Foreign Body Type Research Articles

Nasal foreign bodies in children – our experiences at a tertiary care teaching hospital in Eastern India

BackgroundChildren with nasal foreign body (FB) often come to clinician for its removal. These children often present with foul-smelling nasal discharge, nasal obstruction, nasal mucosal irritation, and epistaxis. In most cases, unilateral nasal FB is easily removed but occasionally may lead to life-threatening situation.ObjectivesTo study the details of the nasal FBs including treatment in children at a tertiary care teaching hospital of Eastern India.Patients and methodsThis retrospective study was done between June 2015 and July 2020 and included children attending the otorhinolaryngology clinic and emergency unit for nasal FB. Patient details such as age, sex, symptoms, type of FB, techniques of removal, and complications are analyzed.ResultsA total of 318 children with FB were included in this study. The mean age of the participants was 4.23 ± 1.8 years (range, 0–16 years); the male to female ratio was 1.6: 1 (male predominance). Most FB cases were owing to organic substances such as vegetables (30.81%), and nonorganic FB were paper piece, plastic piece, foam, metallic nuts, and button battery cell. The commonest clinical presentation among participating children was unilateral foul-smelling nasal discharge. Complications included epistaxis, rhinosinusitis, rhinolith, and perforation of the nasal septum.ConclusionFBs in the nasal cavities are a common accidental medical problem, especially in pediatric age. These nasal FBs are often harmless but may cause complications in some cases if neglected or overlooked without removing it in time. However, the best treatment remains the prevention.

Comparing foreign body injuries patterns between Turkey and European Countries: are female Turkish children more vulnerable?

ObjectivesThe present study aimed at analyzing and comparing Foreign Body (FB) injuries patterns in children from Turkey and other European countries in order to assess any country and culturally specific aspects of FB risk. MethodsData from Susy Safe register were included in the analysis. For this study, ICD-935 (mouth, esophagus and stomach) and ICD-934 (trachea, bronchus, and lung) cases from European countries and from a single center in the Istanbul Bahcelievler State Hospital, Turkey, were extracted from the Susy database. A Multiple Correspondence Analysis (MCA) approach was employed to identify differences or similarities between the groups of FB injuries. ResultsThe Turkey dataset has a larger proportion of females in comparison to the European data (p-value 0.002). According to the MCA analysis, the first two dimensions are explaining 48.11% of the variability (dimension 1, 37.44%; dimension 2, 10.67%). The three largest contributions to dimension 1 are via naturalis removal, not hospitalized, and ICD-935. The greatest contributions to dimension 2 are FB type, and consistency. ConclusionThe most interesting study finding is the higher incidence of females suffering a FB injury in ICD-934-935 in the Turkey dataset compared to that seen in the European dataset and also higher than that for all ICD locations within the Susy Safe register. The higher incidence of females tends to go against the belief that boys suffer higher FB injuries and needs to be further investigated.

Demographic and morphological analysis of granulomatous dermatoses

Introduction: Granulomatous reaction is chronic inflammatory pattern which is characterized by presence of granulomas. Many of the skin granulomatous conditions produce identical pattern and hence it remains always a diagnostic challenge to pathologist. Arrival at the accurate diagnosis is of great interest so that appropriate treatment can be ensured. Aim: To study different morphological patterns of granulomatous lesions of the skin along with the etiology and demographic pattern. Materials and Methods: All the skin biopsies with the histological features of granulomatous disease received in the Pathology Department, Father Muller Medical College for a period of three and half years (Jan 2009 to May 2012) are included in the study. The clinical details and H and E sections of all the cases were reviewed. Results: Of 75 cases of skin biopsies with granulomatous lesions, 65 (85%) were found in males. Out of these, Tuberculoid type of granulomas was seen in 57 cases (76%), suppurative type in 10 cases (13.4%), Necrobiotic type in 4(5.3%) cases and foreign body type in 4(5.3%) cases. Sixty five cases (86%) were infectious granulomatous lesions. Leprosy was amounting to 49 cases (65%), followed by tuberculosis and chromoblastomycosis with each of 8 cases. Other causes were foriegn body granuloma, necrobiosis lipoidica and granuloma annulare. Conclusion: Males are more commonly affected by granulomatous dermatosis. In this study, tuberculoid granulomas were the most common type. The most common cause of granulomatous skin lesion was leprosy. Other common cases were tuberculosis and chromoblastomycosis. Keywords: Granulomatous, Skin, Morphology, Etiology.

