efficacy of rigid bronchoscopy for foreign body aspiration

The aim of the current study was to determine the pattern, presentation and management of foreign body aspiration in our population. This prospective study comprised 55 patients with foreign body aspiration admitted to our department from January 2009 to December 2011. All patients underwent rigid bronchoscopy under local or general anesthesia. The patients' demographic information along with clinical characteristics and their outcome were recorded and reported. The mean age of the children was 13.3 +/- 3.6 years. There were 32 [58.2%] females and 23 [41.8%] males. The frequent symptom was an attack of chocking followed by cough. The predominant sign was wheezing. Rigid bronchoscopy was successful in removing foreign body from 52[94.5%] patients. Three [5.5%] patients who had undergone thoracotomy with bronchotomy needed exploration, after failure of bronchoscopy to remove the foreign body. There was no mortality in our series. Average hospital stay was 12 hours. It could be concluded that rigid bronchoscopy is modality of choice in management of foreign body aspiration especially in pediatric population

Lung contusion: a clinico-pathological entity with unpredictable clinical course

Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion includes ventilation/perfusion mismatching, increased intrapulmonary shunting, increased lung water, segmental lung damage, and a loss of compliance. Clinically, patient's presents with hypoxiemia, hypercarbia and increase in laboured breathing. Patients are treated with supplemental oxygen and mechanical ventilation whenever indicated. Treatment is primarily supportive. Computed tomography [CT] is very sensitive for diagnosing pulmonary contusion. Pulmonary contusion occurs in 25-35% of all blunt chest traumas

Endorectal coil MRI and MR-spectroscopic imaging in patients with elevated serum prostate specific antigen with negative trus transrectal ultrasound guided biopsy

The aim of this study was to see the efficacy of endorectal coil MRI and MR spectroscopic imaging in patients with elevated serum PSA and negative transrectal ultrasonography [TRUS]-guided biopsy. This study was conducted on 87 patients presented with: Elevated prostatic specific antigen levels >5 ng/ml. Symptoms and signs of prostatic carcinoma. Patients with negative TRUS-guided biopsy. Suspicious lesion on TRU. All the patients were subjected to TRUS and followed by TRUS-guided biopsy of the lesion identified on endorectal coil MRI and MR-Spectroscopy. TRUS-guided biopsy of prostate was done with a Siemens Sonoline Adana Scanner. The scanning was performed by mechanical probe 5-7.5 MHz. Out of 87 patients, 43 [49.4%] had hypointense lesion, 11 [12.6%] had hyperintense lesion. Out of 87 patients, MR-spectroscopy showed peak choline-creatine in 74 patients. Normal citrate peak was seen in 13 patients. Patients who had choline-creatine peak, among them 28 [37.8%] had peak in left peripheral zone, 23 [31.1%] had peak in the right peripheral zone, 2 [2.7%] had peak in the central zone, 17 had [23%] peak bilaterally. Four patients [5.4%] had peaks in right and central zones. The difference was statistically significant [P < 0.001]. Prostatic biopsy directed with endorectal coil MRI and MR-spectroscopic imaging findings in patients with elevated serum PSA and prior negative biopsy, improves the early diagnosis of prostatic carcinoma and accurate localization of prostate cancer within the gland.

Penetrating cardiac injury: a review

Cardiac injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent death. Sometimes serious cardiac injury may manifest only subtle or occult symptoms or signs. As there is an epidemic of cardiac injuries in Kashmir valley due to problems of law and order, we herein present a review on management of such injuries