Episodes Of Cough Research Articles

НОВЫЙ ПРИБОР «СИСТЕМА ОЧИСТКИ ДЫХАТЕЛЬНЫХ ПУТЕЙ YANG KUN YK-800» В КИНЕЗИТЕРАПИИ ДЕТЕЙ С ХРОНИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ ЛЕГКИХ

Cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) in children are both accompanied by copious amounts of infected sputum. Kinesitherapy (KT) eliminates mucostasis by providing bronchial drainage. KT methods are being constantly improved. The purpose of this research was to determine the effectiveness and safety of the new vest airway clearance system (ACS) chest vibration therapy machine model YK800 by Zhengzhou Yangkun Medical Instrument Co., Ltd. (Zhengzhou, China) in children with CF and PCD. The ACS consists of a compressor and a vest and creates high-frequency oscillation of the chest promoting drainage of problematic parts of the respiratory tract, small- and medium-caliber bronchi. Materials and methods used: in a study based on the National Medical Research Center for Children’s Health (Moscow, Russia) the KT included 5 sessions with the Yangkun YK800 in 15 patients aged 5 to 17 y/o: 8 with CF and 7 with PCD. Objective criteria: measurement of external respiratory function (ERF) and saturation, monitoring of chest excursion, and the 6-minute walk test. Subjective criteria: complaints, well-being, comfort. Results: objective criteria - improved ERF indicators in % (FVC p=0.004; r=0.829; FEV1 p=0.023; r=0.973; FEF25% p=0.018; r=0.840; FEF50% p=0.016; r=0.827; FEF75% p=0.015; r=0.867), especially high-speed indicators (FEF25%, FEF50%, FEF75%) that indicate the cleansing of mucus in the medium and small respiratory tracts; saturation improved (p=0.020; r=0.548); chest excursion increased (p=0.002; r=0.779). According to the 6-minute walk test, there was a significant increase in the distance traveled (p=0.000; r=0.535), 13 (86.6%) patients at the end of the course rated it as easier. Subjective criteria - 80% of patients noted sen-sations of productive coughing, easier expectoration of sputum: improvement in general condi-tion - 15, reduction in fatigue - 12, increased physical activity - 12, easier expectoration of phlegm - 13, reduction in episodes of paroxysmal cough - 13. Comfort in the use of the vest was rated at 4.4 points, noting mild vibration. Conclusion: the Yangkun YK800 vest airway clearance system as part of the KT has shown its effectiveness and safety in children with CF and PCD.

A clinical case of plastic bronchitis on the background of community-accombined pneumonia

Plastic bronchitis (PB) is a rare acute respiratory disease characterized by the formation of fibrin-rich plugs leading to airway obstruction and respiratory failure. This is due to the organization of the exudate, or transudate, which takes the form of the airways. Mortality in BE reaches 28-60% in patients with congenital heart disease (CHD) and 6-7% among other causes. Exact epidemiological data are unknown. In most patients, BE occurs in the context of underlying diseases, which can be conditionally divided into two groups: diseases of the heart and blood vessels and a secondary complication of pulmonary diseases. Clinical manifestations of PB are manifested by episodes of dyspnea, tachycardia, hypoxia, fever, and cough associated with airway obstruction. All existing treatments are symptomatic. The article presents a clinical case of the development and course of PB in a girl aged 1 year and 10 months against the background of acute community-acquired right-sided segmental (S10) pneumonia.