Study on Assessment of Foreign Body in Rumen and Reticulum of Cattle Come from Different Market Slaughtered at Holeta Municipal Abattoir

Ingestion of indigestible foreign bodies by ruminants is becoming a common worldwide problem which is the associated with a shortage of feed as well as increased pollution of grazing lands with indigestible materials. Cross-sectional study was conducted from November 2016 to April 2017 on 384 ruminants slaughtered at Holeta municipal abattoir and Elfora export abattoir with the objective to determine the prevalence and type of indigestible foreign body in rumen and reticulum of ruminants in association with hypothetical risk factors. Simple random sampling technique was used for selecting the study animals which were ruminants brought from various localities to Holeta municipal abattoir and Elfora export abattoir. Out of 384 ruminants (cattle 128, goat 128, sheep 128) examined for the presence of indigestible foreign bodies, 81 (21.1%) animals were found positive for one or more indigestible foreign bodies in their rumen or reticulum or both . The prevalence of foreign bodies was insignificant between species (p>0.05). Significantly highest prevalence was observed in adult and thin body condition of ruminants than young and medium and good body condition. Plastic material was the most commonly encountered (38.3%) foreign material in all study animals, followed by hair and hide, mixed, rope, clothes, wood strip and metals. In all species the proportion of indigestible foreign body in rumen (70.4%) were significantly higher than reticulum (18.52%) and both rumen and reticulum (11.11%). This study revealed ingestion of different types of indigestible foreign bodies by ruminants in the study area which may pose serious health problem for free grazing ruminant and negatively affect their overall productivity and production. This strongly calls for concerned stakeholders to design and implement appropriate waste disposal practice and thereby reduces the chance of ingesting foreign bodies. Keywords: Export Abattoir, Foreign Bodies, Municipal Abattoir, Reticulum, Rumen, Ruminants, DOI: 10.7176/JBAH/10-24-03 Publication date: December 31 st 2020

The utility of a novel vacuum-assisted foreign body extraction technique from wounds

Retained soft tissue foreign bodies following injuries are frequently seen in the Emergency and Plastic Surgery practice. The patients with such presentations require a watchful and detailed clinical assessment to overcome the anticipant possibility of missing them. However, the diagnosis based on the clinical evaluation is usually challenging and needs to be supported by imaging modalities that are suboptimal and may fail in identifying some types of foreign bodies. Owing to that, serious complications such as chronic pain, infection, and delayed wound healing can be faced that necessitate a prompt intervention to halt those detrimental consequences. The classical method of removal is a surgical exploration which is not free of risks. It can cause injuries to vital structures such as nerves and tendons if the foreign body is close to them, also it can be affected by the surgeon's experience and the foreign body's characteristics.In light of that, we conducted a single-center study to understand the utility of a novel vacuum-assisted technique for foreign body removal. The technique is noninvasive and facilitates a real-time foreign body extraction using readily available materials. Twenty patients with 23 Foreign Bodies of various kinds, shapes, and sizes were recruited in our study by using a nonprobability convenient sampling method. Results demonstrated the ability of the described technique to extract 22 of them with no noticeable side effects. This study may encourage further trials adopting similar principles to promote the management of retained foreign bodies with fewer complications, and a potential of time and cost-saving.

Fore-Stomach Foreign Bodies: prevalence, associated risk factors and types affecting cattle slaughtered at Gondar ELFORA abattoir, northwest Ethiopia

In Ethiopia, recurrent drought and feed shortage coupling with high level of environmental pollution predispose the animals to foreign body ingestion. A cross-sectional study with systematic random sampling approach was employed from November 2018 to April, 2019 with the objectives of estimating the prevalence; identify associated risk factors and to categorize the types of foreign body in cattle slaughtered at Gondar ELFORA Abattoir. Ante-mortem and postmortem examinations were used to collect the data. From the total of 384 animals examined, the overall prevalence of foreign body was 83(21.61%). Adult and old animals were 4.33 (95% CI=0.98, 19.00, p=0.052) and 4.54 (95% CI=1.03, 19.96, p=0.045) times more likely to have a chance of getting foreign body than young animals by keeping another factors constant, respectively. However, the difference is not statistically significant for adult cattle. Moreover, poor and medium body conditioned animals were 2.19 (95% CI=1.04, 4.56, p=0.037) and 1.51 (95% CI=0.72, 3.13, p=0.273) times more likely to acquire foreign bodies than good body conditioned animals by keeping another factors constant. In the positive cases (N=83), 41(49.40%), 34(40.96%), 8(9.64%) and 0(0%) of the foreign bodies were found in the rumen, reticulum, both rumen and reticulum, and omasum, respectively. Majority of foreign bodies identified (79.51%) were non-metallic in nature, including clothes, plastics, rope, sand and stone. Designing and implementation of appropriate solid waste disposal and management practices are strongly recommended to reduce the risk of ingestion of indigestible foreign bodies.
 Keyword: Abattoir; Cattle; Foreign body; Fore stomach; Prevalence

