Submission and Review of Research 2025-Medical Sciences Series

Assessment of the daily nursing workload in the surgical and medical departments at Latakia University Hospital

حسان شاش — 2025-11-23

Nursing represents the largest occupational category in the health sector, with a rate of approximately 59% of health workers. The concept of workload is widely used in the field of nursing, and its analysis gives a clear and real vision and understanding about distributing tasks and assignments on nursing staff. The study aims to assess the daily nursing workload performed by nurses working in the surgical and medical inpatient departments at Latakia University Hospital. Data was collected between January 4, 2024, and November 3, 2024, from all nursing staff in these departments (681 nurses). Four tools were used in the study: Demographic and clinical data tool, direct nursing activities, indirect nursing activities, and supportive activities. The researcher found that the highest level of nursing workload was in department of labor and delivery. The study recommended the need to restructure and distribute the nursing staff in proportion to the workload and assign the implementation of some supportive activities in the department to non-nursing staff in order to alleviate the high levels of nursing workload.

Assessing of Head Nurses' Knowledge about Nursing Performance Appraisal at Lattakia University Hospital

Heiam baddour — 2025-11-23

Performance appraisal plays an important role in our hospitals, especially among our nursing staff who bear the brunt of the work. Therefore, it aims to assess the knowledge of head nurses regarding the performance appraisal of nurses. The sample included 45 head nurses whose working at Lattakia University Hospital. Data were collected using a tool developed by the researcher. After collecting the data, it was transcribed and analyzed using the SPSS statistical program. The results showed that head nurses have a weak level of knowledge regarding nursing performance appraisal, and there were no statistically significant differences between knowledge and the demographic variables of the study, except for years of experience as a head nurse. The study recommended that head nurses must undergo training courses in the field of nursing performance appraisal, that booklets and brochures be available for use as a reference during nursing performance appraisal, and that further research be conducted to identify the difficulties and problems they face that prevent them from performing their role to the fullest extent.

Inrarenal Venous Flow PatterIntrarenal Venous Flow Patterns in Patients with Acute Heart Failure

علاء رسلان — 2025-11-23

Intrarenal venous flow patterns are emerging tools in identifying renal venous congestion and its clinical significance in cardiorenal syndrome (CRS).

Objective: To study the distribution of intrarenal venous flow patterns (IRVF) and their relation to the development of acute kidney injury and prognosis in patients with acute heart failure.

Materials and methods: This is prospective, analytical study included 72 patients admitted with acute heart failure. Their medical history was taken, laboratory evaluation was conducted, and they were classified into three groups according to the IRVF pattern seen on intrarenal Doppler at admission. The occurrence of acute renal injury was recorded according to the RIFLE classification, and the outcomes were followed up, including hospitalization time, in-hospital death, and the need for permanent dialysis.

Results: Monophasic pattern was observed in 27 patients (37.5%), intermittent pattern in 21 patients (29.2%) and continuous pattern in 24 patients (33.3%). Acute kidney injury occurred in 44.4% of patients with monophasic pattern compared to 38% and 20% of patients in intermittent and continuous flow groups, respectively (P=0.01). Also, the prognosis was worse in terms of hospitalization duration and in-hospital death in monophasic pattern and diuretic resistance was observed in them at a higher rate.

Conclusion: Studying intrarenal venous flow patterns is useful for evaluating the reflection of hemodynamic changes in acute heart failure on the kidney and has a useful role in evaluating the prognosis in patients with acute heart failure.

Effect of Applying Telehealth Techniques on Child Health Program Services EffThe Perception and Attitudes of Nursing Staff Regarding the Application of Telehealth Techniques in Primary Healthcare Centers in Salamiyah

Jaber Dardar — 2025-11-23

Telehealth is a natural outcome of continuous advancements in both healthcare and technology, as the integration of these innovations has become one of the key pillars for delivering future healthcare services. The current study aimed to assess the perceptions and attitudes of nursing staff toward the implementation of telehealth technologies. Materials and Methods: The study adopted a descriptive approach and selected a suitable sample consisting of 22 nurses working within the Child Health Program at primary healthcare centers in Salamiyah, Hama Governorate. Data was collected using a tool developed by the researcher after reviewing relevant previous literature.

