Mahmoud Al-Balas

Bio: Mahmoud Al-Balas is an academic researcher from Hashemite University. The author has contributed to research in topics: Breast cancer & Pandemic. The author has an hindex of 4, co-authored 17 publications receiving 192 citations.

Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives

Abstract: As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.

Surgery during the COVID-19 pandemic: A comprehensive overview and perioperative care.

Abstract: COVID-19 disease is a pandemic disease caused by a single-stranded RNA virus that belongs to the coronavirus family known as 2019-nCoV (SARS-CoV-2). The disease is highly contagious and transmitted mainly by droplets or close contact. As the global incidence of COVID-19 disease is increasing dramatically, health systems worldwide started to suffer in terms of its capability to manage affected people and the ability to provide standard treatment for critically ill patients in a safe environment. As Medical staff has extensive contact with patients, families as well as other health care providers, they are very likely to cause cross-infection. This paper aims to provide a comprehensive overview of COVID-19 disease as well as to highlight essential measures that healthcare providers and surgeons need to take into consideration during their management of the patient during the COVID-19 pandemic.

Granular cell tumour of the breast: A rare presentation of a breast mass in an elderly female with a subsequent breast cancer diagnosis

Abstract: A 74-year-old female patient presented with a hard breast mass and dimpling with a clinical suspicion of a carcinoma. Histological evaluation revealed a granular cell tumour. Granular cell tumour is a rare neoplasm, mostly benign in origin that may arise in every body site, 5%-15% of cases occur in the breast. It is strongly suggested that granular cell tumours origin is Schwann cells. Clinically, granular cell tumours presentation may mimic mammary carcinoma and their similar features on mammography and ultrasound make it difficult to differentiate between them.

Expression of therapy-induced senescence markers in breast cancer samples upon incomplete response to neoadjuvant chemotherapy.

Abstract: Senescence is a cell stress response induced by replicative, oxidative, oncogenic, and genotoxic stresses. Tumor cells undergo senescence in response to several cancer therapeutics in vitro (Therapy-Induced Senescence, TIS), including agents utilized as neoadjuvant chemotherapy (NAC) in the treatment of invasive breast cancer. TIS has been proposed to contribute to adverse therapy outcomes including relapse. However, there is limited evidence on the induction of senescence in response to NAC in clinical cancer and its contribution to disease outcomes. In this work, the expression of three senescence-associated markers (p21CIP1, H3K9Me3 (histone H3 lysine 9 trimethylation), and Lamin B1) was investigated in breast cancer samples that developed partial or incomplete pathological response to NAC (n=37). Accordingly, 40.54% of all samples showed marker expression consistent with a senescence-like phenotype, while the remainders were either negative or inconclusive for senescence (2.70 and 56.8%, respectively). Moreover, analysis of core-needle biopsies revealed minimal changes in p21CIP1 and H3K9Me3, but significant changes in Lamin B1 expression levels following NAC, highlighting a more predictive role of Lamin B1 in senescence detection. However, our analysis did not establish an association between TIS and cancer relapse as only three patients (8.1%) with a senescence-like profile developed short-term recurrent disease. Our analysis indicates that identification of TIS in tumor samples requires large-scale transcriptomic and protein marker analyses and extended clinical follow-up. Better understanding of in vivo senescence should elucidate its contribution to therapy outcomes and pave the way for the utilization of senolytic approaches as potential adjuvant cancer therapy.

COVID-19-associated Guillain-Barré syndrome: The early pandemic experience.

Abstract: Guillain-Barre syndrome (GBS) is an inflammatory polyradiculoneuropathy associated with numerous viral infections. Recently, there have been many case reports describing the association between coronavirus disease-2019 (COVID-19) and GBS, but much remains unknown about the strength of the association and the features of GBS in this setting. We reviewed 37 published cases of GBS associated with COVID-19 to summarize this information for clinicians and to determine whether a specific clinical or electrodiagnostic (EDx) pattern is emerging. The mean age (59 years), gender (65% male), and COVID-19 features appeared to reflect those of hospitalized COVID-19 patients early in the pandemic. The mean time from COVID-19 symptoms to GBS symptoms was 11 days. The clinical presentation and severity of these GBS cases was similar to those with non-COVID-19 GBS. The EDx pattern was considered demyelinating in approximately half of the cases. Cerebrospinal fluid, when assessed, demonstrated albuminocytologic dissociation in 76% of patients and was negative for severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2) in all cases. Serum antiganglioside antibodies were absent in 15 of 17 patients tested. Most patients were treated with a single course of intravenous immunoglobulin, and improvement was noted within 8 weeks in most cases. GBS-associated COVID-19 appears to be an uncommon condition with similar clinical and EDx patterns to GBS before the pandemic. Future studies should compare patients with COVID-19-associated GBS to those with contemporaneous non-COVID-19 GBS and determine whether the incidence of GBS is elevated in those with COVID-19.

Barriers to Online Learning in the Time of COVID-19: A National Survey of Medical Students in the Philippines.