Exogenous Lipoid Pneumonia Presenting as an Enlarging Lung Nodule in a Patient with a Long-standing Usage of Petroleum Jelly

Abstract Introduction/Objective Lipoid pneumonia is an uncommon inflammatory lung lesion resulting from the aspiration of endogenous or exogenous oily substances. It has no age or sex preponderance, and its mode of presentation is non- specific. Radiologic imaging findings may mimic that of a malignant lung lesion. Methods We report a case of a 69-year-old female with a history of chronic obstructive pulmonary disease, rheumatoid arthritis and a 30-pack year smoking. She was being followed for an enlarging PET positive spiculated left upper lung nodule. She underwent a CT-guided core biopsy of the lung nodule. Results Biopsy showed histiocytes and multinucleated giant cells with lipid vacuoles and associated marked fibrosis. Review of a percutaneous lung biopsy performed two years prior showed a chronic inflammatory process with associated fibrosis in the presence of nonpolarizable vacuoles, many of which were intracytoplasmic within multinucleate foreign body type giant cells. A re-assessment of the patient with further history taking revealed a longstanding practice of nighttime application of petroleum jelly to nostrils and lips. Together, these findings are consistent with an exogenous lipoid pneumonia. Conclusion Lipoid pneumonia although an entity with limited literature description, should be considered in patients presenting with enlarging lung nodules. Early diagnosis of this lesion ensures appropriate treatment and prevents unnecessary invasive procedures.

Foreign Bodies in Ear, Nose, Throat and Maxillofacial Region: A Study on Their Clinical Profile and Complications.

The clinical picture and treatment options of foreign bodies in ENT vary widely depending on the site of involvement. Our study was a comprehensive review of both luminal and extraluminal foreign bodies in Otorhinolaryngology. A hospital based cross-sectional retrospective study was conducted to study the foreign bodies in ear, nose, throat and maxillofacial region in terms of demography, various modes of entry, site of lodgement, clinical features, treatment modalities and complications. While majority of the previous studies have focused on objects entering through natural orifices of ear, nose and throat, our study was a comprehensive review of both luminal and extraluminal foreign bodies in otorhinolaryngology. It was a retrospective study of four years duration on patients who presented with foreign bodies in OPD and emergency ward. Relevant data were tabulated and clinical and radiological documentation of interesting case scenarios have been depicted. The commonest age group affected was 0-10years with 111 (58.52%) out of 190 cases. The most common site was aerodigestive tract ( 40%), followed by ears (31%), nose (26%) and maxillofacial region (3%). Insects, vegetable seeds and coins were the most common FBs in ear, nose and throat respectively. Foreign bodies have shown seasonal, geographic, socioeconomic and occupational variations in their distribution. Patient's age, type of foreign body, chance of migration to deeper tissue planes, failed unskilled removal attempts, delay in diagnosis and presence of comorbidities can complicate chances of removal.

Technology Driven Newer Ingested Foreign Body: A Case Report.

As technology advances there are chances of new hazards to health also increases. In the current era of the digitalized world using a smart electronic device may cause harm to the children. We reported a case of foreign body ingestion which is new in the field of ENT practice. A 1-year-old male child patient presents with an ingested foreign body memory card guard slot cover. To date, this is a newer one in all types of an old foreign body reported in ENT practice.

Value of multi-slice spiral computed tomography for diagnosis of tracheobronchial foreign body aspiration in children: 5-year retrospective study.