Results: The findings indicated that more than half of the sample (54.5%) had neutral perceptions about telemedicine, meaning they did not view it positively or negatively in a definitive way. Meanwhile, the majority (90.9%) expressed positive attitudes toward adopting this type of healthcare service. Conclusions: The study concluded that nursing staff in the Child Health Program lack a clear vision regarding telemedicine, yet they hold positive attitudes toward its adoption. Therefore, the study recommends training nursing staff on these technologies and providing the necessary infrastructure to ensure their effective integration into the existing healthcare system.

Prognostic Significance of CD20+ and CD8+ Tumor-Infiltrating Lymphocytes in Operable Triple‑Negative Breast Cancer

Yana Hasan — 2025-11-23

Aim: This study aimed to evaluate the prognostic value of stromal TILs and their subsets (especially CD20⁺ and CD8⁺) in predicting 3-year recurrence free survival (RFS) in non-metastatic TNBC patients receiving adjuvant chemotherapy.

Materials and methods: This prospective cohort study enrolled 109 non-metastatic TNBC patients treated with adjuvant anthracycline-taxane-based chemotherapy at Lattakia University Hospital, Lattakia, Syria. (2022–2025). TILs density was evaluated via immunohistochemistry (IHC) on pretreatment specimens using International TILs Working Group guidelines. RFS at 3 years was analyzed via Kaplan-Meier and Cox regression models.

Results: High stromal TILs (≥ 30%) were observed in 59.6% of patients and correlated with younger age (P=0.009), smaller tumors (P=0.026), and node-negative disease (P=0.017). Patients with high TILs had significantly improved 3-year RFS (72.3% vs. 40.9%, P=0.002). Elevated CD20⁺ was associated with reduced recurrence (HR: 3.86, P<0.001). Elevated CD8⁺ was associated with reduced recurrence (HR: 3.38, P<0.001). Co-elevation of CD20⁺ and CD8⁺ synergistically lowered recurrence risk by 68% (P=0.006). Multivariable analysis confirmed TILs (HR: 2.05), CD8⁺ (HR: 3.12), and CD20⁺ (HR: 2.67) as independent predictors alongside nodal status (N3: HR: 4.91), tumor size (T3-T4: HR: 1.72), and tumor grade (G3: HR: 2.18).

Conclusion: TILs subsets, particularly CD20⁺ and CD8⁺, refine prognostic stratification in early TNBC beyond conventional clinicopathologic factors.

Keywords: TNBC, tumor-infiltrating lymphocytes (TILs), adjuvant chemotherapy, CD8⁺, CD20⁺, recurrence-free survival.

The Efficacy of Dose-Dense Neoadjuvant Chemotherapy for Patients with Non-Metastatic Breast Cancer and Clinicopathological Factors Affecting Pathological Response

هيا الريم موفق سعيد — 2025-11-23

Many therapeutic approaches have emerged to improve pathological complete response, which has a prognostic value for breast cancer patients. The most important approach was dose-dense neoadjuvant chemotherapy and we aim to study its efficacy in this study.

The study included 115 patients who attended the Chemotherapy and Radiotherapy Center in Latakia University Hospital between 2021 and 2024 with non metastatic breast cancer eligible for neoadjuvant therapy. All patients received dose-dense neoadjuvant chemotherapy with G-SCF then they underwent surgery with total or conservative mastectomy with axillary lymph node dissection.

The rate of patients achieving pathological complete response (pCR) was 45.21% , the rate of non-pCR was 54.75% .The highest response rate was in HR- , HER2+ patients, with a pathological complete response of 77.7%. A better response was observed in patients who did not have lymphadenopathy at diagnosis and who had grade III tumors.

Dose-dense neoadjuvant chemotherapy is an important treatment approach for breast cancer, especially for TNBC, HER2+ patients.