Association of ulcerative colitis, celiac disease, primary sclerosing cholangitis and liver cirrhosis in a young male.

Inflammatory bowel diseases (IBD), including ulcerative colitis, are chronic autoimmune conditions characterized by inflammation of the digestive system. The exact cause of IBD is unknown, but they often start during adolescence or early adulthood with symptoms such as urgency, rectal bleeding, diarrhea, abdominal pain and tenesmus. Primary sclerosing cholangitis and autoimmune hepatitis are recognized as co-occurring conditions associated with ulcerative colitis. However, the combination of ulcerative colitis, primary sclerosing cholangitis, liver cirrhosis, and celiac disease occurring concurrently has only been reported once before in a female patient. Here, we present the exceptional case of a Syrian adult male with all four of these conditions. This highlights the importance of screening for both celiac disease and cirrhosis in patients with ulcerative colitis and primary sclerosing cholangitis together, despite this combination of comorbidities is rare.

Effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking medical students.

Background: Peer-assisted learning has been shown to be constructive in numerous aspects of undergraduate medical education. The purpose of this study was to evaluate the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking students. Methods: A medical English conversation course was conducted at Damascus University by a group of students. Targeted participants were intermediate level fellow students from the same program. A longitudinal study was carried out between 1 st to 31 st March 2019 to assess changes in self-assessment of English language skills among course participants. Pre- and post-course appraisal involved a review of previous experience with medical English language, a self-assessment of five English language skills, and an objective measurement of medical English knowledge. In addition, participants were requested to respond to a set of statements related to the importance and the usefulness of peer-assisted teaching of medical English skills. Paired-sample Student t-test was used to compare pre- and post-course appraisal results. Results: 42 students attended the course and completed pre- and post-course appraisals in full. Data analyses showed a statistically significant increase in participants' confidence in speaking medical English in public ( p<0.001) and using English in various medical settings (presenting and discussing cases, writing clinical reports, interviewing patients and reading English medical texts). Objective measurements of medical English knowledge confirmed a significant increase in participants' knowledge of methods of administration of therapeutics, knowledge of human body parts in English and familiarity with English medical abbreviations. Most participants agreed that peer-education was effective in teaching medical English skills to non-native English-speaking students and in increasing their confidence when using English in real-life medical scenarios. Conclusions: The present study highlights the effectiveness of peer-assisted teaching of medical English skills to non-native English-speaking medical students. Further validation is required and should compare the effectiveness of traditional versus peer-assisted teaching approaches.