Report of a case of bochdalek hernia in an adult presenting as chronic cough: review of literature and discussion

Adult symptomatic bochdalek hernias (BH) are rare and account for 0.16%-6% of all diaphragmatic hernias. Chronic abdominal pain is commonest type of presentation. We have a patient of BH presented with chronic cough and breathlessness on exertion. Aim was to study clinical course and outcome of patient presented to our institute. We also would like to review relevant literature available online and compare it with our findings. 30-year-male from peripheral area had recurrent episodes of cough and breathlessness on exertion since 7 years. He was treated as a case of lower respiratory tract infection. We did chest radiogram which revealed presence of haziness in left lower zone with obliteration left costophrenic angle. His computerized tomography scan revealed defect of approximate size 43×45 mm in posterolateral aspect of left hemidiaphragm with omental herniation. Patient was operated by lap converted to open primary bochdalek hernia repair. His postoperative course was uneventful. Review of literature done revealed cough as a rare type of presentation. Laparoscopy is becoming emerging modality of treatment to do surgical correction. Adult onset diaphragmatic hernias have variable clinical manifestations. High index of clinical suspicion with imaging studies like contrast enhanced computed tomography (intravenous plus oral contrast) of chest and abdomen are required for timely diagnosis and treatment.

Successful definitive‐intent radiation therapy for recurrent and metastatic feline thymoma with unusual extra‐thoracic metastasis

AbstractA 10‐year‐old, male, neutered, domestic shorthair cat was referred for investigation of cough and dyspnoea episodes. A large cranial mediastinal mass was detected using computed tomography. Upon surgical removal, the mass was diagnosed as a lymphoid‐rich thymoma. Ten months postoperatively, the tumour was reported to recur, followed 2 months later by the development of an axillary mass and enlarged thoracic and superficial cervical lymph nodes. Recurrent and metastatic thymoma was confirmed, which was successfully treated with radiation therapy.

The Burden and Characteristics of Post-COVID-19 Conditions Among Laboratory-Confirmed Delta and Omicron COVID-19 Cases: A Preliminary Study From Maharashtra, India.

Post-COVID-19 conditions (PCC) have emerged as a significant global health concern due to their potential impact on patients' quality of life and healthcare resources. The present study aims to understand the burden and characteristics of PCC in Maharashtra, India, and compares its prevalence among cases infected with Delta and Omicron variants. A retrospective observational study included 617 laboratory-confirmed Delta and Omicron variant cases. These cases were telephonically followed up to document persistent COVID-19 symptoms using a questionnaire based on the Post-COVID-19 Clinical Form from the Global COVID-19 Clinical Platform of the World Health Organization (WHO), and the results were analyzed. Out of 617 laboratory-confirmed COVID-19 cases, 82.97% and 17.03% were Omicron and Delta cases, respectively. The mean follow-up period for Delta and Omicron cases was 78.05 and 21.56 weeks, respectively. A total of 40 (6.48%) cases reported persistent symptoms at follow-up, with a higher prevalence among those infected with the Delta variant (12.38%) compared to the Omicron variant (5.27%). The most common long COVID symptoms reported were malaise (25%), dyspnea (20%), post-exertional fatigue (17.5%), joint pain (15%), and frequent episodes of cough and cold (15%). Additionally, 1.94% of participants developed a new medical condition following COVID-19 infection, most commonly hypertension (25%), lung fibrosis (16.67%), and asthma (8.33%). Factorssuch as more than five acute symptoms, amoderate to severe disease, the need for hospitalization, and hospitalization for more than five days were significantly associated with PCC. Long COVID results in extended disability and illness. The varying impacts of different COVID-19 variants highlight the complex nature of post-COVID-19 complications. Our findings highlight the need for strategic planning of healthcare resources to ensure optimal response and preparedness to manage the burden of PCC.

Comparative Study of Inhaled Fluticasone Versus Oral Prednisone in 30 Dogs with Cough and Tracheal Collapse.