Tracheobronchial foreign body (TFB) aspiration is a significant cause of respiratory problems in children. The timely diagnosis of TFB is important to decrease the mortality rate and the incidence of complications. Advances in radiology have led multi-slice spiral computed tomography (MSCT) to become the best technique for diagnosing TFB. We performed a retrospective study over 5years from July 2008 to June 2013. We collected information on children who were diagnosed with a TFB by bronchoscopy, and analyzed age, sex, location, type of foreign body, and various MSCT manifestations. A total of 382 children were included and 68.6% of them were aged 1 to <2years. The majority (95.8%) of aspirated foreign bodies were vegetation items, and nearly half (47.6%) of them were peanut kernels, followed by sunflower seeds (26.2%). A total of 4.7% of TFBs were in the trachea, 51.0% were in the left main bronchus, and 44.2% were in the right main bronchus. Among the TFBs, 359 (95.5%) showed a high-density shadow in the tracheal / bronchial lumen using MSCT, which could establish the presence of a foreign body directly. Emphysema, localized obstruction and pneumonia were more commonly detected in the 7-21days and ≥21days group compared with those in the <7days group (all P < 0.01). Bronchiectasis was found in two children who were diagnosed at least 21days after aspiration. Multi-slice spiral computed tomography is very sensitive to TFBs. Timely diagnosis and treatment of TFB is important to prevent long-term sequelae in children.

S1698 Metal Screw Embedded in the Appendiceal Orifice

INTRODUCTION: Ingested foreign bodies in the gastrointestinal tract, especially those noted in the colon, often pass spontaneously and rarely cause complications. Foreign bodies involving the appendix are very uncommon and are more likely to be retained. We report the rare case of a metal screw embedded within the appendiceal orifice which was successfully retrieved by colonoscopy without the need for surgery. CASE DESCRIPTION/METHODS: A 56-year-old Caucasian man without significant past medical history who presented to the emergency department with complaints of worsening abdominal pain and nausea for two days. An abdominal x-ray was performed and revealed a foreign body in the right colon suggestive of a metal screw (Figure 1). The patient denied ingesting any metal objects. Symptoms persisted despite conservative management and the foreign body did not pass on its own. Colonoscopy was performed and the metal screw was identified embedded in the appendiceal orifice (Figure 2). It was successfully removed with a Roth net (Figure 3). After the procedure his symptoms resolved. DISCUSSION: Foreign bodies in the gastrointestinal tract rarely cause complications and usually exit without significant intervention. The occurrence of foreign bodies within the appendix is very rare and these are more likely to become retained. This is due to the fact that the peristaltic action at the appendix is insufficient to expel the object back into the colonic lumen. Different types of foreign bodies have been reported in the appendix. The cases reported in the literature involving metal screws, all occurred in children and led to acute appendicitis requiring appendectomy. It is recommended that ingested objects be followed clinically and radiographically for 3 days. However, retained foreign bodies, especially those in the right lower abdominal quadrant, are an exception due to the increased risk of complications. These potential complications include perforation, obstruction, and/or appendicitis. In general, endoscopic removal via colonoscopy is recommended for ingested foreign bodies embedded in the appendiceal orifice. If endoscopy fails or cannot be performed, surgical exploration should be considered.Figure 1.: Abdominal X-ray showing metal screw in the right colon.Figure 2.: Metal screw with tip embedded in the appendiceal orifice.Figure 3.: Metal screw retrieved with Roth net.

Corneal foreign bodies- Management the Ayurvedic way- A Case series

Corneal foreign bodies are one of the most common and serious eye trauma cases reaching an ophthalmologist. Traditional medical systems like Ayurveda are imagined to have a very limited and obsolete role in managing acute traumatic presentations like corneal foreign bodies. Four cases of corneal bodies which were treated by ayurvedic medicines and procedures are being reported here as a case series. Each case had a type of foreign body embedded in their cornea and after removal of the foreign body by suitable methods, they were given ayurvedic topical as well as internal medicines and followed up at regular intervals. All cases healed without any complications. This case series shows that ayuveda can be effectively used to manage many corneal injuries and this area need to be explored on a clinical trial route to reach more valid conclusions.

