of the strongest instruments for measuring the learning environment. However, it has not been translated in French. The objective of this study is the psychometric validation of the DRECT French version.

Material and methods: After translation of the D-RECT questionnaire into French, residents of five Moroccan hospitals were invited to complete the questionnaire between July and September 2018. Confirmatory factor analysis was used to evaluate the validity of the construct using the standardized root mean square residual (SRMR), the root mean square error approximation (RMSEA), the Comparative Fit Index (CFI) and the Tucker- Lewis Index (TLI). Reliability analysis was analysed using Internal consistency and Test-retest.

Results: During the study period, 211 residents completed the questionnaire. Confirmatory factor analysis showed an adequate model fit with the following indicators: SRMR = 0.058 / RMSEA = 0.07 / CFI = 0.88 / TLI = 0.87. The French translation had a good internal consistency (Cronbach alpha score > 0.7 for all subscales) and a good temporal stability (correlation score between two measurements = 0.89).

Conclusion: This French version has an acceptable validity of the construct, a good internal consistency and good temporal reliability, and may be used to evaluate the learning climate. Additional research is necessary in other French-speaking contexts, in order to confirm these results.



Amine Souadka, Mohammed Anass Majbar, Khalid El Himdi, Ismail Kassou, Hind Mrabti, Tijani El Harroudi, Mohammed Ahallat, Abdelkader Belkouchi, Raouf Mohsine, Abdelmalek Hrora, Amine Benkabbou

JOURNAL OF MEDICAL AND SURGICAL RESEARCH – Vol. VII, n 1, June, 2020; Pages: 748-754

Abstract:

Background: Surgical audit experiments have shown a positive, rapid and cost-effective impact on complication rates, recurrence rates, and overall survival even in the absence of interventional measures in digestive cancers. This study audit the quality of surgical procedures for digestive cancers.

Methods: This is a multicentric prospective non-comparative observational study performed in 4 surgical departments in 2 university centers. Eligible patients are adults scheduled for elective surgery for a proven or suspected digestive cancer, in a curative or palliative intent; or included no later than 72 hours after surgery in case of an emergent procedure. The Cancer should be proven or suspected in the following digestive tract: colon, appendix, anus, rectum, esophagus, stomach, esogastric junction, bile ducts, ampulla of Vater, pancreas, duodenum, small intestine and liver. Patients are excluded in case of 1) surgical intervention indicated for: a condition that is not a digestive tract cancer; 2) proven or suspected cancer of non-digestive location 3) a proven or suspected cancer of peritoneal localization. 4) surgical intervention indicated for a progressive disease or a local recurrence proven or suspected of a digestive localization cancer having already been resected (with the exception of situations of iterative liver resection for liver metastasis hepatic and recovery of the tumor bed after the discovery of vesicular cancer on cholecystectomy specimen); 5) intervention is for diagnostic purposes without any curative or palliative intention

A total of 1500 patients is expected. The primary objectives of this study are to assess both 90 days of post-operative outcomes and three years oncological outcomes for patient operated for each included digestive cancer. Secondary objectives arre 1)to analyze treatment decisions made within multidisciplinary team meeting/tumour board for every localization and the completion of preoperative workup staging according to local guidelines and 2) to determine the impact of reporting anonymous trimestrial feedback to surgeons on improving their surgical performance and outcomes 3) To assess quality of life in patient operated for colorectal cancer in curative intent.

Discussion: This is the first multicentric north african registry assessing the quality of surgical procedures for digestive tract cancer and analyzing the impact of reporting sequential anonymous feedback to the surgeon on quality improvement.

Keywords: Qualtiy, Rectal Neoplasms, Digestive cancer, obsergatory, Multicentric cohort study, Surgical procedures



Anass M. Majbar, Amine Benkabbou, Raouf Mohsine, Amine Souadka

JOURNAL OF MEDICAL AND SURGICAL RESEARCH – Vol. VI, n 3, February 2020; Pages: 724-733;

Abstract:

The COVID 19 outbreak has caused the cancellation of most elective oncological surgery around the world to limit the risk of virus dissemination. As we are exiting the crisis, surgical teams will face strong challenges while resuming normal elective surgery. The accumulation of cases will have to be managed by defining strong selection criteria, taking into account the patient and the disease conditions. In order to reduce the risk of infection, non-COVID patients should be treated in dedicated non-COVID areas, preferably in separate buildings or hospitals. Departments, units and operative theaters should put in place rigorous actions and protocols to protect the patient and healthcare workers. Adequate protective equipment must be readily available for healthcare workers and patients. Finally, teams should keep an adaptive mindset by preparing strategies to maintain surgical activity in case of repeated COVID 19 waves.

Keywords: COVID 19, Guidelines, Lockdown ease, Surgical oncology



Chaimae Charoui, Amine Souadka, Saber Boutayeb, Rachida Latib, Laila Rifai, Laila Amrani, Amine Benkabbou, Raouf Mohsine, Mohammed Anass Majbar

JOURNAL OF MEDICAL AND SURGICAL RESEARCH – Vol. VII, n 1, June, 2020. Pages: 764-769

Abstract:

Introduction: The multidisciplinary team oncology meeting (MDT) has become a standard in oncology. The objective of this study was to evaluate the value of a validated tool, the Metric for the Observation of Decision-Making, in the evaluation of the decision-making mode during the digestive cancer MDT in order to reach recommendations for improvement.

