The relationship between serum 25-hydroxy vitamin D status and hypertension in Syrian population: retrospective cohort study.

Introduction: Vitamin D is a liposoluble steroid hormone that plays a crucial role in the maintenance of bone metabolism and calcium homoeostasis. Many studies on the effects of vitamin D on general health have been significantly increased, driven by new findings concerning the systemic and extraskeletal effects of this hormone. This study was performed to determine whether low levels of vitamin D were associated with hypertension in Syrian people. Materials and methods: This retrospective cohort study consisted of 207 subjects, including 83 (40.1%) patients suffering from essential hypertension and 124 (59.9%) patients with normal blood pressure. Aged older than 18 years, who was referred to the endocrinology clinic from September 2022 to September 2023. The data were analysed by using SPSS (version 25). Logistic regression analyses were performed with adjustments for age, sex, and waist circumference. Results: Hypertension rates were 73%, 20%, and 5% in 25-hydroxyvitamin D groups less than 12 ng/ml, 12-20 ng/mL, and greater than or equal to 20 ng/ml, respectively. Odds ratios (95% CIs) for hypertension adjusting for age, sex, and waist circumference were 178.6 (30.5_1045.6), 5.13 (0.9_26.5) for 25-hydroxyvitamin D levels less than 12 ng/ml, and 12-20 ng/ml, respectively, compared with the greater than or equal to 20 ng/ml group. Conclusions: This study has shown a high prevalence of low vitamin D levels (25OHVD/20 ng/ml) among a sample of Syrian people (78.3%). The lowest 25OHVD group was associated with a higher prevalence of hypertension, which refers to an adverse association between vitamin D level and essential hypertension. Further research is needed to confirm this relationship.

Knowledge, Attitude, and Practice Regarding HIV, HBV, and HCV Among Medical Students of Syrian Private University, Damascus, Syria.

BACKGROUND: Hepatitis B, Hepatitis C, and HIV/AIDS are infections that constitute major health concerns impacting national health systems worldwide. This is the first study to determine Syrian medical students' attitudes, awareness and knowledge of HIV/HBV/HCV, regarding general knowledge about, clinical features, transmission, and prevention. METHODS: This cross-sectional study was conducted at Syrian Private University on World AIDs Day (1/12/2019), Damascus, during the Syrian war crisis. Data were collected through self-administered surveys which targeted social demographic information, general knowledge, attitude, towards HBV, HCV, HIV. Data were divided and analysed according to the source of information, study year, marital status, and GPA using one-way analysis of variance to assess the level of knowledge. RESULTS: Of 317 respondents, the majority (59.8%) were males with age ranging from 18 to 30 years of age. . The majority of students 188(59.3%) showed an average level of knowledge, 73(23%) showed a good level of knowledge. This study revealed adequate knowledge. However there were misconceptions regarding transmission pathways. The majority 173(54.6%) had a positive attitude, and 144(45.4%) had a neutral attitude, while none had a negative attitude towards HIV/HBV/HCV infected individuals. Clinical year students (mean 73.0%, SD ± 10.0%) demonstrated higher levels of awareness compared to pre-clinical students (mean 39.7%, SD ± 13.0%). CONCLUSIONS: This study revealed that medical students have adequate knowledge regarding HIV/HBV/HCV. Medical students play a pivotal role in raising awareness and disseminating knowledge among the community, thus more effort should be concentrated on developing educational programs to limit the risks of such infections.

Ischemic Hepatitis Induced by Uremic Cardiac Tamponade in a Patient with Underlying Hepatitis C with a Review of the Literature.

