General Precautions Research Articles

EVIDENCE FOR REINFECTION WITH SARS-COV-2: A CASE SERIES STUDY

Protective immunity conferred by COVID-19 (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown and reinfection with SARS-CoV-2 is not studied well. There are few case reports for reinfection with COVID- 19 which put a question marks on long lasting immunity after COVID- 19 infection. We present five cases with reinfection with SARS-CoV-2.Their age range 25-37years-old, all are united Arab Emirates ( UAE) resident with no travel history for the previous year tested positive for SARS-CoV-2 during a community screen campaign.All tests were done by qualitative PCR test for SARS-CoV-2 RNA through Nasopharyngeal swabs obtained from the patients. The course of disease in the three patientsranging from mild symptoms to asymptomatic. They had multiple SARS-CoV-2 negative test result between April 2020 to October 2020 before reinfection.Thedurations between first and second infections ranging from three to six months.Hence, we suggested that individuals with the previous infection with SARS-CoV-2 dont have long3lasting immunity against reinfections and general precautions are advised for individuals with previous SARS-CoV-2 infections.

Evaluation of the information provided in the instruction manuals of dental light-curing units.

This study evaluated the completeness and accuracy of information in LCU instruction manuals from 40 manufacturers. Instruction manuals from 40 LCUs (20 from leading manufacturers and 20 budget units) were reviewed. Twenty-eight parameters across five categories were assessed using a binary scale (0=incorrect/missing, 1=correct). The categories and their respective evaluation scores were: LCU characteristics (43%), instructions for use (7%), safety precautions (14%), maintenance recommendations (29%), and regulatory certification (7%). These scores were combined to produce a final score. Scores from leading manufacturers ranged between 46-86%, while the budget category ranged from 18-68%. All manuals provided information about the wavelength/spectrum of the LCU. Only Valo X and Valo Cordless reported power values and used the term "irradiance" instead of "intensity." Details such as LED type and active tip emission area were often missing. Instructions on how to use the LCU to photo-cure resins were frequently limited. Although most manuals addressed safety precautions, several lacked details on heat issues and general health precautions. All manuals included maintenance instructions, though information on replacement parts was often missing. Among the LCUs, 85% stated they were CE certified, 32% held both FDA and CE certification, and 63% claimed compliance with ISO and/or IEC standards. There were notable differences in the completeness and accuracy of the instruction manuals. Manuals from major manufacturers generally provided more comprehensive information than their budget counterparts. Instruction manuals should contain accurate information to help clinicians deliver the highest standard of care. The lack of important information about the LCUs in the manuals is concerning.

The Urgency of Enforcing Criminal Sanctions Against Perpetrators Waste Incineration

The global issue of various adverse impacts and dangerous risks due to mistakes in waste management is intensively echoed as a shared responsibility to be resolved. As the holder of the G20 presidency in 2022, Indonesia even raised the issue of sustainable waste management in the G20 forum. Therefore, legal research is important to study and provide solutions to these problems from the legal aspect, so that it is useful, not only at the regional and national levels, but also for the sustainability of life in all parts of the world. The purpose of this study is to find out the urgency of enforcing criminal sanctions listed in local regulations against waste incinerators in Kubu Raya Regency, West Kalimantan Province, Indonesia, reviewed from the relative theory as a criminal purpose. This research is a normative legal research, with a legislative approach and a theoretical approach. Based on the results of the research, there are two reasons for the urgency of enforcing criminal sanctions against the large number of waste incinerators in Kubu Raya Regency. First, it is reviewed from a general precaution in relative theory, which is to prevent everyone from becoming a perpetrator of waste burning. Second, it is reviewed from a special provision in relative theory, which is to prevent the perpetrators of burning waste who have been convicted from repeating their actions. Through criminal law enforcement, if general and special prevention are carried out optimally, it is hoped that the purpose of the regional regulation can be realized, namely to reduce the danger posed by sarnpah, especially burned waste, protect and improve the quality of public health and the environment, and change community behavior in waste management.

