Palmar papules as a manifestation of cutaneous oxalosis in primary hyperoxaluria: A case report and review of the literature

Key Clinical Message Cutaneous oxalosis is a rare manifestation of systemic oxalosis, typically associated with primary or secondary hyperoxaluria. We present a rare case of a 23‐year‐old female diagnosed with primary hyperoxaluria and end‐stage renal disease, who presented with papules on the palms without any vascular complications. The skin can be affected by oxalate deposition, resulting in various manifestations such as vascular complications or calcified nodules. In our case, the patient had primary hyperoxaluria and end‐stage renal disease but exhibited atypical features of cutaneous oxalosis. Histopathology confirmed the presence of oxalate crystals in the dermis, subcutis, and medium‐sized arteries. The mechanism of oxalate deposition in this case remains unclear. This case underscores the importance of considering cutaneous oxalosis in the differential diagnosis of patients with renal failure and skin lesions, and highlights the variability of clinical presentations in primary hyperoxaluria

Attitudes and factors influencing organ donation decision-making in Damascus, Syria: a cross-sectional study

Abstract Organ donation is vital to saving lives, but its success depends on people's willingness to donate organs. This descriptive cross-sectional survey aimed to investigate attitudes towards organ donation in Damascus, Syria. Understanding attitudes is crucial for the success of organ donation programs, especially in countries with similar settings. This study was a descriptive cross-sectional survey aimed at understanding patients’ attitudes towards organ donation in Damascus, Syria. Data was collected through a carefully constructed validated survey through face-to-face interviews. 600 participants were randomly interviewed, 62.8% agreed to donate their organs after death, with helping others being the primary reason. Religious beliefs were the primary reason for organ refusal in males, while for females, it was lack of knowledge and religious beliefs. However, there were no significant differences between genders or educational level and age groups in the acceptance of organ donation. The percentage of those who agree to donate their organs after death encourages taking an effective step to build an integrated donation system, not just a center. Bearing in mind that there is no correlation with age, gender or even educational level, which means that the system may include different groups of society

Knowledge and practice of breast self-examination among breast cancer patients in Damascus, Syria

Abstract Background Breast cancer (BC) represents an important cause of cancer death, its incidence rate has been rising gradually in the Arab world, and in Syria, BC is the most common cancer and the leading cause of cancer death; its prognosis gets better as we detect it early in its first stages. So, it is very important to implement one or more early detection methods such as Breast Self-Examination (BSE), Clinical Breast Examination (CBE), and mammography. BSE represents an effective method to find out changes in breast structure when they happen. This study investigates the knowledge of BSE and its practice in BC patients. Methods A quantitative cross-sectional study in Al-Bairouni hospital in Damascus-Syria was carried out using face-to-face interviews based on a structured questionnaire, which consisted of 4 sections. The data were subjected to statistical analysis using various analytical tests, including the independent t-test, one-way analysis of variance (ANOVA), and Chi-square test. Results Five hundred patients were interviewed. Only 27.4% of patients had a good knowledge of BSE, 17.4% had average knowledge, and 55.2% had low knowledge of BSE. The factors that have an impact on the knowledge of BSE were: family breast cancer history (first and second-degree relatives), education, and the region of living (between governorates). The effect of knowledge of BSE on its practice was positive. However, only 24.8% of patients have been practicing BSE; the reasons for not practicing BSE were: no one has told the patient about it (64.8% of cases), and the patient does not have any symptoms relating to the breast (21.4%).Breast cancer was identified through breast self-examination (BSE) in 15.6% of cases. Conclusion There is a low degree of knowledge and little practice of BSE among Syrian breast cancer patients. Family breast cancer history, governate, occupation, and level of education had a statistically significant effect on knowledge scores of BSE, unlike age and social status. So, some steps should be taken to increase awareness about BSE among Syrian females

Awareness and knowledge of glaucoma among visitors of main public hospitals in Damascus, Syria: a cross-sectional study

