BackgroundTeaching Evidence Based Medicine (EBM) is becoming a priority in the healthcare process. For undergraduates, it has been proved that integrating multiple strategies in teaching EBM yields better results than a single, short-duration strategy. However, there is a lack of evidence on applying EBM educational interventions in developing countries. In this study, we aim to evaluate the effectiveness of a multiple strategy peer-taught online course in improving EBM awareness and skills among medical students in two developing countries, Syria and Egypt.MethodsWe conducted a prospective study with pre- and post- course assessment of 84 medical students in three universities, using the Berlin questionnaire and a set of self-reported questions which studied the students’ EBM knowledge, attitude and competencies. The educational intervention was a peer-taught online course consisting of six sessions (90 min each) presented over six weeks, and integrated with assignments, group discussions, and two workshops.ResultsThe mean score of pre- and post-course Berlin tests was 3.5 (95% CI: 2.94–4.06) and 5.5 (95% CI: 4.74–6.26) respectively, increasing by 2 marks (95% CI: 1.112–2.888; p-value <0.001), which indicates a statistically significant increase in students’ EBM knowledge and skill, similar to a previous expert-taught face to face contact course. Self-reported confidences also increased significantly. However, our course did not have a major effect on students’ attitudes toward EBM (1.9–10.8%; p-value: 0.12–0.99).ConclusionIn developing countries, multiple strategy peer-taught online courses may be an effective alternative to face to face expert-taught courses, especially in the short term.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0924-1) contains supplementary material, which is available to authorized users.

HighlightsMalignant mesothelioma is a rare neoplasm of mesothelial cells.It occurs mostly in the pleura or peritoneum and less frequently in the liver.Primary intrahepatic mesothelioma is not in the WHO classification of hepatic tumors.Mesothelioma is more common in men with a mean age of 58 years.We present a rare case of primary liver malignant mesothelioma in a young female.

Background Composite lymphoma is a rare entity where two or more distinct subtypes of lymphoma coexist within a single organ or tissue. Case presentation We report a new case of a 67-year-old Caucasian male patient, who presented with fatigue, weakness, weight loss, and polyuria. He also had epigastric and left lumbar pain, enlarged spleen, and enlarged left axillary lymph node on examination, with no relevant medical or familial history. A biopsy from the node showed an appearance of T-cell rich, histiocyte-rich diffuse large B-cell lymphoma and nodular lymphocyte predominant Hodgkin lymphoma. The patient was initially treated with adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine chemotherapy regimen, then switched to rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone regimen. During the therapy, some regression was noticed, especially in the size of the splenic enlargement; however, the patient died 2 months after completing the regimen. Conclusion Composite lymphomas should continue to be studied. Also, treatment is still debatable in type, efficacy, and outcomes.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:To assess and compare the efficacy and safety of the different doses of fluphenazine for people with schizophrenia.