Dubai Medical Journal

Background: Supraclavicular (SCL), infraclavicular (ICL), and axillary (AX) brachial plexus nerve blocks are used for the upper extremity. Regional nerve blocks should be considered for their beneficial effects and less risk of complications. Objectives: The aim of this study was to conduct a retrospective evaluation of our experiences in ultrasound (US)-guided techniques of the SCL-ICL and AX approaches for brachial plexus block (BPB) in producing high-quality surgical anesthesia for operations below the shoulder. Methods: The records of 182 American Society of Anesthesiologists (ASA) grade I–III patients undergoing upper extremity and vascular surgeries under BPB by US guidance were evaluated. SCL, AX, and ICL approaches were used. A linear US probe was used for all patients. Data pertaining to demographic characteristics, ASA physical status, underlying diseases, block type, time between the block performance and the start of the operation, duration of the operation, type of surgeries, needle length, toxicity findings, postoperative complications, and success rates were assessed. Results: Demographic data were found to be similar with no statistically significant differences between the study groups (p > 0.05). The three groups were also similar in ASA physical status, type of surgery, the experience of the anesthesiologists who performed the blocks, the time between the end of the block performance and the start of the operation, and the quality of the surgical anesthesia. Transient Horner’s syndrome was detected in 3 patients in the SCL group and in 1 patient in the ICL group. Conclusions: All three approaches can be used for US-guided BPB with adequate quality of surgical anesthesia.

Background: Extrapulmonary complications of COVID-19 including acute mesenteric ischemia are being increasingly reported and are a reason of poorer clinical outcome and increased inpatient mortality rate. Case: Here, we present a case of a young obese male who developed acute superior mesenteric artery thrombosis as a result of COVID-19. Discussion: Some direct causes of mesenteric thrombosis in COVID-19 patients have been hypothesized. Furthermore, immobilization, endothelial injury, and increased prothrombotic factor production are proven causes of thromboembolism in COVID-19. Conclusion: Early detection and management of acute mesenteric ischemia in COVID-19 cases is crucial to improve the prognosis.

Background: As we live in an interconnected globalized world, people and the diseases they carry can be easily transmitted to any place in a matter of hours. SARS-CoV-2 began like all new viruses with an ordinary moment when a cluster of patients admitted to a hospital with pneumonia turned out to have a new strain of coronavirus. The virus’s high transmissibility made the epidemic in China turn into a global pandemic with an ongoing daily reporting of new cases and deaths. However, as fast as viruses spread, the detection of pandemics and taking early measures has become much easier due to the advancement of science in today’s world. The early responses and measures adopted by China, such as early reporting and situation monitoring, large-scale surveillance, and preparation of medical facilities and supplies, were all successful in reducing the epidemic in China generally and in the epicenter Wuhan specifically. The purpose of this review is to focus on the effectiveness of the measures taken by the Chinese government to stop COVID-19 spreading by comparing the country’s response to SARS and CO­VID-19 outbreaks, which will provide an example for the communities, health managers, and leaders of countries to follow on how to prepare, detect, and respond to potential outbreaks. Method: For this article, epidemic preparedness and management strategies under comparison were derived from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) frameworks and guidelines. Other data related to COVID-19 and reported cases were taken from more than 25 official public health organization reports and relevant articles using various databases (e.g., Google Scholar, PubMed and Science Direct). Results: Working on developing resilient systems against infectious diseases should be one of the top priorities of any country. China embraced resilience in its battle against COVID-19 and proved its capability to cope with the outbreak crisis. Despite succeeding in altering the course of the outbreak, healthcare experts warned about possible epidemic recurrence and stressed the need for caution as the pandemic is still ongoing and most of the infected cases are presenting with only mild symptoms.