Coughing is common in dogs with tracheal collapse (TC). The use of inhaled corticosteroids is less widespread than oral ones. This study aims to compare the effects of oral and inhaled corticosteroids in dogs with cough and TC. Thirty dogs were prospectively included and randomized to the prednisone oral group (OG, 14) or fluticasone inhaled group (IG, 16). A clinical score (CS) based on four clinical parameters (respiratory distress, cough episodes, cough frequency, tracheal sensitivity) was monitored at the hospital (enrolment and weeks 2 and 4). Water intake, urination habits, and adherence and tolerance to treatments were monitored weekly. Significant improvements in clinical parameters were identified in both groups throughout the study. Between-group (OG-IG) comparisons revealed no significant differences, indicating equivalent improvement. At the study's endpoint, the IG dogs had a significantly lower CS (5.69 ± 0.79) than OG dogs (6.43 ± 1.02, p < 0.05). Adherence and tolerance were comparable. From weeks 2 to 4, OG dogs were significantly thirstier and urinated more frequently than IG dogs. In conclusion, fluticasone provided good tolerability and efficacy in controlling cough in dogs with TC, and they showed a lower incidence of signs of hypercortisolism compared to prednisone. These data encourage the use of inhaled fluticasone in dogs with cough and TC.

Multiple congenital esophageal strictures masquerading as gastroesophageal reflux disease in an infant: a case report

Congenital esophageal stenosis (CES) is a rare congenital disorder, generally presenting as vague complaints of dysphagia, vomiting and frequent respiratory complaints with symptoms usually appearing with introduction of complimentary feeding. We present the case of an eight-month-old male infant, presenting with regurgitation of feeds, recurrent episodes of cough and poor weight gain. He was diagnosed as a case of isolated multiple membranous esophageal strictures and underwent serial endoscopic esophageal dilatations which subsequently allowed him to swallow solid food and achieve good weight gain.

36-Year-Old Man With Shortness of Breath, Difficulty Swallowing, and Productive Cough

A 36-year-old man from Minnesota presented to the emergency department with a constellation of symptoms that included progressive nausea, difficulty swallowing, shortness of breath, and productive cough with brown sputum. He had a history of alcohol use disorder complicated by malnutrition and protein S deficiency leading to recurrent deep vein thromboses and was on lifelong anticoagulation. Since stopping alcohol 2 months earlier, he developed intermittent episodes of productive cough and malaise. He also developed painless dysphagia and globus sensation, leading to frequent nausea/vomiting, gastrointestinal pain, and unintentional weight loss of 30 pounds. Before presentation, he had worsening shortness of breath in conjunction with a significant increase in brown, nonbloody sputum production. He denied fevers, chills, odynophagia, skin lesions, diarrhea, or myalgias. He reported no travel outside of the state and had no known tuberculosis (TB) exposures but had a history of incarceration. The patient is a heavy cigarette smoker in addition to using smoked cannabis. He did not have significant environmental exposure from his employment. It is unknown if he had any pets. On presentation, the patient’s medications included ascorbic acid 500 mg twice daily, divalproex 250 mg daily at bedtime, enoxaparin 80 mg subcutaneous injections twice daily, and gabapentin 600 mg three times daily. CORRECT ANSWERS: 1. d. 2. b. 3. d. 4. d. 5. c.

Post-Traumatic Cilia Remaining Inert in the Posterior Chamber for 50 Years.

Intraocular foreign body injuries (IOFB) can lead to a number of intraocular pathologies; the visual results depend on the mechanism of the injury, the type of foreign body and the subsequent complications. The presence of intraocular cilia (eye lashes) following penetrating injury or surgical intervention is uncommon. In the present paper, we present a case of a 58-year-old woman with a history of eye trauma and a perforated corneal wound in the left eye that occurred 50 years ago. On the ophthalmological exam we noticed in the anterior chamber a straight linear extension, resembling cilia, extending behind the iris. The patient reports that it appeared during COVID-19 infection, after repeated episodes of coughing. After a follow-up period, we decided to remove the eyelash; 24 h after surgery, the patient complained of severe eye pain. Intraocular pressure (IOP) in LE was 54 mmHg. The slit-lamp examination showed perikeratic congestion, corneal edema and mydriasis. Eye hypotensive treatment was started immediately and the patient's general condition slightly improved. Intraocular cilia can be tolerated for many years without causing any ocular reaction. The decision for surgical intervention must be taken according to the individual needs of the patient and his ocular characteristics with careful pre- and post-operative follow up.

