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Abstract Background Cardiovascular disease (CVD) is a leading cause of global mortality. Early intervention and prevention of CVD depend on accurately predicting the risk of CVD. This study aimed to investigate the association between the TyG index and the risk of coronary heart disease (CHD), congestive heart failure (CHF), heart attack (HA), stroke, and hypertension (HTN) among patients without diabetes in the United States. Methods In this retrospective, cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2020. We conducted several regression analysis models and calculated the sensitivity and specificity of (TyG) index for predicting the onset of CHD, CHF, HA, stroke, and HTN. Results A total of 10,937 individuals without diabetes participated in our study. Individuals with a TyG index greater than 8.96 displayed significant increasing in various parameters, including BMI, systolic/diastolic blood pressure, total cholesterol, LDL, and Apo-B levels (p

AbstractPolycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women’s PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18–45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21–29, and 69.6% held bachelor’s degrees. Those with a bachelor’s degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.

Abstract Background Vitamin D deficiency is an importance preventable problem in the global and associates with lack levels of awareness about vitamin D. According to prior studies, in the Arab world, there is low of knowledge and awareness toward vitamin D deficiency. The target of our study is evaluating the knowledge level about vitamin D deficiency and determining the associated factors with levels of awareness of its. Method This online cross-sectional study was performed in Syria between 25 February to 29 March 2023 to assess the levels of knowledge about vitamin D deficiency among general Syrian population. The study’s survey was obtained from previously published research and we conducted a pilot study to assure the validity and clarity questionnaire. All Syrian individuals aged 18 or older who were able to read and write and willing to participate were included, while, non-Syrian nationality individuals and all medical staff (doctors, nurses, and medical students…), as well, those under 18 age were excluded. The questionnaire consisted of 23 questions separated into four categories. The first section was sociodemographic information of the study population. The second section measured the level awareness of the study population regarding the benefits of vitamin D. In addition, the third and fourth part evaluated knowing of the respondents about sources of and toxicity consequences of vitamin D. The data were analyzed by utilizing multivariate logistic regression in IBM, SPSS V.28 version. Results Overall, 3172 of the study population accepted to participate in this research and 57.9% the majority of them were aged in the range among 18 and 28. While, the average age of the respondents were 30.80 ± 11.957. Regarding with the awareness toward knowledge of advantages and source of vitamin D and outcomes of vitamin D toxicity. Most of the participants mentioned that vitamin D is used to treat bone disease and rickets and contributes in maintaining calcium and phosphates (91.4% and 84.6%, respectively). Whereas, more than half of them reported that sun exposure does not cause vitamin D poisoning and that vegetarians are more likelihood to have vitamin D than non-vegetarians, (54.1% and 54.9%, respectively). Only, age and occupation out of nine predictors variables were significantly correlated with adequate knowledge of Vitamin D (p-value

Abstract Background Atrial fibrillation (AF) is the most prevalent cardiac condition linked to increased mortality due to complications such as stroke. Oral anticoagulant (OAC) is the mainstay in preventing cerebrovascular accidents in patients with AF. Recent evidence identified gaps in physician’s knowledge in diagnosing and managing patients with AF. This study aims to assess Syrian physicians’ knowledge, attitude, and practices regarding the use of anticoagulant therapy in non-valvular AF (NVAF) patients. A cross-sectional study was conducted using a validated web-based questionnaire, which included 56 items separated into four sections that collected information about demographics, knowledge, attitude, and practices. Chi-square and Kruskal Wallis were performed to analyze the statistical relationships between the knowledge, attitude, practice, and demographic variables. Results A total of 497 participants completed the survey, of which 62.6% were between the ages of 25 and 35. The average participant scores for knowledge, attitude, and practices were (48.18 ± 21.57), (81.54 ± 9.26), and (62.83 ± 12.42), respectively. Participants who demonstrated good understanding, a positive attitude, and good practices were 22.3%, 87.3%, and 25.4%, respectively. The fear of bleeding was identified as the most significant barrier to initiating anticoagulant medication in AF patients (55.5%). Doctors who attended training had a better knowledge score than those who did not (mean ± S.D. = 57.24 ± 20.7). Participants who stated that over 70% of their AF patients use aspirin received the highest attitude score (mean ± S.D = 86.98 ± 21.17). PhD participants reported higher practice scores than those with other educational backgrounds (mean ± S.D = 73.96 ± 11.3). Conclusion This research showed that primary care physicians in Syria had optimistic views regarding OAC therapy, suggesting that training interventions targeting physicians may lead to improvement in the treatment of patients with NVAF in Syria.

Abstract Background Pre-eclampsia (PE) is a major contributor to morbidity and mortality in mothers worldwide. Adequate understanding of this condition improves treatment, control, and prevention. This study evaluated preeclampsia awareness among pregnant women in Syria, and the characteristics related to awareness adequacy. Methods This national cross-sectional study was conducted in Syria between 25 October and November 19, 2022. We included pregnant females of all age groups from all Syrian governorates. The questionnaire consisted of sociodemographic characteristics and knowledge of pre-eclampsia and its associated factors, symptoms, and complications. Results Overall, 706 participants were involved in this research, with a mean age of 38.22. Only 52.1% of them reported that they had heard of preeclampsia. Among the participants, 56.5% stated that they would not terminate a pregnancy if they were determined to be likely to develop preeclampsia, while nearly 55.2% agreed to continue the pregnancy rather than deliver prematurely even if their where a potential risk on their health risks. Participants who reported a family history of PE or had already experienced PE were more likely to have appropriate preeclampsia knowledge than those who did not (OR = 2.27, OR = 3.18, respectively). Respondents aged 25 to 35 years had the highest knowledge scores, and participants living in cities scored higher knowledge than rural residents. Conclusion According to our findings, pregnant women in Syria have a awareness gaps regarding the PE topic. This highlights the need to enhance women’s preeclampsia understanding for better pregnancy outcomes. Education through organizations, the media, and national programs is a significant aspect that promotes an adequate understanding of preeclampsia.

Abstract Background Social accountability (SA) within medical education signifies a commitment to address critical regional, societal, and national issues through educational, research, and service activities. In resource-limited regions, marginalized communities face barriers to accessing quality healthcare, and the concept of SA is often poorly understood by students. This study aims to investigate the perspectives, awareness, and comprehension of Syrian medical students regarding the concepts and principles of SA. Methods This cross-sectional online study was conducted in Syria from June 1st to July 25th, 2023, to assess the perspectives on SA among medical students enrolled in pre-clinical and clinical phases from the 3rd to the 6th year, encompassing both stream I and stream II. The questionnaire included three parts: consent and introduction, socio-demographic data, and a 12-item survey assessing social accountability. Data were analyzed using Statistical Package for the Social Sciences software version 24 (SPSS 24). Results A total of 1312 medical students (62.3% females vs. 37.7% males) participated in our analysis. Less than half of the participants (45.7%) reported that their institution had a limited social mission statement regarding the communities they serve. However, only 39.6% reported that their curriculum partially reflected the needs of the population they serve. A mere 7.5% and 6.8% of respondents indicated that their school had excellent community partners and stakeholders shaping their institution, and they learned significantly about other cultures and social circumstances in the medical context through their curriculum. About 24.1% reported that their institution required them to engage in a substantial amount of community-based learning, and 37.4% believed that their class reflected a good representation of socio-demographic characteristics of the reference population. A significant portion of the participants (44.3%) stated that their school did not encourage them to pursue generalist specialties, and 12.7% felt that their institution did not have a positive impact on the community. Among the included participants, 45.8% had some level of SA status, while 37.7% indicated good SA status. Age, gender, and the phase of study were the only sociodemographic characteristics statistically associated with SA status (p-value 0.05). Conclusion This study underscores the significant influence of clinical experience and gender on Syrian medical students’ perceptions of SA. To enhance these perceptions, medical institutions should tailor support services for different stages of training and target initiatives to engage male students.