Abstract: In March 2020, the coronavirus disease 2019 (COVID-19) pandemic forced medical schools in the Philippines to stop face-to-face learning activities and abruptly shift to an online curriculum. This study aimed to identify barriers to online learning from the perspective of medical students in a developing country. The authors sent out an electronic survey to medical students in the Philippines from 11 to 24 May 2020. Using a combination of multiple-choice, Likert scale, and open-ended questions, the following data were obtained: demographics, medical school information, access to technological resources, study habits, living conditions, self-assessment of capacity for and perceived barriers to online learning, and proposed interventions. Descriptive statistics were calculated. Responses were compared between student subgroups using nonparametric tests. Among 3670 medical students, 93% owned a smartphone and 83% had a laptop or desktop computer. To access online resources, 79% had a postpaid internet subscription while 19% used prepaid mobile data. Under prevailing conditions, only 1505 students (41%) considered themselves physically and mentally capable of engaging in online learning. Barriers were classified under five categories: technological, individual, domestic, institutional, and community barriers. Medical students in the Philippines confronted several interrelated barriers as they tried to adapt to online learning. Most frequently encountered were difficulty adjusting learning styles, having to perform responsibilities at home, and poor communication between educators and learners. By implementing student-centered interventions, medical schools and educators play a significant role in addressing these challenges during the COVID-19 pandemic and beyond.

Faculty’s and Students’ Perceptions of Online Learning During COVID-19

Abstract: COVID-19 pandemic has disrupted teaching in a vriety of institutions. It has tested the readiness of academic institutions to deal with such abrupt crisis. Online learning has become the main method of instruction during the pandemic in Jordan. After 4 months of online education, two online surveys were distributed to investigate faculty’s and Students’ perception of the learning process that took place over that period of time with no face to face education. In this regard, the study aimed to identify both faculty’s and students’ perceptions of online learning, utilizing two surveys one distributed to 50 faculty members and another 280 students were selected randomly to explore the effectiveness, challenges, and advantages of online education in Jordan. The analysis showed that the common online platforms in Jordan were Zoom, Microsoft Teams offering online interactive classes, and WhatsApp in communication with students outside the class. The study found that both faculty and students agreed that online education is useful during the current pandemic. At the same time, its efficacy is less effective than face-to-face learning and teaching. Faculty and students indicated that online learning challenges lie in adapting to online education, especially for deaf and hard of hearing students, lack of interaction and motivation, technical and Internet issues, data privacy, and security. They also agreed on the advantages of online learning. The benefits were mainly self-learning, low costs, convenience, and flexibility. Even though online learning works as a temporary alternative due to COVID-19, it could not substitute face-to-face learning. The study recommends that blended learning would help in providing a rigorous learning environment. © Copyright © 2021 Almahasees, Mohsen and Amin.

Online-Learning due to COVID-19 Improved Mental Health Among Medical Students.

Abstract: In reference to the announcement of the pandemic of the new coronavirus 2019-(nCoV), all educational institutions in the Republic of Kazakhstan have switched to online learning (OL). The purpose of this study was to investigate the mental state of the medical students switching to OL in comparison with the mental state of the students who had traditional learning (TL). A repeated questionnaire-based cross-sectional study was conducted among medical students ranging from 1st year to 5th year at Astana Medical University in the 2019–2020 academic year. The first study was conducted during the TL (October–November 2019, N = 619), and the second study was conducted during the OL period (April 2020, N = 798). Burnout syndrome, depression, anxiety, somatic symptoms, and satisfaction with academic performance have been studied. The findings revealed that prevalence of the burnout syndrome, depression, anxiety, and somatic symptoms decreased after transitioning from TL to OL. However, during the OL period, the prevalence of colleague-related burnout increased, which tells us about the negative impact of OL on students’ communication and interpersonal relationships. The most common depression and anxiety symptoms, dissatisfaction with academic performance were among students who indicated a decrease in academic performance during OL. Students who lived alone during the quarantine were more prone to depression during OL. In conclusion, during the quarantine period after the transition from TL to OL, the mental health state of medical students improved, despite the severe conditions of the pandemic.

Medical education challenges and innovations during COVID-19 pandemic.

Abstract: COVID-19 pandemic has undoubtedly disrupted the well-established, traditional structure of medical education. Τhe new limitations of physical presence have accelerated the development of an online learning environment, comprising both of asynchronous and synchronous distance education, and the introduction of novel ways of student assessment. At the same time, this prolonged crisis had serious implications on the lives of medical students including their psychological well-being and the impact on their academic trajectories. The new reality has, on many occasions, triggered the 'acting up' of medical students as frontline healthcare staff, which has been perceived by many of them as a positive learning and contributing experience, and has led to a variety of responses from the educational institutions. All things considered, the urgency for rapid and novel adaptations to the new circumstances has functioned as a springboard for remarkable innovations in medical education,including the promotion of a more "evidence-based" approach.