b> Aim: We aimed to describe the most prominent features of COVID-19 on the chest X-ray (CXR) and to classify them using the radiographic assessment of lung edema (RALE) score. Furthermore, we aimed to correlate the RALE scores with clinically significant outcomes namely intensive care unit (ICU) admission and intubation from the emergency versus during hospital stay. In-hospital, death was studied as a secondary endpoint for severe RALE score. Materials and Methods: A retrospective cohort study was conducted on patients presenting to the emergency department (ED) of a tertiary hospital between the periods of March 2020 to August 2020. Included patients were symptomatic, COVID-19 positive by nasopharyngeal real-time polymerase chain reaction (RT-PCR), who also performed an initial CXR in the ED. Two experienced radiologists interpreted the CXRs and categorized them using RALE score into normal mild, moderate, and severe for further correlation with clinical endpoints. Results: From the 404 CXRs, most were categorized as mild and characteristically CXRs had bilateral lower and mid-zone ground-glass opacities. The frequency of intubation and ICU admission increased as the RALE score worsened with a statistically significant p value of <0.001. Severe CXR required earlier intervention and was found to have the highest proportion of mortality. Discussion: The RALE score has shown to be a highly reliable indicator for worse outcome in patients with acute respiratory distress syndrome. While RT-PCR has variable sensitivities, CXR has demonstrated to have characteristic findings and higher RALE scores having a significant correlation for intubation and ICU admission in this research . Conclusion: The prognostic utility of CXR in COVID-19 has been found to be of statistical significance for intubation and ICU admission. CXR is a simple, portable, and easy-to-disinfect method of evaluation that can be invaluable in determining timely intervention and disposition of patients expecting deterioration.

b> Objective: The aim of this study was to determine the leadership styles of nurse managers and then determine the relationship of the respective styles with the organizational commitment of the nurse managers during the COVID-19 pandemic. Methods: A quantitative correlational study design was employed in this investigation. Simple random sampling yielded 259 nurses who participated in this study. It was conducted between October and November 2021 at the government hospitals of the Hail Region, Kingdom of Saudi Arabia. Results: The nurses’ perceived that their nurse managers employed an idealized influence leadership style (9.15). Age, years of experience, and ward assignment were found to have no statistically significant difference on organizational commitment; however, a significant difference was found with nationality. No significant difference was found regarding age with idealized influence, inspirational motivation, intellectual stimulation, or management by exception; however, it differed significantly with individualized consideration, contingent reward, and laissez-faire leadership. No significant differences were found with the years of experience to idealized influence, inspirational motivation, intellectual stimulation, individual consideration, or management by exception; however, it was found significantly different with the contingent reward and laissez-faire leadership. Concerning nationality, a significant difference was found with idealized influence and inspirational motivation. However, no significant difference was found between nationality and intellectual stimulation, individual consideration, contingent reward, management by exception, or laissez-faire leadership. With the ward assignment, no significant difference was found with idealized influence, inspirational motivation, intellectual stimulation, or contingent reward management by exception; however, a significant difference was found with individual consideration and laissez-faire leadership. Conclusion: During the pandemic, nurse managers employed idealized influence leadership styles. Age, years of experience, and ward assignment were found to be of no significant difference to organizational commitment, but they did have a significant difference to nationality. Age differed significantly with individualized consideration, contingent reward, and laissez-faire leadership. Years of experience was found to be significantly different with contingent reward and laissez-faire leadership. Concerning nationality, a significant difference was found with idealized influence and inspirational motivation. With the ward assignment, a significant difference was found with individual consideration and laissez-faire leadership.