Abstract Background During the reproductive period among pregnant women, the worst pain a woman can experience is labour pain. Untreated labour pain has many detrimental effects on the mother and the fetus. Then, the inadequate levels of awareness and attitudes toward labour analgesia among pregnant women are considered a serious concern that influences no-healthy results for both the mother and the baby. Therefore, this research aimed to define the degree of Awareness, Attitude, and intent to use labour analgesia among pregnant women in Syria. Methods We conducted a cross-sectional study from 7 September to 23 October 2022, in which we included Pregnant Syrian women aged 18 and above. The questionnaire was based on a prior study that included verified and validated scales, which consisted of 23 questions separated into four sections. The sample size was calculated using Fisher’s formula; however, our study included 638 participants. The data was analyzed using IBM SPSS Version 28.0, using descriptive and binary logistic regression methods. Results Among those who had previous deliveries, 39.4% performed a caesarian delivery, and only 1.9% had a delivery at home. Nearly half of the study participants (50.4%) reported adequate knowledge about analgesia for obstetric pain. The inquired pregnant women who had children had more odds of knowledge than participants who had not. Respondents who were childbearing at the health center were more likely to have a good attitude (Adjusted Odds ratio = 4.728, P-value

Background: Problematic internet use (PIU) or internet addiction has become increasingly prevalent, and concerns about its impact on mental health and social functioning have grown. This study aimed to investigate the prevalence of PIU among Syrian university students and its relationship with their demographics, internet user behavior, and mental health. Methods: A cross-sectional study was conducted among undergraduate medical students in Syrian government universities between 12 April and 29 May 2022. The survey included the Beck Depression Inventory and the Internet Addiction Scale. Results: Out of 2891 participants, 75.2% were female, with an average age of 21.87. The average Internet Addiction Test (IAT) score was 49.4, and the overall prevalence of PIU was 89%. Furthermore, 93.0% of participants displayed possible signs and symptoms of depression. PIU was significantly linked with physical abuse (p = 0.001) and mental stress (p = 0.0001). Internet addiction is (AOR:1.723, COR:2.289) fold more likely to occur in those with more than 8 h of sleep per night than in those who sleep for less than 6 h (p-value < 0.05). Unadjusted regression analysis showed that 13 predictors of the independent variables were statistically significant in predicting the presence of internet addiction, such as participants who suffered from a breakup (COR:2.039), domestic violence (COR:2.136), physical abuse (COR:2.190), or mental stress (COR:2.621) were more likely to be affected by internet addiction than those who did not (p-value < 0.05). Conclusions: The study found a high rate of internet addiction among Syrian medical students, with those experiencing mental health problems and depression symptoms more likely to be internet addicts. To prevent PIU, students should be encouraged to participate in extracurricular activities, such as sports, and awareness programs should be enhanced to highlight the negative effects of internet addiction.

Abstract Background The stigma associated with mental diseases in the healthcare system and among healthcare professionals has been identified as a significant barrier to treatment and rehabilitation and to the provision of substandard physical care for persons with mental illnesses. The goal of this study is to assess the attitude of physicians in Syria towards individuals with mental health disorders. Methods An online cross-sectional survey was conducted among phyisicians in Syria to evaluate their attitudes toward patients with mental health disorders and their provided treatment in the time period between August 16 and October 1, 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were all medical specialist trainees from all specialties and residents who had direct contact with people suffering from mental health disorders. The questionnaire was divided into two sections; the first included sociodemographic data on the participants and the second assessed physician’s attitudes toward mental illness patients. With the IBM SPSS V. 28.0 package tool (IBM Corporation, Armonk, NY, USA), descriptive and multivariate logistic regression analyses were used to analyze the data. Results 539 medical residents participated in this research; their average age was 26.11 (+- 1.74) years, and 50.27% were males. City residents had the highest stigma score on the third question (2.66 ± 1.06, P value

Abstract The awareness of cardiovascular diseases (CVDs) contributes to the complications and fatality rates from these diseases among individuals; however, no previous study in Syria was conducted on this topic; thus, this study aims to assess Syrians' awareness of CVDs warning symptoms and risk factors. This online cross-sectional study was performed in Syria between the 1st and 25th of August 2022. The inclusion criteria for the sample were citizens of Syria over 18 who currently reside in Syria. The questionnaire included open- and closed-ended questions to assess the awareness of CVDs. A total of 1201 participants enrolled in the study with a response rate of 97.2%; more than half of the participants (61.4%) were aged 18–24. The most recognizable risk factors and warning signs when asking close-ended and open-ended questions were smoking (95.2%, 37.1%) and chest pain (87.8%, 24.8%), respectively. Overall knowledge scores for risk factors and warning signs were (61.5%). Regarding knowledge score of CVDs risk factors and warning signs, participants aged 45–54 scored higher than other age groups, and respondents with a university education level had a higher score than other educational levels (15.7 ± 0.3), (14.5 ± 0.1), respectively. Participants aged 45–54 have a higher probability of good knowledge of CVDs risk factors and warning signs than participants aged 18–24 (OR = 4.8, P value

Abstract Background Diabetes and arterial hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population’s knowledge and treatment of hypertension and diabetes. It is crucial to investigate how the Syrian public understands and perceives these disorders in order to address the increased incidence and prevalence of hypertension and diabetes. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals. Methods A cross-sectional survey was conducted online between 1 August and 25 August 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. The survey consisted four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents’ knowledge of and comprehension of hypertension and diabetes, and respondents’ awareness of these disorders. Results Among 976 participants, 65.8% were females. the most common causes for hypertension from the perspective of participants were (90.1%) for stress, (87%) High salt consumption, (82.1%) genetics, (78.2%) old age, (78%) obesity (69%) anxiety, and (38.6%) for drug usage. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. There was a statistical significant difference between the knowledge toward the hypertension and the drinking alcohol, which the nonalcoholic knowledgeable persons were the most common (819 / 976)(P

Introduction: Proton pump inhibitors (PPIs) are commonly used to treat acid-related disorders. Their appropriate use depends on the correct indications from the clinician. Owing to the high incidence of use and misuse, PPIs have been identified as an essential pharmacological class for developing deprescribing recommendations. Therefore, assessing physicians’ knowledge and practice regarding PPI usage is critical for paving the way toward targeted recommendations and efforts.Objective: This study aimed to assess Syrian physicians’ perceptions of proton pump inhibitors adverse effects, their benefit in upper gastrointestinal bleeding (UGIB) prophylaxis, and how these perceptions are related to PPI prescription practice.Methods: A cross-sectional study was performed using a web-based questionnaire distributed among Syrian physicians in internal medicine between 28 November and 23 December 2022. The questionnaire assessed perceptions and experiences of PPIs, concerns about specific adverse effects, and their effectiveness for UGIB prophylaxis, in addition to the different scenarios used to determine the best practice for appropriate treatment to manage minimal, mild, moderate, and high-risk UGIB patients.Results: A total of 473 participants completed the questionnaire, with median age ±SD was (28.46 ± 4.58), and most participants (83.3%) were residents. Approximately half of the participants (45.5%) agreed that discussion assistance was provided to continue or terminate PPIs properly. Only 8.9% were very familiar with published evidence of PPI adverse effects. Bone weakening and vitamin B12 deficiency were the most frequently reported side effects (81.8% and 79.7%, respectively). However, dementia (0.4%) and mortality (1.9%) were the least reported adverse effects. More than half of the participants (64%) perceived using PPIs to prevent upper GI bleeding. Non-trainee physicians were less knowledgeable about appropriate GERD management than resident physicians (p < 0.001).Conclusion: The study showed a gap between Syrian physicians’ perceptions and practices regarding PPI use, which necessitates spreading awareness of updated guidelines for PPI usage and their side effects.

