Cyber-bullying is a global issue in the current era. The main objective of this study was to identify the prevalence and determinants of cyber-bully victimization and to analyze the impact of COVID-19 pandemic. A self-reported questionnaire collected data from students aged 14–17 years in Sri Lanka in September 2020. Prevalence of any form of bullying in the cohort of 970 subjects was 4.3%, with 3.5% being subjected to cyber-bullying. While females (57.1%) were more frequently victimized than males, the main perpetrators were males (61.9%). Victims experienced bullying mainly through embarrassing or abusive media circulated via social media and majority was cyber-bullied outside school hours. Although the majority was in the opinion that incidents of cyber-bullying should be reported to adults, most of them divulged only to their friends. Despite the increase in online activity during COVID-19 pandemic, only 10.7% believed that there is a rise in cyber-bullying during this period.
Background
Acute hemorrhagic pancreatitis is a life-threatening condition leading to shock and multiorgan failure. Although prevalent in the general population, the incidence during pregnancy is low, with a high maternal and fetal mortality rate. The highest incidence is in the third trimester/early postpartum period. Infectious etiology for acute hemorrhagic pancreatitis is rare with only a handful of cases following influenza infection being documented in the literature.
Case presentation
A 29-year-old Sinhalese pregnant lady in the third trimester presented with an upper respiratory tract infection and abdominal pain, for which she was managed with oral antibiotics. An elective caesarean section was done at 37 weeks gestation due to a past section. On postoperative day 3 she developed a fever with difficulty in breathing. Despite treatment, she succumbed to death on the sixth postoperative day. The autopsy revealed extensive fat necrosis with saponification. The pancreas was necrosed and hemorrhagic. The lungs showed features of adult respiratory distress syndrome and necrosis was observed in the liver and kidneys. Polymerase chain reaction of lungs detected influenza A virus (subtype H3).
Conclusion
Although rare, acute hemorrhagic pancreatitis from an infectious etiology carries risk of morbidity and mortality. Therefore, a high level of clinical suspicion must be upheld among clinicians to minimize adverse outcomes.
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