Assessing quality of life and depression in non-metastatic breast cancer patients following surgical treatment: A cross-sectional study in Lebanon.

Breast cancer is a global health concern that significantly impacts the quality of life (QOL) of individuals. This study aims to comprehensively examine the interplay between QOL and depression among nonmetastatic breast cancer patients in Lebanon, a region with limited research in this context. A cross-sectional study was conducted at Hammoud Hospital-University Medical Center from January 2018 to January 2023. Data was collected through a self-administered questionnaire distributed as Google Forms via WhatsApp. A total of 193 patients had non-metastatic breast cancer. Out of these, 81 valid responses were obtained. The Patient Health Questionnaire and Quality of Life Scale were used to assess depression and QOL, respectively. A total of 81 patients were included with mean age 54.4 years. Results revealed that 77.8% of patients experienced provisional depression, with 35.8% meeting criteria for major depressive disorder. Financial status and chronic diseases were associated with the likelihood of developing major depressive disorder. The mean QOL score was 81.14, lower than the average for healthy individuals. Educational level and presence of chronic diseases were significant factors influencing QOL. Postsurgical depression prevalence is substantial, underscoring the importance of integrating mental health care. Economic status and comorbidities are influential factors, necessitating targeted interventions. Breast cancer's impact on QOL is profound, falling below that of other chronic conditions. Education empowers coping, while comorbidities impact QOL. Our findings emphasize the multidimensional nature of breast cancer care, advocating for holistic support and addressing emotional well-being.

Factors associated with early postoperative mortality after total anomalous pulmonary venous connection repair: A retrospective cohort study.

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital defect where pulmonary venous plexus fails to connect with the left atrium (LA). Surgical repair is the primary treatment for TAPVC, but factors influencing outcomes are not fully understood. This study investigates the early outcomes of surgical repair for TAPVC and associated factors. A retrospective cohort analysis was conducted on TAPVC patients who underwent surgical repair between 2012 and 2022. Data were collected from medical records and supplemented with phone call validation. Demographic characteristics, surgical data, diagnostic tests, and outcomes were analyzed. Statistical analysis included chi-square, t-tests, and multivariate logistic regression using SPSS. A total of 88 patients underwent surgical repair for TAPVC, resulting in a mortality rate of 21.6%. Weight and bypass time were significantly associated with patient survival. Female patients had a higher likelihood of death. The anatomic type did not significantly influence mortality. Patients with pulmonary venous obstruction (PVO) experienced a higher mortality rate. Notably, ligation of the vertical vein in supracardiac and infracardiac types was associated with lower mortality. In conclusion, our study identifies several key factors contributing to higher mortality rates following TAPVC surgery, including low weight, female gender, prolonged bypass time, and preoperative vein obstruction. Highlighting the significance of surgical technique, particularly the sutureless approach, we advocate for its meticulous consideration to achieve improved outcomes. Furthermore, our findings indicate a potential decrease in mortality associated with vertical vein ligation, which may mitigate the risk of post-repair heart failure. We suggest further rigorous studies to gain comprehensive insights into TAPVC surgical interventions.

Exploring the symptoms and sleep disorders associated with migraines in women of Syria: A cross-sectional observational study.

Background and Aim: Migraine is a prevalent neurological disorder characterized by recurring episodes of debilitating headache accompanied by associated symptoms and sleep disorders. This study aims to investigate migraine-associated symptoms in female migraineurs within the Syrian population and the relation between migraines and sleep issues. Methods: A questionnaire-based cross-sectional observational study was conducted among the Syrian population. A total of 1009 women were enrolled in this study, including women without a history of migraine (Control group) and migraineurs (Case group) who had received a diagnosis of migraine from a hospital or private clinic. Data about migraine-related symptoms, including tingling, visual disturbances, Nausea/Vomiting, and epileptic seizures as well as sleep-related symptoms such as interrupted sleep, frequent awakenings, insomnia, snoring, and narcolepsy were gathered. Chi-square test was used to examine the relation between migraines and sleep issues. Results: A total of 1009 women were enrolled in this study including 531 migraineurs and 478 healthy women. The study revealed that the most commonly experienced symptoms during migraine attacks were nausea/vomiting and visual disturbances, followed by tingling. Total Unduplicated Reach and Frequency analysis showed that visual disturbances and nausea/vomiting were the two most frequent symptoms that co-occurred during migraine attacks. The study also demonstrated a significant relationship between snoring, insomnia, and narcolepsy with migraine (p = 0.038), with these sleep disorders being more prevalent among migraineurs. Conclusion: The findings indicate a significant association between migraines and sleep disorders, with migraineurs being at a significantly higher risk of experiencing poor sleep quality compared to healthy women. Addressing sleep disorders is crucial in managing patients with migraines. This study is the first of its kind in the Syrian population, providing valuable insights into the symptoms and sleep disorders associated with migraines in this population.