Background After the widespread of coronavirus disease (COVID-19) around the globe, it was imperative to establish preventative measures to restrict the virus's transmission. The purpose of this research was to present an overview of the awareness, knowledge, attitude, and abilities of Syrian physicians about telemedicine technology. Methods An online cross-sectional study was conducted from April 1 to May 15, 2022. The questionnaire was taken from published study, and the inclusion criteria consist the Syrian doctors who worked in hospitals during the COVID-19 pandemic, mainly those who had direct contact with patients. Results Among 385 responses, 52.72% of them were females, 83.9% of them were aged less than 30 years old, and 66% were working in the governmental sector; 66% of participants have moderate knowledge about using computers and the internet, 80% have heard about telemedicine. Despite that, 95.1% of participants have not attended any training workshop on telemedicine, and most of them have reported no availability of a telemedicine unit in their department. Only 31.7% participants have shown high awareness of telemedicine. Furthermore, no significant correlation was identified between the academic level with the age and telemedicine awareness, knowledge, attitude, or computer skills. Despite that, there was an obvious correlation between age and computer skills ( P -value

Abstract Background and Aim COVID-19 has shown how crucial awareness of the need to protect public health is to global security. Antibiotic resistance due to antibiotic misuse is seen as a worldwide health issue. Antibiotic use was significant during the COVID-19 epidemic, according to several nations. This research aims to investigate public attitudes on COVID-19, antibiotic resistance, and preventive measures during the COVID-19 pandemic in the Middle East. Methods An online quantitative cross-sectional study in 17 Arabic nations was carried out between January 3 and March 4, 2022, using a structured questionnaire to evaluate participants’ knowledge of COVID-19, their attitudes toward the new standard during the pandemic, and their use of antibiotics, and their resistance to them. The research was available to all Arabic people over 18 nations in the middle east. A convenient snowball sampling technique was used. SPSS version 20.0 was used to analyze the data. To analyze the results, binominal logistic regression was utilized. Statistical significance was defined as a p value of 0.05. Results Of the 6145 responders, 24.1% believed COVID-19 might spread to asymptomatic people, whereas 13.6% thought using antibiotics would accelerate recovery from any illness. Moreover, half of the respondents said antibiotics only work against bacteria (64.6%). 70.8% of participants adopted the necessary safety measures. More than a third of respondents strongly supported placing foreign immigrants in quarantine (33%). However, more than 50% of those surveyed (52.5%) firmly supported using face masks in all public settings. Individuals with a medical education background had 2.6 times more appropriate understanding of antibiotic resistance than others. Furthermore, participants in the 30–49 age range had a better handle on the use of antibiotics and antibiotic resistance than other respondents by 1.1 times. Conclusion Arab Health authorities should reconsider this health issue as soon about the inadequate level of awareness toward antibiotic use, resistance, and preventative practices during COVID-19. Many suggested strategies, especially solving the irregular antibiotic prescriptions during a COVID19 pandemic, should be implemented to increase public awareness of COVID19.

Background & aim: The monkeypox virus (MPXV), an Orthopoxvirus family member, is the zoonotic agent that causes mpox (formerly known as monkeypox). The ongoing mpox pandemic has caused cases across continents involving 110 countries. This study aimed to assess mpox knowledge and its determinants among healthcare personnel. Methods: This cross-sectional study was conducted from June 6 to June 25, 2022, among 17 Arab countries. The self-administered questionnaire consists of 53 questions assessing the knowledge about the monkeypox virus. Results: In total, 5874 medical students and clinical doctors from 17 Arab countries participated in this study. Only 13.8% (n = 812) of respondents have ever received information about mpox during their studies in medicine. The mean knowledge score was 13.84, and the median score was 15 (range 1–34). More than half (51.3%, n = 3012) have heard about mpox before. A low proportion of the participants had a good level of knowledge on mpox. Only 11.7% of respondents had correctly identified the natural host and the incubation period of mpox. More than half (58.9%) were aware of the signs and symptoms of mpox. Few respondents (28%) believed that mpox and smallpox have similar signs and symptoms. Specialist doctors had higher knowledge of mpox (AOR = 2.96, 95% CI = 2.24–3.92, p

Background: Ovarian cancer is the second most prevalent malignancy in women over 40, especially in low-income nations. For every 100,000 women in Syria, 473 new cases of ovarian cancer are diagnosed. This study aims to investigate the knowledge of ovarian cancer symptoms among Syrian women and determine the factors associated with good knowledge. Methods: An online cross-sectional was performed between July 29 and August 17, 2022. The inquired participants in the study were Syrian females above 18 years. The questionnaire consists of 41 questions organized into three sections: sociodemographic information, Confidence in recognizing ovarian cancer symptoms, and women's Awareness of the symptoms of ovarian cancer. Results: This research included 557 Syrian women, and the average age was 23. Only 20.5% of involved women demonstrated a good knowledge of the symptoms of ovarian cancer. The participants who agreed that abdominal pain and pelvic pain are ovarian cancer symptoms formed (36.8%), and (63.9%), respectively.Regarding the additional presenting symptoms of ovarian cancer, “extreme generalized fatigue” was the most often reported symptom (66.1%). Divorced women showed greater knowledge scores than other marital status groups (7.13 ± 3.31, P-value

BackgroundThe aim of this study was to explore potential healthcare workers' (HCWs) concerns about the monkeypox virus in order to create practical solutions to manage this disease.MethodsOnline cross-sectional research was conducted in 11 Arabic countries (Egypt, Saudi Arabia, Yemen, Syria, Libya, Algeria, Tunisia, Iraq, Palestine, Jordan, and Sudan) from 2 August 2022 to 28 December 2022.ResultsApproximately 82% of respondents felt the need to acquire further information. The acceptability of the vaccine against monkeypox has been indicated by more than half of the participants (54.5%). Furthermore, we state that 45% of the participants are knowledgeable about the monkeypox virus, and 53.1% of the participants have never been affected with COVID-19 before are more worried about COVID-19 than about monkeypox. Participants diagnosed with COVID-19 were 0.63 times less likely to worry about monkeypox than those who were not diagnosed with COVID-19. A greater willingness to get the monkeypox vaccination was seen among the age group 21–30 years (42.4%) compared to the other age groups.ConclusionMost healthcare professionals have a moderate knowledge of the monkeypox virus. Furthermore, they demonstrated a low willingness to get the vaccination against the monkeypox virus.

