A rare presentation of hydatid cyst disease at the thigh: a case report from Syria.

Introduction and importance: Hydatid cyst disease is a zoonotic disease caused by Echinococcus granulosus and is recognized as a significant health issue in many countries, particularly Mediterranean countries. Hydatid cysts in the musculoskeletal system are rare, with only a few reported cases. These usually occur as secondary cysts resulting from the hematogenous dissemination from primary sites. Case presentation: This paper reports a case of a 77-year-old man with a mass in his thigh that had been increasing dramatically in size for 4 months with no signs of local inflammation, fever, or any other symptoms. Findings from an MRI were consistent with a large abscess, so a true-cut biopsy was taken before referral. A pathological study after surgery revealed the lesion was a hydatid cyst, and a previously performed biopsy caused a rupture of the cyst. Clinical discussion: Misdiagnosing hydatid cysts, especially in non-usual areas, may lead to an unwelcome biopsy and consequences. Conclusion: This case report highlights the importance of considering hydatid cysts when encountering any enlarging mass, regardless of its location or rate of growth.

Spontaneous intrapartum Posterior Cul-de-sac rupture: A case report and literature review.

Introduction: Posterior Cul-de-sac rupture is a rare delivery complication and a diagnostic challenge to every obstetrician. The associated predisposing factors include genital anomalies (such as vaginal atresia), the use of misoprostol to induce delivery, previous pelvic infection, and caesarean scar. Herein, we report the case of a posterior Cul-de-sac rupture without any disposing risk factor. Case presentation: A 27-year-old G5P4 pregnant woman at the 33rd week of gestation presented with spontaneous onset of labor, the administration of calcium channel blockers failed to stop her active labor, which progressed with a spontaneous rupture of membranes. The fetal heart rate decelerated suddenly to 40 beats per minute. Therefore, an emergency lower transverse cesarean section was performed. During the operation, a transverse 6 cm tear in the posterior vaginal wall was found. The ruptured vagina was sutured and the patient was discharged two days later in a good condition. Clinical discussion: Posterior Cul-de-sac rupture might happen without any predisposing risk factors. Also, the vague and unspecific symptoms -mainly, sudden abdominal pain-can delay the diagnosis of such an entity. Conclusion: we recommend keeping a high level of suspicion for a concealed vaginal wall rupture even in the absence of any predisposing factors, when sudden severe pain during labour cannot be otherwise explained.

Breast cancer screening during the Syrian crisis: A cross-sectional study.

INTRODUCTION: Although breast cancer has a lower incidence in developing countries, mortality rates are higher, mainly due to delay in diagnosis and the poor diagnostic and therapeutic capacities. Although screening tests have been available for quite a long time, delayed and advanced presentation is still common, especially in developing countries. The decade-long Syrian crisis has severely crippled the healthcare system and depleted the already-limited capacities of the healthcare services, which under prioritized the care provided to unurgent cases like breast cancer. This study aimed to investigate the practices of breast cancer screening among breast cancer patients. METHODS: A cross-sectional study conducted in Al-Beiruni Hospital at Damascus University in 2019, through personal interviews using a structured questionnaire. RESULTS: The sample consisted of 519 patients with breast cancer. One-hundred twenty (23.2%) of them reported undergoing one or more of the different screening methods at least once every six months prior to diagnosis. Several factors had a statistically significant association with the probability of undergoing or performing screening methods including living in large cities, having fewer children, having a full-time or part-time job, and the level of education. Patients who reported having a relative diagnosed previously with breast cancer or any other malignancies were also more likely to screen themselves. Inaccessibility to healthcare services, which was exaggerated by the armed conflicts, had a significant association with less practicing of the screening methods too (OR: 0.4 [0.3-0.7]). CONCLUSION: The Syrian war and its direct and indirect consequences negatively affected screening practices of breast cancer.