Abstract Background The main way to prevent blindness from Glaucoma is by early detection and diagnosis; and to do so the awareness must be raised among people where Glaucoma is defined as an acquired chronic optic neuropathy characterized by optic disk cupping and visual field loss. Lack of knowledge about this disease is one of the most important reasons that made it develop to advanced stages. Based on that, we conducted scientific research to assess peoples’ awareness and knowledge about Glaucoma. After reviewing the literature, it was found that this study is the first in Syria. Methods We conducted a cross-sectional study in May 2022. The study included participants, who are above 20 years old, from visitors of Al-Mouwasat University Hospital in Damascus, Syria. During one week, Data was gathered according to the questionnaire, which was presented through face-to-face interviews with participants. We have allocated one point (1) to each question. Three levels of knowledge were adopted, namely; weak level from (0) to (3), average level from (4) to (7) and good level from (8) to (11). Associations between participants' demographic and other details were tested using Chi-square test and other tests, and a p-value of < 0.05 was considered significant. Results A total of 500 participants were interviewed. For awareness of Glaucoma, 33.6% of the participants (n = 168) had heard of Glaucoma, and 66.4% hadn’t (n = 332). Mean test results for the knowledge of Glaucoma was 1.62 out of 11, and only 8% of participants (n = 40) had a good knowledge of Glaucoma. Education Level, governorate, and department of hospital that the patient came for significantly affected the knowledge of Glaucoma. Moreover, hospital, Ophthalmologists' Clinics, and health staff (M = 5.45) were the better Resource for information than family, relatives, and friends (M = 3.16). Finally, social media and the Internet group had the lowest mean test results (M = 1.23). These test results were significant, with a p-value < 0.001. Conclusion The percentage of knowledge and awareness was significantly low. Organized community awareness methods must disseminate more ability to increase the general public's understanding to avoid injury and late diagnosis of Glaucoma

Addressing knowledge gaps in allergies among Syrian hospital patients: a cross-sectional study

Abstract Allergies have a significant impact on health and quality of life worldwide, yet there is limited research on the awareness and knowledge of allergies. This study aimed to explore the level of awareness and knowledge of allergies among visitors in Syrian hospitals. A cross-sectional study was conducted between May and September 2022, and a standardized international questionnaire was administered to 504 visitors in three hospitals in Syria. Data analysis was performed using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 23. The final sample comprised 504 questionnaires with 61.7% of participants achieving an average score. Statistical analysis revealed a significant difference in knowledge of allergy scores between the group with only elementary education (M = 3.76, SD = 1.67, p = 0.011), the group with no education (M = 3.65, SD = 1.65, p = 0.006), and the group with a university education (M = 4.44, SD = 1.25). Notably, no significant differences were found between the other educational groups. A one-way ANOVA was employed to assess the effect of place of living on knowledge of allergy, but no significant differences were observed between the groups (p = 0.462). Lastly, a significant negative correlation was detected between participant age and knowledge of allergy scores (r(502) = − 0.102, p = 0.022). Allergies represent a substantial global health concern that demands attention from healthcare providers, policymakers, and the public. This study emphasizes the importance of investing in health education and awareness campaigns to enhance knowledge and comprehension of allergies, particularly individuals with lower levels of education levels. By equipping individuals with the requisite information to effectively manage their allergies, their overall health and wellbeing can be improved

The mental health impact of the 2023 earthquakes on the Syrian population: cross-sectional study

Background Natural disasters have a significant impact on the mental health of affected populations. The February 2023 earthquakes in Syria and Turkey caused widespread devastation. Aims To explore the mental health impact of the earthquakes in Syria on the population across areas differentially damaged by the disaster. Method This cross-sectional study conducted in Syria included 1406 adults recruited via social media platforms 1 month after the February 2023 earthquakes. Demographic information, earthquake exposure questions, the PTSD Checklist for DSM-5 (PCL-5: for probable post-traumatic stress disorder, PTSD), the Patient Health Questionnaire-9 (PHQ-9: for probable depression) and the seven-item Generalized Anxiety Disorder scale (GAD-7: for probable anxiety) were included to compare outcomes across areas severely, moderately and slightly damaged by the earthquakes. Results Probable PTSD and GAD rates were higher in the severely (57.9 and 57.3% respectively) and moderately damaged regions (55.4 and 56.3% respectively) than in the slightly damaged regions (44.6 and 48.3% respectively) (PTSD: P < 0.001, GAD: P = 0.005). More participants in severely damaged regions (60.6%) reported symptoms of depression compared with moderately (53.1%) and slightly damaged (50.8%) regions (P = 0.003). Poorer mental health outcomes were associated with being female, single, younger, having a damaged or destroyed house, seeing something tragic in person and hearing tragic stories. Seeing something tragic on social media was not statistically significant. Conclusions This study highlights the higher prevalence of probable mental disorders in areas with more severe earthquake damage, with over 50% of the population reporting probable PTSD, depression or anxiety. The study also suggests a significant cumulative effect of these earthquakes on an already trauma- and disaster-affected population

Syrian crises effect on specialty choice and the decision to work in the country among residents of six major hospitals in Syria, Damascus.

