Nasopharyngeal Neoplasms ; Carcinoma ; Lymph Nodes ; Asymptomatic Diseases

Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.

A foreign body (FB) in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.

Rhinoliths result from neglected nasal foreign bodies that gradually increase in size. They are usually discovered incidentally during routine ENT examination or due to the associated symptoms such as nasal obstruction or persistent foul-smelling unilateral nasal discharge. A case of a 14-year-old girl was reported with a year history of the symptom. The foul-smelling nasal discharge noted by her mother was not the main concern to them. She was referred by her primary care physician as she complained of impacted ear wax. However, rhinolith was incidentally found upon routine clinical examination in the ENT clinic and was removed uneventfully.
Nose ; Nose Diseases ; Foreign Bodies

The purpose of this study was to identify the relationship between sleepiness and daily sleep amount, and its significant associated factors among shift workers of the electronics manufacturing industry in Malaysia. 300 shift workers were asked to respond to a survey on demographic information, sleepiness and daily sleep. Sleepiness was surveyed by using the Karolinska Sleepiness Scale and daily sleep was captured by using sleep diary. A total of 255 employees provided valid data for analysis. To test the hypothesis, statistical analysis was conducted using IBM SPSS program version 24. Sleepiness among shift workers found to be increased by the end of the shift. Around 30% of workers did not have an adequate amount of daily sleep. Sleepiness was found to have significant associations with age, marital status, level of education, time of shift, and working experience. Meanwhile, the amount of daily sleep obtained was only significantly associated with the age of the respondents. There is no significant relationship found between sleepiness and daily sleep of the shift workers. Shift workers in the electronics manufacturing industry in Malaysia were exposed to sleepiness at work and reduction in their daily sleep. This will increase the risk of an accident in the workplace. Appropriate intervention program should be implemented to curb this problem.

Thyroglossal duct cyst (TDC) is a developmental anomaly that usually appears in early childhood. The common presentation is midline swelling of the neck, which moves with both tongue protrusion and deglutition. Diagnosis is usually clinical and radiological. Fine needle aspiration cytology (FNAC) can be used as a tool for the exclusion of malignancy in adult patients. In some cases thyroid scan is done to rule out the presence or absence of the normal thyroid gland. A complete work-up is mandatory before cyst removal given that it contains only thyroid tissue. We report the case of a 32-year-old woman with only thyroid tissue in thyroglossal duct cyst.
Thyroglossal Cyst ; Thyroid Gland ; Ultrasonography

Introduction: A foreign body (FB) in the upper aerodigestive tract is a fairly common encounter.Fish bones are the commonest FB seen in adults. The commonest presentation is odynophagia.Usually, the patient will point at the level of FB on the neck to indicate the location.Methods: Clinical report.Results: This case report describes a large FB in an adult with underlying infantile cerebral palsy.Besides dysphagia, it was associated with drooling of saliva and pain in the throat region.Conclusion: FB ingestion with complete obstruction of the oesophagus is an emergency. It maycause total dysphagia as the passage of food is completely blocked.

OBJECTIVE: To compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy. METHODS: Retrospective study of 694 women that underwent laparoscopic management of an adnexal mass. RESULTS: Laparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups. CONCLUSION: Laparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.
Female ; Humans ; Incidence ; Intraoperative Complications ; Laparoscopy ; Laparotomy ; Length of Stay ; Operative Time ; Ovarian Cysts ; Ovarian Neoplasms ; Postoperative Complications ; Retrospective Studies ; Rupture

INTRODUCTIONThe addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.

METHODSThis was a double-blinded randomised controlled trial. Babies who were admitted to the neonatal intensive care unit (NICU) and who required PN were eligible for inclusion in the study. The subjects were randomised to receive either glutamine-added PN (intervention) or standard PN (control). The most important outcomes included time to full enteral nutrition, incidence of sepsis and necrotising enterocolitis (NEC), clinical or culture-proven sepsis.

RESULTSOut of 270 subjects, 132 were randomised to the intervention group and 138, to the control group. Baseline data were comparable in both groups. The median time taken to reach full enteral nutrition was similar for both intervention and control groups (six days in each group, p-value is 0.52). The incidences of NEC, clinical sepsis and culture-proven sepsis did not differ significantly in the intervention and control groups (5.8 vs. 7.1 percent, p-value is 0.68; 15.7 percent vs. 10.2 percent, p-value is 0.21 and 16.5 percent vs. 15.7 percent, p-value is 0.38, respectively). Other outcomes such as duration of ventilation, duration of NICU stay and a subgroup analysis for preterm and term babies also showed no statistically significant differences.

CONCLUSIONAddition of glutamine to neonatal PN was not shown to improve outcome.

Double-Blind Method ; Enteral Nutrition ; Female ; Glutamine ; therapeutic use ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Intensive Care, Neonatal ; Malaysia ; Male ; Parenteral Nutrition ; Respiratory Tract Infections ; diagnosis ; Sepsis ; microbiology ; prevention & control ; Treatment Outcome

Foreign body aspiration is commonly described in infants and children. However, recently, a newhigh-risk group was identified among young women, especially those from the Muslim populationwho wear the traditional hair scarf. This is due to the habit of holding the scarf pin in between thelips to free hands to adjust the scarf more easily. Talking, laughing, or coughing while fixing thescarf may result in inadvertent inhalation of the pin into the tracheobronchial tree. We present acase of scarf pin inhalation and the challenges encountered in managing this patient during thesuccessful removal of the pin via flexible bronchoscopy under fluoroscopy guidance. This particularcase was technically challenging for us as the sharp tip of the needle was pointing upward andpiercing the bronchial mucosa.