BackgroundThis study aims to assess the electrocardiographic interpretation abilities of resident doctors at internal medicine and emergency medicine departments in eight Arabic countries.MethodsAn online cross-sectional study was conducted between October 7, 2022 and October 21, 2022 in eight Arabic countries. The questionnaire consisted of two main sections: the first section included sociodemographic information, while the second section contained 12 clinical case questions of the most severe cardiac abnormalities with their electrocardiography (ECG) recordings.ResultsOut of 2,509 responses, 630 were eligible for the data analysis. More than half of the participants were males (52.4%). Internal medicine residents were (n = 530, 84.1%), whereas emergency medicine residents were (n = 100, 15.9%). Almost participants were in their first or second years of residency (79.8%). Only 36.2% of the inquired resident doctors had attended an ECG course. Most participants, 85.6%, recognized the ECG wave order correctly, and 50.5% of the participants scored above 7.5/10 on the ECG interpretation scale. The proportions of participants who were properly diagnosed with atrial fibrillation, third-degree heart block, and atrial tachycardia were 71.1, 76.7, and 56.6%, respectively. No statistically significant difference was defined between the internal and emergency medicine residents regarding their knowledge of ECG interpretation (p value = 0.42). However, there was a significant correlation between ECG interpretation and medical residency year (p value

Background: This study aims to investigate the knowledge of Syrian women about breast cancer risk factors, warning signals, and barriers. Breast cancer is the most common cancer worldwide and the leading cause of cancer death among women. It develops when cells in the breast tissue grow uncontrollably, forming a tumor that can spread to other parts of the body. Materials and Methods: This survey was conducted online from September 3 to September 27, 2022, and focused on Syrian women over the age of 18. It was divided into two sections, one focusing on sociodemographic characteristics and the other on breast cancer risk factors, warning signals, and barriers. Results: This study found that the majority of the 1305 participants had inadequate knowledge of breast cancer risk factors, warning signs, and barriers. Those with higher levels of education, such as Ph.D. students, had the highest overall scores. The sample was mostly made up of housewives, married women, and women with moderate monthly incomes. Conclusion: This research found that Syrian women have inadequate knowledge about breast cancer, including risk factors, warning signs, and barriers. To reduce mortality rates, increase survival rates, and improve early diagnosis, local health organizations should provide awareness courses to emphasize the importance of annual breast exams.

Background: Preconception care was instituted in 2013 by the World Health Organization (WHO) to promote more attention to pregnant women by medical staff. Preconception care attempts to optimize pregnancy outcomes and promote health by managing and treating variables that influence it. Obstetric care providers in LAMICs have been reported to have low levels of preconception care awareness. This study investigates the Knowledge, attitudes, and practice-related features of obstetric care providers in Syria's public health institutions about preconception care. Methods: A cross-sectional study was undertaken in Syria between 6 September 2022 and 7 October 2022 to evaluate obstetric care providers' Knowledge, attitudes, and practice at public health institutions regarding preconception care and related concerns. The questionnaire was designed using a validated scale from a prior study conducted in Ethiopia. The inclusion criteria for study participants were obstetricians and gynaecologists, midwives and residents, and nurses of Obstetrics and Gynecology. There were six sections in the questionnaire (sociodemographic information, Knowledge, practice attitude, additional factors associated with Preconception practice, and related actual & potential access to resources). The data were subjected to descriptive and multivariate logistic regression analysis using the IBM SPSS V. 28.0 software. Results: The mean age of 499 participants was 31.8 (SD = 9.7). Most participants were female (81.8%) and physicians (60%). 91.4% of respondents were deemed knowledgeable about preconception care. the most identified question (96.2%) was (Women intending pregnancy should be encouraged to defer pregnancy until they have reduced their drug, alcohol, and cigarette usage). (24.8%) participants regularly queried their patients about their reproductive life plan, with women aged 18 to 49 being the most often questioned group (92.3%). Only 18.6% of physicians routinely informed their patients about environmental dangers and contaminants. In addition, 53.5% of responders inquired about the patient's surgical and medical histories. 29.7% of participants strongly agreed that PCC provides an opportunity to improve the health of couples, particularly women, whereas 18.2% are certain that PCC does not belong to their scope of duties. Knowledge was more likely to be poor among participants who had never seen a doctor practicing PCC than among those who had (OR=2.81, P value = 0.026). Participants who did not get training on reproductive life plan examination throughout their practice time were less knowledgeable than those who did (OR = 2.91, P value= 0.04). Conclusion: Our results have shown that obstetric care providers in Syria have good Knowledge of and low to moderate practice and attitude towards preconception care. Improving access to training, carrier development, Internet, and library services is vital to improving PCC training. It is recommended that extra platforms be made accessible to obstetric care providers during their training to assist them in becoming preconception carers and in raising awareness about the significance of preconception care.

Background: Healthcare workers have dealt with a range of psychological problems during the COVID 19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work stress-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreasing professional success. The goal of this study was to find out how many healthcare workers burned out during the Omicron wave of the COVID-19 pandemic and to find out what factors put them at risk for this psychological effect. Methods: This cross-sectional research was performed in Syria during the current Omicron wave of COVID-19 pandemic to evaluate the Burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian healthcare workers who treated COVID-19 patients the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants. Results: A total of (729) healthcare providers inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31±9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study's participants are residents, and 72.8% of the participants carried for COVID19 patients. The prevalence of high level of burnout among the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion, also the participants who carried for COVID19 patients were much more likely (30.1%%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who carried for COVID19 patients were 1.76 times more likely than participants who did not carry for COVID19 patients to experience severe burnout (OR:1.766, 95%CI:1.2-2.4, P-value

Background: According to the World Health Organization (WHO), breast cancer (BC) is women's most common type of cancer. In LAMICs, breast cancer incidence is low. However, a lack of information about the signs and symptoms of breast cancer potentially results in the disease's progression to life-threatening stages.This study aimed to determine the levels of breast cancer symptom awareness among Syrian women and to identify the variables associated with a high level of awareness. Methods: From 3 September 2022 to 27 September 2022, Syrian women participated in an online cross-sectional survey to measure their knowledge about breast cancer, risk factors, and symptoms. This survey was derived from previous research that included a comprehensive, authorized scale. The admission requirement was 18-year-old or older Syrian women from all Syrian governorates. The questionnaire was divided into two portions; the first component included sociodemographic characteristics. Based on the original BCAM scale, the second portion assessed the participant's knowledge of breast cancer symptoms, risk factors, and obstacles. Using the IBM SPSS V. 28.0 software, descriptive and multivariate logistic regression analyses were performed on the data. Results: Among 1305 study participants, the mean age and standard deviation of the individuals were 30.7 and 11.2, respectively. Students constituted almost three-quarters (75.2%) of the study respondents. The average level of knowledge about risk factors was higher among women with chronic diseases (Mean = 4.44, SD = 2.176), whereas jobless people had a higher average level of information regarding obstacles than other subgroups of practical circumstances. In addition, single women scored higher on the barrier comprehension scale than other marital status groups (mean=3.34, SD=2.32). Only two variables, including age and educational level, were statistically significant in predicting an acceptable degree of knowledge of the risk factors for breast cancer. Participants with a PhD were more aware than other educational subgroups (P-value 0.05; OR =6.186). Participants with a PhD. are projected to be 6.18 times more aware of breast cancer risk factors than those with lower levels of education. Women with chronic conditions were 1.84 times more likely than others to be aware of breast cancer barriers. Conclusion: Our findings indicate that Syrian females have a poor to moderate knowledge of breast cancer symptoms, risk factors, and barriers. It is proposed that more breast cancer awareness campaigns be conducted and that yearly screening programs be improved to combat the late detection of this illness. Social media and television might be effective venues for raising awareness of breast self-examination and early identification of symptoms.

