Introduction : The Syrian crisis started 9 years ago causing substantial damage to the country’s infrastructure, and the consequences of this tragedy have further stunted the underdeveloped research environment in Syria. This paper aims to address the challenges of conducting medical research among Syrian academics during the Syrian crisis. Methods: The data were collected from (471) Syrian researchers (MsC or PhD students, university professors) from 13 universities and hospitals, covering 10 governates. A questionnaire was developed to collect the data and 52 factors were identified as research challenges. Results: The main institutional challenges are: (94%) insufficient funding, (80.3%) difficulties in acquiring supplies and equipment, (79.6%) lack of neutrality in approving research proposals. In regards to the personal challenges, (70.1%) expressed a high level of motivation to carry out research but only (33.4%) are confident that they have enough knowledge, (53.1%) do not have academic writing skills, (73.5%) do not have the basic information about medical statistics. For the crisis related factors, (83.5%) cite collecting data and reaching the sources of data as the main challenge, (80.4%) for losing contact with the patients because of the war situation, (76.3%) for lack of governmental support for the research during the crisis. Conclusion: Syrian medical researchers continue to face a number of challenges and the Syrian crisis has brought more problems and obstacles to the surface. However, despite those numerous challenges, researchers from Syrian institutes are still working on research projects.

Introduction:Since the declaration of COVID-19 as a global pandemic, there has been a dramatic increase in the number of infected cases. Thus, the number of hospital admissions has peaked during a short period, which in return has created a huge burden on healthcare workers. The effect of this pandemic on HCWs can be more severe in war-torn countries. This research aims to explore the psychological effects of the current pandemic on healthcare providers in Syria and compare it with the situation of Syrian HCP outside Syria.Materials and methods:660 has participated in this cross-sectional study using an online questionnaire during two phases (two months apart). The first sample included 76 participants which were used for comparison only, and the second sample consisted of 584 participants (118 outside Syria, 466 inside Syria). The study included demographic, social, and workplace-related questions, as well as three scoring systems including The Pittsburgh, Sleep quality index (PSQI), Kessler Psychological Distress Scale (K10), and Generalized Anxiety Disorder (GAD 7).Results: 72.4% of the first sample had poor sleep quality compared to 80% for the second sample, while over 40% of the first sample had scored well on the Kessler scale and 17% scored severe stress disorder, the second sample scored 29.8% and 27.9% on the same index retrospectively. Over 70% of the two samples scored mild on the generalized stress disorder index. Both inside and outside Syria samples had very similar results on the three indices, and no significant difference was noticed between the sample inside Syria and the sample outside Syria for the Pittsburgh Sleep Quality Index (P=0.900), and for the Generalized Anxiety Disorder score (P=0.798), and no significant difference was noticed between the two samples for the Kessler Psychological Distress Scale (P=0.231). Conclusion: The current pandemic has imposed new concerns related to the preparedness of health systems worldwide but especially in countries with limited resources. Additionally, addressing mental health issues has become vital to ensure that healthcare systems are more effective.Regions of low income and those suffering from armed conflict may benefit from the conclusions of this study to ameliorate the medical practice conditions in the setting of such pandemics as COVID-19.

Chondral delamination is the separation or debonding of the articular cartilage from the underlying subchondral bone. The hyaline cartilage has a limited capacity for healing, meaning it does not possess the innate ability to restore its normal structure or to heal the subchondral bone once detached from it. The purpose of this article is to report the outcomes of a microfracture technique used to manage chondral delamination in a 59-year-old male; we also reviewed the treatment options mentioned in the literature. The patient was admitted to the Department of Orthopedic Surgery complaining of recurrent severe right knee pain with multiple episodes of knee locking, denying any direct or twisting trauma to the knee. The plain X-ray showed mild degenerative changes with articular surface irregularity. On Magnetic resonance imaging, wide chondral delamination was noted in the medial femoral condyle. After 12 months’ post-op, his condition improved. No locking was observed. Pain improved in comparison to the pre-operative levels. The international knee documentation committee improved from 26.4% to 52.9%. In a follow-up magnetic resonance imaging, the adhesion of most parts of the delaminated cartilage.