S1712 The Machiavellian Passenger

INTRODUCTION: Diarrheas affect a great number of individuals worldwide. Chronic diarrheas are defined as increased frequency of loose stools for more than 4 weeks. However, defining the etiology of chronic diarrheas is a challenging task, as ideal strategies for evaluation have yet to be established. Parasitic disease should always be considered as a possible cause in endemic regions. One important parasite to consider is Schistosoma. Clinical manifestations can range from asymptomatic to maculopapular rash, fever, headache, and diarrhea. This is the case of an unusual passenger found in a diagnostic colonoscopy. CASE DESCRIPTION/METHODS: A 77-year-old Puerto Rican male with past medical history of pulmonary sarcoidosis and Hepatitis B exposure presented with watery diarrhea for the last three years. The patient described about three episodes of loose stools daily aggravated by food intake and associated with abdominal pain and bloating. Physical exam was essentially unremarkable without stigmata of liver disease. Blood workup displayed thrombocytopenia and eosinophilia. Liver enzymes, coagulation parameters, and albumin were all within normal limits. Stool ova and parasites and urine and stool cultures were negative. ESR and CRP were not elevated. Abdominopelvic CT scan and abdominal sonogram were solely remarkable for fatty infiltrations with hepatocellular disease and splenomegaly. As a result, a diagnostic colonoscopy was performed. Random biopsies were obtained from the colon and sub centimeter tubular adenoma in the sigmoid colon. Biopsies from the rectum revealed a small non-necrotizing granuloma with a foreign body type giant cell at rectum suggestive of a parasitic infection. Schistosoma antigen was ordered and yielded a positive result. The patient was subsequently treated with praziquantel, which resulted in resolution of diarrhea and improvement in platelet count. DISCUSSION: Schistosomiasis is a serious infection endemic in the Caribbean and other places around the world. Therefore, this parasite should form part of the differential diagnosis when a patient presents with chronic diarrheas, eosinophilia and thrombocytopenia. Despite stool or urine microscopy being the gold standard for the diagnosis of schistosomiasis, our case illustrates how this is not infallible. The importance of combining social history, clinical presentation, histopathology and serum biomarkers should not be overlooked.

Nasal foreign bodies identified by rhinoscopy in dogs: 42 cases.

To evaluate signalment, clinical presentation, location and type of nasal foreign bodies identified by rhinoscopy in dogs. We retrospectively reviewed medical records from dogs that presented for consultation between April 2012 and June 2019 and were diagnosed with nasal foreign body via rhinoscopy. Forty-two dogs met the study's inclusion criteria. Thirty (71.4%; 30/42) were purebreds. Males accounted for 59.5% (25/42) of cases. The median age was 4.0 years old and 76.2% (32/42) were dogs up to 7 years of age. Mean bodyweight was 21.8kg and dogs weighing more than 10kg were overrepresented (78.6%; 33/42). Sneezing occurred in 78.6% (33/42) of cases. Foreign body retrieval was achieved by rhinoscopy in all cases. The foreign body was extracted from the right nasal cavity in 52.4% (22/42) of cases and from the left one in 42.9% (18/42). Two dogs (4.8%; 2/42) presented with one foreign body in each nasal cavity. Most nasal cavity foreign bodies (90.5%; 38/42) were grass awns. Three (7.2%; 3/42) were mineral and one (1/42) was fabric. Follow-up was documented for 35 patients, of which 97.1% (34/35) experienced resolution of clinical signs. Seven cases (16.7%; 7/42) were lost to follow-up. Nasal foreign bodies were more common in dogs up to 7 years of age and heavier than 10kg. Sneezing was the primary clinical sign. The vast majority of foreign bodies were grass awns and rhinoscopy was an effective means of nasal cavity foreign body retrieval.

Managing Pediatric Foreign Body Ingestions: A 10-Year Experience.

Foreign body (FB) ingestion is a common global issue in pediatrics. Most of the ingested FBs pass through the gastrointestinal tract, but up to 20% of cases require endoscopic removal. In this study, we retrospectively reviewed all pediatric cases of FB ingestion requiring endoscopic removal over a 10-year period in a tertiary hospital to compare the symptoms at presentation and outcomes with those reported in previous studies and to assess the association of the outcomes with patient and FB characteristics. A retrospective chart review of children 16 years or younger who underwent upper endoscopy for FB ingestion from 2008 to 2018 in a tertiary hospital was included. Data on demographics, clinical presentation, characteristics of FBs, endoscopic findings, and outcomes were reviewed. The clinical data were further evaluated to determine the circumstances surrounding FB ingestion, FB management, and patient outcomes. Descriptive analysis of the data was performed using medians, frequencies, and percentage; χ2 or Fisher exact test was used to assess the dependence between categorical variables. Eighty-six patients (median age, 5.1 years; 67% males) underwent endoscopy for suspected FB ingestion, with a confirmation rate of 91%. Coins were the most commonly ingested FBs (n = 49, 57%). Most patients were symptomatic (84%); 97% of patients in whom the FB had an esophageal location and all patients in whom the FB was not detected by endoscopy were symptomatic (P = 0.007). The most frequent symptoms were drooling (70%) and unexplained crying (48%). Unexplained crying was more common in younger than in older patients (P < 0.001). The FB was more likely to be located in the esophagus in patients with drooling (P < 0.001) and dysphagia (P < 0.001). The distribution of FB location differed according to the FB type, with coins most frequently located in the esophagus and sharp and other FBs in the stomach (P = 0.023). Only 7 patients (8%) developed mild FB-related mucosal injury. No complications occurred during FB removal. All patients had an uneventful outcome. Foreign body ingestion is common among younger children, and the clinical presentation can be variable. The presence or absence of symptoms, as well as the type of symptom, could aid clinicians in implementing diagnosis and proper management approaches in patients who ingest FBs requiring endoscopy.

