Background and purpose: Although foreign body aspiration in children is uncommon but it is life-threatening in children under 3 years old. The aim of this study is to review the data records on nature, location and symptoms of foreign body aspiration, diagnostic method, and prediction for improving the health care knowledge and its prevention.Materials and methods: Children with suspected foreign body aspiration were studies retrospectively from 2001 to 2009. Relevant clinical data including age, gender, place of residence, foreign materials and their location were retrieved.Results: Eighty data records of 57 males and 23 females, ages 8 to 180 months were analysed. The most common age was under 3 years old (8 months to 3 years). Thirty eight cases lived in urban areas and 42 cases in rural areas. The most common symptom was cough. Fifteen percent of the subjects had normal clinical examination. The most common foreign bodies were nuts.Conclusion: Foreign body aspiration is an uncommon but life threatening event which occurs mainly involves under 3 years old children. The most common cause is nuts. Close supervision of young children is essential as a preventive measure.

Dear editor, Meconium aspiration syndrome (MAS) is a leading cause of neonatal morbidity and mortality. MAS is defined as respiratory distress in the first four hours after birth in the presence of meconium-stained amniotic fluid (MSAF) (1). MAS is categorized as moderate (requiring oxygen therapy with a fraction of inspired oxygen (FIO2) of 40% or greater for at least 24 h) or severe (requiring assisted mechanical ventilation) (2). MAS can lead to the development of pulmonary injuries by a different mechanism (3). MSAF may contribute to multiple long-term and short-term adverse outcomes, including increased risk of neonatal resuscitation, low Apgar score, respiratory distress, pulmonary diseases, and neonatal sepsis. Globally, the incidence of MAS is reported to be 5%-10% in infants, which accounts for an estimated 12% of all neonatal deaths (4). Over the past several years, there have been tremendous advancements in the treatment of MAS....

Background and Aim: Fine Needle Aspiration Biopsy is an effective diagnostic method in the field of medical pathologies. Easiness, accuracy, validity and usefulness of this method have been verified frequently. This method is useful not only for soft tisse or even intraosseous lesions, but also recurrence of tumors (metastasis), resistence to treatment, verification of malignancy, differentiation between malignancy and benignment and determination of organisms causes infection. Unfortunately the use of this method is not common in dental pathology. So this study intendes to show the diagnostic value of FNA specially for intraosseous lesions causing jaw radiolucency.Methods and Materials: This investigation consisted of 80 patients who were referred to Taleghani General Hospital who were then referred to the pathology or surgery departments at Shahid Beheshti dental school.Cases consist of 29 females (36.25) % and 51 males (63.75%). Sampletaking was conducted using a 10 cc, gauge 19 syringe.Results: Results show 90% sensitivity and 75% specificity for jaw radiolucent lesions in FNA method. Correlation between FNA and jaw radiolucencies was significant (P<0.001) and it's power was at equal accepctable level according to cramer's V (phi - cramer's =0.623). Based on FNA cytology power, lesions with positive predictive value of 78.30 had a microscopic view compatible to the findings of other similar studies.Conclusion: FNA can be used as a reliable method for rapid, early and in expensive diagnosis, resulting in an on time, and appropriate treatment plan.

Introduction: Bowel feeding is an effective and safe method for patients who are admitted to intensive care wards but despite its many benefits has side effects such as respiratory aspiration. Pneumonia caused by aspiration is responsible for 15-20% of hospital infections, 24% increase in length of hospitalization, and 39% increase of expenses. It is one of the ten reasons of death in USA that can be prevented by appropriate method of feeding.Objective: This study aims to determine the chance of respiratory aspiration in intermittent bolus tube feeding in patients admitted to ICU and trauma wards.Methods: In this quasi- experimental study 36 patients admitted to ICU and trauma wards were fed by intermittent tube bolus method, for 3 days. Each time 150-300cc food liquid was administered for 7 times a day every 3 hours to patients with a 60 cc syringe in 10-15 minutes. In order to measure the respiratory aspiration, 0.5 cc methylen blue 1% was added to 500 cc of each meal. In case of patient's need for suction, when the blue color of methylen blue was observed in patients secretion they appeared to have respiratory aspiration.Results: Data analysis showed that respiratory aspiration occurrence in bolus method was 5.6%.Conclusion: According to results, it is obvious that bolus method as mentioned in texts is still the standard method and risk of respiratory aspiration decreases if it is used properly.

