Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.

The anatomical structures of the first, second and third instars of Chrysomya rufifacies (Macquart) were examined by light microscopy. Observations were documented on the three main characteristics; the cephalopharyngeal skeleton, anterior spiracle and posterior spiracle. The first instar larva bore cornuae of fairly pigmented delineation with slim hypostomal sclerite and distinct dental sclerite. First instar did not have obscured anterior spiracle but posterior spiracles were obscured with thin lining of opened peritreme. Intersegmental spines were evident. The second instar larva displayed a prominent anterodorsal process approaching closer to hypostomal sclerite while upper margin of the dorsal cornua was slightly pigmented. Each anterior spiracle consisted of nine to ten papillae, arranged in a single row. Peritreme of the posterior spiracle thick, opening at the end of peritreme was not wide and confined to two spiracular slits. The third instar larva showed a prominent arch of the ventral cornua with broad and bold appearance. It approached the dorsal cornua and became narrow at the incision median. The anterior spiracle consisted of a single row of nine to ten papillae while intersegmental spine could be identified with one to three dark pigmented tips. A dark pigmented and wide periterime was observed confining three short and thick spiracular slits while button was poorly pigmented. The most distinctive feature of this second and third instar larva was the slender, thorn-like tubercle with numerous spined tips on the middle line segment of the body. These findings provide identification features of C. rufifacies larvae instars.

ABO blood groups have been associated to increased susceptibility in allergic diseases, including asthma and atopic dermatitis. Although few studies demonstrated the association of ABO blood groups with allergic rhinitis, the evidences are still generally scarce and involved certain population. Therefore, this study aimed to investigate the association of ABO blood groups and allergic rhinitis in the Malaysian population. Further analysis was conducted to investigate the association between ABO blood groups and specific allergens, such as house dust mites, in patients with allergic rhinitis. A total of 163 patients with allergic rhinitis and 163 controls were recruited from AMDI, USM, Penang and HUSM, Kelantan. Blood samples were collected from both groups, and ABO phenotypes were identified using the tube method. The Pearson Chi-square test was employed to determine the association. Statistical significance was set for an alpha error of 5% (p-value < 0.05). O blood was identified as the most common blood group. However, no significant associations of ABO blood groups were observed in the allergic rhinitis patients. The result was also not significant with the O blood group being the highest prevalence and the AB blood group being the least prevalence to house dust mites allergy. This study provides beneficial information for future studies on the predictive role of blood groups in clinical practices. In our study, most of the participants recruited were Malays which might cause genetic bias. Therefore, employing a multi-centered and multiracial approach with larger sample size is recommended for future research.
Rhinitis, Allergic