Effect of pH, Carbonate and Clay Content on Magnesium Measurement Methods on Hungarian Soils

More exact information on soil nutrient management is crucial due to environmental protection, nature conservation, decreasing sources for mining, general precaution, etc. Soil magnesium (Mg) analytical methods of potassium chloride (KCl), Mehlich 3 (M3), water (WA) and cobalt hexamine (CoHex) extractions are compared with an elemental analysis and X-ray fluorescence (XRF) analysis. The ratio of the available to the total Mg content was calculated and compared on the whole dataset. The results showed that the linear regressions between all the pairs of Mg content measurement methods were significant. The linear relationship between the KCl and CoHex methods has the highest determination coefficient (R2 = 0.96), followed by WA–M3 (R2 = 0.68), M3–CoHex (R2 = 0.66) and M3–KCl (R2 = 0.60). The M3 solution demonstrated a greater capacity for extracting Mg from the soil. The second part is the analysis of the influence of CaCO3, pH, soil texture and clay content on the measurable magnesium content of soils. It was established that the extraction methods, the soil and the classification method of the soil properties affect the evaluation. These results may help through the nutrient replenishment and the melioration of soils. These results can help the examination of mineral nutrients, especially the Mg uptake.

COVID-19 in Children with Chronic Kidney Disease; Does it Differ Much?

COVID-19 is known to have a mild course in children, however more data on pediatric chronic kidney disease (CKD) is needed. We aimed to assess the incidence and severity of COVID-19 in pediatric CKD patients. A questionnaire including demographics, COVID-19 history, symptoms, and vaccination status was applied to patients with CKD. We also retrospectively reviewed the presentation and outcomes of SARS-CoV-2 infection in this patient group from March 2020 to December 2021. 220 patients were included, 48 were found to have experienced COVID-19. There was no significant difference regarding age, gender, underlying kidney disease, CKD stage, dialysis status, type or number of immunosuppressive medications, and glomerular filtration rate between patients with and without COVID-19. Most were infected by a household member (43.8%) and during outpatient or inpatient care (18.8%). Four (8.3%) were asymptomatic, and 43 (89.6%) had mild infection. Severe COVID-19 was observed in only one patient. Eleven (22.9%) patients with COVID-19 were previously vaccinated. Acute kidney injury was detected in 4 (8.3%); as stage 1 in all. Median follow-up after COVID-19 was 4.6 months. All patients fully recovered, and no renal disease flare or death was observed. Although the vaccination rate was low in our cohort, the majority of the children with COVID-19 showed a mild course. Along with the vaccination, general precautions seemed to be successful for this population.

Prevalence and risk factors of needle stick injury among healthcare workers in the emergency department, King Saud Medical City, Riyadh, Saudi Arabia

Objective: This study aimed to evaluate the risk factors and prevalence of needle stick injuries (NSIs) among healthcare workers (HCWs) working in the emergency department (ED) at King Saud Medical City (KSMC) in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted on 194 HCWs in the ED at KSMC. A pre-designed questionnaire was used to collect the data about participants' demographics, work characteristics, previous exposure to NSI, and circumstances related to NSI. Results: Among the studied 194 HCWs, 45.5% had an age range from 18-30 years, 50.5% were females, 57.7% had a Saudi nationality, 41.2% had a work experience of 5-10 years, and 38.1% were nurses. Of them, 25.8% had previous exposure to NSI and among them, 60% had NSI once, 48% had a superficial injury, 16% had a penetration of gloves, and 84% wore personal protective equipment. The most common device associated with injury was a syringe (32%), 52% received medical attention within 2 hours, and 64% washed the site with soap. NSI was significantly higher among HCWs aged 31-40 years, with a work experience of 5-10 years, and among nurses. Conclusion: NSIs were frequent among the participants. Hospital managers and health policymakers should develop plans to boost healthcare professionals' adherence to general precautions.

Adoption of Post-Harvest Handling Practices by Ginger Farmers in Palpa District, Nepal

Ginger has the potential for export and increased income for farmers in Nepal. Proper post-harvest handling practices has led to low market prices and significant post-harvest losses of ginger. The study was conducted in Palpa district to examine the post-harvest practices and technology adoption among ginger farmers. Data from 66 farmers in Bagnashkali, Purbakhola, Nisdi, and Rampur municipalities was collected through interviews, key informant interviews, and focus group discussions. Descriptive analysis was performed using MS Excel and SPSS. Results showed that 72.7% of farmers practiced storage, with Bhakari (60.41%) and Pit (39.59%) being the common storage types. Storage molds affected 72.2% of respondents, while 28.8% reported wrinkling during storage. Washing was practiced by only 7.6% of farmers. Manual grading was reported by all respondents, with no commercial grading observed. Black sutho production was carried out by 65.2% of farmers. Value addition activities such as sorting were practiced by 65% of respondents, while 25% engaged in transportation and packaging. Respondents' awareness of ginger post-harvest practices varied, with 75.76% having low awareness, 16.66% medium awareness, and 7.58% high awareness. Farmers' general precautions during harvesting, such as avoiding rhizome injury and minimal trimming and sorting, were not accompanied by specific precautionary practices, contributing to their challenges. The findings emphasize the importance of adopting modern post-harvest practices to increase production, improve product quality, and command higher market prices. Implementing these measures will enable ginger farmers in Palpa district to enhance their income and contribute to the growth of the ginger industry in Nepal.