Assessing the impact of war on medical residents' specialty choices and migration decisions is critical to ensure the sustainability of healthcare systems worldwide. This study aimed to evaluate the effect of the Syrian crisis on specialty choices, related factors, and decisions to work in Syria among residents of six major university hospitals in Damascus. A cross-sectional study was conducted using a validated questionnaire from 20/4/2022 to 20/5/2022, including all eligible residents with no missing data. The questionnaire was comprised of 68 items, and residents were divided into two groups: group 1 included residents who made their specialty choice after the end of the military war in Damascus 2018, while group 2 included residents who made their specialty choice (the point of submitting their lists and applying for residency) during the war. A total of 370 residents were included, with 38.4% females and 61.6% males. Our findings revealed that 30% of residents preferred working in Syria, while 43.5% preferred working abroad. The factor of a "safer and more stable life" was significantly higher in Group 1 than in Group 2 (3.86>3.5, p-value = 0.026). Additionally, Group 1 residents were more likely to choose radiology, pathology, laboratory, and psychiatry specialization as their specialties, while choosing surgical specializations and hematology decreased compared to Group 2 (p-value2.21, Standard deviation = 0.22, p-value = 0.033). The Syrian crisis and its economic aftermath have influenced residents' specialty choices and practice locations. Even after the war's end, the high level of migration intentions could negatively affect the quality of provided healthcare services

Clearing the path to vision restoration: an analysis of attitudes and associated factors towards cornea donation in Syria

Objective This study aims to assess attitudes and associated factors towards cornea donation among visitors of a main public hospital in Damascus. Findings of this study can contribute to the development of effective donation campaigns and applying cornea donation in Syria.Methods This cross-sectional study included individuals who were above 18 years old and were visitors of Al-Mouwasat University Hospital in Damascus, Syria. Data were gathered using a questionnaire administered through face-to-face interviews with the participants. A validated questionnaire was used and consisted of three sections: demographic information, awareness assessment and evaluation of participants’ attitudes towards corneal donation. Associations between participants’ demographics and variables were tested using χ2 test, and a p value of &lt;0.05 was considered significant.Results 637 participants were randomly interviewed. 70.8% of the sample were female and 45.7% have heard about cornea donation. 68.3% of the participants accepted donation of their cornea after death, but this decreased to 56.2% when it comes to donation from relatives after their death. The main reasons for refusing and accepting cornea donation were religious beliefs (10.8%) and intention to help others (65.8%), respectively. Women were more likely to accept donation after death than men (71.4% vs 60.8%, p=0.009). Finally, acceptance of cornea donation would increase if participants lived in a more developed country (71.7% vs 68.3%).Conclusion Despite the high willingness, corneal donation in Syria is still not enough. Corneal donation requires an ensured donation system that supports and organises the processes, a simplified education about the importance of donation, and clarifying the right instructions of religion

Rhabdomyosarcoma or Fibrosarcoma? A Case of Large Ulcerated and Necrotic Lesion on the Forearm of a Newborn

Congenital infantile fibrosarcoma (CIFS) is a rare malignant soft tissue tumor. The incidence of fibrosarcoma is estimated to be 0.3 per 100 000 population per year, and it accounts for less than 1% of all soft tissue sarcomas. We present a case of a 7-day-old newborn with a large ulcerated and necrotic lesion on the left forearm, which was initially misdiagnosed as rhabdomyosarcoma. Magnetic resonance imaging (MRI) revealed a soft tissue mass with cystic components affecting the forearm and distal humerus muscles. Fine-needle biopsy was performed and initially diagnosed as rhabdomyosarcoma but later confirmed as low-grade fibrosarcoma with positive immunostaining for vimentin. The patient underwent a transhumeral amputation with follow-up chemotherapy at a specialized oncology center. This case underscores the importance of interdisciplinary collaboration and specialized care in managing complex medical conditions in infants. Early detection and appropriate management of these tumors are essential for improving outcomes and reducing morbidity and mortality. Despite the rarity of this case, it serves as a reminder of the importance of considering neoplastic lesions in the differential diagnosis of soft tissue masses in newborns