The epidemiology of multisystem inflammatory syndrome in children (MIS-C) and the provisional case definition are still being updated by the WHO. There is no solid evidence regarding the clinical presentations, severity, and outcomes. This case report tackles a 4-year-old female. Her main manifestations were persistent high-grade fever (40.0°C), diarrhea, poor oral intake, fatigue, and less activity with mucocutaneous involvement. Blood test revealed elevated inflammatory markers, as well as D-dimer, cardiac enzymes, and IL-6 with lymphopenia. She had a history of coronavirus disease (COVID-19) infection 4 weeks prior to admission. We describe a patient diagnosed as MIS-C or so-called SARS-CoV-2-induced Kawasaki-like hyperinflammatory syndrome. It seems to be caused by delayed response to SARS-CoV-2. It mimics Kawasaki disease, with unique presentations, such as diarrhea, capillary leak, and myocardial dysfunction, complicated by macrophage activation syndrome. Eventually, she completely improved with aggressive management including intravenous immunoglobulin, intravenous methylprednisolone, anti-IL-6, and aspirin. This is one of the early cases presented to our tertiary hospital fulfilling the CDC criteria of MIS-C. Based on this case, we suggest that pediatricians need to be aware of such clinical presentations and early referral to tertiary care health facility for further diagnosis and management. MIS-C is not common but a highly critical complication of COVID-19 infection in pediatrics resulting in life-threatening illnesses. Knowledge about the wide spectrum of presenting clinical manifestations, disease severity, and early detection and management is crucial to prevent a serious outcome.

b> Introduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >18 years of age were included. The primary variables of interest, ferritin, CRP, and D-dimers, for each patient throughout hospitalization were recorded. Primary clinical outcomes of length of stay in ICU and survival were recorded. Demographics: age, gender, BMI, and nationality. Ferritin, CRP, and D-dimers were recorded daily if available for the whole ICU stay, and all other variables were recorded on admission day to ICU. Results: The sample includes 235 records. More than 95% of patients have all markers on the day of admission to ICU were ferritin (median 1,278; IQR 1,424), D-dimer 1.21 (3.4), and CRP 129.5 (121). Daily average levels of markers were different from their admission day level: ferritin 1,395 (1,331), D-dimer 3.11 (5.52), and CRP 107 (75.8). Multiple logistic regression analysis determined that average CRP during the stay was the only predictor of survival. Discussion: Data on markers utilization to detect the acute phase of inflammation help clinicians focus on the opportunity window for intensive treatment. Conclusion: Average CRP during the stay in ICU is higher than CRP on admission. Average CRP is the only factor that predicts survival.

b> Introduction: Coronavirus has caused more than a million deaths as of October 2020. Hospitals consider tracheostomy after the patient is virus negative, usually after 3 weeks. Prevalence and timing of tracheostomy and its impact on survival among COVID patients are unknown. Methods: A retrospective, single-center study of all patients with COVID-19 ARDS who underwent tracheostomy was conducted. Patients with age <18 and patients treated with ECMO were excluded. Duration of ventilation before tracheostomy was recorded. Clinical variables, outcome variables, and confounding variables were recorded and compared between patients with tracheostomy and without tracheostomy. The aim was to determine prevalence and timing of tracheostomy and its impact on clinical outcomes. Results: We found that tracheostomies were performed only in 21 out of 196 patients (10.8%). Tracheostomies were performed after 3 weeks on average (22.1 ± 7.5 days). Survival was significantly higher in patients who underwent tracheostomy (85.7 vs. 42.5%, p = 0.001). LOSICU was longer for tracheostomy patients than patients without tracheostomy (median [IQR]: 35 [23–47] vs. 15 [9–21], p = 0.001). Patients who underwent tracheostomy had a higher proportion of treatment with continuous renal replacement therapy (CRRT) (52 vs. 30%, p = 0.04), more COVID-19 swab testing (6.5 [4.5–8.5] vs. 5 [3–7], p = 0.002), more days on mechanical ventilation (34.5 [24–45] vs. 11 [5.5–16.5], p = 0.001), and more length of stay in the hospital (54 [38–70] vs. 20 [10.5–29.5], p = 0.001). All other factors were not statistically different between the 2 groups. Approximately 29% of patients had possible false-negative testing as their swab became positive after being negative. Conclusion: Tracheostomy was performed only in 10% of our patients with COVID-19 ARDS. Time to tracheostomy was after 3 weeks on average. Survival was better in patients with tracheostomy, but tracheostomized patients stayed longer in the ICU and hospital and utilized more days of mechanical ventilation and CRRT.

