ABSTRACT
Foreign body aspiration is a rare clinical finding in adults, among which very few are reported, probably due to absence of classical clinical features in adults when compared to children and due to lack of awareness. We present a 57-year-old with chronic productive cough who was diagnosed to have pulmonary tuberculosis (TB), complicated by long-standing foreign body in the tracheobronchial tree. There are many cases reported in literature where there have been misdiagnosis with respect to pulmonary TB as foreign body or foreign bodies as pulmonary TB. However, this is the first case where retained foreign body and pulmonary TB coexisted in a patient.
Subject(s)
Foreign Bodies , Tuberculosis, Pulmonary , Child , Male , Adult , Humans , Middle Aged , Bronchoscopy/adverse effects , Bronchoscopy/methods , Bronchi/diagnostic imaging , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnosis , Cough/etiology , Foreign Bodies/complications , Foreign Bodies/diagnosis , Retrospective StudiesABSTRACT
Tracheobronchopathia osteochondro-plastica (TPO) is a rare disorder of yet unknown etiology. The common clinical features include cough with expectoration, breathing difficulty, hemoptysis, and recurrent airway infections, which can lead to a misdiagnosis as another chronic respiratory illness in a large number of cases due to the rare nature of TPO. Here we present a 25-year-old lady who was misdiagnosed as bronchial asthma for many years, and was found to have TPO after difficulty in intubation for administering general anesthesia prior to a surgical procedure.
Subject(s)
Osteochondrodysplasias , Tracheal Diseases , Adult , Bronchoscopy , Diagnostic Errors , Female , Humans , Intubation, Intratracheal , Osteochondrodysplasias/diagnosis , Osteochondrodysplasias/surgery , Tracheal Diseases/diagnosis , Tracheal Diseases/surgeryABSTRACT
INTRODUCTION: The objectives of this study were to: (i) evaluate the effectiveness of 'parent's kiss' as a technique for removal of nasal foreign bodies in children; and (ii) determine whether this technique reduces the number of children requiring general anaesthesia for their removal. PATIENTS AND METHODS: This was a prospective observational study in the accident and emergency and ENT departments at Luton and Dunstable Hospital. The participants were 31 children with nasal foreign bodies, under the age of 5 years, presenting via the acute services over a 6-month period. The primary outcome measured was successful removal of nasal foreign body with the 'parent's kiss' technique. Secondary outcome was reduction in the number of general anaesthetics following introduction of the technique. RESULTS: The technique was successful in 20 out of the 31 children (64.5%) in the study group. Only one patient required general anaesthesia for removal of nasal foreign body (3%). This compares with a rate of 32.5% requiring removal under general anaesthetic in the preceding 6-month period. The 'parent's kiss', when not successful, seemed to improve the visibility of the foreign body making their subsequent removal easier. CONCLUSIONS: The 'parent's kiss' is an effective technique. It is non-traumatic, both physically and emotionally, for the child subjected to it. We advocate that it should be used routinely as a first line of management in children with a nasal foreign body in the primary care setting.
Subject(s)
Foreign Bodies/therapy , Nasal Obstruction/therapy , Nose , Parents , Child, Preschool , Emergency Service, Hospital , Humans , Infant , Patient Satisfaction , Pressure , Prospective Studies , Treatment OutcomeABSTRACT
Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine-ichthammol (GI) solution and Triadcortyl (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Gramicidin/administration & dosage , Neomycin/administration & dosage , Nystatin/administration & dosage , Otitis Externa/drug therapy , Quaternary Ammonium Compounds/administration & dosage , Triamcinolone Acetonide/administration & dosage , Acute Disease , Adolescent , Adult , Aged , Drug Combinations , Female , Glycerol/administration & dosage , Humans , Male , Middle Aged , Pain Measurement , Solvents/administration & dosage , Treatment OutcomeABSTRACT
In all the cases of P.V Syndrome, it is better to find out by endoscopy even if barium swallow is normal. Thus in P. V. syndrome, the accuracy of barium swallow is only 19% and 81% are reported as false negative.In strictures and malignancies, the level of lesion reported by barium swallow should not be relied upon in all the cases, and they should be confirmed by endoscopy.Endoscopy provides us with a definite diagnosis and allows biopsy and hence histological confirmation. Barium Swallow is an important examination that can be used to rule out certain lesions. So endoscopy can be avoided in these patients. Failure rate of Barium Swallow can mostly.