Fall From Height Cases of Pediatric Intensive Care Unit and The Curfew of the COVID-19 Period Possible Effects on it

Background/Purpose: To investigate whether the curfew of the COVID-19 pandemic influences the fall from height cases in children’s age group.
 Methods: This study was conducted in the Pediatric Intensive Care Unit (PICU) of XXX Training and Research Hospital between 01 January 2017 and 01 January 2022. This study enrolled 39 males (35.1%) and 72 females (64.9%) aged 4.4 ±4.1 years. 
 Results: The findings indicate that when the school precautions existed, the number of fall cases who were admitted to PICU decreased 10-fold. Additionally, when the general precautions were performed, the number of fall cases who were admitted to PICU decreased 31,8%. On the other hand, the logistic regression model, which was established to predict the independent factors of higher fall cases among all of the fall cases admitted to PICU, was found to be significant. Falling from the 'storey of building', which is one of the variables included in the analysis, contributed significantly to the model and was in a 54.4-fold significant relationship with High Falls (above 4.57 meters). While pneumocephalus injury was associated with High Falls 9.2 times, pneumothorax was associated 15.9 times.
 Conclusion: Our results have three implications. First, it was presented that above 4,57 meter falls cause more severe injuries than lower falls. Second, injury patterns, social parameters, epidemiological differences, required prevention equipment, and education of caregivers of fall cases were revealed. Third, the influences of the curfew on the COVID-19 pandemic were discussed.

Uptake of hepatitis B vaccination and associated factors among health sciences students, Mogadishu, Somalia.

Hepatitis B is a potentially fatal liver infection caused by the hepatitis B virus (HBV). It is a serious issue for global health. It considerably raises the risk of cirrhosis and liver cancer-related death and can result in chronic infection. The risk of infection is high among health sciences students due to the risk of occupational contact with fluids of infected patients and the risk of needle stick injury. The most effective way of preventing HBV infection is the vaccination of students prior to their posting to healthcare settings. There is no data available about HBV vaccination uptake among Health Sciences students in Somalia. Therefore, this study aimed to determine HBV vaccination uptake and associated factors toward HBV among health science students in Somalia. A cross-sectional study was undertaken among health sciences students from August to October 2022. Data were gathered using Kobo Toolbox using a standardized questionnaire with questions on characteristics, knowledge attitude, and HBV prevention practices. A total of 569 students were involved in the study. Stata version 15 was utilized for the analysis. Bivariate and multivariate logistic regression analysis, as well as descriptive statistics, were performed. In order to assess the existence and significance of the relationship between the outcome and risk factors, an adjusted odds ratio with a 95% confidence interval (CI) was used. Statistical significance was considered as a p-value ≤0.05. Of the 569 study participants, 33.4% (95%CI: 29.6-37.4) received a full dose of the HBV vaccine in this study. Participants had good HBV prevention knowledge, attitudes, and practices at 69.6, 37.96, and 50.6%, respectively. The lack of access and the high cost of the vaccine were the reasons for not taking the vaccine. Second-year [AOR: 0.22 (0.12-0.43)]. Positive attitude [AOR: 0.54 (0.31-0.93)], and good practice [AOR: 6.99 (3.62-13.5)]. The study indicated that 33.4% of health sciences students had received the required HBV vaccination doses, academic year, attitude, and practice were significantly associated with full-dose vaccination status. The unavailability of the vaccine and the high cost of vaccination were the most common reasons for not taking the vaccine. It is recommended that students receive vaccinations before beginning clinical rotations, and give instruction on infection prevention strategies and general precautions, particularly regarding HBV infection.

