Primary cardiac rhabdomyosarcoma in a mitral valve involved with rheumatic disease.

A 51-year-old female underwent emergency mitral valve replacement for mitral stenosis with an undetermined mass which was attached to the anterior mitral leaflet. Histopathological testing of the excised specimen confirmed the diagnosis of rheumatic mitral disease in combination with a primary rhabdomyosarcoma. Postoperative adjuvant chemotherapy with pazopanib hydrochloride was given. At 10 months of follow-up, repeated computed tomographic screening has not shown any signs of local recurrence or secondary metastases. The potential for the existence of primary rhabdomyosarcomas should be borne in mind when faced with undetermined masses on mitral leaflets, even in the presence of rheumatic disease.

Cutaneous metastases as a primary manifestation of invasive ductal carcinoma of the breast: a case report.

Cutaneous metastases as the first sign of invasive ductal carcinoma are not common. The ambiguous presentation of asymptomatic lesions may result in various diagnoses including dermatologic causes. Early diagnosis is essential in such cases. Case presentation: A 43-year-old woman with no risk factors for developing breast cancer at a young age was diagnosed with invasive ductal carcinoma of the left breast after dermatologic complaints of diffuse lesions on the left-back and right subclavian region. The patient remained asymptomatic except for the recent cutaneous presentation, which did not arouse much suspicion. Conclusion: Cutaneous metastases of breast cancer remain uncommon, but at the same time represent a poor prognosis for the patient, and when they do occur, treatment options are limited. The delay in taking the proper diagnostic measures in such cases imposes a need to adopt a wider perspective when dealing with the possible occurrence of advanced disease. This also adds up to the importance of breast self-examination by women at a young age and full examination by physicians, especially when they encounter a misguiding presentation.

Rectal prolapse as a manifestation of inflammatory bowel disease with celiac disease in a 2-year-old male: a rare case report.

The co-occurrence of inflammatory bowel disease (IBD) and celiac disease (CeD) is uncommon. The typical sign of this co-occurrence is malabsorption which leads to anemia, diarrhea, and malnutrition. In rare cases, recurrent rectal prolapse may also occur. Case presentation: A 2-year-old Syrian male baby presented with failure to thrive and chronic diarrhea for 18 months, along with recurrent rectal prolapse for the last 6 months. Biopsies taken confirmed a diagnosis of stage 3b celiac disease according to the Marsh classification. Furthermore, biopsies taken confirmed a diagnosis of IBD. Then, a high-fiber diet to manage IBD and celiac diet were both needed simultaneously, with signs of rectal prolapse, diarrhea, and bloating, occurring when either or both diets were stopped. Clinical discussion: The diagnosis was initially explained by the malnutrition and anemia. Even after the gluten-free diet, the patient showed no improvement in diarrhea and developed inferior gastrointestinal bleeding suggested anal fissure, infectious colitis, polyps, IBD, or solitary rectal ulcer syndrome. The relationship between celiac disease and IBD, in children, is still unclear. Current studies suggest that such co-occurrence is associated with higher risks of developing other autoimmune-related disorders, growth and puberty delay, and comorbidities. Conclusions: In the cases of pediatric co-occurrence of IBD and celiac disease, a conservative therapy consisting of two-fold diets for the two diseases should be tried first. If this step succeeds in controlling the clinical picture, it removes the necessity of introducing immunological pharmacologic treatments that may induce unfavorable side effects in a child.

Awareness and knowledge of familial Mediterranean fever among medical scope students in Syrian universities: A cross-sectional study.

Introduction: Familial Mediterranean fever is an autoinflammatory autosomal recessive disorder common among individuals of Mediterranean descent. It is characterized by recurrent episodes of fever accompanied by peritonitis, pleurisy, pericarditis, and/or arthritis, sometimes accompanied by an erysipelas-like rash. Mimicking manifestation of other inflammatory conditions and the diversity of symptoms leads to insufficient knowledge and understanding. General knowledge about this disease is considered low in most populations, but this bears greater consequences in people with high incidence rates. This study investigates the knowledge of familial Mediterranean fever among a group of medical students in public and private Syrian universities. Methods: A cross-sectional study was conducted in May 2022, and an international standard-based electronic questionnaire was adopted. The study included 758 current undergraduate medical scope students from public and private universities in Syria. The survey used for this study included inquiries made to assess awareness using global standards. It was divided into 2 sections, with 7 questions focusing on sociodemographic characteristics and 17 questions assessing the students' understanding of Familial Mediterranean fever. Results: Our analysis showed strong correlations between the knowledge of Familial Mediterranean fever and certain specialization, college, academic year, and marital status. The mean score of answers was 9.39 out of 17 for all participants. The mean score of answers for medical students was 10.01 out of 17, while it was 8.81 for pharmaceutical students and 6.51 for dental students. These differences were statistically significant, p-value <0.001. This means medical students know better than pharmaceutical students, who already have better knowledge than dental students. Conclusion: We conclude that medical scope students' knowledge about the disease of Familial Mediterranean fever and its management is ineffective, especially among dental students, even in a country with high prevalence rates for Familial Mediterranean fever like Syria.