Down syndrome (DS), characterized by trisomy 21, significantly increases susceptibility to leukemia, although the occurrence of multiple myeloma (MM) in DS is exceedingly rare. This report details the case of a 45-year-old female with DS who was diagnosed with MM, highlighting diagnostic and therapeutic complexities. It emphasizes the importance of tailored therapeutic strategies for treating MM in individuals with DS and the need for specialized approaches in these cases.

Conflict adversely affects respiratory health in both direct and indirect ways among populations whose health is already compromised through the compounding effects of conflict. Our aim is to review academic and grey literature relevant to respiratory health in the Syrian conflict (now more than a decade in duration) to explore its impacts on populations across Syria. We performed a scoping literature review of academic and grey literature on respiratory health in Syria between March 2011 (taken as the start of the conflict for practicality) and December 2023. Of 11,472 papers screened, 34 met the inclusion criteria, of which 29 were peer reviewed. Key themes identified included the impact of conflict on asthma diagnosis and management; the burden of respiratory tract infections (RTIs) and COVID-19; the impact of chemical weapon use and the impact of destruction and interruptions to the health system(s) across Syria on respiratory health. This review highlights the need for more in-depth exploration of the impact of conflict on respiratory health in Syria with focus on social determinants, for example, shelter, public health interventions, smoking cessation, and supporting early diagnosis and treatment of respiratory conditions to counter the effects that conflict has had on respiratory health.

BACKGROUND: Identifying healthcare services and also strengthening the healthcare systems to effectively deliver them in the aftermath of large-scale disasters like the 2023 Turkey-Syria earthquakes, especially for vulnerable groups cannot be emphasized enough. This study aimed at identifying the interventions undertaken or proposed for addressing the health needs or challenges of vulnerable groups immediately after the occurrence of the 2023 Turkey-Syria earthquakes, as well as for prioritizing their healthcare service delivery in the post-Turkey-Syria earthquake.
METHODS: In this scoping review compiled with the five steps of the Arksey and O\'Malley framework, five databases, including PubMed, Science Direct, Web of Science, OVID, and Google Scholar, were searched for studies published between March and April 2023 in line with the eligibility criteria. Interventions for enhancing post-earthquake healthcare services (PEHS) were grouped into seven (7) categories, adopted from previous guidelines and studies. Each one was assigned a default score of a value equal to one (1), which, in the end, was summed up.
RESULTS: Of the 115 total records initially screened, 29 articles were eligible for review. Different interventions they reported either undertaken or proposed to address the healthcare needs and challenges, especially faced by the most vulnerable groups in the aftermath of the Turkey-Syria earthquakes, were categorized into 7 PEHS. They were ranked with their scores as follows: humanitarian health relief (25); medical care (17); mental health and psychosocial support (10); health promotion, education, and awareness (9); disease surveillance and prevention (7); disability rehabilitation (7); and sexual and reproductive health (5).
CONCLUSIONS: Since there are no proper guidelines or recommendations about the specific or most significant PEHS to prioritize for vulnerable groups after the occurrence of large-scale earthquakes, this scoping review provides some insights that can help inform healthcare service delivery and prioritization for vulnerable groups in the post-2023 Turkey-Syria earthquakes and other similar disasters.

Risky behaviors are defined as emotional and behavioral problems that harm mental and physical health. The present study aimed to systematically review and synthesize research investigating the risky behaviors of Syrian children living in Turkey. The study was conducted through a systematic review of articles published in the Scopus and Web of Science database between 2013 and the present day, and met the STROBE reporting criteria. The inclusion criteria for studies in the systematic review were established, and studies that focused on Syrian-origin forced migrant child-adolescents aged 7-18 years and investigated risky behaviors without a clinical diagnosis and treatment purpose were included. Four studies with a sample of 790 children were examined. According to the findings of this study, there is a measurement issue for risky behaviors. In this study, there are numerous factors influencing risky behaviors, including those related to traumatic life events due to war, psychopathology, acculturation-related factors, and sociodemographic factors. The most significant finding highlighted in the study is the need for methodological improvements and context-specific studies to be repeated in future research, to ensure statistical generalizability and clinical implications in research on this subject.
Studies on the factors influencing risky behaviors in children and adolescent forced migrants have been conducted using diverse research designs, questions, hypotheses, and results. Risky behaviors are defined as emotional and behavioral problems that harm mental and physical health. The present study aimed to systematically review and synthesize research investigating the risky behaviors of Syrian children living in Turkey. According to the findings of this study, there is a measurement issue for risky behaviors. In this study, there are numerous factors influencing risky behaviors, including those related to traumatic life events due to war, psychopathology, acculturation-related factors, and sociodemographic factors.

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BACKGROUND: Mediastinal Liposarcoma (ML) is an exceedingly rare neoplasm, accounting for less than 1% of all liposarcomas. Surgical resection is the most effective therapeutic modality, while adjuvant radiation therapy may be recommended for unresectable tumors.
METHODS: This case report presents a rare case of a 52-year-old Syrian male patient with well-differentiated mediastinal liposarcoma (ML) who presented with exertional dyspnea, cough, and weight loss. Imaging studies revealed a large tumor causing extrinsic compression on the right lung, as well as compression of the heart and great vessels. CT-guided biopsy confirmed a diagnosis of well-differentiated liposarcoma, and the patient underwent surgical resection. The patient had a rapid postoperative recovery and was discharged on the fourth day post-operation, displaying an excellent postoperative status. The patient was followed up for 3 months postoperatively with no recurrence.
CONCLUSIONS: This report highlights the significance of incorporating ML into the differential diagnosis of mediastinal masses, particularly in individuals presenting with exertional dyspnea and weight loss. Furthermore, this report provides a comprehensive review of previously reported cases of ML in the medical literature.