DISTORIES

DISTORIES is a small open-source and open-access Instagram zine project, gathering testimonies from disabled contributors. This project began in the context of the summer of 2021, as mask mandates and general precautions around COVID-19 were being relaxed. Each chapter of the zine is introduced by a question, framing stories and snapshots of experience as well as demands, affirmations, and dreams shared by contributors. The project was stewarded by geunsaeng ahn from September 2021 to July 2022.

Preparedness for hospital safety during COVID-19 pandemic: A survey of private hospitals in Vietnam

Objectives: Hospitals in private sectors also play an important role in the health system by providing crucial medical treatment to the population, especially during a pandemic crisis. Decision No. 3088/QD-BYT was issued by the Minister of Health (MOH) of Vietnam to promulgate the set of criteria for safe hospitals to prevent COVID-19 and other acute respiratory infections. This study was employed to describe the implementation of criteria for safety to prevent COVID-19 among private hospitals in Vietnam in 2020. Methods: A cross-sectional study based on secondary data were extracted and analyzed from a recent survey of hospital safety conducted by MOH. Total of 178 private hospitals were selected in this study. The study received ethics approval from the Hanoi Medical University. Results: The the proportion of private hospitals classified as “safe hospital” was 94.4%, “safe hospital with moderate level” was 3.9% and “unsafe hospital” was 1.7%. Thus, basically, most private hospitals in Vietnam have met the standards of safe hospitals according to Decision 3088/QD-BYT. In which, the criterion 8 “Hospital hygiene” had the highest level of compliance, followed by criterion 3 “General precautions” and 1“Establishment of steering committee and formulation of prevention plan”. Conclusions: Most private hospitals in Vietnam had met the standards of safe hospitals according to Decision 3088/QD-BYT. Ministry of Health should improve the criteria in Decision 3088/QD-BYT to be more suitable with the emerging new situation and threat of the pandemic and develop mechanisms and regulations that require not only public hospitals also private hospitals to regularly report on disease preparation and response.

Nursery outbreak caused by enteroaggregative Escherichia coli serogroup O111:H21.

This study describes, for the first time, the occurrence of an epidemic of enteroaggregative Escherichia coli (EAEC) O111:H21 in a Belgian nursery and describes a practical approach concerning its management. Few data exist in the literature on this type of outbreak. Clinical and microbiological investigations were needed to find a link between the cases and identify the causative agent. The microbiological procedure followed was first based on conventional analyses: isolation using selective cultures, identification by MALDI-TOF MS, antibiogram, determination of the serogroup by agglutination, then whole genome sequencing. A total of 7/21 children were infected with this pathogen. Four cases could be confirmed by a molecular technique, wgMLST, as belonging to the same bacterial clone. The action plan put in place focused on symptomatic case eviction, strict general hygiene precaution as well as specific cleaning and disinfection measures. The epidemic did last only a few days. It appears important, in the context of an epidemic, that clinical laboratories standardize their practice by equipping themselves with molecular techniques such as a multiplex which does not focus only on the serotype O157:H7 and which make it possible to distinguish the different pathotypes of E. coli by targeting several virulence genes (stx, aggR…). However, cost/effectiveness studies are awaited to confirm the interest of a systematic search by molecular method for the pathogen involved in a suspected outbreak occurring in a nursery.

Global concerns about camel flu: outbreak, etiology, genomic structure, transmission, symptoms, diagnostic tests, prevention, and treatment - correspondence.

Global concerns about camel flu: outbreak, etiology, genomic structure, transmission, symptoms, diagnostic tests, prevention, and treatment - correspondence.

Single-Center Experience in Detecting Influenza Virus, RSV and SARS-CoV-2 at the Emergency Department.

Reverse transcription polymerase chain reaction (RT-PCR) on respiratory tract swabs has become the gold standard for sensitive and specific detection of influenza virus, respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this retrospective analysis, we report on the successive implementation and routine use of multiplex RT-PCR testing for patients admitted to the Internal Medicine Emergency Department (ED) at a tertiary care center in Western Austria, one of the hotspots in the early coronavirus disease 2019 (COVID-19) pandemic in Europe. Our description focuses on the use of the Cepheid® Xpert® Xpress closed RT-PCR system in point-of-care testing (POCT). Our indications for RT-PCR testing changed during the observation period: From the cold season 2016/2017 until the cold season 2019/2020, we used RT-PCR to diagnose influenza or RSV infection in patients with fever and/or respiratory symptoms. Starting in March 2020, we used the RT-PCR for SARS-CoV-2 and a multiplex version for the combined detection of all these three respiratory viruses to also screen subjects who did not present with symptoms of infection but needed in-hospital medical treatment for other reasons. Expectedly, the switch to a more liberal RT-PCR test strategy resulted in a substantial increase in the number of tests. Nevertheless, we observed an immediate decline in influenza virus and RSV detections in early 2020 that coincided with public SARS-CoV-2 containment measures. In contrast, the extensive use of the combined RT-PCR test enabled us to monitor the re-emergence of influenza and RSV detections, including asymptomatic cases, at the end of 2022 when COVID-19 containment measures were no longer in place. Our analysis of PCR results for respiratory viruses from a real-life setting at an ED provides valuable information on the epidemiology of those infections over several years, their contribution to morbidity and need for hospital admission, the risk for nosocomial introduction of such infection into hospitals from asymptomatic carriers, and guidance as to how general precautions and prophylactic strategies affect the dynamics of those infections.

