Foreign body over the hard palate is a rare clinical entity that happen almost exclusively in young pediatric age group with only about 40 odd cases ever reported. Most cases in the literature are described as incidental findings of hard palate mass causing heightened anxiety to parents and clinicians alike during routine oral cavity examination. Owing to its rarity and lackluster presenting symptoms, this simple condition are often overlooked but has high propensity to develop into life threatening condition if dislodged into the airway.
The purpose of this study was to determine the
DNA yield and quality from different non-invasive
sampling methods and to identify the method which
gave the highest DNA yield. Method: Thirty-eight
volunteers had been recruited in this study where
blood, buccal cells and saliva were collected using
various collection techniques. Buccal cells were
collected by 1) cytobrush and 2) saline mouth rinsing
or “swish”. Meanwhile saliva was collected by passive
drooling method. Upon processing the white blood
cell (WBC), buccal cells and saliva samples, DNA
extraction was performed according to the
manufacturer’s protocol. Quantification and quality
(DNA ratio at A260/A280) of the extracted DNA were
determined using NanoDropND-1000®. T-test was
performed to compare means between DNA obtained
from various collection methods. Results: DNA yields
from buccal cells collected with cytobrush, “swish”,
saliva and WBC (mean ± SD) were (8.2 ± 5.9)ng/μl,
(28.2 ± 14.9)ng/μl, (5.9 ± 9.5)ng/μl and (105.3 ±
75.0)ng/μl respectively. Meanwhile the mean DNA
ratio at A260/A280 for cytobrush, “swish”, saliva and
WBC were 2.3, 2.0, 1.7 and 1.8 respectively. Post hoc
test with Bonferroni correction suggested that DNA
yield from “swish” technique exhibited the least mean
different as compared to the DNA extracted from WBC
(p
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 may
cause total dysphagia as the passage of food is completely blocked.
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 may cause total dysphagia as the passage of food is completely blocked.
Severe acutepoisoning of cypermethrin is rare. We reportedthiscase about a47-year old man who was brought to the Emergency Departmentwith drowsiness and drooling of saliva after intentional self-harm with 2.25gram of cypermethrin.His initial condition was stable. However, nine hours after admission, he developed seizures and reduced conscious level. He was ventilated overnight for airway protection. Management of acute severe poisoning is discussed in this case report.
Ptyalism gravidarum, or sialorrhea, is the excessive secretion of saliva during pregnancy. Treatment of ptyalism gravidarum is often challenging due to its unknown etiologies. This article discusses a case of ptyalism gravidarum with concomitant hyperemesis in which the condition was successfully treated with hypnosis. A 28-year-old woman presented with ptyalism 2 months into her pregnancy and hyperemesis 3 months into pregnancy with associated vomiting that occurred following every meal. Hypnosis was administered at week 16 of pregnancy to eliminate ptyalism and hyperemesis, to prepare for childbirth, and to increase overall psychological well-being. Ptyalism resolved by week 36, concurrent with the final hypnosis session.
Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.
This study aims to determine the most efficacious dose of Botulinum neurotoxin type A (BoNT-A) in reducing sialorrhea in Asian adults with neurological diseases. A prospective, double-blind randomized controlled trial was conducted over 24 weeks. Thirty patients with significant sialorrhea were randomly assigned to receive a BoNT-A (Dysport(®)) injection into the submandibular and the parotid glands bilaterally via an ultrasound guidance. The total dose given per patient was either BoNT-A injection of (i) 50 U; (ii) 100 U; or (iii) 200 U. The primary outcome was the amount of saliva reduction, measured by the differential weight (wet versus dry) of intraoral dental gauze at baseline and at 2, 6, 12, and 24 weeks after injection. The secondary outcome was the subjective report of drooling using the Drooling Frequency and Severity Scale (DFS). Saliva reduction was observed in response to all BoNT-A doses in 17 patients who completed the assessments. Although no statistically significant difference among the doses was found, the measured reduction was greater in groups that received higher doses (100 U and 200 U). The group receiving 200 U of Dysport(®) showed the greatest reduction of saliva until 24 weeks and reported the most significant improvement in the DFS score.