UNASSIGNED: Osimertinib is the treatment of choice for epidermal growth factor receptor (EGFR)-mutated advanced non-small-cell lung cancer (NSCLC). Because of its high price, many low-income countries, such as Syria, cannot provide osimertinib, which makes it difficult to choose the appropriate treatment for these patients. This study aimed to review articles that assessed tyrosine kinase inhibitors (TKIs) for advanced NSCLC and developed an appropriate treatment plan for Syrian patients.
UNASSIGNED: An electronic literature search was conducted of published phase II and III studies that assessed the efficacy of EGFR-TKIs for advanced NSCLC between January 2003 and May 2022.
UNASSIGNED: Seventeen articles were reviewed. The results were similar when erlotinib or icotinib was compared with gefitinib. Progression-free survival and overall survival for afatinib and dacomitinib were longer than for gefitinib, with small significant differences. Osimertinib was the only TKI that showed efficacy against the T790M mutation, which showed an improvement over the first- and second-generation TKIs. Osimertinib as a first-line therapy is not cost-effective compared with first- and second-generation TKIs.
UNASSIGNED: Osimertinib is the preferred first-line treatment in patients with advanced EGFR-mutated NSCLC. First- and second-generation TKIs are still considered good options, especially in low-income countries that cannot cover the costs of osimertinib.

To provide an overview of the holistic impact of the armed conflict on medical education and health professionals\' training (MEHPT) in Syria.
Syria is a country which underwent an armed conflict for 10 years and suffered from the weaponisation of health.
A mixed-methods systematic review including quantitative, qualitative, mixed-methods and textual literature between 2011 and 2021 including papers on the Syrian MEHPT undergraduate and postgraduate education and training personnel (including medicine, dentistry, pharmacy, nursing, midwifery and allied health professionals). The electronic search was conducted in October 2018 in Embase, Global Health, Medline, PsycINFO, Web of Science, PubMed, Scopus, CINAHL and grey literature. And an update to the search was conducted in August 2021 in PubMed, Google Scholar and Trip database.
The impact of conflict on the MEHPT system, personnel, experiences, challenges and channels of support.
Of the 5710 citations screened, 70 met the inclusion criteria (34 quantitative, 3 qualitative, 1 mixed-method, and 32 reports and opinion papers). The two major cross-cutting themes were attacks on MEHPT and innovations (present in 41% and 44% of the papers, respectively), followed by challenges facing the MEHPT sector and attitudes and knowledge of trainees and students, and lastly health system and policy issues, and narrating experiences.
Conflict in Syria has politicised all aspects of MEHPT. Influenced by political control, the MEHPT system has been divided into two distinguished geopolitical contexts; government-controlled areas (GCAs) and non-GCAs (NGCAs), each having its characteristics and level of war impact. International and regional academic institutes collaboration and coordination efforts are needed to formulate educational platforms using innovative approaches (such as online/blended/store-and-forward/peer-training/online tutoring) to strengthen and build the capacity of the health workforce in conflict-affected areas.

The war in Syria, which started over 11 years ago, has devastated the country\'s water sources, healthcare system, and other vital facilities for healthy living. The country is vulnerable to outbreaks, especially epidemic-prone ones like cholera, due to its fragile health system. Syria experienced its last hit of cholera in 2009, which led to the deaths of several Syrian children and affected about 1,000 people. The current cholera resurgence in Syria calls for public concern. Considering the poor access to clean water, the forced relocation of people, and other destruction caused by the war, these factors have exposed Syrian children to infectious diseases like cholera. We argued for more efforts toward the implementation of Water, Sanitation and Hygiene (WASH) in the country. We also pointed out the need for proper education and sensitization campaigns using all available resources to educate the populace, mass chlorination of wells, mapping vulnerable areas, and implementing WASH while encouraging vaccination coverage for cholera as a strategy to reduce its incidence. Improving the national surveillance systems will aid in the timely and appropriate reporting of any outbreak. Again, more negotiations should be done to seek a lasting solution to ending the war and restoring peace and serenity in the country.

The COVID-19 pandemic has increased the burden on the collapsing health system in northwest Syria. The situation was exacerbated by the low rates of adherence to preventive measures and acceptance of the COVID-19 vaccine. In this study, we systematically analysed studies related to Risk Communication and Community Engagement programs, and community awareness in northwest Syria in order to determine the most widespread prevention methods, the community\'s perspectives and knowledge of epidemic prevention, and the factors that prevent effective community engagement and uptake of COVID-19 prevention precautions in an area that has been suffering from the scourge of conflict for more than ten years. Based on the research findings, low adherence to COVID-19 prevention measures is mainly due to external factors related to socioeconomic status, scarcity of resources, and poor living conditions. Therefore, this study suggested that integrated multi-sectoral humanitarian programs that address these factors holistically are more effective than solely public health interventions in involving the community to become an active part of the Risk Communication and Community Engagement programs and ensuring their effectiveness.