Common Radiological Findings in Children with Suspected Foreign Body Inhalation

BACKGROUND: Foreign body inhalation is an emergency situation, affecting children mostly in first decade of life. An aspirated solid or semisolid object may lodge in the larynx or trachea may cause complete obstruction. Lesser degrees of obstruction or passage of the obstructive object beyond the carina can result in less severe signs and symptoms. Chronic debilitating symptoms with recurrent infections might occur with delayed extraction, or the patient may remain asymptomatic. Many aspirated foreign bodies are unexpectedly discovered, go undetected, or are misdiagnosed. In many cases with suspected foreign body radiological findings may reveal other findings e.g. emphysema, atelectasis, air trapping. OBJECTIVE: To determine the frequency of common radiological findings among children with suspected foreign body inhalation. MATERIAL AND METHODS: This cross-sectional descriptive study was conducted at Department of ENT, Khyber Teaching Hospital, Peshawar, from April 2017 to October 2017. In this study a total of 141 patients were observed. All patients were subjected to detailed history and clinical examination. X ray chest (AP and lateral views) of all the patients was performed to detect common radiological findings (Radio-opaque Foreign Body (FB), Pneumonia, Emphysema, atelectasis and Air Trapping). The demographic details like name, age, gender, address and contacts were recorded on a pre-designed proforma. RESULTS: In this study mean age was 8 years with SD ± 3.563. Sixty percent children were male while 40% children were female. Sixteen percent children had Radio opaque FB, 13% children had pneumonia, 28% had emphysema, 18% children had atelectasis while 25% had Air trapping. CONCLUSION: Our study concludes that the frequency of Radio opaque was 16%, pneumonia 13%, emphysema 28%, atelectasis 18%, Air trapping 25% among children with suspected foreign body inhalation. KEY WORDS: radiological findings, suspected foreign body inhalation, Pneumonia, Emphysema, atelectasis and Air Trapping

Experience of endoscopic intra-gastric balloons removal during COVID-19 pandemic in 98 patients.

Introduction: During COVID-19 pandemic, all elective surgical interventions were suspended, including bariatric and metabolic (B&M) surgeries and endoscopic procedures. Delayed extraction of intragastric balloons associated with a higher complication rate [1]. Experts agreed that endoscopic bariatric procedures are semi-elective/urgent procedures and can be performed following specific protocol during this pandemic [2].Objective: To share our experience of endoscopic removal of air-filled intragastric balloons during COVID-19 pandemic following a suggested algorithm.Methods: Retrospective data review for patients who underwent endoscopic removal of intra-gastric balloons during COVID-19 pandemic in a tertiary hospital (29 February 2020 —15 June 2020).Results: Ninety-eight patients with age ranged between 14 — 71 years, mean of 33.1 ± 10.9 years. Body mass index (BMI) was 32.8 ± 4.7 kg/m2. Thirty-four were females (34.7%). Three patients (3.1%) had type II diabetes (T2D), one (1%) had hypertension (HTN), one (1%) was asthmatic and one (1%) had coronary artery disease (CAD). Procedures were performed at 15.6 ± 7 minutes. No complications occurred. No patient developed COVID-19 symptoms within 14 days after removal. Thirteen patients (13.2%) had Reverse-Transcription Polymerase Chain Reaction (RT-PCR) swab tests for contact with COVID-19 positive patients and their results were negative. All the involved medical staff had negative RT-PCR tests results by the end of June 2020.Conclusion: Following our suggested algorithm, endoscopic intra-gastric balloon removal during COVID-19 pandemic was safe with a favorable outcome.

Increase of the particle hit rate in a laser single-particle mass spectrometer by pulse delayed extraction technology

A single-particle mass spectrometer (SPMS) can provide a wealth of valuable information on chemical and physical parameters of individual particles in real time. One of the main performance criteria of the instrument is efficiency of particle detection (hit rate). Most SPMS instruments use constant electrical field (DC) extraction, where stationary high voltage is applied to the extraction electrodes. As the aerosol particles initially carry a certain charge, those with a high amount to charge can be deflected by this electric field and lost, thus decreasing the hit rate. We realized that the delayed extraction technique can eliminate the stochastic dispersion of the particle beam caused by their deflection in the stationary electric field. As the result, the hit rate of the instrument can be significantly improved. Also, as the effect of the deflection in the electric field is mass dependent, it can cause distortion of the measured size distribution of the particles. Hence, the delayed extraction technique can bring the recorded distribution closer to the actual one. We found that the delayed extraction technique provides a mass resolution improvement as well as increases the hit rate. The gain in the hit rate depends on the type of particles. It can be 2 orders of magnitude for model particles and up to 2–4 times for ambient particles. In the present work we report experiments and results showing the effect of the delayed extraction on the beam divergence caused by particle charge, the hit rate improvement, and the effect of the delayed extraction on the measured particle size distribution.