A 5-year-old girl presented with a history of
fever for four days associated with odynophagia.
She was treated with amoxycillin prescribed
by a general practitioner for 3 days prior to
presentation. However, the symptoms were
worsening and associated with drooling of
saliva and poor oral intake. There was history
of recurrent acute tonsillitis in the past two
years, with 5 to 6 episodes per year. The child
had completed regular immunizations up to her
current age. There was no similar presentation
amongst family members and friends. (Copied from article).
Introduction Children with cerebral palsy (CP) are often prescribed Rehabilitation and Seating Systems (RSS) to assist in daily activities, posture improvement and prevention of muscular-skeletal complications. In Sarawak, a special project to produce RSS was started under a partnership of a Japanese physiotherapist, health department and the community using local material.Aim To document the RSS project and to determine usefulness and costaffordability of these systems for cerebral palsy children and their families.
Methods The details of RSS manufactured were retrieved from the clinic notes and secretary file. Parents of children who received the seating systems between July 2004 and September 2008 were invited to complete a 5-point Global Parental Perception Questionnaire (GPPQ) between December 2008 and January 2009.
Results 277 RSS were manufactured between July 2004 and February 2011 (which included modified wheel chair, wooden chair, corner chair, buggy chair and standing frame), and used by children all over Sarawak. Parents of 73 children who used the seating systems completed the 5-points GPPQ. Ten families required full sponsorship. Children spent more time sitting up and brought outdoor more often after the systems became available. Majority of parents reported positive experience in their children with sitting ability, smiles, interaction with people, learning skills and easiness of doing physiotherapy. No change was noted with passing of motion drooling / oral secretion. Most parents agreed that the cost was affordable and worth paying.
Conclusions A community based initiative to manufacture RSS by using locally available material and skill, at affordable price for the parents was feasible and useful for the family/children with CP.
There have been previous reported deaths due to clozapine-induced
constipation. In all these cases, patients have experienced prior abdominal
symptoms over a period of weeks or months. Clozapine is an anti-psychotic
drug, and it is widely used for treatment of schizophrenia. The important
side-effects of clozapine include postural hypotension, weight gain,
tachycardia, cardiomyopathy, cardiomyositis, seizures, hypersalivation and
agranulocytosis. However, constipation induced by clozapine need to be
addressed since it may cause fatal consequences. Constipation associated with
clozapine is thought to be mediated by the drugs' pronounced dosedependent
cholinergic and serotonergic antagonism. Hence, a clozapineinduced
rapidly fatal bowel ischaemia is the highlight of this report and this
risky side-effect should be aware by the psychiatrist or physician before
commencing the treatment.
Introductions: Recurrent oral ulcers primarily effect mucosal surfaces and are among the most common chronic inflammatory diseases. Numerous studies to find the aetiopathogenesis have been conducted however the cause still remains unclear. Saliva is of utmostimportance for oral health maintenance. In current study, saliva was used as a diagnostic tool for comparison of salivary flow rate and pH in patients suffering from recurrent oral ulcers and control group. Materials and Methods: Saliva samples taken from 20 recurrent aphthous ulcer patients and 20 control (healthy) patients using a convient sampling method. Drooling method was used to collect unstimulated whole saliva sample. Pre-weighted specimen bottles were used and then weighed after sample collection on a graduated scale where as chair-side pH meter was used to determine the salivary pH. Independent t-test and Pearson’s correlation were performed. A p-value of less than 0.05 was considered statistically significance. Results: Positive correlation was found between the flow rate and pH in recurrent oral ulcer patients. Patients with recurrent oral ulcers had higher flow rate and pH compared to the control group. These effects were exaggerated in female patients with ulcers. Conclusions: Disturbances in salivary flow rate and pH were not significantly associated with recurrent oral ulcers.