Factors influencing research productivity among Syrian medical professionals amidst conflict: a case-control study.

BACKGROUND: Medical research productivity is globally increasing, with a lagging progress in third-world countries due to significant challenges, including inadequate training and brain drain. Syria had been showing a slow upward trend until the war broke out and severely hindered academic growth and productivity. A deeper understanding of the factors influencing research productivity in this context are fundamental to guide educational policies and resource allocation. Previous cross-sectional studies that evaluated the perspectives of Syrian academics on the issue were limited by the small sample size of published healthcare workers, making it difficult to identify the factors that enabled them to pursue research. METHODS: To address this challenge, we employed a case-control design. We isolated published early-career Syrian healthcare workers and compared their characteristics and perceptions to unpublished matched controls. Authors in the fields of medicine, dentistry, and pharmacy affiliated with any Syrian University were identified through an extensive search of PubMed and Google Scholar.These authors were invited to complete a questionnaire that covered participants' research contributions, alongside their self-assessed knowledge, attitudes, and barriers towards research. The questionnaire was publicly published to recruit an equal sample of matching controls, with half consisting of unpublished researchers and the other half of participants without prior research contributions. RESULTS: Six-hundred-sixteen participants were recruited. Their knowledge, attitudes, and perceived barriers explained 46% and 34% of the variability in research involvement and publication, respectively (P < 0.001). Getting involved in and publishing research studies associated with higher research-related knowledge and attitudes (P < 0.001). Respondents' assessment of research-related barriers and their academic scores did not differ between cases and controls. Superior research-related knowledge and attitudes were associated with male gender, higher English competency, and better internet connectivity. Meanwhile, extracurricular training and mentors' support were associated with more positive research-related attitudes and less perceived barriers. CONCLUSIONS: Research productivity of medical professionals in Syria exhibits a positive correlation with their knowledge and favorable attitudes towards medical research. Noteworthy, the demographic variations are linked to disparities in research-related knowledge and motivation. In conclusion, these results suggest a potential avenue for enhancement through concentrated efforts on improving extracurricular training interventions and mentors' support.

Improving Academic Writing in a Low-Resource Country: A Systematic Examination of Online Peer-Run Training.

Problem: Syrian medical research synthesis lags behind that of neighboring countries. The Syrian war has exacerbated the situation, creating obstacles such as destroyed infrastructure, inflated clinical workload, and deteriorated medical training. Poor scientific writing skills have ranked first among perceived obstacles that could be modified to improve Syrian research conduct at every academic level. However, limited access to personal and physical resources in conflict areas consistently hampers the implementation of standard professional-led interventions. Intervention: We designed a peer-run online academic writing and publishing workshop as a feasible, affordable, and sustainable training method to use in low-resource settings. This workshop covered the structure of scientific articles, academic writing basics, plagiarism, and the publication process. It was also supplemented by six practical assignments to exercise the learned skills. Context: The workshop targeted healthcare professionals and medicine, dentistry, and pharmacy trainees (undergraduate and postgraduate) at all Syrian universities. We employed a systematic design to evaluate the workshop's short- and long-term impact when using different instructional delivery methods and assignment formats. Participants were assigned in a stratified manner to four groups; two groups attended the workshop synchronously, and the other two groups attended asynchronously. One arm in each group underwent a supervised peer-review evaluation for the practical writing exercises (active), while the other arm in each group self-reviewed their work on the same exercises using exemplary solutions (passive). We assessed knowledge (30 questions), confidence in the learned skills (11 questions), and the need for further guidance in academic writing (1 question) before the workshop and one month and one year after it. Impact: One-hundred-twenty-one participants completed the workshop, showing improved knowledge, confidence, and need for guidance. At one-year follow-up, participants showed stability in these gains. Outcomes for the synchronous and asynchronous groups were similar. Completing practical assignments was associated with greater knowledge and confidence only in the active arms. Participants in the active arms engaging in the peer-review process showed greater knowledge increase and reported less need for guidance compared to those who did not engage in the peer-review. Lessons learned: Peer-run interventions can provide an effective, affordable alternative to improving scientific writing skills in settings with limited resources and expertise. Online academic writing training can show improvements regardless of method of attendance (i.e., synchronous versus asynchronous). Participation in supplementary practical exercises, especially when associated with peer-review, may improve knowledge and confidence.