b> Introduction: Telemedicine was launched in Dubai in December 2019. The service provided live interaction between patients and physicians through videos simulating a consultation in a clinic. Methods: This study is a multicenter comparative cross-sectional retrospective study that included 13 health centers in Dubai. The data in this study were taken before and during the coronavirus (COVID-19) pandemic retrospectively. All patients from both telemedicine and primary health care (PHC) clinic visits were included. Results and Discussion: A total of 121,035 patients were involved in this study; there were 55,622 patients before COVID-19 and 65,413 patients during the COVID-19 pandemic. During the coronavirus pandemic, patient utilization of telemedicine increased significantly in comparison to patient visits to the PHC centers. Before the COVID-19 pandemic, only 104 (0.2%) patients used telemedicine, while during the pandemic, the utilization of telemedicine increased to 9,183 (14%). More females than males preferred telemedicine use over visiting the PHC center. With the pandemic, elder patients used telemedicine more than the younger age groups. Telemedicine was used for different types of consultations such as acute, chronic, and COVID-19 related. The most common type of consultation in telemedicine during the pandemic was for chronic diseases (67.7%). Conclusion: In this comparative study, more patients used telemedicine in the time of COVID-19 pandemic whether it was for acute, chronic, or CO­VID-19-related consultations. Telemedicine proved to be a very useful tool at the time of disasters such as the COVID-19 pandemic.

b> Aim: This study aimed to investigate the prevalence of psychological health outcomes and associated factors among health-care workers (HCWs) during COVID-19 pandemic. Subject and Methods: This observational cross-sectional study was conducted on 550 HCWs at 4 different clinics (fever, clean, telemedicine, and mixed clinics) in Dubai Health Authority from July 2020 to September 2020. Severity of depression, anxiety, and stress was examined by calculating the Depression Anxiety Stress Scale (DASS-21) for each subscale, while insomnia was determined by Insomnia Severity Index (ISI) score. Factors associated with psychological symptoms were identified by univariate (ANOVA and independent t test), and independent factors were detected by multivariate linear regression analysis after controlling other variables. p value of <0.05 was considered with significant results. Results: A total of 400 participants completed the survey. Majority of them were females (84.5%, n = 338) and aged between 18 and 31 (53.5%, n = 214). About 76.5% ( n = 306) reported symptoms of depression, 315 (78.8%) anxiety, 254 (63.5%) stress-based, and 187 (46.8%) suffered from clinical insomnia. Frontline HCWs at fever clinic were at higher risk of developing burnout symptoms ( p < 0.001). Furthermore, being younger, nonmarried, and nurse had no kids and changed accommodation during the crisis; all together were at higher risk of developing burnout symptoms ( p < 0.05). Adjusted linear regression showed that age was the major independent factor affecting DASS-21 subscales without affecting the level of insomnia (<0.01). In addition, being worried about the family and loved ones independently influenced higher levels of depression and anxiety-based (<0.001). Conclusion: This study revealed that COVID-19 outbreak has a significant psychological impact on frontline HCWs and the most vulnerable groups to psychological distress. Efficient support and interventions are needed to protect HCWs from being infected and promote their well-being.