Treatment protocol with alternative iron drugs in patients with an allergic reaction during iron replacement therapy

In our study, we aimed to show that alternative iron salts containing different additives are safe to use in patients who have type 1 hypersensitivity reactions to iron drugs and need iron replacement therapy. Materials and methods: Between January 2022 and June 2022, patients who had previously developed type 1 hypersensitivity reactions with iron preparations and needed iron replacement were included in the study. The study was designed retrospectively. Skin tests were first performed on patients to demonstrate a type 1 hypersensitivity reaction. If skin tests were negative and there was no history of life-threatening anaphylaxis, oral provocation tests were continued. If the absence of variability in symptoms and perimeter values, the drug allergy test was considered negative. Results: Twenty-two patients were included in the study. Twenty-one of the patients were female and one was male. Iron deficiency anemia was found in nine patients, and low iron stores in thirteen patients without anemia were found. Type 1 hypersensitivity reaction developed with Iron 3 Carboxymaltose in 7 patients, Iron 2 Sulfate in 5 patients, Iron 2 Glycine in 4 patients, Iron 3 Hydroxy Polymaltose in 4 patients, Iron 2 Fumarate in 1 patient and Iron 3 Hydroxide Sucrose in 1 patient. Allergy tests with all alternative iron drugs containing additional additives were negative. Conclusion: If patients with allergic reactions cannot be referred to allergy clinics, we think that oral iron salts with different additives can be used after the first dose is given in the hospital under general anaphylaxis precautions. We show that oral iron salts containing different additives can be safely used.

Formulation and Evaluation of a Disinfectant Solution Based on Natural Products

Hands are the main mode of transmission of microorganisms. Hand hygiene is considered the most effective measure of general precautions in the prevention of microbial contamination. The hydroalcoholic solution containing a high concentration of alcohol can cause a burning sensation and marginal irritation of the skin. This is precisely the main reason for the need for a disinfectant solution but which does not have the disadvantages of the hydroalcoholic solution and it is the objective of our end-of-studies dissertation which is the formulation of a disinfectant solution based on essential oils by comparing its effectiveness with the hydroalcoholic solution. In order to measure the antibacterial effect, we performed the aromatogram technique on the hydroalcoholic solution as well as on ours based on essential oils, the effect of which is assessed by measuring the diameter of an area of inhibition. The result obtained allowed us to confirm that the hydroalcoholic solution is effective but it causes skin irritation, while our natural solution has proven to be very interesting for its antibacterial power and its moisturizing effect with aloe Vera.

Adoption of post-harvest handling practices by ginger farmers in Palpa district, Nepal

Ginger has the potential for export and increased income for farmers in Nepal. Proper post-harvest handling practices has led to low market prices and significant post-harvest losses of ginger. This study was conducted in Palpa district to examine the post-harvest practices and technology adoption among ginger farmers. Data from 66 farmers in Bagnashkali, Purbakhola, Nisdi, and Rampur municipalities was collected through interviews, key informant interviews, and focus group discussions. Descriptive analysis was performed using MS Excel and SPSS. Results showed that 72.7% of farmers practiced storage, with Bhakari (60.41%) and Pit (39.59%) being the common storage types. Storage molds affected 72.2% of respondents, while 28.8% reported wrinkling during storage. Washing was practiced by only 7.6% of farmers. Manual grading was reported by all respondents, with no commercial grading observed. Black sutho production was carried out by 65.2% of farmers. Value addition activities such as sorting were practiced by 65% of respondents, while 25% engaged in transportation and packaging. Respondents\' awareness of ginger post-harvest practices varied, with 75.76% having low awareness, 16.66% medium awareness, and 7.58% high awareness. Farmers\' general precautions during harvesting, such as avoiding rhizome injury and minimal trimming and sorting, were not accompanied by specific precautionary practices, contributing to their challenges. The findings emphasize the importance of adopting modern post-harvest practices to increase production, improve product quality, and command higher market prices. Implementing these measures will enable ginger farmers in Palpa district to enhance their income and contribute to the growth of the ginger industry in Nepal.

