Background:The 2019 novel coronavirus (COVID-19) is highly contagious and can spread a pandemic, so it is related to serious health issues and major public concerns, and is considered by the medical community to be the greatest concern because it is the greatest risk of infection.Objective: To identify and assess the psychological effects of the COVID-19 pandemic on healthcare professionals in Khartoum state hospitals 2021.

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Introduction: Epidural anesthesia is a neuraxial technique that is widely used for surgical, obstetric, and chronic pain management. It involves injecting an anesthetic material into the epidural space through the intervertebral space using an epidural needle. Epidural anesthesia may result in complications including epidural hematoma, epidural abscess, and shearing of the epidural catheter. Breakage of the tip of the epidural catheter is a rare complication. Patient concerns: A 27-year-old primigravid woman, previously well, was admitted for normal vaginal delivery, for which she received epidural analgesia. After delivery, the epidural catheter was removed and the tip was missing. Diagnoses: A neurosurgical consultation requested magnetic resonance imaging of the lumbar spine with intravenous contrast. Magnetic resonance imaging failed to reveal any missing part. Interventions: A multidisciplinary team deferred surgical removal of the tip and followed-up with the patient. Outcomes: Weekly follow-up of 3 months showed no symptoms or neurological sequelae. Conclusions: Breakage of the epidural catheter tip is an infrequent complication of epidural anesthesia. An expert physician should insert or remove the epidural catheters. The decision between conservative and surgical management should be case-based, with open discussion with the patient.

Background Monkeypox is a zoonotic disease caused by Monkeypox virus, an Orthopoxvirus. The 2022 Monkeypox outbreak has provoked a considerable amount of fear among the public. Awareness about this disease would modify the public attitudes in the fight against Monkeypox. We conducted this study aiming to assess the awareness and prediction of the middle east public about Monkeypox. Methods This cross-sectional study was conducted in August 2022. Data were collected from eight middle east countries using an online self-administered questionnaire distributed through educational and social media platforms. Statistical analysis was conducted using SPSS version 26. Results About 11,016 individuals have participated in this study. The majority of the participants have not seen a Monkeypox case, but will not travel to a country with the epidemic. Most of the participants knew the causative organism. Importantly, the majority were not aware of Monkeypox mode of transmission, symptoms, complications, and vaccination. A considerable proportion were aware of the disease protective measures. Participants' awareness was mostly gained from social media and it varied by age, gender, educational level, and country. The majority predicted acquiring Monkeypox when protective measures not taken, progression to a pandemic with economic consequences, and ability of ministry of health to control the epidemic. Participants' predictions varied by their country. Conclusion Middle east public knowledge about monkeypox is poor. Raising awareness about Monkeypox (especially mode of transmission, symptoms, and preventive measures) would be of benefit in controlling the epidemic. This study constitutes an evidence upon which health education programs could be designed.

Background and Objectives: Patients of end-stage renal disease are prone to have a very low quality of life (QoL). Variety of factors influence the QoL among sufferers of chronic kidney disease comprising of type of dialysis, sufficiency/adequacy of dialysis, and associated burden of disease. We conducted this study amidst the pandemic to determine the associated factors for poor QoL in hemodialysis patients during the ongoing pandemic.Patients and Methods: This cross-sectional study was conducted in a hemodialysis unit of a tertiary care hospital. A total of 118 participants responded to the validated questionnaire of Quality of Life Index-dialysis version-III (QLI). Higher scores signify good QoL, total scores are further categorized into subgroups desirable, relatively desirable and undesirable.Results: The mean age of the participants was 57.36 ± 10.03 years and mean body mass index of 26.73 ± 5.54 kg/m 2 . The mean total QoL of the study population was found quite low (12.99 ± 5.89). Majority of respondents fell in undesirable category of QoL (49.2%). Total QoL (P = 0.004) and subscale health/functioning (P = 0.003) were significantly lower in females. All the subscales along with total QoL scores were found lower in twice-weekly dialyzed patients (P < 0.001). Marital status (P = 0.049) and twice-weekly dialysis (P < 0.001) were found significant with undesirable QoL. On multivariate analysis, significant determinants of undesirable QoL were twice-weekly dialysis (P = 0.001), catheter access (P = 0.034), phosphate (P = 0.005) and uric acid (P = 0.006).Conclusion: Inadequate dialysis due to lesser frequency per week leading to poorly cleared toxic substances were most significant contributors of poor QoL in our study.