<p> <b><span>Introduction: </span></b><span>Foreign body aspiration is not uncommon in children. It can be associated with significant morbidity and mortality. This study aims to determine and analyze the characteristics of local pediatrics airway foreign body (FB) aspiration.</span><span> </span><b><span>Methods:</span></b><span> A retrospective study of medical records from KK hospital (1997-2010) is done. Patient demographics, clinical/investigative findings, duration of hospitalization and complications are analyzed.</span><span> </span><b><span>Results: </span></b><span>The sample consisted of 26 patients (eight months - 13 years of age), who underwent rigid bronchoscopy for FB removal over the last 13 years. Seventy-seven percent were three years of age or younger. Peak incidence (61.6%) was at one to two years of age. Nineteen were males and seven were females. The top three clinical presentations were: cough (61.5%), choking (46.2%) and wheezing (42.3%). Decreased air entry (34.6%), tachypnea (26.9%) and no significant findings (23.1%) were the most common features on physical examination. The most common radiographic findings were consolidation (30.8%), presence of a foreign body (23.1%) and no abnormality (23.1%). Aspiration was primarily into the right main bronchus (38.5%), and 61.5% of the FB was organic in nature [principally peanuts (38.5%)]. Mean hospitalization duration was three days. Delayed diagnose in three cases were secondary to mis-diagnoses as croup (n</span><span> </span><span>=</span><span> </span><span>two) and respiratory tract infection (n</span><span> </span><span>=</span><span> </span><span>one). Complications were noted in eight cases (30.8%). There was no mortality. <b>Conclusion: </b>High index of suspicion is required in diagnosing airway FB. Physician’s diagnostic acumen is vital in prompt successful treatment. Heightening public’s awareness is the key to prevention of pediatrics FB aspiration.</span><span></span> </p>
Background There is a paucity of Asian-based data regarding the diagnostic yield of computed tomography imaging in the initial assessment of idiopathic unilateral vocal fold palsy. Objectives To investigate the diagnostic yield of computed tomography in idiopathic unilateral vocal fold palsy cases in an Asian tertiary hospital, and to determine the causative pathologies and positive predictive factors. Method A retrospective chart review was conducted of patients (between 2010 and 2018) with a clinical diagnosis of idiopathic unilateral vocal fold palsy who underwent contrast-enhanced computed tomography of the neck and chest at Tan Tock Seng Hospital, Singapore. Results The overall computed tomography diagnostic yield was 21 per cent, with malignancy accounting for 63.6 per cent of diagnoses. Degree of vocal fold weakness was the only significant predictor of positive computed tomography findings (11.5 per cent in vocal fold paresis vs 29.1 per cent in vocal fold paralysis, p = 0.025). None of the patients with negative computed tomography findings went on to develop disease after a mean follow up of 14.3 months. Conclusion Computed tomography is a useful initial investigation for idiopathic unilateral vocal fold palsy, particularly in cases with vocal fold paralysis.
Background Aerosol‐generating procedures (AGPs), such as nasoendoscopy, are considered high‐risk during the COVID‐19 pandemic due to risk of virus aerosol transmission. We aim to evaluate the efficacy of an innovative system in reduction of aerosol contamination. Methods Pilot study involving 15 healthy volunteers performing aerosol‐generating activities with the prototype, compared with and without a standard surgical mask. Results We found an increased frequency of smaller‐sized particle emissions for all four expiratory activities. The particle emission rate with the prototype mask was significantly slower over time for the smallest sized particle (0.3 μm) during breathing, speaking and singing compared with similar activities without the mask (p < .05). We found similar trends for coughing for larger particles but that did not reach statistical significance. Conclusion The innovation offers good protection against aerosol transmission through the physical barrier of the mask, the negative pressure environment within the mask, and the unit's dual filtration function. Level of evidence Level 2b.
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