IPM: General precautions while spraying.

IPM: General precautions while spraying.

Transcranial direct current stimulation in perinatal mental health: current status and future directions

Abstract One in five women in the peripartum period (from pregnancy and up to twelve months after delivery) will experience a mood or anxiety disorder. While pregnant or breastfeeding, 70-80% of women diagnosed with mood/anxiety disorders refuse medication, postpone treatment, or accept treatments below clinical dose. 20-30% might consider antidepressants but quit breastfeeding. Untreated perinatal depression/anxiety has detrimental effects in women’s overall health and wellbeing, negatively impacting infant’s health and development. Additionally, untreated perinatal mental health disrupts the mother-infant dyad and family relationships, representing a heavy burden on societies. Transcranial direct current stimulation (tDCS) is known to have a beneficial effect (with modest effect sizes) in Major Depression, showing a safe profile. tDCS uses portable devices, easily combined with remote health care, and has proven its potential to be transferred to home-based delivered treatments. Despite the available evidence not supporting the need for a general precaution against its use in the perinatal period, researchers, IRBs, regulators and manufacturers keep conveying the idea that tDCS is a high-risk intervention for pregnant or breastfeeding women, leading to a lack of studies about tDCS as an alternative treatment for perinatal disorders. A systematic review of the literature will be presented, about the evidence of efficacy of tDCS to manage depressive/anxiety symptoms in the peripartum period. Further, this review will be informed by qualitative data on the subjective experiences and expectations about tDCS as an alternative treatment to perinatal mental health from women with lived experience of PPD and perinatal mental health professionals. With this data we aim to set the context for future research about the use of tDCS in perinatal mental health and shed light to the needed changes by regulatory bodies, the market, research, and the clinical practice about the usability of tDCS in perinatal mental health. Research Category and Technology and Methods Clinical Research: 9. Transcranial Direct Current Stimulation (tDCS) Keywords: tDCS, Peripartum depression, Efficacy, Acceptability

Which non-steroidal anti-inflammatory drug (NSAID) is safer in patients with Non-steroids Exacerbated Respiratory Disease (N-ERD)? A single-center retrospective study.

In patients with NSAID-Exacerbated Respiratory Disease (N-ERD), respiratory symptoms occur as a result of the use of cyclooxygenase (COX)-1 inhibitor non-steroidal anti-inflammatory drugs (NSAIDs). Patients with N-ERD generally tolerate selective COX-2 inhibitor NSAIDs. However, respiratory symptoms may be exacerbated in patients with N-ERD due to the intake of selective COX-2 inhibitor NSAIDs. The aim of this study was to evaluate which selective or partial COX-2 inhibitor NSAID is safer in patients with N-ERD. Forty-nine patients with a history of respiratory hypersensitivity reactions to NSAIDs (N-ERD) who underwent a drug challenge test with celecoxib, nimesulide, meloxicam, and paracetamol between January 2021-April 2022 were retrospectively evaluated. Of the 49 patients who underwent the drug challenge tests, 16 (32.7%) were male and 33 (67.3%) were female and the mean age was 37.67 ± 11.62 years. The most common comorbidities were chronic urticaria [n= 21 (42.9%)] and allergic rhinitis [n= 21 (42.9%)]. As a result of drug challenge tests, celecoxib, nimesulide, meloxicam, and paracetamol drug challenge tests were positive in 2 (4.1%), 8 (16.3%), 7 (14.3%) and 11 (22.4) patients, respectively. The rate of allergic reaction to celecoxib was statistically significantly lower than other drugs (p= 0.001). In paired comparisons of the drugs, the allergic reaction rate with celecoxib was statistically significantly lower than with nimesulide (p= 0.031) and paracetamol (p= 0.004). Selective COX-2 inhibitor NSAIDs are safe in patients with N-ERD. NSAIDs should be prescribed to these patients following general medical precautions and drug challenge tests.