Unveiling the complexity of right middle lobe syndrome: a case series highlighting the association with asthma.

Introduction and importance: Right middle lobe syndrome (MLS) is a rare lung disorder primarily affecting children with a history of asthma or atopy. It encompasses a range of pathological and clinical conditions, from recurrent collapses of the middle lobe to bronchiectasis. In this study, the authors present a case series featuring four individuals with MLS associated with asthma, aiming to deepen our understanding of this uncommon condition. Case presentation: Four paediatric patients with right MLS exhibited symptoms of persistent cough, dyspnoea, and recurrent asthma exacerbations. Radiographic evaluations confirmed features consistent with right MLS, and bronchoscopy revealed mucus plugs and oedematous airways obstructing the right middle lobe bronchus. Treatment with bronchodilators, antibiotics, and corticosteroids led to symptom improvement and resolution of atelectasis. Clinical discussion: MLS is a rare condition characterized by chronic collapse of the right middle lobe and bronchiectasis. It is challenging to diagnose MLS, but computed tomography (CT) scans provide detailed lung images for confirmation. Treatment focuses on addressing the underlying cause, such as infections or mucus obstruction. Lobectomy may be considered in severe cases. This case series emphasizes the need for further research on MLS, as its rarity and characteristics remain unclear. Conclusion: These cases exhibited obstructive MLS with and without asthma. Accurate diagnosis is challenging, requiring imaging techniques. MLS has clinical implications, particularly in asthma patients. Future studies should focus on understanding the aetiology of non-obstructive MLS.

Infantile inflammatory bowel disease in three Syrian infants: a case series.

BACKGROUND: Inflammatory bowel diseases, consisting of Crohn's disease and ulcerative colitis, are chronic bowel relapsing inflammatory disorders. Inflammatory bowel diseases begin rarely in infants. Approximately 25% of patients with inflammatory bowel diseases present before the age of 20 years. Very early-onset inflammatory bowel disease occurs before the age of 6 years; infantile inflammatory bowel diseases occurs before the age of 2 years, and is extremely rare in infants under 1 year of age. CASE PRESENTATION: Herein, we report a case series of 7-month-, 11-month-, and 12-month-old Syrian infants that presented with diarrhea, hematochezia, and pale appearance and were finally diagnosed with infantile inflammatory bowel disease and treated. CONCLUSIONS: Early diagnosis and ruling out infantile inflammatory bowel diseases despite its rarity are recommended. Over and above that, new drugs such as vedolizumab, golimumab, and less invasive treatment methods should also be taken into consideration for better response and adequate remission with improved quality of life.

Clinical presentation and management of multisystem inflammatory syndrome in children associated with covid-19: a retrospective observational descriptive study in a pediatric hospital in Syria.

OBJECTIVE: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 is a rare and serious medical condition. This study aims to review the clinical presentation, laboratory parameters, outcomes, and management of MIS-C cases in a pediatric hospital in Syria. METHODS: This retrospective observational study aimed to investigate MIS-C between May 2020 and October 2021. Data collection involved extracting information from medical records, and patients were identified based on the case definition established by the World Health Organization (WHO). Various laboratory investigations, diagnostic evaluations, clinical presentations, and treatments were performed to assess patients. Descriptive statistical analysis was conducted using Microsoft Excel. RESULTS: A total of 232 COVID-19 cases were reported with COVID-19 Infection. Among these cases, 25 (10.77%) were identified as MIS-C. The median age of the patients was 5.5 years, with the majority being male patients (72%). Patients experienced fever (100%), bilateral conjunctivitis (88%), rash (84%), gastrointestinal symptoms (76%), and cardiac dysfunction (72%). Other notable findings included oral cavity changes (64%), edema (36%), cervical lymphadenopathy (36%), and neurological manifestations (28%). Respiratory symptoms were uncommon (16%). All patients recovered, with no recorded deaths. CONCLUSION: The predominant presence of positive SARS-CoV-2 IgG in the majority of patients in this study supports the post-infectious nature of MIS-C. Respiratory symptoms were less prevalent in both pediatric COVID-19 and MIS-C patients. Early supportive care is crucial in management, although additional research is needed to establish definitive guidelines. Larger studies are necessary to overcome the limitations of this study and to enhance our understanding of MIS-C in pediatric COVID-19 patients.

A unique case of intralobar pulmonary sequestration in an elderly patient: A case report.