BackgroundMental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted.MethodsAn online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life.ResultsAmong 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support.ConclusionsThere are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.

Background: Based on the stroke mortality rate, Syria was ranked 98th worldwide in 2020. Approximately 80% of strokes are avoidable by managing well-known modifiable risk factors, such as diabetes, hypertension, and cardiovascular disease. Due to the high prevalence of several modifiable risk factors for stroke in Syria, it is necessary to increase Syrians' understanding of strokes and encourage people to engage in healthy practices to eradicate these risk factors. This research aimed to evaluate the knowledge, attitudes, and health-related perceptions of adult Syrians about stroke. Methods: This cross-sectional research was conducted between 2 September and 10 October 2022 among Syrians using an online survey to measure their knowledge, attitudes, and practices regarding stroke. This questionnaire was derived from a previously published article, and the inclusion criteria for this research were all Syrian residents aged 18 or older. The questionnaire utilized for this study consisted of three major sections: socio-demographic data, knowledge of stroke, and attitudes and perceptions about stroke. RESULTS: 53.3 % of the 1,143 research participants were female. Most respondents (94.3%) recognized the brain as the organ impacted by stroke. Hypertension was the stroke's most identifiable cause and risk factor (72.8% and 73.6%, respectively). 72.8 % of participants recognized hypertension and atherosclerosis as causes of stroke. 94.3 % of survey participants accurately identified the oranges impacted by the stroke; however, only 50.1% properly identified the warning symptoms. 61.4 % of participants utilize the Internet as a source of stroke-related information. 22.3% of individuals aged 21 to 30 had identified at least one stroke warning sign. 12.58% of individuals with a high socioeconomic position have shown a solid understanding of stroke risk factors. Females were projected to be 1.55 times more knowledgeable about stroke warning signs than men (P value

Background: The incidence of colorectal cancer is the second highest among women and the third highest among males. Screening for the disease has resulted in a significant decrease in both the prevalence and death rate of colorectal cancer (CRC) during the last two decades. Research has indicated that people unaware of the dangers of colorectal cancer may not participate in diagnostic procedures, which delays detection and reduces the likelihood of survival. Aim: This cross-sectional research seeks to examine the level of knowledge of CRC risk factors in Syria and the variables correlated with a greater level of awareness. Methods: An online cross-sectional study was conducted from 1 to 25 August 2022 to assess the Syrians' degree of awareness of Colorectal Cancer risk factors in Syria and the characteristics associated with a high level of understanding. The survey is based on another study, and the sample inclusion criteria of study participants were Syrian nationals aged 18 or older from all Syrian governorates. The questionnaire included 35 questions divided into 3 sections, sociodemographic variables such as (age, sex, marital status, educational level, occupation…etc.), evaluation of participant knowledge of colorectal cancer risk factors such as (alcohol consumption, Red meat consumption, lack of fiber in the diet, obesity, and old age), and symptoms such as (blood in stool, abdominal pain, constipation, change in defecation habits, general tiredness, unexplained weight loss). Results: Among 702 Syrian national participants, (n=430, 61.3%) were females, and (n=272, 38.7%) males. Only (n=67, 9.5%) participants have a chronic disease. Most participants have shown good knowledge of colorectal cancer symptoms (n=301, 42.9%), and (n=297, 42.3%) participants have shown moderate knowledge of colorectal cancer symptoms. Only (n=123, 17.6%) participants have shown a good understanding of colorectal cancer risk factors, whereas (n=293, 41.7%) have demonstrated poor knowledge. Educational level was related to greater knowledge of colorectal cancer risk factors (P-value 0.05). No correlation was found between other variables and a good awareness of colorectal cancer symptoms and risk factors (P-value > 0.05). Ph.D. degree of educational level (OR = 15.41, 95% CI: 1.211–196.16; P-value

Background: Cholera is a communicable acute bacterial infection caused by a gram-negative bacterium that is Vibrio Cholera. Worldwide, is estimated that an incidence of 1.3–4.0 millions of cholera infection, leading to 21,000–143,000 deaths annually. Prevention of cholera require a proactive approach rather than reactive, as it`s identified to be the best strategy to decrease the cholera spreading risk in given population or community. Recently WHO warned that, the cholera spreading risk in Syria is very high, which linked to drinking of untreated water and food contamination. Aim: we conducted this study with aiming to assess the level of knowledge, attitude and practice regarding risks of cholera infection, preventive measures and preparedness among community in Syria. Consequently, recommending suitable measures based on study results. Methods: An online cross-sectional study was conducted in Syria to assess knowledge, attitude, and practice regarding cholera and cholera vaccine among general population in Syria. The inclusion criteria for participation were Syrian nationality aged 18 or more, male or female, from all governorates of Syria, never have cholera previously, and were willing to participate. The questionnaire was consisting of four sections. The first section was about sociodemographic data. The second section evaluated respondents' self-reported knowledge on cholera and divided into two parts (2a: Knowledge on cholera, its prevention and treatment. 2b Knowledge on cholera vaccine). The third section evaluated respondents’ self-reported practice relating to cholera and its vaccine, this section divided into two parts (3a: Practice relating cholera and its treatment/management. 3b: Practice relating cholera vaccine. The fourth section inquired respondents’ attitude toward cholera and cholera vaccine. 52.9% thought that cholera outbreaks happen in summer seasons. Results: Among 1563 Syrian national participants, (n=982, 62.8%) were females, and (n=581, 37.2%) males. 60.9% of respondents did not recognize the cholera in the first place. Passing watery stool was the most recognized symptom of cholera with 50.3%, severe dehydration with 31.1%, and repeated vomiting with 10.3%. Lack of safe drinking water was recognized as the most common cause for cholera. Most respondents (54.1%) have chosen IV saline as the treatment of choice for cholera. 85.3% of respondents are with providing health care to the infectants in health centers. Conclusion: According to our findings, there is insufficient understanding of the cholera symptoms and risk factors. The need for better understanding of such common outbreaks is essential to counter them. Consequently, there is a greater need to increase cholera awareness and education programs on the disease's signs and symptoms and its risk factors.

Background: Diarrhea kills more than 2,000 children worldwide and over 1.3 million annually. There is still a gap in home management knowledge, attitude, and excellent practice of diarrheal illness.This research aims to understand mothers' knowledge, attitudes, and behaviours about diarrhoea in children under the age of five in Syria to minimize the number of fatalities and enhance the efficacy and efficiency of treatment. Methods: From the 8th to the 18th of September 2022, a cross-sectional online survey was done in Syria. The questionnaire was modified based on prior research that used a thorough, validated scale. Mothers having at least one child under the age of five and Syrian nationalities from all Syrian governorates were eligible to participate in the study. Four components make up the questionnaire. In the first section, information regarding the participants' demographics was provided. In the second section, mothers were tested on their knowledge of diarrhoea. Mothers' actual attitudes regarding preventing and treating diarrhoea were also analyzed. Results: 49.9% of the 996 participants were between the ages of 25 and 34, while 62.6% of the children were between the ages of 26 and 59 months. 46.2 percent of participants had a Bachelor's degree. 82.4 % of moms classified diarrhoea as the frequent passage of watery stools (3 or more times). 53.7 percent of respondents had used ORS; however, only 33.7% said they knew how to prepare it. Mothers with children aged 25–59 months were more informed about the prevention and home-based treatment of diarrhoea in their children (mean=6.07, SD= 2.36) than those aged 35–44 (mean=6.16, SD= 2.36). Mothers' excellent economic status was associated with greater diarrhoea management knowledge (mean=6.5, standard deviation = 2.50). (Mean = 7.28, Standard Deviation = 2.50) Mothers with a high school diploma or above had more understanding of diarrhoea management than those with a lower level of education. 28.7% of mothers with children between 25 and 59 months exhibited excellent knowledge of prevention and home-based treatment of diarrhoea. 43.4% of mothers with a bachelor's degree or more showed a positive attitude toward diarrhoea management. Only 6.3% of moms with a low socioeconomic position have shown appropriate diarrhoea control practices. Three out of six predictor factors were substantially connected with mothers' attitudes about diarrhoea management, including the age of the child, the mother's employment, and her level of education (P0.05). Two of the six predictor factors were substantially connected with mothers' practice of diarrhoea control, including the mother's employment and socioeconomic position (P0.05). Women with higher socioeconomic status are expected to perform diarrhoea treatment 1.69 times more often than those with a lower socioeconomic status. Conclusion: We indicated that mothers' beliefs and actions about the prevention and home management of diarrheal illnesses in children younger than five were inadequate. Therefore, it is important to plan and execute health education, information distribution, and community discourse to improve the prevention and treatment of diarrhea in children under five.

