Beyond the Norm: Tracheostomy's Vital Role in Unconventional Foreign Body Removal.

BACKGROUND: Foreign Body Aspiration (FBA) is one of the paediatric emergencies which require timely diagnosis and management. The inherent tendency of children to explore small objects with their mouths often prove to be fatal as they are difficult to remove once aspirated. CASE REPORT: We present the case of a 5-year-old boy who presented with dyspnea and vomiting following the aspiration of a pen cap. Chest radiograph and Rigid Bronchoscopy helped to identify the foreign body but it couldn't be removed by Rigid Bronchoscopy alone due it's wedge-shaped nature. Hence, an unconventional method of foreign body removal was performed by making a tracheostoma, pushing the foreign body to the level of tracheostoma and thereby taking it out from the tracheostoma under strict monitoring of anesthesia team. CONCLUSION: Alternative approaches like this are required for prompt intervention in a difficult case as it helps to reduce complications produced by repeated failed attempts.

Ear Mites as an Overlooked Source of Ear Itching and Tinnitus - A Case Series.

Otoacariasis is a rare condition characterized by ticks and mites in the ear canal. Human otoacariasis remains underrepresented in literature as otoacariasis is more common in animals. Systemic diseases being transmitted by these arachnids pave the way for potential complications. This case series sheds light on this uncommon condition by highlighting the diverse symptomatology and difficulties in diagnosis and treatment. Three different presentations highlight the diversity of this condition. A 40-year-old male exhibited itching and tinnitus, revealing a mite on the tympanic membrane on otoscopy. A 35-year-old female with persistent itching and tinnitus showed multiple whitish mites on examination. A 50-year-old female complained of ear pain and was found to have a tick attached to the external auditory canal. The relevance and rarity of human otoacariasis are highlighted in this study, thereby encouraging caution in situations of earache. We aim to increase clinician awareness about this condition and the necessary interventions required by conducting a thorough literature review.

Digital Health Literacy: Evaluating the Readability and Reliability of Cochlear Implant Patient Information on the Web.

Hearing aids and implants are used to treat hearing loss, with cochlear implants being the most successful option for severe sensorineural hearing loss. Patients frequently use the internet as a trusted source of clinical information before committing to any therapeutic procedure, including receiving a cochlear implant. A health resource's readability and dependability influence its value to patients. Readability refers to how easily language can be understood, whereas reliability refers to the correctness and consistency of the information presented. JAMA standards and the DISCERN tool were used to assess the reliability of the websites listed. For readability analysis, the FRE, FKG and GFI were chosen. The acceptable readability level was set to < 7 for the FKG, GF score over 17 as the equivalent of college-level education and ≥ 80.0 for the FRE. The readability scores vary across the sources, suggesting a range of comprehension levels required for understanding the cochlear implant patient information found on Google. There was a statistical difference detected in Discern score between the groups (p = 0.008). The mean discern score was significantly higher in hospital generated sources when compared to industry (3.13 ± 0.69 vs. 2.11 ± 0.78, p = 0.03).

Validating a linear regression equation using mid-upper arm circumference to predict body mass index.

BACKGROUND: Estimating body mass index (BMI) in hospitalised patients for nutritional assessment is challenging when measurement of weight and height is not feasible. The study aimed to validate a previously published regression equation to predict BMI using mid-upper arm circumference (MUAC). We also evaluated the proposed global MUAC cut-off of ≤24 cm to detect undernutrition. METHODS: We measured standing height, weight, and MUAC prospectively in a sample of stable patients. Agreement between calculated and predicted BMI was evaluated using Bland-Altman analysis. RESULTS: We studied 201 patients; 102 (51%) were male. Median (IQR age was 42 (29-50) years. 95% limits of agreement between predicted and calculated BMI were +0.6767 to +1.712 and the bias was +1.076. MUAC ≤24 cm was 97% sensitive and 83% specific to detect undernutrition. CONCLUSION: BMI derived from MUAC had poor calibration for estimating actual BMI. However, low MUAC has good discriminative accuracy to detect undernutrition.