How Can We Do Better? Learning From 617 Pediatric Patients With Airway Foreign Bodies Over a 2-Year Period in an Asian Population.

Background: Foreign body (FB) in the pediatric airway is a prevailing and crucial emergency with presenting symptoms often overlapping with other common pediatric conditions. There are limited number of large cohort studies in an Asian population which demonstrate the diversity of symptoms, investigations which will aid in obtaining the diagnosis, and management. Using this large cohort, we aim to evaluate the type and location, clinical presentations and outcomes of medical management related to pediatric airway FB in an Asian society.Methods: This is a retrospective study of all airway FB treated in Kunming Children's Hospital, China from February 2016 to June 2019. Six hundred and thirty-two clinical and operative records of all airway FB were retrieved and reviewed from the hospital's central electronic medical records. A total of 617 patients were included in our study.Results: The age ranged from 4 months to 12 years (mean = 1.74 years). The duration of symptoms ranged from 1 h to 605 days, with the diagnosis established at an average 9.16 days. Almost all had multiple symptoms, most commonly cough (98.5%) followed by noisy breathing (98.2%). Majority of the FBs (95.5%) were organic and the rest inorganic. Of the organic FBs, peanut was the most common (31.6%), followed by walnut (13.3%) and sunflower seeds (9.2%). Comparatively, 80.8% of the organic FBs were retrieved incomplete while 85.7% of the inorganic FBs were completely intact. Multiple FBs were noted in 43.3% of the patients, with 2.4% of them in different locations.Conclusions: Airway FB can be easily missed with resultant delay in diagnosis. In an Asian population, walnut and sunflower/pumpkin seeds feature more prominently compared to Western populations. Sunflower seed FBs tend to present earlier and are found intact in the trachea. Rigid bronchoscopy is the most common technique used to remove such FBs and pulmonary-related complications post-operatively, though rare, are the most common adverse outcomes. Preventive strategies targeting the appropriate age group and this type of FB may be useful in an Asian population.

Ear, nose and throat foreign bodies and their spectrum in rural South India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Ear, nose and throat foreign bodies are among the most common emergencies presenting to Otorhinolaryngologists world over and when dealt with poorly can cause high morbidity and mortality. Our study aimed at analysis of age, gender, types of foreign bodies and various aspects of their management in rural population.&lt;br /&gt; &lt;strong&gt;Methods:&lt;/strong&gt; An observational prospective study was conducted in MVJ Medical College and Research hospital, Hoskote which is a tertiary care teaching hospital in rural Karnataka. 224 patients complaining of foreign body in ear, nose and throat between June 2018 to December 2019 were analyzed.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 224 patients, majority were &amp;gt;10 years of age (57%). Most common site was ear (63.8%) followed by nose and throat. Single site foreign bodies were vast with cotton being most common object. About 67% foreign bodies were organic objects with 28%living and 72% non-living. 4% of the cases needed anesthetic augmentation for removal of which only 8 cases required general anesthesia. 60% cases were previously attempted removal cases with 2.7% cases developing sequela at follow up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Early presentation, timely intervention and skilled removal by otorhinolaryngologists can help prevent adverse outcomes of foreign body Ear Nose and throat.&lt;/p&gt;

Percutaneous antegrade removal of foreign bodies in the urinary tract: a 20-year, single-center experience.