b> Introduction: Non-communicable diseases (NCDs) have been a global epidemic long before the advent of COVID-19. Understandably, with the onset of COVID-19, health priorities shifted. The aim of this study was to explore the impact of COVID-19 through attitudes and experiences on the health and well-being of the Malta adult population suffering from NCDs, a year into COVID-19. Methods: An anonymous survey was distributed online between February 1 and 26, 2021 using Google Forms^®. This assessed the impact of COVID-19 on medical care, intention to take a COVID-19 vaccine, and whether COVID-19 was acquired. Quantitative and qualitative analyses were performed. Results: Out of the 1,034 participants, 34.82% (95% CI, 31.97–37.77; n = 360) reported to suffer from NCDs (single NCD, n = 276; 2 NCDs, n = 56; 3 NCDs, n = 28) with 6.94% (95% CI, 4.71–10.09) of these reported acquiring COVID-19. Since COVID-19, the NCD population visited the general practitioners less (47%) than those without NCDs (32%) ( p ≤ 0.001). With a consensus of concern and fear, “I rather skip check-ups than risk getting COVID-19 in waiting room or clinic.” Postponement and cancellations of medical appointments were reported: “had to do blood tests privately as health centre was not doing them” and “delayed treatment and still awaiting further appointments that were postponed more than once.” The majority intended to take COVID-19 vaccine. Conclusions: It is clear that individuals with NCDs have experienced a general negative effect on their medical care. It’s recommended that a dual action strategy is embraced to ensure that both NCDs and COVID-19 are treated simultaneously, leaving no one behind.

b> Background: The outbreak of coronavirus 2019 (COVID-19) which emerged in December 2019 spread rapidly and created a public health emergency. Geospatial records of case data are needed in real time to monitor and anticipate the spread of infection. Methods: This study aimed to identify the emerging hotspots of COVID-19 using a geographic information system (GIS)-based approach. Data of laboratory-confirmed COVID-19 patients from March 15 to June 12, 2020, who visited the emergency department of a tertiary specialized academic hospital in Dubai were evaluated using ArcGIS Pro 2.5. Spatiotemporal analysis, including optimized hotspot analysis, was performed at the community level. Results: The cases were spatially concentrated mostly over the inner city of Dubai. Moreover, the optimized hotspot analysis showed statistically significant hotspots ( p < 0.01) in the north of Dubai. Waxing and waning hotspots were also observed in the southern and central regions of Dubai. Finally, there were nonsustaining hotspots in communities with a very low population density. Conclusion: This study identified hotspots of COVID-19 using geospatial analysis. It is simple and can be easily reproduced to identify disease outbreaks. In the future, more attention is needed in creating a wider geodatabase and identifying hotspots with more intense transmission intensity.

There are several differences in illness presentation in clinical practice. Because diseases are ever-evolving, a single negative test cannot totally exclude the presence of a disease. The most frequent etiologies of erythema multiforme (EM), a prevalent mucocutaneous condition, are herpes infection and the use of numerous medicines. As a novel virus, SARS-CoV-2 is not often the primary differential for EM eruptions. This case represents a young female patient who presented solely with EM symptoms involving the distal parts of her upper and lower extremities after a positive swab for SARS-CoV-2. The condition improved with symptomatic treatment, and there were no major complications.

On 11 March 2020, WHO declared the SARS-CoV-2 outbreak as a pandemic, representing a public health emergency of unprecedented dimension. COVID-19 is a multisystem Novel viral infection with protean manifestations and variable degrees of clinical presentation. The most common presentation is upper and lower respiratory tract illness. Cutaneous manifestations of COVID-19 have rarely been described. In this case report, we present a 41-year-old male patient who presented with fatigue and follicular skin rash followed almost 2 weeks later with fever, left upper limb transient weakness, and pneumonia. Of interest is that the patient’s skin lesions tested positive on COVID-19 antigen test. The patient received a course of anti-COVID-19 treatment as per our national guideline, and he made a full clinical and radiology recovery.

The COVID-19 pandemic broke out at the end of 2019 and throughout 2020 there were intensive international efforts to find a vaccine for the disease, which has already led to the deaths of a few million people. In December 2020, several pharmaceutical companies announced that they had succeeded in producing effective vaccines and after approval by the various regulatory bodies, countries started to vaccinate their citizens. With the start of the global campaign to vaccinate the world’s population against COVID-19, there was a strong renewal of the debate about the possibility of enforcing vaccination, either directly or indirectly, in particular on account of the rapid spread of the pandemic. This article presents the stand that Jewish ethics takes on this issue. According to the norms of Jewish ethics, a moral person has an obligation toward his fellows and G-d to be vaccinated. Notwithstanding the importance of vaccination, Jewish ethics does not allow direct coercion but recognizes that someone who does not get vaccinated presents a danger to the public and so can be prevented from circulating freely. Thus, Jewish ethics permits indirect compulsion by keeping children and adults who are not vaccinated away from educational institutions and public places, respectively. Only occasionally and in special circumstances would it be permitted to resort to shaming of a person who refuses to be vaccinated and only if he/she is deemed a particular danger to the public health.

