In Australia, approximately 18% of newborn babies are admitted to a neonatal intensive or special care nursery. While most babies admitted to a neonatal intensive or special care nursery are discharged home within a few weeks, around 6% of babies spend more than 2 weeks in hospital. For the parents of these babies, much of their leave entitlements (Australian Government Paid Parental Leave Scheme is up to18 weeks for the primary care giver and up to 2 weeks for partners) are used before their baby comes home from hospital. The time babies and parents spend together in the early developmental period, during the hospitalisation and when the baby is discharged home, is crucial for optimal child development and bonding. Yet care givers who have a baby admitted to neonatal intensive or special care for extended periods are not currently entitled to any extra parental leave payments in Australia. We recommend the Australian Paid Parental Leave Act is changed to allow primary carers access to 1 week of extra parental leave pay for every week in hospital (for babies admitted to hospital for more than 2 weeks), up to a maximum of 14 weeks. For fathers and partners of these babies, we recommend an additional 2 weeks of extra Dad and Partner Pay. The net cost, taking into account likely productivity benefits, would be less than 1.5% of the current cost of the scheme and would improve health and socio‐economic outcomes for the baby, family and society.

Objective: To review cases of adult acute epiglottitis in a tertiary government hospital and describe the clinical presentations, diagnostics performed, management and outcomes. Methods: Study Design:            Retrospective Chart Review Setting:                       Tertiary Government Hospital Subjects: Records of patients admitted by or referred to the Department of Otolaryngology Head and Neck Surgery with a diagnosis of acute epiglottitis from January 2008 to August 2014 were identified from the department census and charts were retrieved from the Hospital Record Section and evaluated according to inclusion and exclusion criteria.  Information regarding demographic data, clinical features, laboratory and other diagnostic examinations, medical management, and length of hospital stay were collected. Results: There were 20 cases in seven years and eight months. Most were male, 18 to 37-years-old, presenting with dysphagia, odynophagia and a swollen epiglottis on laryngoscopy. Abnormal soft-tissue lateral radiographs of the neck and leukocytosis were seen in 73 % and 83% respectively. Intravenous antibiotics and corticosteroids were administered in all cases, and mean hospital stay was 11.2 days. Conclusion: Adult acute epiglottitis should be highly suspected in patients presenting with dysphagia, odynophagia, and muffling of the voice even with a normal oropharyngeal examination. History of respiratory infection, co-morbidities, smoking and alcohol intake, concomitant laryngeal pathology and supraglottic structure insults contribute to development of the disease.  Laryngoscopy is still the gold standard in diagnosis. Airway protection is mandatory but prophylactic intubation or tracheostomy are not advised.  Intravenous antibiotics are necessary and corticosteroids may be of benefit.  Keywords: epiglottitis, supraglottitis, epiglottis, adult, Philippines

Objective: To present an atypical case of a live fish lodged in the throat of a pediatric patient and discuss its management. Methods: Study Design:            Case Report    Setting:                       Tertiary Government Hospital Subject:                      One   Results: An 8-year-old girl swallowed a live fish when she accidentally fell in a body of water. Failed attempts to remove the live fish prompted consult in the emergency room of our hospital, where removal of the foreign body was successfully done using Mixter right angle forceps assisted with a gloved finger. Transient cyanosis and unresponsiveness during extraction was overcome with oxygen by mask, and she regained consciousness. She was allowed to go home as no other untoward events or complications were observed.   Conclusion:  All ingested foreign bodies, particularly in children, require immediate attention. The survival of patients with upper aerodigestive and airway foreign bodies depends on early recognition and prompt multidisciplinary management. Keywords: Foreign body, endoscopy, foreign body ingestion, impaction, oropharynx