Long Covid Infection and Peripheral Neuropathy – Initial Presentation of Eosinophilic Granulomatous Polyangiitis (EGPA) (P14-4.005)

<h3>Objective:</h3> Describe a case of EGPA after long COVID presenting with peripheral neuropathy, and negative antineutrophil cytoplasmic antibody (ANCA). <h3>Background:</h3> EGPA, formerly known as Churg-Strauss syndrome, a rare and potentially fatal systemic disorder, is characterized by Asthma, vasculitis, skin changes, hyper eosinophilia, and positive ANCA testing. Peripheral neuropathy with sensory deficits and pain is one of the presenting symptoms. Occasionally, EGPA presents as cranial nerve mononeuropathy. Rare cases of ANCA associated vasculitis have been reported during or soon after SARS-COV-2 and influenza infections. There is insufficient evidence that COVID-19 triggers EGPA. <h3>Design/Methods:</h3> NA <h3>Results:</h3> A 46-year-old woman presented with 25-pound weight loss within six months, 3-day history of pain, swelling, paresthesia of the left foot, pain in her left calf followed 6 days later by severe pain and paresthesia of the right foot. She had 1-day of transient binocular, oblique diplopia, right dilated, non-reactive pupil, and temporal area pain. One year before, she had SARS-COV-2 infection followed by intermittent episodes of dry cough, and shortness of breath that required inhaled corticosteroids. Neurological examination revealed hypoesthesia of dorsum and sole of the left foot, brisk left patellar reflex, decreased left ankle jerk, and down going plantar reflex. There was mild erythema over dorsum of the left foot with minimal tenderness. Laboratory testing showed hyper eosinophilia, elevated white cell count, ESR, serum IgE level, and rheumatoid factor; C-reactive protein, cyclic citrullinated peptide and ANCA were negative. EMG/NCS showed prolonged right H-reflex. Right sural nerve and gastrocnemius biopsy demonstrated necrotizing arteriolitis, vascular and perivascular chronic infiltrates with numerous eosinophils and mononuclear cells. MRI revealed pansinusitis. She responded to oral steroids and Mepolizumab. <h3>Conclusions:</h3> This case highlights the importance of having vasculitis in the differential diagnosis in patients with painful neuropathy and prior SARS-COV-2 infection. Nerve and muscle biopsy is a useful tool in confirming the diagnosis. <b>Disclosure:</b> Dr. Donegal has nothing to disclose. Dr. Jacoby has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Jacoby has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Jacoby has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for N/A. The institution of Dr. Jacoby has received research support from ABPN. Dr. Treidler has nothing to disclose.

Abstract 5439: Deep understanding of medication events from clinical narratives is essential to building a holistic picture of cancer patient medication history

Abstract MOTIVATION: One of the most complex aspects of providing care to cancer patients is building an accurate list of medications a patient is taking. Medication lists need to capture the necessary clinical context about how the patient uses the drug, such as if they can no longer afford a medication or decide to change the frequency at which they take it due to side effects. While hidden from the medication list, these changes are significant to medical decision making. Moreover, many studies focus on providing cancer medication safely. Still, providers are often not aware of other medications, which clinicians may administer in a different practice than the one providing cancer care. While many solutions attempt to improve the medication list, they frequently ignore one of the highest quality sources of medication information: clinical narratives. In this work, we propose utilizing Natural Language Processing (NLP) to extract medications and medication change events from clinical narratives. METHODS &amp; DISCUSSION: In this work, we utilize NLP to extract medications and medication change events from clinical narratives. We use the medication event extraction schema from the N2C2 2022 Challenge to train and evaluate various models for two classification tasks. The first is Event Classification (EC), to identify if a medication was changed. The second is Event Context Classification (ECC) to understand the nature of any change. Using this schema, we can parse a sentence from a clinical note such as “She was experiencing a bad episode of dry cough, so stopped taking lisinopril.” Parsing such a note helps us understand an actor (the patient) initiated an action (stopping the medication) with a temporality (in the past) and with a certainty (not hypothetical). Our approach for both tasks involved using a pre-trained clinical language model while varying the context window around a medication, masking extraneous drugs, and using mark-up tokens around events. The most performant experiments utilized more extended context around a drug, with irrelevant drug masking. We also note that longer-range encoders had better F1 performance than the original BERT architectures. We achieved a 92% performance (micro F1) for EC when detecting a medication change. For ECC, we achieved scores of 74%, 90%, 73%, and 88% (micro F1) over the categories of Action, Certainty, Temporality, and Actor. CONCLUSION: Given the performance observed, this approach could allow clinicians to incorporate additional extracted medication context to improve patient care and provide high-quality treatment plans. Furthermore, we can aggregate this information across patients to give more insights to clinicians and researchers about the actual use of medications. Citation Format: Jacob Hoffman, Neehar Mukne, Daniela Weiss, Christine Swisher, Max Kaufmann. Deep understanding of medication events from clinical narratives is essential to building a holistic picture of cancer patient medication history. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5439.