Pulmonary sequestration (PS) is a rare congenital anomaly characterized by non-functional lung tissue receiving blood supply from an abnormal source. PS is typically diagnosed in young individuals but is uncommon in the elderly. This abstract describes a case of PS in a 62-year-old male patient presenting with recurrent fever, chronic cough, and difficulty breathing. Imaging revealed abnormal lung tissue disconnected from the bronchial tree, with blood supply from the descending thoracic aorta. Surgical intervention successfully treated the condition. The case emphasizes the need to consider PS as a possible diagnosis, even in older patients, and suggests further research into its possible etiologies.

Bladder stone formation due to neglected double J stent: a case report.

Introduction and importance: Double J (DJ) stents are commonly used in genitourinary procedures, but they can lead to complications including infection, hematuria, encrustation, and stone formation. The longer the duration of encrustation, the greater the risk of complications and renal dysfunction. Forgotten stents pose challenges for patients and can require endourological or open surgical procedures. Case presentation: A 40-year-old man with hypertension and coronary artery disease had a forgotten DJ stent for 3 years, causing suprapubic pain and dysuria. Kidney, ureter, and bladder (KUB) revealed a coiled DJ stent with a large bladder stone and encrustation, and an open cystolithotomy was successfully performed. Recovery was uneventful, and the patient was discharged without complication. Clinical discussion: Ureteral stents, including the DJ stent, are commonly used for urological conditions but can cause complications if retained beyond the intended timeframe. Optimal timing for stent removal is crucial, and patients' healthcare knowledge and adherence are critical to preventing retention. KUB X-ray can evaluate stent encrustation and bladder stones. Cystoscopy is the typical approach for stent removal, but supplementary interventions may be necessary. Open surgery was recommended for removing a large bladder stone and encrusted stent in this case. Conclusion: Timely removal of DJ stents is crucial to avoid complications. Extended retention can cause problems such as encrustation and stone formation. Patient education and adherence are essential to prevent retention and forgetfulness. This case report highlights the importance of careful management of patients with DJ stents for optimal outcomes and prevention of complications.

Unobstructed infracardiac total anomalous pulmonary venous connection in a 7-month-old infant: A rare case report.

Key Clinical Message: This case underscores the importance of early detection and treatment for total anomalous pulmonary venous connection, a rare congenital heart condition, through comprehensive newborn physical exams and prompt specialist referrals. Abstract: Total anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease that is typically diagnosed in neonates. TAPVC has four subtypes, with the infracardiac type at risk of obstruction. TAPVC is usually diagnosed in newborns but can occur in other age groups. In this case, a 7-month-old male with recurrent cyanotic episodes was diagnosed with TAPVC of the infracardiac type using computed tomography angiography. The patient underwent successful surgical repair with a favorable postoperative course and was discharged in stable condition, and further follow-up was not possible beyond 2 months. This case emphasizes the importance of early recognition and management of this condition to prevent the progression of subsequent complications.

Pulmonary pseudoaneurysm in the setting of concurrent COVID-19 and pulmonary mucormycosis: A rare case report.

Key Clinical Message: This case illustrates the possible danger of PAP emergence in individuals with a confluence of conditions capable of inducing vascular impairment, like COVID-19, pulmonary mucormycosis (PM), and diabetes. Abstract: Pulmonary mucormycosis (PM) is a highly lethal invasive infection. It is a rare complication of COVID-19 and is associated with a high mortality rate. Pulmonary pseudoaneurysm (PAP) is a severe manifestation of this condition, often resulting in death. Management involves endovascular therapy followed by surgery and appropriate antifungal treatment.

Mediastinal liposarcoma: a case report and review of the literature.

BACKGROUND: Mediastinal Liposarcoma (ML) is an exceedingly rare neoplasm, accounting for less than 1% of all liposarcomas. Surgical resection is the most effective therapeutic modality, while adjuvant radiation therapy may be recommended for unresectable tumors. CASE PRESENTATION: This case report presents a rare case of a 52-year-old Syrian male patient with well-differentiated mediastinal liposarcoma (ML) who presented with exertional dyspnea, cough, and weight loss. Imaging studies revealed a large tumor causing extrinsic compression on the right lung, as well as compression of the heart and great vessels. CT-guided biopsy confirmed a diagnosis of well-differentiated liposarcoma, and the patient underwent surgical resection. The patient had a rapid postoperative recovery and was discharged on the fourth day post-operation, displaying an excellent postoperative status. The patient was followed up for 3 months postoperatively with no recurrence. CONCLUSION: This report highlights the significance of incorporating ML into the differential diagnosis of mediastinal masses, particularly in individuals presenting with exertional dyspnea and weight loss. Furthermore, this report provides a comprehensive review of previously reported cases of ML in the medical literature.

