Monkeypox Post COVID19: Knowledge, Worrying, and Vaccine Adoption of the Arabic General Population (preprint)

Abstract: Background: The outbreak of monkeypox was designated a global public health emergency by the World Health Organization on July 23, 2022. There have been more reported 60000 cases worldwide, most of which are in places where monkeypox has never been seen due to the travel of people who have the virus. This research aims to evaluate the Arabic general population on monkeypox disease, fears, and vaccine adoption after the WHO proclaimed a monkeypox epidemic and to compare these attitudes to those of the COVID-19 pandemic. Methods: This cross-sectional study was performed in some Arabic countries (Syria, Egypt, Qatar, Yemen, Jordan, Sudan, Algeria, and Iraq) between August 18 and September 7, 2022 to examine the Arabic people perspectives on monkeypox disease, fears, and vaccine adoption and to compare these attitudes to those of the COVID-19 pandemic. The inclusion criteria were the general public residing in Arabic nations and older than 18. This questionnaire has 32 questions separated into three sections: sociodemographic variables, prior COVID-19 exposure, and COVID-19 vaccination history. The second portion assesses knowledge and anxieties about monkeypox, while the third section includes the generalized anxiety disorder (GAD7) scale. Logistic regression analysis were performed to compute the adjusted odds ratios (aOR), and their confidence intervals (95%CI) using STATA (version 17.0) Results: A total of 3665 respondents from 17 Arabic countries were involved in this study. Almost two third (n= 2427, 66.2%) of participants expressed more worried about COVID -19 than monkeypox diseases. Regarding the major cause for concern about monkeypox, 39.5% of participants attributed their anxiety they or a member of their family may contract the illness, while 38.4% were concerned about another worldwide pandemic of monkeypox. According to the GAD 7 score, 71.7% of respondents showed very low anxiety toward monkeypox. 43.8% of the participants scored poor levels of knowledge about monkeypox disease. Participants with previous COVID-19 infection showed greater acceptance to receive the monkeypox vaccine 1.206 times than those with no previous infection. A higher concern for the monkeypox than COVID-19 was shown by the participants who perceived monkeypox as dangerous and virulent 3.097 times than those who didn’t. Participants who have a chronic disease (aOR: 1.32; 95%CI: 1.09-1.60); participants worried about monkeypox (aOR: 1.21; 95%CI: 1.04-1.40); and perceived monkeypox as a dangerous and virulent disease (aOR: 2.25; 95%CI: 1.92-2.65); and excellent knowledge level (aOR: 2.28; 95%CI: 1.79-2.90) have emerged as significant predictors. Conclusion: Our study reported that three fourth of the participants were more concerned about COVID-19 than monkeypox disease. As well, most of the participants have inadequate levels of knowledge regarding monkeypox disease. Hence immediate action should be taken to address this problem. Consequently, it is crucial to learn about monkeypox and spread information about its prevention.

Post COVID-19 Retinal Evaluation Using Optical Coherence Tomography Angiography: A Case Control Study.

PURPOSE: To study the effect of coronavirus disease of 2019 (COVID-19) on retinal vasculature by Optical Coherence Tomography Angiography (OCTA). METHODS: Macular OCTA images of patients recovered from COVID-19 infections were studied including foveal avascular zone (FAZ), capillary vascular densities (CVD) of the superficial and deep capillary network (SCP, DCP), and central foveal thickness (CFT). RESULTS: The FAZ area was significantly larger in post COVID-19 cases compared to the healthy controls (p=0.032). Post COVID-19 cases had significant lower CVDs in perifoveal quadrants of the SCP. They also had lower CVD in the whole area, parafoveal, temporal and inferior perifoveal areas in the DCP. The parafoveal DCP area showed a positive correlation with disease duration (r=0.249, p-value=0.018). The whole SCP was significantly larger in cases with lymphopenia (p-value=0.004). CONCLUSION: This study found asymptomatic retinal vascular affection in post COVID-19 eyes showing a relation with disease clinical and laboratory features.

Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique.

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

COVID-19 and Cognitive Impairment: A Cross-Sectional Clinic Based Study (preprint)

Background: Patients with dementia are more prone to acquire COVID-19 infection. Patients with COVID-19 showed a tendency to develop cognitive impairment. Objectives: We aimed to study the clinical manifestations of COVID-19 infection among adult Sudanese demented patients and the prevalence of cognitive impairment among adult Sudanese non demented patients. Method: ology: This is a descriptive cross-sectional study which took place in Sudan, Khartoum state in the period (September-December 2021) in a private neurology/psychiatry clinic. 135 adult Sudanese patients were included in this study and were divided into two groups. The first group consists of 100 patients with a known history of dementia that got infected recently with COVID-19, while the second group consists of 35 patients who developed some sort of cognitive impairment after recovering from COVID-19 infection. Regarding the second group, cognitive functions were assessed by senior consultant neurologist and senior consultant psychiatrist using a well validated neuropsychological measure. Results: : Out of 100 patients in the first group, females were 60 and males were 40. Age distribution is between 63 -98. The common presenting symptoms of COVID-19 among this group were: Cough and fever (90 patients), diarrhea and vomiting (5 patients), breathlessness (4 patients), coughing of blood (5 patients), convulsions (1 patient), paraplegia (1 patient) and hemiplegia (1 patient). Regarding the second group, Age distribution varied from 30 to 80 years. Cognitive functions impairment was noticed as follows: Memory recall (22%), memory recognition (23%), memory encoding (24%), processing speed (16%), executive functioning (19%), phonemic fluency (17%) and category fluency (17%). Conclusion: Patients with dementia are more susceptible to develop COVID-19 infection. Patients with COVID-19 Infection are at risk of developing some sort of cognitive impairment after recovery.