Long-standing undiagnosed foreign body aspiration with concomitant pulmonary tuberculosis in an Immunocompetent man.

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.

Tracheobronchopathia osteochondroplastica: A rare case of misdiagnosis and difficult intubation.

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.

A randomised controlled trial comparing Triadcortyl with 10% glycerine-ichthammol in the initial treatment of severe acute otitis externa.

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.

The relative sensitivity of barium swallow examination.

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.