Delaying Premolar Extraction for Conservation of Anchorage: A Prospective Case Control Study

Introduction: Anchor loss (AL) is the most common side effect of orthodontic treatment. Anchorage planning is the vital step of every orthodontic treatment. The aim of this study was to evaluate the amount of anchor loss of maxillary first permanent molar in early v/s delayed premolar extraction cases treated using fixed orthodontic mechanotherapy. Materials & Method: Sixty orthodontic patients, having either Class I or Class II Division 1 malocclusion with no or minimal crowding were divided equally into early extraction and the delayed extraction group (30 each). The patients were treated using MBT prescription 022” slot brackets with standard wire sequencing until 0.019”x 0.025” stainless-steel wire. Pre and post levelling study models were used for assessing the amount of space loss using palatal rugae as a stable point from the points marked on the 1st molar (point A on mesiobuccal cusp and point B on the distobuccal cusp). The obtained data was tabulated and was subjected to statistical t test (p<0.05). Result: The distance of point A to the 3rd rugae reduced after treatment by 0.39mm (3.4%) and by 0.48 mm (3.24%) in delayed and early extraction groups respectively. Similarly, the distance from point B was reduced by 0.48 mm (3.24%) and by 1.77mm (6.28%) in delayed and early extraction group respectively. The change in point A and point B in Early extraction cast group was 76% and 71% more respectively than the delayed Extraction cast group. All the findings were statistically significant (p<0.05). Conclusion: Anchor loss is an inevitable after effect following premolar extraction. Greater chances of anchor loss in early extraction group is noted. And delaying premolar extraction in cases with mild crowding (<4mm) can effectively help in anchorage preservation.

Thermal Processing of Peanut Grains Impairs Their Mimicked Gastrointestinal Digestion While Downstream Defatting Treatments Affect Digestomic Profiles

Resistance to digestion by digestive proteases represents a critical property of many food allergens. Recently, a harmonized INFOGEST protocol was proposed for solid food digestion. The protocol proposes digestion conditions suitable for all kinds of solid and liquid foods. However, peanuts, as a lipid-rich food, represent a challenge for downstream analyses of the digestome. This is particularly reflected in the methodological difficulties in analyzing proteins and peptides in the presence of lipids. Therefore, the removal of the lipids seems to be a prerequisite for the downstream analysis of digestomes of lipid-rich foods. Here, we aimed to compare the digestomes of raw and thermally treated (boiled and roasted) peanuts, resulting from the INFOGEST digestion protocol for solid food, upon defatting the digests in two different manners. The most reproducible results of peanut digests were obtained in downstream analyses on TCA/acetone defatting. Unfortunately, defatting, even with an optimized TCA/acetone procedure, leads to the loss of proteins and peptides. The results of our study reveal that different thermal treatments of peanuts affect protein extraction and gastric/gastrointestinal digestion. Roasting of peanuts seems to enhance the extraction of proteins during intestinal digestion to a notable extent. The increased intestinal digestion is a consequence of the delayed extraction of thermally treated peanut proteins, which are poorly soluble in acidic gastric digestion juice but are easily extracted when the pH of the media is raised as in the subsequent intestinal phase of the digestion. Thermal processing of peanuts impaired the gastrointestinal digestion of the peanut proteins, especially in the case of roasted samples.

Biochemical and biological validations of a faecal glucocorticoid metabolite assay in mandrills (Mandrillus sphinx)

Stress is a major factor in determining success when releasing endangered species into the wild but is often overlooked. Mandrills (Mandrills sphinx) are vulnerable to extinction due to habitat loss and demand for bush meat and the pet trade. To help bolster in situ populations, rehabilitated rescued mandrills recently were released into a protected area in the Republic of Congo. The goal of this study was to validate the use of faecal glucocorticoid metabolite enzyme immunoassays (EIAs) in mandrills and test field-friendly faecal hormone extraction techniques that can subsequently be used to monitor the stress physiology and welfare of mandrills throughout the release process. Using faecal samples collected from ex situ mandrills, we tested cortisol, corticosterone, 11β-hydroxyetiocholanolone (69a), and 11-oxoetiocholanolone EIAs. Absolute concentrations, hormone profiles following medical procedures or translocation, and high-performance liquid chromatography fraction immunoreactivity showed that the 69a assay was the best choice to monitor the stress response in this species. Samples with delayed extraction or drying times had 40–80% lower 69a concentrations than samples extracted immediately post-collection and frozen. The 69a EIA is an appropriate assay for monitoring welfare in this species in situ or ex situ, and results indicated that consistent extraction methods are important for accurate comparisons.