Ischemic hepatitis is a rare cause of acute liver injury (ALI) and is associated with various etiologies including cardiac failure, trauma, hemorrhage, and respiratory failure that all result in poor perfusion and oxygen delivery to the liver. A 30-year-old patient complained of orthopnea with a history of hepatitis C treatment and is currently on hemodialysis (HD) due to chronic allograft rejection. Also, he had previous pericardial effusion (PEFF) due to inadequate dialysis. Laboratory tests on admission revealed urinary tract infection, HCV PCR positive, and high blood urea nitrogen. Computed tomography of the chest showed massive PEFF. Echocardiography revealed a massive PEFF that measured 3.6 cm on the apical four-chamber window, and the inferior vena cava diameter was 27 mm with a decreased collapsibility of ˂20% in inspiration. The patient was treated for UTI and started the treatment for HCV. Also, increased HD sessions with minimal heparinization of the dialyzer circuit were obtained along with daily monitoring of PEFF by echocardiography. At first, echocardiography did not reveal frank signs of cardiac tamponade, but after 2 sessions of HD, the patient developed chest pain, worsening orthopnea, JVP elevation, and dropping of the systolic BP. Echocardiography showed specific signs of cardiac tamponade, which included an increased effusion to 4.4 cm and changes in velocities of the mitral valve and tricuspid valve during the respiratory cycle by more than 25% and 40%, respectively. The patient was transmitted to ICU, and pericardiocentesis was obtained. Two days later, asymptomatic ALI was noticed by elevation of the following tests: ALT, AST, LDH, PT, and INR. However, ALI exhibits a rapid and spontaneous resolution to nearly normal tests after 10 days. Although the patient was hemodynamically stable, the liver injury occurred and might be attributed to ESRD and hypertension that caused thickened heart walls, diastolic dysfunction, and subsequently hepatic congestion, in addition to previous liver injury due to HCV. We present a rare case of ALI caused by uremic pericardial tamponade with an overview of the current literature with regard to this entity. So, we emphasize monitoring liver function tests in the context of PEFF, especially in patients with chronic kidney disease.

Oral cancer knowledge and practice among medical students: A cross-sectional study during the Syrian crisis.

Background: lack of medical practitioners' knowledge about oral cancer has contributed to delays in referral and treatment. Oral cancer is amenable to treatment when detected early, which leads to better prognosis and survival rates. In this study, we aimed to assess the knowledge of the Syrian medical students about the risk factors of oral cancer, oral cavity changes associated with oral cancer, and the relation between the relation with Human Papilloma Virus (HPV) and oral cancer. Methods: This is a cross-sectional study conducted at the Syrian Private University. Data were collected through self-administered questionnaires, which targeted social demographic information, general knowledge, risk factors, oral changes and HPV knowledge associated with oral cancer. Data was categorized and analyzed to assess and compare the levels of knowledge between clinical and preclinical students. Results: 301 out of 401 medical students responded to the questionnaires bringing the response rate to 75.25%. The study revealed adequate knowledge about oral cancer, general information, clinical features, risk factors and relation to HPV. Clinical students showed higher levels of awareness compared to pre-clinical students. No significance in knowledge was found between the genders. Conclusion: The findings of the present study suggest that there is a need to reinforce the medical curriculum concerning oral cancer education, particularly in prevention and early detection to improve practices.

Knowledge of breast cancer among medical students in Syrian Private University, Syria: a cross-sectional study.

BACKGROUND: Breast cancer is the most common cancer among women and the second leading cause of cancer death globally. Since early diagnosis is crucial to reducing mortality, high levels of knowledge regarding general information, risk factors, and symptoms are required among healthcare professionals to deliver breast cancer care. This study aimed to determine Syrian medical students' knowledge about breast cancer in the fields of general knowledge, common clinical features, and risk factors. METHODS: This cross-sectional study was conducted at the Syrian Private University in October 2019 (Breast Cancer Awareness Month), Damascus, during the Syrian war crisis. Data were collected through self-administered surveys and analyzed using the Statistical Package for Social Sciences version 25.0 (SPSS Inc., United States). The chi-square test was applied to assess the relationship between the level of knowledge and gender. One way analysis of variance was performed to assess the overall differences in mean knowledge score by study year, GPA, mother's education, and source of information. Unpaired Student's T-test was used to analyze the differences in mean knowledge scores (continuous variable) based on smoking status and alcohol consumption. RESULTS: Of 320 students, 301 completed the questionnaire (response rate = 94.0%), of which 179(59.5%) were males. The study revealed above-average knowledge scores (total mean = 68.4%) regarding breast cancer, general information (71.9%), common clinical features (71.6%), and risk factors (71.6%). Clinical students (4th, 5th, and 6th years) scored higher compared with pre-clinical students (1st, 2nd, and 3rd years). CONCLUSION: This study showed above-average knowledge scores regarding breast cancer. More efforts to correct misinformation, through reassessing the university curriculum and promoting awareness about breast cancer are required.

