Background Systemic lupus erythematosus (SLE) is a chronic inflammatory multi systematic disease of unknown aetiology. SLE has a wide range of symptoms. The most common symptoms are joint pain, skin rash and fever. Oral lesions in SLE manifest in a variety of forms, such as oral mucosal ulceration, mouth burns, xerostomia and salivary gland diseases, temporomandibular joint disease, periodontal disease, dysgeusia, white lesions, oedema, bleeding and petechiae. Objective This study was conducted to evaluate the prevalence of oral mucosal lesions and their related factors in patients with SLE, giving the lack of comprehensive statistical data in Syria and the differences between reported prevalence. Patients and methods A cross-sectional study was performed in the Al-Mouassat University Hospital in Damascus. Patients were evaluated appropriating observation, clinical examination, completing questionnaires, studying patient’s medical records and paraclinical laboratory tests if required. Four types of oral lesions were evaluated: ulcer, erythema, white plaque and spots. The diagnosis of these lesions was made according to observation and clinical examination, and the location of each lesion was also recorded. Data were analysed using SPSS version 16.0. Result In this study, 42 (70% %) out of 60 patients (38 women and 4 men) had oral lesions, while 18 (30%) had none. The most common areas for the lesions were the buccal mucosa (26.1%) and the lips (14.2%). Of the 42 patients with oral lesions, 12 (27.6%) showed ulcers. There was a significant relationship between the following factors and oral lesions: oral hygiene status, the duration of the disease involvement, frequency of pregnancies, the amount of daily use of corticosteroids without significant difference between dosage groups, and medications used for SLE treatment other than corticosteroids (p < 0.008) without mentioned names or dosages. Conversely, age, sex, cigarette smoking and medications other than those used for SLE treatment were not significantly related to the presence of oral lesions (p value was greater than 0.05 in all subjects).

Castleman's disease is a rare disorder, yet a rarer newly described syndrome called TAFRO syndrome was discovered to accompany it. TAFRO represents the constellation of symptoms (Thrombocytopenia, Anasarca, MyeloFibrosis, Renal failure, Organomegaly). Most cases were described in Japan. We present the first case of TAFRO syndrome in Syria. A 58-year-old Caucasian male with no relevant history presented with fatigue, oliguria, decreased platelets, increased creatinine level, hepatosplenomegaly, ascites, pitting edema and lymph node enlargement. Possible differential diagnoses were excluded by laboratory, radiologic and cytologic tests including TB, malignancy and autoimmune diseases. A biopsy of a supraclavicular lymph node confirmed Castleman disease. Our patient had Catleman's disease, and presented with only four diagnostic criteria for TAFRO syndrome (Myelofibrosis was absent) in addition to other minor characteristics (microcytic anemia, negative HIV and HHV-8 infections.) which make the presentation consistent with TAFRO syndrome described in the Japanese cases. The criteria for diagnosing TAFRO syndrome are still changing, and the pathophysiology behind it is unclear. We recommend further research to understand this syndrome taking into account that its prevalence might be worldwide.

Background: A considerable number of medical students experience musculoskeletal pain (MSP) during their academic years. In this study, we seek to determine the prevalence of MSP, as well as its associated risk factors, among a sample of medical students at two major universities in Damascus, Syria.Methods: A cross-sectional study was conducted in two universities, with a total of 2009 medical students participating in filling-in the paper-based questionnaire. A modified version of the Standardized Nordic Questionnaire was utilized in this study. Results:The questionnaire was completed by 2009 medical students. The majority were between the ages of 21 and 25 years old, female (53%), and in their clinical years (55%). 1081 (54%) of all students had at least one MSP site in the previous week, while 1654 (82%) had at least one MSP site in the last year. MSP in the previous week was strongly linked with a history of trauma (odds ratio [OR] 2.26, 95% confidence interval [CI] 1.79-2.86, p = 0.001), as well as a family history of MSP (OR 1.40, 95% CI 1.12-1.76, p = 0.0029). MSP in the previous year was significantly associated with gender (OR 0.637, 95% CI 0.50-0.80, p = 0.0001), history of trauma (OR 4.59, 95% CI 2.93-7.17, p ≤ 0.001), and family history of MSP (OR 4.59, 95% CI 1.36-2.68, p = 0.0002). On multivariate analysis, factors associated with MSP in the previous week and last year were familial history of MSP (p = 0.0457) (p = 0.0024), respectively, and a history of trauma (p ≤ 0.001). Conclusion:MSP had a high prevalence among Syrian medical students, especially female students, those with history of trauma, and those with a family history of musculoskeletal disorders (MSD). This major health problem should be known to medical institutions, and awareness programs are required.