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Background Colorectal cancer (CRC) is the third most common cancer globally, with rising incidence in developing countries due to lifestyle and dietary shifts. CRC often presents with late-stage symptoms, leading to higher mortality. Early detection through screening can significantly improve survival rates. In Syria, CRC is the second most common cancer, but screening rates remain low, especially following the decade-long war. This study aims to assess the knowledge of CRC and evaluate the awareness of CRC screening among Syrians to guide prevention and detection strategies. Methods A cross-sectional online survey was conducted from September 27 to October 21, 2023, across six governorates: Damascus, Homs, Aleppo, Latakia, Hama, and Tartus, using a self-administered questionnaire distributed via social media. Statistical analysis was performed using SPSS v28.0, with a Chi-square test to explore differences in knowledge based on socio-demographical factors. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and multinomial regression was performed to confirm relationships established by the Chi-square analysis. Results The study included 772 participants, 42.6% of whom were aged 30–35 years. The majority were female (64.4%) and married (56.3%). Only 27.8% considered themselves informed about CRC. While 54.8% had heard of colonoscopy, only 15.4% had undergone the procedure. Significant knowledge gaps were identified, particularly regarding the link between adenocarcinoma polyps and CRC (29.9%), the role of diet (33.2%), and the protective effect of aspirin (17.7%). Individuals aged 50 and above demonstrated higher awareness levels, particularly in recognizing CRC’s hereditary nature ( p -value = 0.033) and the potential for cure ( p -value = 0.012). Education and economic status were also strongly associated with better CRC knowledge, and males generally exhibited higher awareness than females. Conclusion This study highlights significant gaps in CRC knowledge and screening awareness among Syrians, emphasizing the need to integrate education and complimentary screening into national health policies. Targeted campaigns, nonprofit collaboration, and media engagement are essential to bridge these gaps. Future research should address limitations like sampling bias and the cross-sectional design through longitudinal and comparative studies to guide tailored interventions.

Background Hyperhidrosis (HH), characterized by excessive sweating, poses a significant challenge to patients’ quality of life. This meta-analysis evaluates the safety and efficacy of topical glycopyrronium bromide (GBP) in treating primary hyperhidrosis, a chronic condition affecting various body regions. Despite its prevalence, primary axillary hyperhidrosis is often undertreated due to a lack of awareness and social stigma. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing GBP to a placebo in primary hyperhidrosis patients. Eligibility criteria included outcomes related to perspiration suppression and symptom improvement. Results Four RCTs involving 1401 patients were included. GBP significantly increased Hyperhidrosis Disease Severity Scale (HDSS) responders (RR = 2.33, 95% CI [1.99 to 2.74], p  < 0.00001) and Axillary Sweating Daily Diary (ASDD/ASDD-C) responders (MD = 3.07, 95% CI [2.32 to 4.06], p  < 0.002) without significantly causing adverse events. Dermatology life quality index was also significantly improved in the GBP group (MD = -2.32, 95% CI [-3.09, -1.55], P  < 0.00001). Conclusion GBP demonstrated effectiveness in reducing sweat production while improving HDSS and DLQI scores. Adverse events included dry mouth and anticholinergic effects. Dry eye and local skin reactions were not significant, which makes GBP promising in managing primary hyperhidrosis, offering improvements in symptoms and quality of life. While adverse events should be considered, further research with larger sample sizes and long-term follow-up is warranted for comprehensive clinical integration. Key points • We found that topical glycopyrronium can be an effective treatment for hyperhidrosis, reducing sweat production and improving patients’ symptoms. • We also found that the increase in certain adverse events necessitates careful consideration in clinical decision-making.

Background Medications are commonly found in every household. In Syria, where healthcare infrastructure faces significant challenges, improper storage can lead to reduced medication efficacy and increased health risks. Additionally, inappropriate disposal practices pose serious environmental concerns, especially in a region already grappling with environmental degradation. This study aimed to evaluate the knowledge, and practices of Syrian individuals regarding the appropriate storage and disposal of home medications . Method A cross-sectional study was conducted from September 22 to October 20, 2023, using an online survey distributed via social media apps (WhatsApp, Facebook, and Telegram) in Syria. The questionnaire, adapted from a similar study in Saudi Arabia, was translated to Arabic using the forward–backward translation technique. A convenience sampling technique was used. Inclusion criteria were participants over eighteen with expired or unused medications at home. Descriptive statistics, Chi-square tests, and binary logistic regression analysis were performed using SPSS version 27, with statistical significance defined as p  < 0.05. Results A total of 2,217 responses were analyzed, with the majority of participants being female (79%) and aged between 21–30 years (56%). The study found that 90.7% of respondents dispose of expired medications in the garbage, while 95% keep medications in their original containers. Additionally, 30% consult pharmacists for storage instructions, and 64% read storage information on medication leaflets. Logistic regression analysis revealed that males were less likely to check expiration dates before use (OR: 0.58, 95% CI: 0.40–0.84) and periodically (OR: 0.68, 95% CI: 0.54–0.85). Participants aged 31–40 years were less likely to check expiration dates periodically (OR: 0.46, 95% CI: 0.31–0.68), while those with children under six years old were more likely to do so (OR: 1.29, 95% CI: 1.01–1.67). Males were also less likely to read storage instructions (OR: 0.61, 95% CI: 0.50–0.76) but more likely to ask pharmacists about them (OR: 1.26, 95% CI: 1.01–1.57). There was no significant difference in these practices between medical professionals and the general population. Conclusion This study reveals gaps in the practices related to the storage and disposal of medications among the Syrian public. The findings suggest a need for targeted public education and awareness programs to improve these practices and reduce the associated health and environmental risks.

