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Cramps are very common in hemodialysis (HD) patients. A high ultrafiltration rate and volume contraction have been implicated in the pathogenesis, but the underlying mechanism is not yet fully elucidated. We present a male HD patient with cramps during his session, attributed to acute limb ischemia due to thrombosis of a common femoral artery aneurysm (CFAA). The true CFAAs are extremely rare, but the pseudoaneurysms (or false aneurysms) are less uncommon resulting after femoral catheterization for diagnostic and therapeutic procedures. This aneurysm was eccentric in shape which in conjunction with the patient’s history of femoral catheterization strongly suggests us to consider it a pseudoaneurysm. Although the patient was operated with the clinical suspicion of arterial embolism due to atrial fibrillation and the subtherapeutic anticoagulation, no embolus was found in the aneurysm. We want to emphasize that the presence of cramps is not always innocent, simply attributed to HD. Rarely, it may result from or mask severe and devastating acute leg ischemia caused by thrombosis of a CFAA. Notably, the thrombosis of a CFAA (true or false) is an extremely rare condition. We suggest all the HD patients with a history of femoral cannulation to undergo a vascular ultrasound in the related femoral artery at least once, to manage and to prevent the complications.

Congenital contractural arachnodactyly, commonly known as Beal’s syndrome, is an extremely rare genetic disorder caused by mutations in the fibrillin-2 (FBN2) gene located on chromosome 5q23. It is an autosomal dominant inherited connective tissue disorder characterised by a Marfan-like body habitus, contractures, abnormally shaped ears and kyphoscoliosis. We report a seven-year-old Omani male who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2014 with seizures. He was noted to have certain distinctive facial features and musculoskeletal manifestations; he was subsequently diagnosed with Beal’s syndrome. Sequencing of the FBN2 gene revealed that the patient had a novel mutation which was also present in his mother; however, she had only a few facial features indicative of Beal’s syndrome and no systemic involvement apart from a history of childhood seizures. To the best of the authors’ knowledge, this is the first report of Beal’s syndrome with seizure symptoms as a potential feature

Background: Coronary Artery Disease (CAD) is one of the leading causes of morbidity and mortality worldwide. It occurs due to constriction or obstruction of the coronary artery, which is instigated by atherosclerosis, vasospasms, or a combination of these factors. Medication adherence is a key aspect in preventing the proliferation of diseases, mitigating the likelihood of adverse events such as myocardial infarctions and cerebrovascular accidents, and enhancing the overall health outcomes for patients. Objective (s): To Assess the level of medication adherence among patients clinically diagnosed with coronary artery disease hospitalized and attending the outpatient cardiac consultation unit. Methodology: A descriptive study was used. using purposive sampling. The study targeted 334 patients hospitalized in cardiac care units and attending the outpatient cardiac clinic, and it targeted three hospitals in Babylon Health Directorate in Iraq. Data were collected for the period from November 26, 2024 to January 16, 2025. Medication adherence was assessed using General medication adherence scale (GMAS). Results: The results shown that the majority of the participants in the study with age group of \"60 and more\" years as reported (42.2%), the larger portion of participants are graduated with elementary school (24.6%). The study found that patients (47.3%) have partial adherence level of medication. Conclusions: The study concludes that most of the patients exhibit partial adherence level of medication. This means that they adhere to their medication some of time and miss doses other times. Recommendations: Raising awareness about the importance of continuing to take medication even if you feel better by establishment of educational workshops and seminars for patients by guidance units is essential.