COVID-19 vaccination side effects among the child age group: a large cross-sectional online based survey in Saudi Arabia.

BACKGROUND: Multiple vaccines have been tested in clinical trials for their efficacy and safety. In Saudi Arabia, Pfizer-BioNTech or Moderna were approved for children, however, previous studies to report their safety profile are limited. This research aims to understand the side effect of children's vaccination against SARS-CoV-2 infection in Saudi Arabia. METHODS: This was an observational retrospective cross-sectional study was conducted using an online survey in Saudi Arabia from March to May 2022. The inclusion criteria were parents aged 18 years and above who live in Saudi Arabia and have vaccinated their children. The self-reported questionnaire was adopted from published studies to investigate the study objectives Descriptive statistics were used to describe patients' demographic characteristics, continuous data were reported as mean ± S.D., categorical data were reported as percentages (frequencies), and logistic regression was used to identify predictors of persistent post-COVID-19 symptoms. RESULTS: This study had a total of 4,069 participants. Only 41.9% of the participants reported that their child(ren) had been infected with the coronavirus. 2.00 was the median number of children (IQR: 1.00-4.00). More than half of the study participants (64.2%) reported that a family member had been infected with the coronavirus. Both parents received COVID-19 vaccination, according to most participants (88.7%). Most participants (70.5%) stated that all children who met the vaccination criteria had received the vaccine. Most participants (83.5%) said their child or children had two doses of their vaccine, and about half (50.4%) of those who received the vaccine reported experiencing side effects. In addition, the majority (78.9%) reported that the side effects appeared within one day of receiving the vaccine, and nearly two-thirds (65.7%) reported that the side effects lasted between one and three. A total of 11,831 side effects cases were documented. Pain at the injection site, hyperthermia, and fatigue were the most reported side effects, accounting for 15.3%, 14.1%, and 13.2%, respectively. CONCLUSION: It appears that the side effects of the COVID-19 vaccine for children are minor, tolerable, and like those described previously in clinical trials. Our data should encourage the public about the safety of receiving the COVID-19 vaccine for children.

Facial Edema Induced by Glycopyrrolate in a Patient With Metastatic Tongue Cancer: A Case Report.

Glycopyrrolate, an anticholinergic medication, is commonly used for managing excessive secretions in palliative care, especially in patients with advanced head and neck cancers. However, its side effect profile, particularly in complex oncological cases, is not fully understood. This case report presents a 62-year-old male with metastatic squamous cell carcinoma (SCC) of the tongue, who was managed in a palliative care setting. Glycopyrrolate 0.2 mg subcutaneously (SC) or intravenously (IV) every six hours was initiated to control chest secretions. While the patient showed initial symptomatic improvement, he subsequently developed significant and unexpected facial edema extending to both lower eyelids. The edema did not respond to antibiotics or corticosteroids and only improved after discontinuation of glycopyrrolate, suggesting a potential adverse reaction, although the advanced stage of his illness may have also contributed to the development of edema. This case underscores the importance of monitoring for rare adverse effects like facial edema when using glycopyrrolate, particularly in patients with advanced metastatic cancers. Further research is warranted to explore the underlying mechanisms of this reaction and guide safer clinical practice.

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) and Precocious Puberty With a Third Ventricle Arachnoid Cyst.

Arachnoid cyst (AC) is a rare defect of the central nervous system that accounts for 1% of all intracranial lesions, of which only 1% of reported cases are located in the third ventricle. Endocrine manifestations associated with AC include precocious puberty, growth hormone deficiency, and hypothalamic dysfunction. We report a child who presented with a visual field defect, hyponatremia, and precocious puberty related to a third ventricle AC. Hyponatremia as a complication of AC is rare. A literature review revealed two case reports of Syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with suprasellar AC. The pathophysiology of SIADH in AC is not well understood. Hyponatremia may worsen following endoscopic fenestration of the AC secondary to changes in intracranial pressure. In conclusion, hyponatremia with AC should be recognized during the preoperative and postoperative periods and may require treatment with hypertonic saline in addition to fluid restriction.

Left paraduodenal hernia: a rare cause of recurrent abdominal pain: case report.

Internal hernias are quite rare, accounting for fewer than 1% of all abdominal hernias. Moreover, the most frequent cause of internal herniation is paraduodenal hernia (PDH). Diagnosing paraduodenal hernias can be difficult due to the wide range of symptoms that can occur. It is a case report of paraduodenal hernia that was diagnosed and managed in a tertiary center. We describe the case of a 55-year-old male patient who had been experiencing nonspecific abdominal discomfort for the last 5 years and had several comorbidities and positive serology. An abdominal computed tomography (CT) revealed that he had a left PDH, which was effectively treated with laparoscopic surgical repair. The study's strength is that it was correctly identified by CT and subsequently laparoscopically corrected. A gastrografin swallow study was also performed postoperatively to ensure there was no leak. The study's flaw is that the patient was misdiagnosed for five years in other medical facilities. Because paraduodenal hernia is an uncommon diagnosis, it's important to keep it in mind as one of the differential diagnoses for persistent discomfort. It also needs accurate imaging in order to identify and successfully manage it. To demonstrate the relevance of this uncommon condition, future research is needed to report on any misdiagnosis or treatment. To conclude, nowadays the best option for paraduodenal hernia repair is laparoscopic surgery. However, because it can present with a wide variety of symptoms and diagnosis might be challenging, it demands a high index of suspicion. The gold standard for identifying paraduodenal hernia is still a CT scan of the abdomen. Patients who are stable and have no signs of intestinal obstruction might decide to have their hernia repaired to avoid future problems. To demonstrate the relevance of this uncommon condition, future research is needed to report on any misdiagnosis or treatment.