The term “trichobezoar” refers to foreign and indigestible material in the gastrointestinal tract, and it can indicate several underlying mental illnesses. A 38‐year‐old woman reported experiencing sudden intensive abdominal pain, along with a two‐month history of vomiting, nausea, exhaustion, and abdominal discomfort. The diagnosis of gastrointestinal perforation was validated by investigations. During an emergency laparotomy, a perforated stomach ulcer with enormous trichobezoar occupying the entire gastric lumen was revealed. The giant trichobezoar was removed, along with the appendix. The pathology report revealed serositis, fibrosis, and active chronic Helicobacter pylori gastritis. Trichobezoar exhibits variation in locations and volumes. These frequently starts with minimal symptoms but over time can produce nausea, vomiting, peritonitis, hematemesis, abdominal pain, or even perforation, especially in patients who are at risk of developing ulcers and have a large trichobezoar. Key Clinical Message A report on trichobezoar is included in the current study. This case describes a woman who shows symptoms of mental and digestive illnesses. A large trichobezoar was identified, extending her entire stomach, that caused a perforated ulcer, which was discovered during an emergency laparotomy.

Vulvar fibroma typically has small sizes that do not exceed 5 cm and grows slowly. However, in rare cases, it can grow rapidly and reach giant sizes.Vulvar fibroma typically has small sizes that do not exceed 5 cm and grows slowly. However, in rare cases, it can grow rapidly and reach giant sizes.

Purpose of Review Pediatric myocarditis, although rare, is associated with high morbidity and mortality, especially in emergency department (ED) settings where timely diagnosis and intervention are crucial. This systematic review and meta-analysis aim to consolidate current evidence regarding the clinical presentations, diagnostic findings, and outcomes of pediatric myocarditis in the ED, with an emphasis on the need for improved diagnostic and therapeutic strategies. Recent Findings A systematic search of PubMed, Scopus, Web of Science, EMBASE, and Medline was conducted through December 2023, identifying 17 studies that met strict inclusion criteria. Across 737 pediatric myocarditis cases, common clinical presentations included poor feeding (60.4%), fever (51%), respiratory distress (49.8%), and hypoperfusion (45.9%). Laboratory findings indicated elevated troponin in 80.4% of cases and increased C-reactive protein in 63.3%. Imaging and ECG data revealed cardiomegaly in 44.7% and ST/T wave abnormalities in 47.5%. Intensive Care Unit (ICU) admission was required for 88.1% of cases, with 46.9% needing mechanical ventilation, and an overall mortality rate of 15.7%. Summary Pediatric myocarditis presents with non-specific symptoms, complicating early diagnosis in the ED. High rates of ICU admission and mortality highlight the urgency for rapid identification and timely intervention. Future research should aim to refine diagnostic markers and optimize treatment protocols to improve outcomes in this vulnerable population

Thymomas are rare tumors originating from thymic tissue and rarely metastasize. They can be diagnosed either incidentally or symptomatically when compressing or invading nearby structure. A 36-year-old man presented with significant high-grade fever, chest pain that worsens upon lying down, and dyspnea. A chest X-Ray and computed tomography followed by biopsy confirmed the diagnosis of thymoma. The management included chemotherapy cycles, followed by surgery. Pericardiectomy was performed with en-bloc thymectomy and partial resection of the infiltrating lung. Venous drainage was restored by 8/16 mm inverted bifurcated brachiocephalic-superior vena cava Dacron bypass. The pericardium was reconstructed by a synthetic Dacron patch, and the right diaphragm metastasis was resected. Neoadjuvant chemotherapy was initiated. After 3 months of follow-up, no recurrence was evidenced by computed tomography.