Overlapping between squamous cell carcinoma and mucocutaneous leishmaniasis in a diabetic patient.

Mucocutaneous leishmaniasis (MCL) is a leishmania infection; that usually affects the oral and nasal mucosa. The coexistence of leishmania and malignancy is rarely reported and mainly in immunocompromised patients. We report a case of an overlapping between leishmania and squamous cell carcinoma (SCC) in a 60-year-old immunocompetent Syrian female. The patient presented with a one-year crusty nodule on the lower lip. Since she lives in an endemic region, leishmaniasis was suggested, and confirmed with a Giemsa-stained smear. After 20 days of meglumine antimoniate treatment, the patient revealed no signs of recovery, thus, the treatment was prolonged with the addition of sodium stibogluconate injections. Later, she presented with increased symptoms. A biopsy was performed due to SCC suspicion, and it was verified. The patient underwent complete surgical removal of the lesion. After a one-year follow-up, no recurrence was observed. We illustrated the importance of considering SCC in cases of refractory leishmaniasis.

Central giant cell granuloma formation in an edentulous area in the posterior portion of mandible: A case report.

INTRODUCTION: Central Giant Cell Granuloma (CGCG) is a non-neoplastic benign lesion. It is primarily observed in the maxilla and mandible, with the mandible being the more reported site of the lesion. The lesion often manifests in the anterior regions of the mandible, extending occasionally across the midline. This case reports a rare presentation in the posterior portion of the mandible, in an edentulous area. PRESENTATION OF CASE: A 33-year-old female with a history of extraction of teeth 36 and 37 six months ago presented with a main complaint of a mass in the oral cavity. The oral examination revealed an expansive multilocular mass (4 × 3 cm) located on the alveolar ridge in the left posterior portion of the mandible, extending around tooth 33 with an intact masseter muscle. The histopathological findings were consistent with CGCG. Consequently, the lesion was surgically removed with no clinical or radiological recurrence observed during the 4-month post-operative follow-up. DISCUSSION: While previous reports of CGCG in the posterior portion of the jaw showed destructive lesions that caused mandibular ramus destruction along with swollen masseter muscle, this case reports no involvement of the masseter muscle. Also, while some studies linked CGCG to tooth-bearing regions, our case suggests a possible traumatic link even after extraction. CONCLUSIONS: This case presents a rare CGCG occurrence in the posterior jaw, notably without masseter muscle involvement. It also indicates that CGCG can manifest in edentulous regions.

23-Year-old male with multiple giant facial pyogenic granulomas being treated with combined topical timolol and steroid: A case report.

Introduction and importance: Pyogenic Granuloma (PG) commonly presents as a solitary, erythematous, non-tender, skin lesion, usually not exceeding 2.5 cm. Although Surgical excision is the first-line treatment, conservative treatments are recently developing. Solitary PG is well documented unlike multiple PGs, as the latter is rarely described in terms of its presentations and treatments. Case presentation: This interesting case report describes a 23-year-old male who developed multiple PGs on the nasal area (2cmx2cm) and mandibular area (10cmx2cm) after sutures removal secondary to a recent history of trauma. The lesions regressed after successfully treated with two months of timolol drops and topical corticosteroids. Subsequently, intralesional corticosteroids injections were given once-per-month for two months, with residual fibrosis of the regressed lesion. Clinical discussion: While the most common site for multiple PGs is the interscapular region, this case reports giant, facial, multiple PGs followed suture removal. Although ß-blockers were reported to successfully treat solitary PG, only a few cases were raised to discuss this treatment in terms of multiple PGs. This case completes the series and reports successfully-treated multiple PGs using a combination of topical timolol and steroid. Conclusion: This case supports the need to consider multiple PGs as a differential diagnosis following sutures removal even when it reaches rarely reported diameters. Also, it suggests topical timolol and steroids as an effective conservative treatment in similar cases of multiple giant PGs. Notably, the treatment failed to sidestep scar formation.