Background: After the widespread of COVID-19 around the globe, it was imperative to establish preventative measures to restrict the virus's transmission and enable clinicians to remotely monitor patients' status and avoid direct contact with them. The purpose of this research was to present an overview of the awareness, knowledge, attitude, and abilities of Syrian physicians about telemedicine technology. Methods: An online cross-sectional study was conducted from 1 April to 15 May, 2022 to assess Syrian doctors' awareness, knowledge, attitude, and skills towards telemedicine. The questionnaire was taken from published study, and the inclusion criteria consist the Syrian doctors who worked in hospitals during the COVID19 pandemic, mainly those who had direct contact with patients. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0. Results: Among 385 responses, 52.72% of them were females, 83.9% of them were aged less than 30 years old, and 66% were working in the governmental sector. 66% of participants have moderate knowledge about using computers and the internet, 80% have heard about telemedicine. Despite that, 95.1% of participants have not attended any training workshop on telemedicine, and most of them have reported no availability of a telemedicine unit in their department. Only 31.7% participants have shown high awareness of telemedicine. Furthermore, no significant correlation was identified between the academic level with the age and telemedicine awareness, knowledge, attitude, or computer skills. Despite that, there was an obvious correlation between age and computer skills (P Value

Background: Over 1 million new Sexual transmitted disease (STIs) are acquired daily throughout the globe, according to WHO data, with the majority of cases being asymptomatic. In Syria, statistics on STI awareness, attitude, and practice are few, and there is little information on Syrians' sexual and reproductive health concerns. The present research aims to determine which individuals factors best predict knowledge, attitudes, and behaviours about HIV/AIDS and other STIs in a Syrian population. Method: In the Syrian governorates between August 15 and September 16, 2022, a descriptive community-based cross-sectional survey was carried out. Syrian nationality, male or female, aged at least 18 years, citizen of any Syrian governorate, and willingness to engage in the survey were the study's inclusion criteria. Based on a previous study, a modified online semi-structured questionnaire was made on Google Form and used to collect the data. The questionnaire was divided into five main section that socio-demographic information, knowledge and practice relating STIs, knowledge and practice relating HIV/AIDS, attitude toward HIV/AIDS and attitude toward STIs. Results: The research involved 1076 individuals in total. More over half (55%) of them were women, with the majority (86%) of them being between the ages of 18 and 30. Only 739 respondents (67%) were aware of voluntary counselling and testing (VCT), and only 35% were aware of the means by which HIV infection may be prevented. The most often mentioned AIDS/HIV-related statistic was that those who have several sex partners have a greater chance of contracting HIV (92%). Furthermore, just 66% and 44%, respectively, of respondents knew how STDs are transmitted. In general, individuals' understanding of STDs was rated at 56%. Furthermore, 50% of the individuals had a positive attitude about the STD information. We used a logistic model to tease out the role of demographics and found that men were 1.43 times more likely to be aware of AIDS/HIV than women were. Additionally, residents of cities were 1.42 times more likely than residents of rural areas to be knowledgeable about STDs. Conclusion: According to this research, Syrians' knowledge, attitudes, and behaviors about STIs, HIV, and other diseases were generally insufficient. This provides definitive evidence that HIV programmes need to verify that Syrian people have access to basic information about HIV/AIDS and other STIs. As a result, the health organizations should conduct both international and local helpful interventions in order to address this medical problem and enhance the awareness of the Syrian community about HIV/AIDS and other STIs illnesses as soon as possible.

Background: World Health Organization (WHO) verified 780 cases of monkeypox across 27 countries between 13 May 2022 and 2 June 2022. The World Health Organization (WHO) classified the growing worldwide monkeypox epidemic a PHEIC on July 23; the bulk of confirmed cases have been found in European locations. The purpose of this research is to assess the level of awareness toward human monkeypox virus among the Syrian medical students, general practitioners (GPs), medical residents, and specialists. Methods: We performed a cross-sectional online survey in Syria between 2 may and 8 September, 2022 to assess medical students', general practitioners', residents', and specialists' knowledge about the monkeypox virus. The utilized tool was developed with input from the World Health Organization, the Centers for Disease Control and Prevention, and cross-sectional studies conducted in Indonesia. The survey has 53 questions divided into three groups: demographic information, work-related details, and monkeypox knowledge. The time-efficient and simple snowball method of sampling was used. Version 28.0 of SPSS was used to analyze the data. Results: A total of 1257 healthcare workers and medical students throughout all of Syria's governorates took part in the research. The percentage of responders who learned anything about monkeypox in medical school was just 6.2% (n = 78). As a whole, students scored 10.23 out of a possible 15, with 11 being the adequate level for knowledge. About half of the participants (n = 700) are familiar with the term "monkeypox." As well, half of the respondents (n = 663) just learned about monkeypox during the last few days, while almost half (n = 530) only learned about it within the past month. Almost participants didn't know adequately about monkeypox. The natural host and incubation time for monkeypox were correctly identified by just 2.7% of responders and 33.3% of the whole population, respectively. 1.8% of participants gave the right response when asked about the symptoms of monkeypox. Sixty percent of the study sample think the symptoms of monkeypox and smallpox are identical. The females had higher knowledge toward monkeypox (aOR = 1.5, 95% CI = 1.26-1.80, p

