Background The current COVID-19 pandemic is affecting all aspects of society worldwide. To combat the pandemic, measures such as face mask–wearing, hand-washing and -sanitizing, movement restrictions, and social distancing have been introduced. These measures have significantly disrupted education, particularly health professions education, which depends on student-patient contact for the development of clinical competence. The wide-ranging consequences of the pandemic are immense, and health professions education institutions in sub-Saharan Africa have not been spared. Objective This paper describes a protocol for assessing the preparedness of selected health professions education institutions in sub-Saharan Africa for remote teaching and learning during the COVID-19 pandemic. Methods A mixed-methods design with a case study approach will be used. The awareness, desire, knowledge, ability, and reinforcement model of change was selected as the conceptual framework to guide the study. Eight higher education institutions in 6 sub-Saharan countries have participated in this study. Data will be collected through electronic surveys from among whole populations of academic staff, students, and administrators in undergraduate medicine and nursing programs. Qualitative and quantitative data from each institution will be analyzed as a case study, which will yield an inventory of similar cases grouped for comparison. Quantitative data will be analyzed for each institution and then compared to determine associations among variables and differences among programs, institutions, or countries. Results Our findings will provide information to higher education institutions, particularly those offering health professions education programs, in Africa regarding the preparedness for remote teaching and learning to influence efforts related to web-based teaching and learning, which is envisaged to become the new normal in the future. Conclusions This study has not received any funding, and any costs involved were borne by individual consortium members at the various institutions. Ethics approval from the institutional review board was obtained at various times across the participating sites, which were free to commence data collection as soon as approval was obtained. Data collection was scheduled to begin on October 1, 2020, and end on February 28, 2021. As of this submission, data collection has been completed, and a total of 1099 participants have been enrolled. Data analysis has not yet commenced. International Registered Report Identifier (IRRID) DERR1-10.2196/28905

Formalin embalming method is cheaper and commonly used. Thiel method is said to be complex, expensive, not commonly used but offers better cadavers for student teaching. The study aimed at exploring the effects of two embalming methods; modified Thiel and formalin methods on cadavers in terms of muscle softness, joint flexibility, tissue colour, formalin smell and the ease with which structures can be identified. This was an experimental study design done over the period of three months where four adult male cadavers were embalmed (two under each method) and the outcome was compared. Using gravity about Ten Litres of arterial and five Litres venous Thiel fluids was slowly infused into each Thiel cadaver through the carotid artery and femoral vein respectively and cadavers remained overnight. Thiel cadavers were submerged in the tank containing about 300L of Thiel fluid, covered with a blanket and left for eight weeks. Each formalin cadaver was infused with about 15Litres of 10% formalin using the carotid artery and then wrapped in transparent plastics. Thereafter, cadavers were codified and placed in different rooms where participants examined and dissected some regions starting with Thiel cadavers and crossing over to the formalin cadavers after twenty-four hours. Thiel cadavers were softer than formalin (mean = 4.89 ± 0.53 Thiel and 2.1 ± 1.26 for formalin). For joint flexibility, at least 75% of participants strongly agreed for Thiel and at least 75% of the participants strongly disagreed for formalin (mean = 4.81 ± 0.86 Thiel and 1.71 ± 1.13 formalin). Tissue colour was closer to natural in Thiel compared to the formalin cadavers (mean = 4.82 ± 0.55 Thiel and 1.77 ± 1.07 formalin). There were no complaints due to irritant formalin smell in Thiel cadavers as opposed to the formalin ones (mean = 1.15 ± 0.55 Thiel and 4.56 ± 1.15 formalin). At least 75% agreed that it was easy to identify structures in the Thiel cadavers than formalin (mean = 4.67 ± 0.61 and 2.61 ± 1.14 formalin). Thiel embalming method offers good quality cadavers that are soft, flexible; tissue colour closer to natural state and without is strong formalin smell and structures can easily be identified. Key words: Cadaveric embalming, modified Thiel, formalin methods

The Lamina Terminalis represents an important neuroanatomical structure by which third Ventriculostomy could be performed into the subarachnoid space through the Cisterna Chiasmatica. Recent studies have indicated a role for Lamina Terminalis fenestration in approaching pathologies of the third ventricle. However, there is limited knowledge on the anatomical features, variations and the vasculature of the Lamina Terminalis in a Zambian population. This study was aimed to explore the anatomy of the Lamina Terminalis, the Cisterna Chiasmatica and its neurovascular  relationships as seen in a Zambian population and compare with the findings in the literature. The study was a descriptive cross-sectional design in which 32 post-mortem human cadaveric brains were systematically sampled. The Lamina Terminalis region was examined in 27 male cadavers and five female cadavers of age range between 25 and 66 years (mean 34.1 ± 9.2years). Data was collected using a data collection form, entered and analyzed by descriptive statistics using Statistical Package for Social Sciences (SPSS) software version 22. Mean and standard deviations were used to describe variables. The base of the brain was detached from the floor of the cranial cavity and the Lamina Terminalis exposed fully by retracting both optic nerves and the optic Chiasma posteroinferiorly. Thetriangular Lamina Terminalis measurements were performed as the distance between the midportion of the upper aspect of the chiasma and the lower aspect of the anterior commissure (height), which averaged 8.6 ±1.0mm. The distance between the medial edges of the optic tracts (base) averaged 13.1 ±1.1mm and the area averaged 56.9 ± 11.6mm2. The Lamina Terminalis membrane showed variations in appearance; 20 were transparent with a large dark midline gap and 10 were less translucent with a slender midline gap and two were indistinct. The Cisterna Chiasmatica was observed as a dilated subarachnoid space adjacent to the Optic Chiasma. For neurovascular relationships, 24 cadavers showed arterioles arising from the posterosuperior aspect of the anterior cerebral artery to perforate the anterior perforating substance(s), supplying the chiasma, and optic tracts; whereas, eight cadavers showed arterioles arising  posteroinferiorly and ramifying on the Lamina Terminalis. The Lamina Terminalis membrane is variably developed. There are variations in the membrane appearance, measurements and neurovascular relationships. These findings will supplement a knowledge gap in neuroanatomy and help prevent complications during Lamina Terminalis fenestration in approaching pathologies of the third ventricle.Key words: Lamina Terminalis, Cisterna Chiasmatica, Third Ventriculostomy

