Highlights The COVID-19 pandemic had significant mental health impacts on the population of Kuwait. Unemployment, uncertainty, distress, increasing deaths and lockdown measures contribute to the burden. From our experience risk factors include; female, smoker, past psychiatric history, increased social media use. Availability of psychological support and mental health awareness reduces the burden.

Although the approved COVID-19 vaccines have proven to be safe and effective, multiple beliefs and misconceptions still exist influencing the vaccine uptake rates around the world. The multifaceted complex phenomenon of vaccine hesitancy could jeopardize the efforts to overcome this pandemic. The aim of this study is to identify the prevalence and examine the factors associated with vaccine hesitancy in Kuwait. This is a web-based cross-sectional study conducted in Kuwait from March 2021 until April 2021, during the second wave of the COVID-19 pandemic. Our questionnaire examined basic demographic information, attitudes towards the COVID-19 vaccines as well as reasons for and against accepting the vaccine. Out of the 2345 responders, the majority are fully convinced to take the vaccine (83%) and the rate of vaccine hesitancy is 17%. Vaccine hesitancy is higher among non-healthcare workers, those previously positive for the COVID-19 virus, and those against vaccines in general. Vaccine hesitancy could jeopardize the efforts to overcome this pandemic; therefore, intensifying nationwide education and dismissal of falsified information is an essential step towards addressing vaccine hesitancy.

Purpose To assess the analgesic efficacy of the circumferential periosteal block (CPB) and compare it with the conventional fracture hematoma block (HB). Methods This study was a prospective single-center randomized controlled trial performed in a national orthopedic hospital. Fifty patients with displaced distal radius (with or without concomitant ulna) fractures requiring reduction were randomized to receive either CPB or HB prior to the reduction. Pain was sequentially measured using the visual analogue scale (VAS) across three stages; before administration of local anesthesia (baseline), during administration (injection) and during manipulation and immobilization (manipulation). Further, the effect of demographic factors on the severity of pain was analyzed in multivariate regression. Finally, complications and end outcomes were compared across both techniques. Results Patients receiving CPB experienced significantly less pain scores during manipulation (VAS = 0.64) compared with HB (VAS = 2.44) (p =  < 0.0001). There were no significant differences between groups at baseline (P = 0.55) and injection (P = 0.40) stages. Conclusion The CPB provides a superior analgesic effect over the conventional HB with no documented complications in either technique. Level of evidence Therapeutic Level II.

Ewing sarcoma is a rare poorly differentiated and highly malignant tumor primarily affecting the skeletal system. It most commonly presents during the first two decades of life and rarely might it be of extraskeletal origin. Majority of extraskeletal cases are reported in the paravertebral and lower limb, with very few cases reported in the cervical spine region. We report a case of extraskeletal Ewing sarcoma in a 42-year-old man who presented with a 1-year history of neck swelling associated with neck pain, diagnosed by computed tomography and magnetic resonance imaging scans, in conjunction with histological analysis. Very few cases of cervical EES presenting as dumbbell tumors have been documented in the literature especially in this age group.

No abstract