Background: An estimated 17.8 million lives were lost in 2017 due to cardiovascular disease (CVD), resulting in a total of 330 million years of life lost and an additional 35.6 million years of disability. Numerous studies have shown the importance of education and awareness in promoting positive and long-lasting behavioral changes. This study aims to assess Syrians' awareness of cardiovascular disease (CVD) warning symptoms and risk factors and investigate further into the variables that contribute to this awareness. Methods: A cross-sectional survey was undertaken online between August 1 and 25, 2022, to examine Syrian individuals' awareness of cardiovascular disease risk factors and early warning signs. The study's questionnaire was constructed based on prior research, and the inclusion criteria for the sample were citizens of Syria over the age of 18 who currently reside in Syria. There were three categories of questions on the questionnaire: sociodemographics, an evaluation of CVD knowledge using both open- and closed-ended inquiries, and medical history and behavioral risk factors. Results: There were 1201 inquired participants; 728 (60.6%) were males, and 473 (39.5%) were females. Concerns about developing diabetes were reported by 45.8% (n=550), hypertension was feared by 54.0% (n=540), and 43.9% (n=572) of individuals, and heart disease was feared by 45.9% (n=572). The internet and social media platforms were the most common ways they learned about it. Closed-ended questions indicated that the majority of participants (n=1164, 94.9%) had recognized CVD risk factors, with smoking (95.2%), obesity (93.6%), cholesterol (91%), and hypertension (90.3%) being the most often reported risk factors. Close-ended questions regarding CVD warning indicators revealed that most participants (n=897, 74.7%) correctly identified the warning symptoms. However, in response to open-ended questions, most participants (n=478, 39.8%) did not identify CVD risk factors, as well only (n=291, 24.2%) did. In addition, open-ended questions concerning CVD warning signs indicated that more than half of the participants (n=680, 56.6%) had poor identification of the warning symptoms. The age group between 55 and 64 years had the greatest CVD risk factors, and education was related to greater knowledge of CVD risk factors (P-value

Background: Palliative care is a method to alleviate pain and enhance the quality of life for patients suffering from the consequences of a life-threatening illness. The knowledge of palliative care among healthcare professionals is poor; therefore, training programs are needed to offer patients appropriate treatment and improve their health. In Syria, as palliative care programs are rarely applied, we aim to evaluate the knowledge regarding palliative care among healthcare workers. Methods: This is an online cross-sectional study conducted between July 24 and August 28, 2022 to measure palliative care knowledge and its applications among Syrian healthcare workers. The questionnaire for the study was designed in light of a previous study, and the inclusion criteria were Syrian healthcare workers, including physicians and nurses, as well as medical and nursing students. The four sections of the questionnaire included sociodemographic information in the first part, while the second, third, and fourth parts assessed experience, knowledge, and attitude toward palliative care among healthcare workers, respectively. Data were analyzed in IBM SPSS V. 28.0 using descriptive and multivariate logistic regression analysis. Results: Among 602 participants, 66.2% of participants were females. Most respondents were medical students (72.9%), while residents and nurses or nursing students represented 18.8% and 8.3%, respectively. The majority of participants (84%) answered the question about pain treatment goals correctly, while a small percentage (5.3%) answered the question about whether or not long-term opioid use is addictive correctly. No significant difference in the overall knowledge score was shown among geographical areas, genders, and different specialties. Regarding the knowledge questions related to palliative care, only 14 participants were considered knowledgeable. The three most responses that received agreement regarding the attitudes towards palliative care were “Pain relievers should be given as needed to terminally ill patients” (89.7%), “Spiritual care must include counseling for the terminally ill patient” (84.3%), “Patients have the right to determine their own degree of psychosocial intervention” (81%). A significant difference existed between urban and rural residents in terms of the attitude score. When comparing first-year students to those in their fifth year, students in their fifth year were 8.06 times more likely to have a positive attitude. Conclusions: Our results demonstrated that healthcare professionals have inadequate knowledge about palliative care. There is an urgent need to introduce palliative care to the health system in Syria in order to improve the quality of life of these patients in their terminal stages of illness and to provide care for patients who need it.

Background: TB was reported to have the highest mortality rate among other infectious diseases in 2018 worldwide. Syria and other low-income countries have a higher incidence rate of TB in comparison to high-income countries. Stigma toward TB is extremely high in low-income countries like Syria, and these stigma delays patients from seeking healthcare facilities. Our purpose in this study is to assess the Syrian's knowledge, attitudes, and practices toward TB and understand their Practice related to this disease. Methods: An online cross-sectional questionnaire was distributed between15 September 7 October 2022, among Syrians to assess their knowledge, attitudes, and practices toward TB. This questionnaire was adapted from a published study, and the inclusion criteria were all male and female Syrian citizens aged 18 or above. The survey was divided into four questions: the first section assessed sociodemographics, and the other sections were about knowledge, attitude, and practices, respectively. Using IBM SPSS V. 28.0, the data were submitted to descriptive and multivariate logistic regression analyses. Results: About (38.6%) of the 1407 participants in this research were male. The research participants' knowledge scores indicated that 78.1% have excellent knowledge. However, 54.1% of interviewees agreed that shaking someone's hand may transmit tuberculosis. Regarding attitude, more than two-thirds (85.7%) of the participants in the survey had an optimistic outlook. Accordingly, most participants (81.3%) had effective TB preventive and control practices. Participants aged 61 to 70 had more TB knowledge than other age groups (P value

Background: Diabetes and hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population's knowledge and treatment of hypertension and diabetes, so it is crucial to assess how the Syrian population acknowledges and perceives these illnesses. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals. Methods: A cross-sectional study was conducted between 1 August and 25 August 2022 to assess adult awareness, knowledge, attitude, and behavior about hypertension and diabetes. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. On the questionnaire, there were four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents' knowledge of and comprehension of hypertension and diabetes, and respondents' awareness of these disorders. Results: Among 976 participants, (65.8%) were females. Participants reported hypertension caused by (90.1%) stress, (78.2%) old age, (69%) anxiety, and (38.6%) drug usage. High salt consumption (87%), genetics (82.1%), and obesity (78%) are all risk factors for hypertension. In addition, minimizing salt consumption (92.4%), regular exercise (87.2%), and avoiding anxiety (85%) are preventative measures for hypertension. Participant answers to hypertension consequences were (75.8%) foot ulcer and (74%) eyesight loss. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. Alcohol use was linked to hypertension knowledge (P < 0.05). Participants whose lifestyles did not include alcohol use had a higher hypertension knowledge level (90.3%). Participants with a family history of diabetes have a greater knowledge of hypertension (92%) than those without (66.9%). Almost age groups have shown good knowledge of diabetes, especially participants aged above 55 (93.8%). However, most individuals have examined blood pressure (82.3%), whereas fewer than half had screened for blood sugar (64.4%). 82.2% of individuals check their blood pressure frequently, whereas 6.2% monitor their blood sugar. Men have a higher hypertension knowledge than females (mean=8.39, SD=2.02), P-value< 0.05, and knowledge of hypertension among participants was shown to be higher among those in good income status than other economic levels (mean=8.34, SD=1.98), P-value< 0.05. Participants between the ages of 40 and 55 showed better knowledge of diabetes compared to other age groups (mean=11.32, SD=2.54), P-value< 0.05; as well, men demonstrated greater knowledge of diabetes than females (mean=10.76, SD=2.79), P-value< 0.05. Conclusion: Our results demonstrated that the Syrian population has a good to moderate understanding of hypertension and diabetes. However, there is still a shortage of standardized, regular screening practices. Since individuals remain involved in unhealthy lifestyle habits, it is vital to provide accurate information about hypertension and diabetes.

Abstract Background and Aims Antibiotic resistance is seen as a worldwide health risk as a result of the overuse of antibiotics. Many countries noted that antibiotic usage was high during the COVID‐19 pandemic. The purpose of this study is to evaluate Syrians' knowledge, attitudes, and practice about the use of antibiotics and antibiotic resistance during the COVID‐19 epidemic. Methods A cross‐sectional study was conducted using an online questionnaire to collect the data from the Syrian population from February 5 to March 4, 2022. Syrians 18 years or older all over the world were able to participate in this study. A convenience snowball sampling method was used. SPSS version 20.0 was used to analyze the data. To examine the results, binominal logistic regression was used. Statistical significance was defined as a p

Abstract Pena–Shokeir syndrome is considered to be a fatal congenital condition that is rarely diagnosed in neonates. We present the first‐ever reported case of Pena–Shokeir syndrome from Syria. Clinical assessment and early prenatal diagnosis are both needed to give the mother and baby more realistic options.