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Background Southern Africa, like other parts of the world, has always strived to deliver quality health professions education. These efforts have been influenced to a larger extent by the socio-economic and cultural context of the region, but also by what happens globally. The global disruption caused by the COVID-19 pandemic necessitated the implementation of emergency remote teaching (ERT) to continue delivering on the mandate of educating future health professionals in 2020. The purpose of this research was to describe the change process through which selected health professions education institutions (HPEIs) in the Southern African region adjusted their academic programmes for remote learning and teaching during the COVID-19 related pandemic. Methods A mixed methods study with a case study design was applied using the ADKAR model as a conceptual framework for data interpretation. The study population consisted of educators, students, and administrators in undergraduate medical and nursing programmes from six institutions in five countries. Results A total of 1,307 respondents provided data for the study. Many of the institutions were caught off-guard when most educators and almost all students were required to leave their universities and go into isolation at home. Stakeholders immediately became aware of the need to adopt online approaches as an emergency measure. In all programmes, educators, students, and administrators agreed that they should change and wanted to change, and some students realised that they had to take charge of their own learning independently. Overall educators reported confidence with the use of standard Microsoft software, while knowledge of learning management systems proved more challenging for both educators and students. Many stakeholders, especially students and administrators, reported uncertainty about their ability to function in the new reality. Conducive family dynamics, a quiet space to study, good connectivity, a reliable electricity supply and appropriate devices were reported to reinforce learning and teaching. Conclusions The findings highlight the need to scale up educational infrastructure, prioritise strategic directives, drive continuous professional development of educators and foster co-constructivist approaches towards student centered education, including formal online learning.

Anatomical variations in the origin of the branches of the arch of the aorta are frequent. In this case report the left common carotid artery arose as a branch from the brachiocephalic artery. The left common carotid artery arose at a distance 11mm from the arch of the aorta and had an internal diameter of 9mm.

Vertebral artery is an important source of blood supply to the brain which arises from the subclavian arteries. Anatomical variations have been incidentally reported during autopsy and angiograms. These variations predispose to development of aneurysms, dissections and may lead to vertebrobasilar ischaemia and posterior circulation stroke. Knowledge of variations of the great vessels of the neck is important for endovascular interventionists and diagnostic radiologists, more so in the era of new therapeutic options for intracranial interventions. Forty-two computerised tomography angiograms at the University Teaching Hospitals, Radiology Department Lusaka were examined to investigate vertebral artery variations in a Zambian population and determine the origin of the vessels. These paired vessels were examined thoroughly individually. Eighty-four arteries were examined eighty one (96.4%) had origin from the subclavian artery while three (3.6%) left took origin from the aortic arch. Variations found were two (2.4%) right vertebral arteries had fenestrations, ten (11.9%) had dual origin and one (1.2%) left was hypoplastic. The age ranged from 18 and 81 with mean age of (42.5±) of these seven females and four males had variations. Demographic characteristic (gender and age) had no statistically significant association to variations of vertebral artery (P>0.05). Variations of the vertebral artery are common. Knowledge of these variations is important and helpful in preventing iatrogenic injuries and haemorrhage during endovascular intervention and diagnostic procedures.Keywords: Vertebral artery, duplication, fenestrations, hypoplasia

Background. Zambia is a nation of nine million people, and has too few physicians to meet the country's health needs. Following the strategy of other sub-Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce. A needs assessment was undertaken to better understand the landscape into which Zambian family medicine is being placed. Methods. In 2014, a nine-question survey in Likert-scale format was developed, validated, and then delivered to four stakeholder groups: (i) practicing clinical physicians, (ii) the general public, (iii) the University of Zambia's School of Medicine's academic faculty and (iv) medical students. The needs assessment was delivered through several different mechanisms: via web-based service, to respondents' email addresses; in paper form, to population samples of convenience; and verbally, through face-to-face encounters. Results. The number of stakeholders from each group who responded to the needs assessment were: clinical physicians, 27; general public, 15; academic faculty, 14; and medical students, 31. Five of the nine survey statements achieved super-majority consensus, with >66% of stakeholders in each group agreeing. Two additional statements achieved a simple-majority consensus with >50% agreement within each stakeholder group. Conclusion. This survey suggests that there is a broad-based a priori understanding of family medicine in Zambia, and general agreement that its presence would be valuable to Zambia's healthcare system.