Accidental foreign body (FB) ingestion is common in the elderly, particularly edentulous and denture wearers. The most commonly ingested FBs are food-related, including fish and chicken bones. While small FBs can pass through the gastrointestinal tract without any complications, large or irregular-shaped FBs usually cause complications. These complications include choking, ulceration, perforation, fistula, abscess formation, or even death. Ingestion of a large chicken bone that reaches the anal canal without causing injury is extremely rare. We present a rare case of accidental chicken bone (xiphoid process) ingestion that manifested itself by projecting from the anus while defecating. Interestingly, the patient did not experience any food choking or abdominal pain, nor did she have any type of dementia. However, the patient could not grind food properly due to the loss of her upper molar teeth, which made her develop a habit of rapid swallowing. On examination, the chicken bone was seen within the anus with a sharp edge embedded in the mucosal wall. While a plain pelvic X-ray failed to display the FB, a pelvic CT scan with a 3D illustration showed its dimensions (5.0 x 2.5 x 3 cm). A plain pelvic CT scan confirmed the presence of the bone-contrast FB within the anal canal without injuring the surrounding anatomical structures. The FB was gently manipulated and successfully extracted after administering 5 ml of lidocaine gel enema. The patient was counseled regarding proper chewing habits, and she was referred to a dental clinic for a professional assessment. Seven days later, the patient was seen again at the clinic for a follow-up and was found to have an uneventful recovery. Maintaining good dental health and proper eating habits, as well as increasing awareness among edentulous individuals and denture wearers, are required to prevent accidental FB ingestions.
Introduction There needs to be more evidence about the tobacco products utilized by individuals who smoke and the primary determinants contributing to the development of smoking behavior. Our study aimed to assess the prevalence and factors associated with using one or more tobacco products among employees from various ministries in Kuwait. Methods A cross-sectional study was conducted among employees in different ministries in Kuwait from December 27, 2018, to January 3, 2019. A questionnaire about smoking status and socio-demographic variables was used. Results There was a total of 1057 participants in this study. Of the participants, 26% (n=275) reported using at least one tobacco product. The proportion of smoking of at least one tobacco product was higher among men (n=243, 46.5%) than women (n=32, 6%). Among smokers, 1.5%, 5.9%, and 18.6% reportedly use only three, two, and one tobacco products, respectively. Of the study participants, 26% were smokers, 20.3% were exclusively cigarette smokers, and 21.8% reportedly started cigarette smoking at the age of 15 years or less. Male compared to female workers had higher odds of being smokers of at least one tobacco product (adjusted OR= 15.3, 95% CI= 10.0-23.4). Participants were significantly (p= 0.009) more likely to use at least one tobacco product if their monthly income in Kuwaiti Dinars ranged from 501-1000 KD (adjusted OR= 1.9, 95% CI= 1.2-3.0) or 1501-2000 KD (adjusted OR= 2.3, 95% CI= 1.2-4.5) compared to those who had monthly income range 500 KD or less. Conclusion The male gender and high income of the participants were significant predictors of the use of at least one tobacco product. Anti-smoking campaigns, mass media interventions, and increasing tobacco product taxes may minimize this population's tobacco consumption.