COVID-19 has affected the life and health of more than 1 million people across the world. This overwhelms many countries’ healthcare systems, and, of course, affects healthcare providers such as nurses fighting on the frontlines to safeguard the lives of everyone affected. Exploring the issues that nurses face during their battle will help support them and develop protocols and plans to improve their preparedness. Thus, this integrative review will explore the issues facing nurses during their response to the COVID-19 crisis. The major issues facing nurses in this situation are the critical shortage of nurses, beds, and medical supplies, including personal protective equipment and, as reviews indicate, psychological changes and fears of infection among nursing staff. The implications of these findings might help to provide support and identify the needs of nurses in all affected countries to ensure that they can work and respond to this crisis with more confidence. Moreover, this will help enhance preparedness for pandemics and consider issues when drawing up crisis plans. The recommendation is to support the nurses, since they are a critical line of defense. Indeed, more research must be conducted in the field of pandemics regarding nursing.

b> Background: It is well known that COVID-19 infection affects multiple systems in the body. Reports have documented many changes in the hematopoietic system in the pathophysiology of the disease, and many haematological markers like lymphopenia and high d dimer have been linked to worse outcomes after COVID-19 infection in adult patients. Aim: The aim of the study was to find out the prevalence and any significant difference in routine haematological parameters on presentation in paediatric and adult patients with COVID-19 infection. Methodology: We conducted a multicentre retrospective descriptive observational study and investigated the prevalence of haematological abnormalities at the presentation of 1,000 PCR swab-confirmed COVID-19-infected randomly selected adult and paediatric patients admitted to 3 tertiary hospitals in Dubai from 15 March–30 May 2020. Data were gathered through their electronic medical records, and all analysis was done using the Statistical Package for the Social Sciences software (SPSS). Results: The prevalence of at least one abnormal haematological parameter was 95.1% (794/835) on the first presentation to the hospital. After adjusting of age and gender, the prevalence of any white cell abnormality was 34.7% (290/835) (5.7% leukopenia, 9.6% leucocytosis, 25.4% lymphopenia, 5.5% neutropenia, 16.4% neutrophilia, 7.3% monocytosis, and 1.2% eosinopenia). A prevalence of 15.3% (128/835) anaemia, 9.5% (79/835) thrombocytopenia, and 4.3% (36/835) thrombocytosis was also observed. The prevalence of other abnormal blood parameters was C-reactive protein 69.5% (573/835), D dimer 57.5% (280/835), high lactate dehydrogenase 52% (383/835), high ferritin 72.1% (452/835), high international normalized ratio 5.1% (38/835), prolonged prothrombin time 32.2% (240/835), and prolonged activated partial thromboplastin time 35.6% (264/835). A significant difference in the prevalence of these abnormalities was evident between adult and paediatric populations, and these abnormalities were much more prevalent in adults but interestingly paediatric population tended to have a higher incidence of neutropenia, eosinophilia, and monocytosis ( p < 0.001). Conclusion: COVID-19 infection tends to be milder and has better outcomes in the paediatric population. The immune system responds differently to the infection in these populations. The response is exaggerated in adults reflected by the increased prevalence of haematological abnormalities like raised inflammatory markers and other white cell abnormalities and has been linked with increased severity of infection and mortality.

