Parieto-occipital scalp arteriovenous malformation with drainage into the posterior superior sagittal sinus: A case report.

This case report presents the unique clinical presentation of an 18-year-old female patient with an 8-year history of a progressively enlarging pulsatile mass in the left parieto-occipital region of her scalp. Remarkably, there was no history of trauma, headache, or other associated neurological deficits. Advanced imaging techniques, including computed tomography angiography and magnetic resonance imaging, revealed a vascular lesion consistent with an arteriovenous malformation beneath the scalp. Notably, the arteriovenous malformation's nidus was primarily supplied by branches of bilateral superficial temporal and occipital arteries, with a more pronounced involvement on the left side. Further magnetic resonance imaging characterization confirmed the diagnosis as a high parieto-occipital arteriovenous malformation/dural arteriovenous fistula. This case underscores the importance of a multidisciplinary approach involving neurosurgery and interventional radiology to the diagnosis and management of complex vascular lesions, particularly when they occur in unusual anatomical locations, like in our patient. The long-term clinical course and outcomes of such cases warrant continued investigation.

Perforated small bowel lymphoma: a rare presentation of Crohn's disease.

Adenocarcinoma and lymphoma, potential complications of Crohn's disease (CD), may result in small intestinal perforations, particularly in those on immunosuppressive therapy. The ileum is typically the site of small intestinal perforations in CD, and the link between CD and lymphoma remains uncertain. This case report explores a long-term CD patient on immunosuppressive therapy who presented with acute abdominal pain. Imaging revealed signs of intestinal perforation, successfully managed with surgery. The final pathology report confirms the diagnosis of diffuse large B-cell lymphoma. This report sheds light on the complicated nature of gastrointestinal lymphoma in CD patients.

Epidemiology of Common Ocular Manifestations among Patients on Haemodialysis in West Bank, Palestine.

Objectives: This study aimed to assess the prevalence of ocular manifestations and associated factors in patients on haemodialysis. Methods: A cross-sectional study of patients on haemodialysis from a haemodialysis unit in Nablus, Palestine, was conducted. Medical examination for ocular manifestations (intraocular pressure, cataract, retinal changes and optic neuropathy) was performed using Tono-Pen, portable slit-lamp and indirect ophthalmoscope. Predictor variables were age, gender, smoking, medical comorbidities (diabetes, hypertension, ischaemic heart disease [IHD], peripheral arterial disease [PAD]) and use of antiplatelet or anti-coagulation medications. Results: A total of 191 patients were included in this study. The prevalence of any ocular manifestation in at least one eye was 68%. The most common ocular manifestations were retinal changes (58%) and cataract (41%). The prevalence of non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR) and NPDR or PDR was 51%, 16% and 65%. Two patients had PDR in one eye and NPDR in the other, and therefore, they were counted only once making the total for this category 71 rather than 73 patients. An increase in age by one year increased the odds of having cataract by 1.10 (95% confidence interval [CI] = 1.06-1.14). Patients with diabetes had higher odds of having cataract (odds ratio [OR] = 7.43, 95% CI: 3.26-16.95) and any retinal changes (OR = 109.48, 95% CI: 33.85-354.05) than patients without diabetes. Patients with diabetes and IHD or PAD had higher odds of having NPDR than those with diabetes without IHD or PAD (OR = 7.62, 95% CI: 2.07-28.03). Conclusion: Retinal changes and cataract are common ocular manifestations among patients on haemodialysis. The findings emphasise the importance of periodic screening for ocular problems in this vulnerable population, especially older patients and those with diabetes, to prevent visual impartment and associated disability.

Knowledge, attitudes, and practices of Palestinian people relating to organ donation in 2016: a cross-sectional study.

BACKGROUND: Organ transplantation is the treatment of choice for organ failure, but organs are scarce and their availability is affected by relational ties, religious beliefs, cultural influences, body integrity, medical mistrust, and other factors. This aim of this study was to assess the knowledge, attitudes, and practices of Palestinian population with respect to organ donation. METHODS: In this cross-sectional study, we used a validated questionnaire delivered by land telephone to collect data on the knowledge, attitudes, and practices relating to organ donation in the general population of the West Bank. Stratified sampling and simple random sampling were applied using data obtained from the Palestinian Telecommunication Group in 2016. Stata version 20 was used for statistical analysis, and a p value less than 0·05 was considered significant. Ethics approval was obtained from the Institutional Review Board of An-Najah National University, and all participants gave verbal informed consent. FINDINGS: The questionnaire was completed by 385 (68%) of 565 people approached (mean age 42 years [SD 14·13]). 266 (69%) respondents were married, 311 (80%) were employed, and 375 (97%) were Muslim. 136 (35%) respondents were university students or post-graduates. Half of participants lived in urban areas. Local religious clergy were reported as being the source of general information by 150 (40%) participants. 273 (71%) respondents had adequate knowledge about organ donation, TV being the main source of information for 207 (60%) participants. 70 (26%) respondents would consider donation only after death, and 342 (67%) respondents would only consider donating to a close family member, whereas 341 (100%) respondents believed that their organ could be misused and 219 (64%) believed organ donation carries a health risk. 135 (49%) respondents preferred to donate to a recipient of the same religion. 266 (78%) individuals believed that organ donation should be promoted in the occupied Palestinian territory, although 188 (55%) reported organ donation to be culturally unacceptable. Religious beliefs and fears of complications were the main obstacles to organ donation. An adequate level of knowledge was associated with the female sex (p=0·008), level of education (p=0·046), monthly income (p=0·041), and marital status (p=0·012), whereas a positive attitude to organ donation was associated with religious score (p=0·015), marital status (p=0·031), and knowledge score (p=0·003). A high level of knowledge was associated with employment and the perception of organ donation as permitted in religion, whereas a positive attitude was associated with single marital status, high level of knowledge, and residence in cities. INTERPRETATION: Despite adequate knowledge and positive attitudes towards organ donation, a comprehensive study is necessary to fully understand the local characteristics that influence organ donation by Palestinians and to better inform decision makers and future policies. FUNDING: None.