ABSTRACT
The SARS-COV-2 pandemic led to the development of several vaccinations to contain the disease. The Pfizer-BioNTech COVID-19 (BNT162b2) vaccine was recommended on May 2021 for use in children above 12 years and older. The vaccine is safe, well tolerated and highly effective. Initial reports showed no serious adverse events; however, cases of myocarditis in young healthy male adolescents have been reported. We report two cases of myocarditis/perimyocarditis who presented with short history of chest pain following administration of the second dose of the MRN COVID-19 vaccine.
Subject(s)
BNT162 Vaccine , COVID-19 , Myocarditis , Adolescent , Child , Humans , Male , BNT162 Vaccine/adverse effects , COVID-19/prevention & control , Myocarditis/chemically induced , SARS-CoV-2ABSTRACT
IMPORTANCE: Children with neurodevelopmental disorders have a higher prevalence of sleep disturbances. Currently there is variation in the use of melatonin; hence, an up-to-date systematic review is indicated to summarise the current available evidence. OBJECTIVE: To determine the efficacy and safety of melatonin as therapy for sleep problems in children with neurodevelopmental disorders. DATA SOURCES AND STUDY SELECTIONS: PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials were searched from inception up to January 2018. Two reviewers performed data assessment and extraction. We assessed randomised controlled trials that compared melatonin with placebo or other intervention for the management of sleep disorders in children (<18 years) with neurodevelopmental disorders. DATA EXTRACTION AND SYNTHESIS: We identified 3262 citations and included 13 studies in this meta-analysis. MAIN OUTCOMES: Main outcomes included total sleep time, sleep onset latency, frequency of nocturnal awakenings and adverse events. RESULTS: Thirteen randomised controlled trials (n=682) met the inclusion criteria. A meta-analysis of nine studies (n=541) showed that melatonin significantly improved total sleep time compared with placebo (mean difference (MD)=48.26 min, 95% CI 36.78 to 59.73, I2=31%). In 11 studies (n=581), sleep onset latency improved significantly with melatonin use (MD=-28.97, 95% CI -39.78 to -18.17). No difference was noted in the frequency of nocturnal awakenings (MD=-0.49, 95% CI -1.71 to 0.73). No medication-related serious adverse event was reported. CONCLUSION: Melatonin appeared safe and effective in improving sleep in the studied children. The overall quality of the evidence is limited due to heterogeneity and inconsistency. Further research is needed.
Subject(s)
Central Nervous System Depressants/therapeutic use , Melatonin/therapeutic use , Neurodevelopmental Disorders/complications , Sleep Wake Disorders/drug therapy , Child , Humans , Models, Statistical , Sleep Wake Disorders/etiology , Treatment OutcomeABSTRACT
Antenatal Bartter syndrome is a rare condition that can present with different clinical features. These features include early onset maternal polyhydramnios, failure to thrive, prematurity and nephrocalcinosis.We are presenting this 20-day-old girl who had an antenatal history of polyhydramnios. She developed persistent non-bilious vomiting that was associated with constipation soon after birth. She presented with failure to thrive and features suggestive of intestinal obstruction. On the initial evaluation, she was noted to have hypokalaemic, hyponatraemic metabolic alkalosis. The initial work-up was done to exclude surgical and renal causes of her presentation, and the diagnosis was confirmed by gene analysis to be type III-classic Bartter syndrome. She was closely monitored for her growth and development with the appropriate salt replacement therapy.