Experience in the use of phytotherapy in the treatment of bronchitis in children

Introduction. Cough is one of the most common symptoms faced by a pediatrician in clinical practice. The most common cause of acute cough in children is a viral infection. A growing amount of scientific data indicates that phytotherapy is an effective and safe form of auxiliary treatment of acute and chronic inflammatory diseases of the respiratory tract, accompanied by cough and sputum formation (tracheitis, tracheobronchitis, bronchitis).Aim. To evaluate the effectiveness of the use of herbal medicinal product (extract combination of thyme herb and Hedera helix leaves) in acute bronchitis, including in children with bronchitis of atypical etiology.Materials and methods. A comparative prospective follow-up of 60 outpatient patients aged 3–12 years with a diagnosis of Acute bronchitis was carried out. The patients were divided into groups: group 1 (n = 28) – receiving the phytopreparation, of which 8 children with mycoplasma bronchitis – a combination of herbal medicinal product + clarithromycin; group 2 (n = 32) – receiving ambroxol, of which 10 patients with mycoplasma bronchitis – a combination of ambroxol + clarithromycin. Patients were included in the study for 2–3 days of the disease, control points of examinations – 6–7 days and 10–12 days. The time period of the study is 2019–2021.Results. Against the background of taking the drug herbal medicinal product, there was a faster decrease in cough episodes (from 85 to 10% of patients), the transfer of dry cough to wet, as well as normalization of daily activities (95%), compared with ambroxol. The maximum effect was achieved by the 10th day of observation. In atypical bronchitis, results were obtained confirming the effectiveness and safety of using the drug herbal medicinal product with an antibiotic.Conclusions. The results obtained indicate the expediency of using the drug herbal medicinal product in acute bronchitis, including in combination with an antibiotic for bronchitis of atypical etiology.

Novel Technology to Identify Times of Peak Nighttime Cough Frequency in Severe Asthma

Patients with asthma frequently report nighttime cough as a primary symptom that disrupts sleep. New digital technologies permit passive monitoring during nighttime sleep hours and allow for the identification and quantification of the occurrence of cough episodes.

Healthcare-Seeking Behaviour Due to Cough in Finnish Elderly: Too Much and Too Little