Primary neuroendocrine tumor in the retroperitoneal cavity: A rare case report.

INTRODUCTION AND IMPORTANCE: Neuroendocrine tumors (NETs) are rare malignancies, accounting for a small percentage of gastrointestinal and bronchopulmonary cancers. Retroperitoneal NETs are infrequent and can be primary or metastatic. They are commonly metastatic rather than primary tumors, with primary retroperitoneal NETs being exceptionally rare. CASE PRESENTATION: A 38-year-old woman presented with left flank pain persisting for one year, which had progressively worsened. Imaging revealed a large retroperitoneal mass exerting pressure on the stomach, spleen, liver, and upper pole of the left kidney. A biopsy of the tumor was done and the results were consistent with NET. The tumor, which measured approximately 19 × 12.5 × 11 cm, was surgically removed, and the pathological findings were consistent with the results of the biopsy prior to the surgery. CLINICAL DISCUSSION: Neuroendocrine tumors are rare and exhibit diverse characteristics based on location, size, hormone secretion, and metastasis. Retroperitoneal neuroendocrine tumors are typically metastatic and rarely primary. The extremely large size of the tumor in this case highlights the surgical challenges associated with retroperitoneal NETs. Imaging, such as CT and MRI, plays a crucial role in diagnosis. CONCLUSION: The study emphasizes the need to consider primary NETs as a possible cause of large retroperitoneal masses, especially if the tumor size is significant. Surgical resection is the primary treatment option with generally favorable outcomes. However, the size of the tumor can complicate treatment, and further research is needed to evaluate the effectiveness of postoperative adjuvant therapy and develop therapeutic approaches for recurrent NETs.

A wandering spleen with 720° torsion and persistent ascending and descending mesocolon in a 5-year-old Syrian male: A case report.

INTRODUCTION AND IMPORTANCE: The spleen is normally found in the left hypochondrium and it is fixed in its place by numerous suspensory ligaments. When the ligaments are elongated or abnormally developed, it causes a rare medical condition called Wandering spleen. A persistent ascending and descending mesocolon is also a congenital anomaly, resulting from the failure of fusion of the primitive dorsal mesocolon. CASE PRESENTATION: Herein, a 5-year-old male child with sudden and acute onset of abdominal pain, constipation, nausea, tachycardia, and low urine output, imaging and blood tests revealed evidence of intestinal obstruction and normocytic anemia and neutrophilia. A laparotomy revealed persistent ascending and descending mesocolon, with a torsioned vascular pedicle of the spleen, resulting in splenomegaly and infarction. The surgeon successfully derotated the torsioned pedicle and performed a splenectomy. The patient had an uneventful postoperative course and was discharged without complications. CLINICAL DISCUSSION: This case could be asymptomatic and the diagnosis is incidental or it could be presented with ambiguous symptoms. The differential diagnosis of WS varies according to the clinical presentation and the associated complication. For instance, in the case of WS torsion and acute presentation, the differential diagnosis is ovarian torsion, acute appendicitis, and intestinal obstruction. Currently, surgery is the only suggested treatment option even in asymptomatic patients as well. CONCLUSION: This case of a Wandering Spleen is associated with a persistent ascending and descending mesocolon, suggesting that there may be certain risk factors. Therefore, we suggest making more research about wandering spleen in association with persistent mesocolon.

Pulmonary artery aneurysm and hemoptysis as uncommon sequelae of COVID-19 infection: a case report from Syria.

Pulmonary artery aneurysm (PAA) is a rare vascular disease, and it is known to be an extremely rare complication following infection with the coronavirus disease 2019 (COVID-19). Other etiologies of the disease are cancer, congenital heart anomalies, and vasculitis. While it is usually an asymptomatic disease, PAA can sometimes present with severe symptoms such as hemoptysis due to the rupture of the aneurysm. Case presentation: Here, The authors report a case of a 75-year-old female patient presented with hemoptysis. She had normal vasculature on a previous computed tomography scan when she was diagnosed with COVID-19. Four months after having COVID-19, and with a computed tomographic pulmonary angiography -assisted diagnosis, the patient was later diagnosed with PAA. Clinical discussion: PAAs have a wide nonspecific range of symptoms. The main diagnostic test is computed tomography angiography. Treatment is still controversial with no definite agreement on the management. Conclusion: COVID-19 infections can cause severe damage to blood vessels, especially in the context of other etiologies that can further damage the vasculature. This report demonstrates the importance of patient follow-up and monitoring post-COVID-19 infection in reducing further complications and mortality.