Delta-8-Tetrahydrocannabinol Exposure and Confirmation in Four Pediatric Patients.

INTRODUCTION: Delta-8-tetrahydrocannabinol (THC) is a known isomer of delta-9-THC, both found naturally in the Cannabis sativa plant and thought to have similar potency. Delta-8-THC products are widely accessible in retail shops which may lead to a rise in pediatric exposures with substantial clinical effects. CASE REPORT: This is a case series of four pediatric patients that were seen between June and September 2021. The patients presented with varied clinical symptoms including confusion, somnolence, seizure-like activity, hypotension, and tachycardia after exposure to delta-8-THC products obtained in retail shops. Basic urine drug screen immunoassays revealed positive results for cannabinoids in all patients. Subsequent confirmatory drug analysis of residual biological samples of blood and/or urine was sent to the University of California San Francisco Clinical Toxicology and Environment Biomonitoring Laboratory with the assistance of the Drug Enforcement Administration's Toxicology Testing Program (DEA TOX). Confirmatory testing revealed 11-nor-9-carboxy-delta-8-THC, the metabolite of delta-8-THC. Delta-9-THC and its metabolites were not detected on confirmatory testing in any of the cases. DISCUSSION: Clinical effects of delta-8-THC in children include but are not limited to altered mental status, seizure-like activity, and vital sign abnormalities. Delta-8-THC exposure may lead to a positive urine drug screen for cannabinoids, but confirmatory testing is needed to differentiate from delta-9-THC.

Sleep quality, stress level and COVID-19 in university students; the forgotten dimension.

Introduction: COVID-19 is a novel pandemic that has had a profound impact on global physical and psychological health. We aimed to investigate the impact of COVID-19 on stress, sleep quality, and insomnia among South Valley University students in Egypt during the quarantine period. Material and Methods: A questionnaire, including the Pittsburgh sleep quality index, the insomnia severity index, the perceived stress scale and COVID-19 fear index was distributed to the undergraduate students through the online platforms of South Valley University during the period of 1st to 15th June 2020. Results: Of a total respondent sample of 2,474 students, 24.5% had high-perceived stress levels, 31.3% had clinical insomnia, and about 80% were identified as generally poor sleepers by the PSQI. Being female, having a chronic disease, having a sleep disorder before the quarantine, or consuming caffeine were the main factors associated with high stress levels, clinical insomnia, and poor sleep quality. Also, levels of fear of COVID-19 were higher among people with high stress levels, clinical insomnia, and poor sleep quality. Conclusion: Considerable levels of stress and poor sleep quality were identified among undergraduate university students during the pandemic/home isolation period. The effect was more obvious among certain demographic groups and among the students who scored higher in the fear of COVID-19 scale.

Knowledge, attitudes, and practices of Egypt's future physicians towards antimicrobial resistance (KAP-AMR study): a multicenter cross-sectional study.

Antimicrobial resistance (AMR) is a growing threat that causes over 700,000 deaths per year worldwide. The goal of the current multicenter, cross-sectional study was to identify the knowledge and practice gaps in antimicrobial stewardship among Egypt's undergraduate medical students. Nine-hundred and sixty-three participants (375 male) from 25 medical schools responded to our self-administered questionnaire. Overall, the majority of students (96%) exhibited fair/satisfactory knowledge and attitude scores towards AMR. However, the most common misconceptions were that skipping one or two antimicrobial doses does not contribute to AMR (43%) and that antimicrobials are the drug of choice for the treatment of sore throat (38.8%). About 36% of the students thought that bacteria cause common cold and influenza. In terms of practices, about 62% of the students reported taking antibiotics when they have cough or sore throat and saving the remaining antibiotic for the next time. About 48% of the students reported that when they start feeling better, they stop the antibiotic course, and 41% stated that they often/sometimes discard the remaining leftover or share the leftover antibiotics with their friends. Interestingly, males had more frequently poorer levels of knowledge than females (p = 0.02). Moreover, students in the clinical science years (p < 0.001), living in urban areas (p = 0.02) or Cairo (p < 0.01) reported better practices than their counterparts. Educational programs about antimicrobial stewardship and the role of healthcare professionals in preventing AMR should be introduced early in medical curricula. Further, active educational techniques as clinical scenarios that simulate clinical settings and interactive learning workshops would be more efficient teaching methods.