IntroductionCough-related healthcare-seeking has not been studied specifically in the elderly, although chronic cough is most prevalent among them. We studied the frequencies and predictors of any (≥ 1) and repeated (≥ 3) doctor’s visits due to any cough episode during the past year, and due to the current cough episode.MethodsThis was a cross-sectional email survey among a Finnish community-based elderly population. Participants with current cough and age ≥ 64 years were included in the analyses (n = 1109).ResultsThe proportions of participants with ≥ 1 and ≥ 3 cough-related doctor’s visits during the past year were 25.9% and 7.1%, respectively. Repeated visitors accounted for 55.9% of the visits during the past year. These visits first increased with cough duration but decreased after 5 years. In the multivariate analysis, bronchiectasis [aOR 3.22 (CI95% 1.08–9.58)], asthma [2.62 (1.56–4.40)], chronic sputum production [1.61 (0.94–2.76)], low self-assessed health status [1.40 (1.04–1.88)] and Leicester Cough Questionnaire total score [1.34 per tertile (1.10–1.62)] predicted repeated cough-related doctor’s visits during the past year. The proportions of ≥ 1 and ≥ 3 doctor’s visits due to current cough were 31.8% and 15.5%, respectively. Among participants with current chronic cough, 60.1% had not visited a doctor.ConclusionA minority of participants accounted for most of the cough-related doctor’s visits during the past year, whereas most participants with chronic cough had never sought medical help for it. The heavy healthcare users were not those with the longest cough episodes. Repeated visitors due to cough were characterised by chronic phlegmy respiratory conditions, and quality-of-life impairment.

Advances and Highlights of miRNAs in Asthma: Biomarkers for Diagnosis and Treatment.

Asthma is a heterogeneous inflammatory disease of the airways that causes breathing difficulties, episodes of cough and wheezing, and in more severe cases can greatly diminish quality of life. Epigenetic regulation, including post-transcriptional mediation of microRNAs (miRNAs), is one of the mechanisms behind the development of the range of asthma phenotypes and endotypes. As in every other immune-mediated disease, miRNAs regulate the behavior of cells that shape the airway structure as well as those in charge of the defense mechanisms in the bronchi and lungs, controlling cell survival, growth, proliferation, and the ability of cells to synthesize and secrete chemokines and immune mediators. More importantly, miRNAs are molecules with chemical and biological properties that make them appropriate biomarkers for disease, enabling stratification of patients for optimal drug selection and thereby simplifying clinical management and reducing both the economic burden and need for critical care associated with the disease. In this review, we summarize the roles of miRNAs in asthma and describe how they regulate the mechanisms of the disease. We further describe the current state of miRNAs as biomarkers for asthma phenotyping, endotyping, and treatment selection.

A Case of Migratory Foreign Body in Left Bronchus -Scarf Pin.

Tracheobronchial foreign body aspiration is a life threatening emergency which requires immediate medical attention. Foreign body aspiration caused by sharp objects like scarf pins was more common in young girls, possibly due to casual handling of sharp objects. Most of the patients were symptomatic with cough and choking episodes. The penetration and dislodgement was the most commonly reported symptom in the majority of the patients. Here we are presenting a case of a young female with accidental swallowing of sharp scarf, following which she developed throat pain and cough. A detailed radiological examination was performed which showed that a foreign body had migrated into the left bronchus, which was removed with a bronchoscope. This case demonstrates the emergency management of a sharp foreign object that was inhaled into the airway.

Epidemiology &amp; Management of Cough in Smaller Settings-An Indian Case Study

Nearly every person experiences at least one episode of cough every year in their lifetime. Most, people seek care outside home only after trying known home remedies, especially when cough disturbs their sleep due to postnasal drip. Available data suggest that an average Indian adult has 3 episodes of cough per year, while an average child has 7-10 such episodes every year. The COVID-19 pandemic has increased the magnitude of cough across the world since early 2020. The most annoying part about a cough is “phlegm or mucus.” Mucus forms a protective lining in certain parts of our body, protects our body from foreign invaders by trapping the irritants and expel them in a cough. Excessive Phlegm or mucus is produced as a response to an irritant from the environment like allergies, smoke, smoking, dust, and infections. Excess phlegm or difficulty to expel phlegm can be tackled as per its cause or origin. No doctor or a health care worker, in his/her clinical practice has a day without seeing a patient with cough. The diagnostic tests are either not available, or unaffordable, if available and used take a long time for definitive diagnosis. Another problem is of self-medication with innumerable number of over-the-counter cough syrups. Most practitioners know about the types of coughs, their symptomatic treatment and over the counter cough syrups and mucolytics, but very few know, the Ideal rationale of managing cough. Having analysed six varieties of coughs namely i) Cough due to postnasal drip in an elderly person ii &amp; iii) Cough of Community acquired Pneumonia in a child and an adult by antibiotics iv) Cough in an elderly person managed by traditional approach of using roasted Guava fruit v) A case of Cough variant Asthma vi) Cough among Covid 19 cases and vii) Cough in COPD case in an elderly, the author is recommending a simple symptoms based logarithmic approach for differentiating various conditions causing cough and managing them empirically. This article highlights the need for a rational approach for small settings or individual practitioners. Materials &amp; Methodology: This review is based on the review of literature on the ideal rationale of managing cough, own learning from personal practice and practices observed among colleagues, in public sector teaching institutes and private sector hospitals. The article addresses the general practitioner’s dilemma of diagnosis and management by simple symptoms based logarithmic approach and managing empirically.