Efficacy of Colchicine and Budesonide in Improvement Outcomes of Patients with Coronavirus Infection 2019 in Damascus, Syria: A Randomized Control Trial.

COVID-19 was reported in China in 2019 and has spread worldwide. Transmission occurs through respiratory secretions and, less commonly, through contaminated surfaces. The severity of the disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). In this study, we aim to investigate the efficacy of two agents (oral colchicine and budesonide inhaler) in COVID-19 infection management, compared with supportive care alone. 77 patients were admitted to the isolation section of Al Assad University Hospital, between the 1st of August and the 30th of August. A total of 49 patients were included in this randomized control trial, after excluding ineligible patients. The random sample was divided into three groups; the first group was supportive care plus colchicine, the second group was supportive care plus budesonide inhaler, and the control group was supportive care alone. PaO2/FiO2 was improved in the budesonide group, higher than the supportive and colchicine groups. The median hospitalization days were shorter when using colchicine or budesonide, opposed to supportive care alone (8 vs 10 days, respectively). 34 patients (69.3%) were discharged, and 27 patients (55.1%) were followed up until they were weaned from oxygen and made a complete recovery. There was a significant decrease in mortality with colchicine (3 patients; 21.4%) compared with supportive care (7 patients; 33.3%) and the budesonide group (5 patients; 35.7%).

Female medical students' awareness, attitudes, and knowledge about early detection of breast cancer in Syrian Private University, Syria.

INTRODUCTION: Breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. The study aims to determine the community awareness levels in our country and extrapolate knowledge and awareness about the methods of early detection. METHODS: It was performed as cross-sectional study in Syrian Private University in Damascus, Syria from January to March 2019. The population included female students of all years in medical faculties: medicine, pharmacy and dentistry collages. Data collection have been done by breast cancer awareness measure (BCAM) questionnaire. RESULTS: The total participants were 407 divided into three faculties. The average knowledge rate was (57.5%). (70 %) of participants were not familiar with mammography. It is a good result that (86.7 %) acquainted about self-examination and (94.8%) believe that it is very important. But it is obvious that the practical side is poor, there were (32.7%) of students who apply BSE. CONCLUSION: This study showed a lack of awareness among medical students. Perhaps the most important reason is the lack of awareness programs that must include all strata of society, especially students of medical colleges and doctors for their important role in spreading awareness to avoid this danger that surrounds our ladies.

Simultaneous laparoscopic partial pericystectomy and cholecystectomy: Is it safe? A case report.

BACKGROUND: Initial reservations regarding spillage and the ability to manage the cyst wall have been allayed by many reports which show satisfying results with minimal complications using laparoscopic techniques. Here, we study the possibility and safety of simultaneous laparoscopic pericystectomy with one of the most common laparoscopic procedure; laparoscopic cholecystectomy. CASE PRESENTATION: A 37 y/o female from a rural area in Syria was referred to our clinic after one year of total pericystectomy from both right and left lobes of lung. She was scheduled for a second operation to resect a third hydatid cyst from her liver. We noted that she also complained of a cholelithiasis and it would be very helpful to manage both these problems altogether. DISCUSSION: previously, one manuscript discussed in details the safety of laparoscopic simultaneous partial pericystectomy and total cystectomy for hydatid liver cysts. The anaphylactic shock, surgical site infection (SSI) and recurrence were still challenges in any participation of laparoscopic hydatid pericystectomy with other kind of surgery from the same ports. Here, we also paid an attention for the duration and cost of this practice. CONCLUSION: The combination of the laparoscopic pericystectomy with other producers may be safe in certain selective cases and does not increase the possibility of postsurgical complications like infections or recurrence. We found this intervention could be effective and useful.