Most patients with coronavirus disease 2019 (COVID-19) present with respiratory symptoms that range from mild symptoms to severe illness leading to mortality. Some might be asymptomatic and others may present with unusual presentations. A 55-year-old male with a past history of ischemic stroke, ischemic heart disease, and type 2 diabetes mellitus presented with right-sided weakness and a history of abdominal pain, diarrhea, and fever. He tested positive for COVID-19. Computed tomography (CT) abdomen showed the presence of splenic abscess and small intraperitoneal gas indicating pneumoperitoneum. Laparotomy revealed ruptured splenic abscess and splenectomy was done. The patient continued to show features of severe sepsis with multiorgan failure and died on postoperative day 16. COVID-19 mainly affects the respiratory system but extrapulmonary affection has been reported. Direct invasion and damage to the organs by the virus could be the reason behind the development of the extrapulmonary manifestations.

b> Background: COVID-19 is an emerging respiratory virus which was initially reported to the WHO on December 31, 2019 and declared as a public health emergency by the WHO on March 11, 2020. Aim: The aim of the study was to investigate the public knowledge, attitudes, and practice toward COVID-19. Method: This is an online cross-sectional study. The questionnaire was in both Arabic and English languages and consisted of 4 segments (demographic, knowledge, attitude, and practice). The results were collected anonymously. The data were entered in Excel sheets and then exported and analyzed using SPSS software. Results: A total of 1,602 UAE residents completed the questionnaire. The mean knowledge score is 71%, which reflects good knowledge. The mean attitude score is 78%, which reflects a positive attitude. The mean practice score is 76%, which reflects good practice. Ninety-four percent of the population avoid handshakes, 93.3% wear face masks regularly, 85.5% use hand sanitizers, and 66% wash their hands, 22.7% drink honey with ginger, 13% still prefer to take garlic, and 82% chose to constantly update themselves with information about COVID-19; however, only 10% relied on purely medical sources. Conclusions: This study showed that UAE residents have satisfactory knowledge and favorable practice, with an overall high positive attitude. However, it is still encouraged to continue efforts in spreading awareness and public health education across all platforms, as well as increase awareness campaigns and correct misconceptions circulating on nonmedical platforms since they are a major source of information for the public.

Concerns in the United Kingdom (UK) that Black, Asian and Minority Ethnic (BAME) populations have disproportionately higher rates of coronavirus disease 2019 (COVID-19) than white populations have led to ethnicity being identified as a risk factor within the latest guidance from Public Health England. The purpose of this case report was to determine whether the risk reduction assessment would aid the line manager support a BAME health-care employee who was concerned that his ethnicity put him at greater risk of contracting COVID-19. This report described the case, protocol, and outcome of undertaking a risk reduction assessment. It is concluded that the risk reduction assessment may assist line managers implement appropriate adjustments for BAME employees in order to alleviate their concerns and mitigate the risks of COVID-19.

b> Background: Renal transplant recipients are at risk to acquire COVID-19 infection quite frequently, owing to their immunocompromized state. Nevertheless, data on the effects of this infection on patients and graft function are sparse from the Arab world. Methods: This retrospective cohort study was conducted in Dubai Hospital from April 1, 2020, to August 1, 2021. We analyzed 42 COVID-19-positive renal transplant recipients’ data. Information concerning demographics, comorbidities, medications, clinical and laboratory data, and outcomes was collected from the electronic medical records. Univariate analyses were performed to determine the association of acute kidney injury (AKI) with in-hospital mortality. Results: Median age was 47.46 (17–66) years; about 59% of patients were male. Eleven (26.19%) patients developed AKI during hospitalization. On admission high ferritin, C-reactive protein, creatinine, and low absolute lymphocyte count are identified risk factors for in-hospital AKI. Seven (21.87%) patients had their calcineurin inhibitor levels touch a toxic peak possibly due to an interaction with antivirals. Mortality was 14.28%, and the same number of patients required mechanical ventilation during treatment. Conclusion: A significant number of renal transplant recipients suffered from AKI during COVID-19 infection, and the mortality rate in this study population was less than in studies from other countries in the region. More insights are required to manage this infection in renal transplant recipients.