A case report Case Report of Idiopathic Pulmonary Haemosiderosis in a Child with recurrent chest infections

Idiopathic Pulmonary Hemosiderosis (IPH) is a rare condition, usually occurring in children and teenagers. The classic presentation is of haemoptysis, iron deficiency anaemia and diffuse pulmonary infiltrates. We report a case of IPH in an 8 year old boy, who presented with recurrent episodes of fever, cough and respiratory infections without any trigger since childhood.

AIRWAY NERVE BLOCK VERSUS NEBULIZATION BY LIGNOCAINE DURING DIAGNOSTIC FLEXIBLE BRONCHOSCOPY UNDER MODERATE SEDATION: A RANDOMIZED CONTROLLED TRIAL

<h3>Background</h3> Flexible bronchoscopy is an important procedure for the diagnosis and management of patients with respiratory diseases. This study aimed to assess safety and effectiveness of local anesthetic nebulization versus airway nerve block for upper airway anesthesia during diagnostic fiberoptic bronchoscopy under moderate sedation. <h3>Methods</h3> This randomized, controlled trial enrolled 120 patients scheduled for diagnostic fiberoptic procedures. The patients received 5 ml of 10% lignocaine by air-driven jet nebulizer for 20 minutes (Group A, n = 60) or bilateral superior laryngeal nerve block and trans-tracheal instillation of 4 ml of 2% lignocaine along with viscous lignocaine gargles twice (Group B, n = 60). In the postoperative period, the patient tolerance was assessed. <h3>Results</h3> Both groups were comparable in all baseline characteristics. The pain score was significantly lower in the nerve block group. Cough and requiring lignocaine were significantly more frequent in the nebulization group. No significant differences between the studied groups regarding intraoperative and postoperative PaO2, PaCO2, heart rate and mean blood pressure except heart rate; were significantly higher in the nebulized group. PaO2 reductions at intraoperative and postoperative (compared with induction) were non-significantly higher in the nebulized group. PaCO2, heart rate and mean blood pressure elevations in intraoperative and postoperative (compared with induction) were higher in the nebulized group, and the differences were non-significant in heart rate only. <h3>Conclusion</h3> Airway nerve block was associated with reduced consumption of lignocaine and less cough episodes during the procedure compared to nebulized lignocaine.

A Machine-Learning-Based Detection Method for Snoring and Coughing

&lt;p&gt;Poor sleep quality is a common disease for modern people. Snoring is one of the essential indicators to measure Obstructive Sleep Apnea (OSA). When sleeping, the number of episodes of snoring and coughing are related to the estimated sleep quality. This study proposes a method to detect snoring and coughing in patients when sleeping. The proposed method includes three stages. Firstly, the nightly sound data for a patient are segmented to each independent event. Secondly, the time domain signal is changed to a frequency domain signal by Fourier Transform, and then the features are extracted from the snoring and coughing episodes. Lastly, the Support Vector Machine (SVM) and the Hidden Markov Model (HMM) are used to recognize snoring and coughing. The result of our experiment demonstrates that this method has good detection performance.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;