While removing urinary tract foreign bodies is mostly performed through retrograde cystoscopy, antegrade removal using interventional procedures is reported less frequently. To evaluate the safety and effectiveness of percutaneous antegrade removal of urinary tract foreign bodies. A total of 14 consecutive patients (age range 9-80 years) who percutaneous antegrade removal of urinary tract foreign bodies between January 2001 and March 2020 were reviewed. Detailed removal procedures and complications were reviewed retrospectively. Types of foreign bodies were sheared percutaneous nephrostomy (PCN) catheters (n = 5), sheared double J stents (n = 3), migrated ureteral catheters (n = 3), embolization coils (n = 2), and a 0.018-inch guide wire (n = 1). The mean and median indwelling times (range 0-306 days) of the foreign bodies were 58.3 and 1.5 days, respectively. Computed tomography (CT) scans were conducted in six patients, and the extent and nature of the foreign bodies were well-visualized on CT scans. The removal access was new PCN access (n = 8), the tract missing PCN catheter (n = 3), pre-existing PCN access (n = 2), and percutaneous dissection (n = 1). The removal success rate was 92.9% (13/14) with either a simple (n = 8) or modified (n = 4; combination of a snare and guide wire is used) snare technique or a direct forceps grasp (n = 1). The mean procedure time for successful cases was 14.2 min (range 7-25 min). Procedure-related hematoma with (n = 2) or without (n = 1) renal pelvis injury occurred in three patients, which were all self-limited within one week. Percutaneous antegrade removal is safe and effective for urinary tract foreign bodies.

Comparison of Different Types of Corneal Foreign Bodies Using Anterior Segment Optical Coherence Tomography: A Prospective Observational Study.

Purpose The present study highlighted the value of anterior segment optical coherence tomography (AS-OCT) for different types of corneal foreign bodies in humans. Methods This study was a prospective observational study. The patients included were divided into two groups. If the patients were directly diagnosed based on eye injury history and slit-lamp examination, then they were assigned to Group A. Otherwise, the patients were assigned to Group B. We compared and described the characteristics of the corneal foreign body in both groups using AS-OCT. Results From October 2017 to January 2020, 36 eyes of 36 patients (9 females and 27 males) with a mean age of 37.8 ± 11.7 years were included in the study. Patients in Group A were the majority and accounted for 72.2% (26/36). High signals on AS-OCT images were the main constituent and accounted for 92.3% (24/26) in Group A and 70.0% (7/10) in Group B. Most of the patients in Group A, 96.2% (25/26), had clear boundaries. A blurred boundary was observed in 70.0% (7/10) of the patients in Group B. The foreign bodies on AS-OCT images had key characteristics of a high signal followed by a central zone shadowing effect and a low signal followed by a marginal zone shadowing effect. Further, all of the lesions could be directly located in Group B, and 92.3% (24/26) of the patients in Group A did not have directly located lesions. Six representative cases are described in detail. Conclusions AS-OCT is a valuable tool in the diagnosis and management of corneal foreign bodies, especially for unusual corneal foreign body.

Rigid Bronchoscopy: A Life-Saving Intervention in the Removal of Foreign Body in Adults at a Busy Tertiary Care Unit.

IntroductionForeign body (FB) aspiration is a potentially lethal emergency and is not uncommon in adults. Rigid bronchoscopy (RB) is a useful procedure for the extraction of these FBs, and it has a high success rate. The aim of this study was to document the clinical presentation of FB aspirations and management outcomes of non-vegetative FB extraction using RB as a therapeutic modality.MethodThis prospective interventional study was conducted in the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi from May 2019 to April 2020. Patients of both genders of ages 12 years or above, presenting with FB aspiration were included. RB was performed in all patients.ResultsChest radiograph (CXR) identified FBs in all 60 patients, 51 of whom were females and nine males. In 24 (40%) patients, a CT scan was performed to accurately localize the FB. Left bronchus was the most common location of the FB (n=39; 65%). Scarf pin was the most common type (n=45; 75%) of FB, followed by sewing needle (n=7; 11.7%), safety pin (n=5; 8.3%), and tire repair needle (n=3; 5%). In 53 (88.3%) patients, RB was successful in retrieving the FB. Thoracotomy was performed in the remaining seven patients due to inaccessibility. One (1.7%) patient died due to the rupture of the thoracic aortic aneurysm.ConclusionAccidental aspiration of pins and needles can be fatal in adults. RB is a life-saving modality for safely removing these FBs. However, thoracotomy should be used as a life-saving procedure in cases of FBs affecting secondary bronchi or beyond.