Results: Eight consecutive MDTs were observed (N = 228 patients). On average, 32 patients were discussed by MDT with an average of 2 min 55 s (interval: 30 s-10 min 16 s) per patient. A decision was reached in 84.6% of the cases. Although the medical information was judged to be of good quality, the psychosocial information (average 1.29) and the patients’ point of view (average 1.03) were judged to be of low quality. For teamwork, the contribution of surgeons (average 4.56) and oncologists (average 3.99) was greater than radiologists (3.12), radiotherapists (1.74) and pathologists (1.02).

Conclusions: The tool made it possible to identify a disparity in the quality of the different aspects of the information and in the participation of specialists, making it possible to identify specific improvement measures. Its regular use would improve the quality of patient care.

Keywords: Decision making, Quality improvement, Multidisciplinary concertation meeting, MDT-MODe, Morocco



Said Bensbih, Amine Souadka, Amalia Giuliani Diez, Otmane Bouksour

JOURNAL OF MEDICAL AND SURGICAL RESEARCH – Vol. VII, n 1, June, 2020. Pages: 755-763

Abstract:

The health system is a fundamental building block of a country’s social project. Approaches and strategies differ but some concepts such as Patient Centred Care (PCC) seem to be more and more popular nowadays as the customer centric advocated in the industry. The research has focused on this trend of PCC with several different definitions but without having a particular focus on the context of Low and Middle Income Countries (LMICs). The objective of this study is, through an extensive literature review, to analyze this concept, to unify the dimensions described by different authors, to define a concept that can be proposed to LMICs and to determine facilitating factors as well as obstacles for its implementation.

Keywords: Conceptual model, Health system, Low and middle income countries (LMICs), Patient Centered Care



Imad Marzak, Mohammed Anass Majbar, Kholoud Houssaini, Amine Benkabbou, Amine Souadka, Raouf Mohsine, Mohamed Raiss, Abdelmalek Hrora

Journal of Medical and Surgical Research. Volume 6, Pages 697-701

Abstract:

Background: Over 20 million inguinal hernia repairs are performed in the world every year. These repairs require the use of various techniques. In Morocco, there is a prominent disparity in terms of types of structure, human assets and available equipment, patient selection, and perioperative management protocols. The goal of this study was to audit the results of the surgical treatment of inguinal hernia repairs in adults in Morocco.

Methods: This nationwide cross-sectional prospective study has been conducted by the Moroccan Society of Surgery (la Société Marocaine de Chirurgie) and the Moroccan Society of Digestive Surgery (la Société Marocaine de Chirurgie Digestive). It included male patients aged 18 and above, with an inguinal hernia that has been clinically diagnosed by a surgeon and repaired during the recruitment phase that extends over a period of 30 days. The measured variables consist of the anesthesia type, preoperative antibiotic treatment, surgical technique, length of in-hospital stay and intraoperative and postoperative complications up to 30 days.

Results: The response rate of the survey was 88.78% which led to the study of 95 cases. 12 patients (12.6%) received general anesthesia , 82 patients (86,3%) regional anesthesia , and 1 patient (1.1%) local anesthesia. No prophylactic antibiotics were prescribed to 14.7% of the patients while they were systematically administered to 84.2% of the patients at the induction, and a few days prior to surgery for one patient. Various approaches were used to repair the inguinal hernia. 83.2% of the patients were operated with the Lichtenstein technique. Laparoscopic transabdominal preperitoneal approach (TAPP) was performed on 11.6% of the patients. Outpatient surgery was performed on 2.1% of the patients. 12 patients developed a postoperative seroma, of which 5 patients were operated using laparoscopic TAPP. Only 2 patients previously operated using the Lichtenstein open mesh repairs have developed a postoperative hematoma. 1 patient (1.1%) died postoperatively.

Conclusion: This study showed disparities in the perioperative management of inguinal hernia in Morocco. Potential improvement opportunities were determined through the conducted nationwide study. In this regard, scholarly societies could play a significant role by programming ongoing training sessions, with the aim of sensitizing surgeons to the best practice of inguinal hernia repair.

Keywords: Inguinal Hernia, laparoscopic Repair, Lichtenstein Repair, Morocco, Surgical Audit

 

 



Souadka A, Benkabbou A, Majbar MA, Essangri H, Amrani L, Mohsine R, Ghannam A, El Ahmadi B, Belkhadir Z.
Oncologist. 2020 Jun 14:10.1634/theoncologist.2020-0360. doi: 10.1634/theoncologist.2020-0360.

Abstract

The COVID‐19 pandemic has overwhelmed health system capacity and affected cancer centers worldwide. This letter to the editor proposes the need to prepare for a long‐lasting battle.


Copyright by Digital Zone 2018. All rights reserved.