How safe is ryle’s tube feeding.

Administration of fluid diet by nasogastric tube is indicated in patients who are unable or unwilling to take sufficient nourishment by mouth. Ryle's tube is one among such devices, which is commonly used for feeding unconscious patients, and for performing stomach wash in cases of suspected poisoning. But before using this tube for any procedure it is imperative to check the correct position of the distal end of the tube. This is because, occasionally the tube may inadvertently enter the airway instead of the gastrointestinal tract. In rare cases, even when the tube is positioned in the gastrointestinal tract, fatality can result. A case is reported here in which, an adult male with a history of head injury was admitted to the hospital in an unconscious state, and died after a period of about 12 hours following admission. At autopsy, food particles were seen in the lung parenchyma, which indicated faulty positioning of Ryle's tube that had led to fatality. Chest X-ray showed the Ryle's tube curving at the fundus of the stomach and re-entering the oesophagus.

Difficulties of assessing precise age in old persons a case report.

We report a case of an elderly person who alleged his age to be eighty five years, was referred from Health secretary as directed by the Honorable High court of Karnataka. The individual presented himself alone to the District Hospital for the examination and certification by the District surgeon. A panel of doctors was constituted, who examined the person individually and reported to the concerned authority. Surprisingly the age was found to be less by 25-30 years. This paper focuses on the difficulties faced by the experts in opining the age of elderly individuals.