Corona Virus Disease 2019 (COVID-19) predominately affects the adult population and it is estimated that children account for only between 2% and 5% of all COVID-19 cases. 1-3 The manifestations in children are usually mild but severe manifestations have been reported. Here we share our experience in pediatric patients with COVID-19. In Brunei Darussalam, all reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed COVID-19 cases were admitted to the
Objective: Adverse drug reaction (ADR) is regarded as one of the major challenges in the treatment of drug-resistant tuberculosis (DR-TB). It can lead to non-compliance or interrupting treatment completion, which can contribute to avoidable morbidity, drug resistance, treatment failure, reduced quality of life, or mortality.
Methods: A retrospective cohort study was conducted in the Ernakulam district of Kerala from 2016 to 2019. All DR-TB patients registered under the DR-TB center were enrolled in the study. Due to privacy and confidentiality HIV infected patients and patients below 12 y of age were excluded in this study and only the data with ADR reported by patients is collected from medical records.
Results: Out of the total 146 patients, about 75 % of patients experienced at least one ADR during treatment, and a total of 208 ADRs were reported. Among all the ADRs, the most common ADR was gastritis (12.98%) followed by ototoxicity (10%) and vomiting (5.76%), etc. It was found that males (78.76%) within the age group 46-65 y exhibited more ADR than females. Some of the ADR requires drug withdrawal and replacement with other drugs and most of the patients also needed symptomatic treatment without modifying the treatment regimen. All ADR reported were collected and causality assessment was done via WHO and Naranjo scale. The majority of ADR belongs to the “probable” category in the WHO scale and Naranjo scale. The evaluation of the severity of ADR by using the Modified Hartwig and Siegel scale indicated that most of the ADR was of moderate level showing a 4b reaction. The study also assessed the preventability of ADR using the Schumock and Thornton preventability scale.
Conclusion: Many of the ADRs were unidentified or not reported due to several reasons like milder ADR, patient lack of knowledge, Negligence of symptoms, unawareness of health providers, etc. Whereas the long-term treatment and diversities in age, gender, etc. were found as major contributors to ADR along with comorbidities. New drugs in combination with existing drugs created the potential for previously unnotified reactions. Pharmacovigilance should address the safety of therapy and identify ADRs, especially the serious ones with routine monitoring to prevent mortality, morbidity, and other negative outcomes.
Background: Sleep is a vital human need that must be satisfied in a sufficient quantity and in a suitable quality. Because of the possible effects on memory reorganization, learning, decision-making, critical thinking, academic achievement, social conduct, and the cardio metabolic system, adolescent sleep patterns deserve special consideration. Objectives: To Assess the quality and pattern of sleep among adolescents. Materials and Methods: The study included 604 adolescents aged 10 to 18 carried out in three districts of central Kerala. Students were given a questionnaire that included PSQI scale items as well as demographic information. Seven components such as subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction were the major parameters assessed. Results: The group as a whole had a mean age of 14.4 years (SD: 0.40). The male students participated in this study were 307 (50.8%) and female students 297 (49.1%). Stressful life situations occurred for 90 (14.9%) students, of which 37 (6.1%) male and 53 (8.7%) female students. 126 students (20.8%) reported presence of medical condition among which 61 (10.1%) were males and 65 (10.7%) were females. Students who had stressful life events 36 (39.56%) and those who had medical issues 36 (28.57%) were shown to have lower sleep quality. Sleep disturbances were reported higher in students with stressful life events 2 (2.19%) and medical condition 2 (1.58%). Students with medical conditions reported a higher percentage of stressful life events 20 (21.97%). Conclusion: Majority of adolescents has good quality sleep and a few are facing sleep related difficulties.
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