Patients due to tube feeding which can expose them to returning gastric contents and respiratory aspiration. This study is conducted to determine the effect of fenugreek seeds on residual gastric volume and respiratory aspiration of patients with mechanical ventilation.Materials & Methods: In this double-blind randomized controlled clinical trial with before and after design, 60 mechanically ventilated patients hospitalized in ICUs were divided into intervention and control groups. Intervention group (30 patients) and control group (n=30) after matching for sex, age, disease status and medications. Intervention group received 3 mg fenugreek seeds twice a day for 5 days and the control group received only the routine treatment.Respiratory aspiration and gastric residual volumes of admission and during the five days were measured. Data analysis was performed using cocran test and repeated measures was done with Anova, also the significance level of 0.05Result: There was a significant difference between the fenugreek group and the control group in the first admission (p=0.00). The mean and standard deviation of the residual volume increased in the control group compared with receiving Fenugreek seeds, which was significant (p=0.00). There was a trend toward a decrease in respiratory aspiration in the fenugreek group (3.3% vs.33.3%, p=0.005). Rat mortality was no significant difference in the 2 groups.Conclusions: Results showed that gastric feed with fenugreek seeds might reduce residua gastric volume and help reduce the incidence of respiratory aspirationin patients with mechanical ventilation.

Objective: Aspiration of a foreign body in the airways of children is one of the important emergencies in children, which is associated with high mortality and morbidity if not diagnosed promptly or managed effectively. The aim of this study was to investigate the clinical and radiographic findings in children with foreign body aspiration.    Methods: In a large cross-sectional retrospective study at a tertiary hospital from 2009 to 2019, children with foreign body aspiration were evaluated. The required information (demographics, clinical examination findings, and results of radiological and bronchoscopy reports) was extracted from the medical records of the patients in the hospital archive.    Results: In this study, 330 patients were enrolled, 61. 2% of whom were male. The mean age of the patients was 2. 65±2. 68 years. The average time interval from the onset of symptoms to the final diagnosis was 11. 54 days. The most common location and type of aspirated foreign body were the right main bronchus (60%) and seeds (39. 1%), respectively. Cough and decreased unilateral lung sounds were the most common clinical symptoms (91. 5%) and physical findings (50. 6%), respectively. The most common finding on chest X-ray was local emphysema (43%).    Conclusion: Foreign body aspiration can lead to irreparable injuries if it is not recognized and managed promptly. Aspiration of a foreign body can result in serious harm if not quickly diagnosed and properly managed. Clinical suspicion of aspiration and the management of these children are critical.

Gastroesophageal reflux disease (GERD) is defined with clinical symptoms of heart burning and regurgitation. It may be associated with external esophageal symptoms such as chronic cough, asthma, laryngitis, chronic lung disease, sinusitis and pulmonary fibrosis. In the present study, rats with chronic aspiration of gastroduodenal contentswere studied for cellular phenotypes and cytokine concentrations in bronchoalveolar lavage and lung tissue.Thirty-six male Albino N-MRI rats were randomly divided into six groups. After anesthesia and tracheal intubation, the animals received either 0.5ml/kg of normal saline (control), gastric juice, pepsin, hydrochloric acid or bile salts by injection into their lungs twice a week for 8 weeks. In sham group nothing was injected. Thereafter, cellular phenotypes and cytokine concentrations of Interleukine (IL) -1a, IL-1b, Transforming Growth Factor (TGF) -b, Tumor Necrosis Factor (TNF) a., and IL-6 were assessed in bronchoalveolar lavage and lung tissue homogenates.The numbers of epithelial cells, macrophages, neutrophils and lymphocytes in BAL and levels of cytokines IL-1a, IL-6, TNFa. and TGF-b in BAL and lung tissue of test groups were significantly higher than the control group. Aspiration of bile salts caused more cytokine levels and inflammatory cells compared to other reflux components.It can be concluded that GERD with increased cytokines and inflammatory cells in lung could cause or exacerbate asthma and pulmonary fibrosis.