After the widespread of COVID-19 virus worldwide, vaccination targeted reducing spread of cases and mortality rates. However, vaccination hesitancy was observed among the communities worldwide. Vaccination hesitancy involved parents regarding the decision of vaccinating their children- After obtaining ethical approval, an online cross-sectional study was conducted from 1 March to 22 April 2021 to evaluate the parents' acceptance of vaccinating their children against the COVID-19 virus in Syria. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0 package program (IBM Corporation, Armonk, NY, USA). Among 283 participants, 105 participants agreed to vaccinate their children, and 178 were not. A significant correlation between age and vaccine willingness was found (P-value < 0.0001*), especially in the age group between 18 and 30 years old (45.2%). Parents who accepted vaccinating themselves were more willing to vaccinate their children (34.6%). According to our results, there is a greater need to enhance awareness and knowledge programs about the vaccine's effectiveness and encourage parents to accept giving the vaccine to their children.

Abstract We report a rare case of a 50‐year‐old female patient with COVID‐19 presented to the emergency department where supplementary oxygen is delivered via noninvasive face mask ventilation. X‐ray imaging confirmed the existence of pneumoperitoneum. CT scan was not applicable due to the advanced status of the patient.

Bullying is defined as unpleasant behavior that causes someone to feel disturbed or embarrassed, affecting their self-esteem. Based on this premise, we set out to investigate bullying among Syrian graduate medical education residents and fellows, estimate its prevalence among specific subgroups, and give recommendations to help validate the findings and enhance the graduate medical education training experience. A sample of 278 residents and fellows in Syrian graduate medical school were recruited for the study in a national cross-sectional survey, with 276 participants completing a Bullying survey in 2021 and two people refusing to participate. Participants in the survey were asked to provide basic demographic and programming information and three general Bullying and 20 specific bullying behavior items. Differences across groups were compared for demographic and programmatic stratifications. About 51% of participants had experienced one or more bullying behaviors, 69% said they had been bullied, and 87% said they had witnessed Bullying. Residents and supervisor-attendings were the most common sources of perceived Bullying (~67 and 62%, respectively), followed by patients (58%), nurses (46%), and pharmacists (46%) (33%). More specific bullying behaviors have been recorded by female Arabic Syrians who are shorter than 5'8, have a body mass index (BMI) of 25, and are 30 years old or younger who were -compared to males- more likely to report attempts to minimize and devalue work (55 vs. 34%, P ≤ 0.01) and criticism and work monitoring (56 vs. 33%, P ≤ 0.01). In addition, general medical graduates and PGY-2-PGY-6 respondents reported more specific bullying behaviors than private medical graduates and post-graduate participants in the first year (PGY 1), respectively. For example, a significant difference is noticed when reporting unreasonable pressure to perform work (83 vs. 6%, P ≤ 0.01). Except for physical violence, which does not differ statistically between groups, most bullying behaviors were reported by participants with statistically significant differences between study groups—many residents and fellows in Syria's graduate medical school system report being bullied. Anti-bullying rules and a multidisciplinary strategy including all players in the medical system are essential to eradicating these pervasive practices in healthcare.

Background: The outbreak of monkeypox was declared a global public health emergency by the World Health Organization on 23 July 2022. There have been 60,000 cases reported worldwide, most of which are in places where monkeypox has never been seen due to the travel of people who have the virus. This research aims to evaluate the general Arabic population in regard to the monkeypox disease, fears, and vaccine adoption after the WHO proclaimed a monkeypox epidemic and to compare these attitudes to those of the COVID-19 pandemic. Methods: This cross-sectional study was performed in some Arabic countries (Syria, Egypt, Qatar, Yemen, Jordan, Sudan, Algeria, and Iraq) between 18 August and 7 September 2022. The inclusion criteria were the general public residing in Arabic nations and being older than 18. This questionnaire has 32 questions separated into three sections: sociodemographic variables, prior COVID-19 exposure, and COVID-19 vaccination history. The second portion assesses the knowledge and anxieties about monkeypox, while the third section includes the generalized anxiety disorder (GAD7) scale. Logistic regression analyses were performed to compute the adjusted odds ratios (aOR) and their confidence intervals (95%CI) using STATA (version 17.0). Results: A total of 3665 respondents from 17 Arabic countries were involved in this study. Almost two-thirds (n = 2427, 66.2%) of the participants expressed more worry about COVID-19 than monkeypox diseases. Regarding the major cause for concern about monkeypox, 39.5% of participants attributed their anxiety to the fear that they or a member of their family may contract the illness, while 38.4% were concerned about monkeypox becoming another worldwide pandemic. According to the GAD 7 score, 71.7% of the respondents showed very low anxiety toward monkeypox and 43.8% of the participants scored poor levels of knowledge about monkeypox disease. Participants with previous COVID-19 infection showed a 1.206 times greater acceptance to receive the monkeypox vaccine than those with no previous infection. A 3.097 times higher concern for monkeypox than COVID-19 was shown by the participants who perceived monkeypox as dangerous and virulent than those who did not. Participants who have a chronic disease (aOR: 1.32; 95%CI: 1.09–1.60); participants worried about monkeypox (aOR: 1.21; 95%CI: 1.04–1.40), and perceived monkeypox as a dangerous and virulent disease (aOR: 2.25; 95%CI: 1.92–2.65); and excellent knowledge level (aOR: 2.28; 95%CI: 1.79–2.90) have emerged as significant predictors. Conclusions: Our study reported that three-fourths of the participants were more concerned about COVID-19 than monkeypox disease. In addition, most of the participants have inadequate levels of knowledge regarding monkeypox disease. Hence, immediate action should be taken to address this problem. Consequently, learning about monkeypox and spreading information about its prevention is crucial.

Background Globally, lung cancer is the leading cause of cancer fatalities and the second most frequent cancer. Population knowledge of the features of lung cancer is a crucial strategy for early diagnosis and decreasing the mortality rate of lung cancer patients. In this study, we aim to assess the Syrian population’s knowledge of lung cancer and its risk factors and to measure awareness of symptoms related to lung cancer. Methods This national cross-sectional study was conducted between October 12 to November 21, 2022, in Syria. We included Syrian people above 18 years from all Syrian governorates. The questionnaire consisted of three categories of questions: sociodemographic information, awareness of lung cancer symptoms, and awareness of lung cancer risk factors. Results Overall, 2251 participants were involved in this research; almost half of them (47.3%) were aged between 21-30 years, and 30.9% indicated they are smoking cigarettes. The overall mean score of knowledge regarding closed questions about risk factors of lung cancer was 4.29; however, the mean score of knowledge regarding open questions about symptoms of lung cancer was 1.52. About half of the study sample (51.3%) indicated that unexplained weight loss is a possible symptom of lung cancer. Our findings showed that cigarette smokers have a lower probability of having adequate knowledge toward lung cancer risk factors than a non-smoker (AOR=0.73, COR=0.68, P-value Conclusion According to our findings, there is inadequate knowledge toward lung cancer risk factors and moderate knowledge of lung cancer symptoms. Along with educational programs to raise public knowledge of the dangers of smoking and other LC risk factors, effective tobacco control policy execution is crucial.