RESUMO
Intranasal corticosteroids are first-line therapy in the treatment of allergic rhinitis (AR) and are conventionally prescribed once daily as continuous therapy. The decreased consumption of drugs is proposed to have decreased side effects. The present study aimed at comparing the effect of INCS as a spaced therapy with the conventional continuous therapy. Case records of patients with Allergic Rhinitis, who were started on INCS were studied and improvement in symptom score was compared between continuous and spaced therapy groups. In total 182 patients with AR were studied, with 91 patients in each group. Among the total group, 57% were males, 54% were < 40 years of age, 54% had > 10 years of allergy history and 94% had no family history. There was significant improvement in mean Visual Analogue Score (VAS) for all patients in both groups (p = 0.001). However, the comparison of differences in VAS before and after therapy did not show significant difference for the two groups (p = 0.791). Our study suggests that the efficacy of INCS in controlling AR symptoms is observed to be similar with spaced therapy, as in continuous therapy. Spaced therapy may therefore be recommended for better patient compliance, lesser cost and avoidance of the side effects resulting in overall improvement of quality of life for allergic patients.
RESUMO
BACKGROUND: Screen use is increasing rapidly among preschool children and excess screen use in these children has been associated with cognitive side effects and speech delay. We undertook this study to estimate the risk associated with screen time in children, parental supervision, and parent-reported cognitive development among preschool children aged 2-5 years. METHODS: A cross-sectional study was done between July 2019 and January 2020 involving parents of all students aged 2-5 years, attending 2 kindergarten schools in Thiruvalla using a self-administered questionnaire. Parents also used the Werner David Development pictorial scale (WDDPS), a screening tool to report cognitive development. The schools were sampled based on convenience. RESULTS: Of the 189 children included in the study, 89.4% had excess screen use (> 1 h per day) and the average use was 2.14 h. 45.0% of parents supervised screen use inconsistently (self-reported). Meal-time screen use (OR 3.8, 95% CI 1.3-10.8), receiving screen on demand (OR 3.7, 95% CI 1.2-11.3), and using devices other than computers (OR 6.5, 95% CI 1.6-26.8) were significantly associated with excess screen use in pre-school children. Similarly, those children with inconsistently supervised screen time were significantly more likely to have suspected deficits in attention (OR 3.2, 95% CI 1.3-8.2), intelligence (OR 4.1, 95% CI 1.3-13.3), and social skills (OR 15.3, 95% CI 1.9-121.2), compared to children whose screen use was consistently supervised. CONCLUSION: Screen time in the majority of preschool children is above the recommended limits, and inconsistent supervision by parents was seen in almost half of the study participants. Inconsistently supervised screen time is associated with suspected cognitive delays in children.
