A Case of Chronic Cough and Pneumonia Secondary to a Foreign Body

Foreign body aspiration occurs when a solid or semisolid object becomes lodged in the larynx or trachea. It can be a life-threatening emergency, especially if it is large enough to occlude the airway. However, small aspirated objects may go unnoticed until symptoms occur. Therefore, it is frequently misdiagnosed. A high level of clinical suspicion, patient\u27s risk factors, and thorough history and physical examination are essential in making the diagnosis. It should be considered in cases where there is unresolved chronic cough with or without associated recurrent pneumonia especially in patients with risks for aspiration

Comorbidities among infertile women at NKST hospital Mkar-Gboko, North-Central Nigeria

Background:  Infertility, a common, non-fatal ailment, is sometimes associated with substantial comorbidity that can add adverse outcomes during treatment or pregnancy and increase costs of care. This study aims to assess the magnitude and pattern of comorbidities in infertile Nigerian women.Method: This descriptive retrospective study was undertaken at NKST Hospital Mkar-Gboko, Nigeria, from 1st January 2005 to 31st July 2013. Clinic records of patients who attended the gynaecological outreach clinic were retrieved and analyzed using descriptive statistics and test of associations with Microsoft Excel 2013.  Jos University Teaching Hospital gave ethical clearance.Results: 1,926 women seen during the study period, 1030 (53.5%) presented for infertility care. 941 (91.4%) women had complete records, among them, 476 (50.5%) met the inclusion criteria, and their records were analyzed. The mean age of the women was 32.6±6.0 years with a range of 20 to 53 years, see Table1. There were 52 comorbid conditions among the 476 women. The comorbidities included uterine myoma, previous appendectomy/pelvic surgeries, genital tract infections/retroviral disease, hypertension, obesity and diabetes, among others, see Table 4. Table 2 and 3 shows there is a significant statistical association between comorbidity type, age, parity, duration of infertility and symptoms complex between infertile women and comorbidities (p<0.05).Conclusion: Comorbidities that can influence treatment and pregnancy outcomes are common among infertile women in central Nigeria. This finding strongly supports the routine assessment of women for comorbidities during infertility care for appropriate multidisciplinary management and counselling

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Focusability of laser pulses at petawatt transport intensities in thin-film compression

Thin-film compression (TFC) and the focusability of high-power laser pulses after self-phase modulation in thin films at transport intensities (∼1 TW∕cm 2 ) for petawatt laser systems is demonstrated. High-energy (∼296 mJ) laser pulses are compressed from ∼55 fs to ∼31 fs. Additionally, the focusability of high-power (∼45–55 TW) flat-top laser pulses after spectral broadening in thin films is found to be largely maintained, showing only modest decreases in the energy contained in the central part of the focal spot. In light of these findings, TFC offers a method for moving toward single-cycle pulse durations at significantly higher energies than those found at present, and if beam instabilities can be mitigated, maybe even higher intensities

Focusability of laser pulses at petawatt transport intensities in thin-film compression

Thin-film compression (TFC) and the focusability of high-power laser pulses after self-phase modulation in thin films at transport intensities (∼1 TW∕cm 2 ) for petawatt laser systems is demonstrated. High-energy (∼296 mJ) laser pulses are compressed from ∼55 fs to ∼31 fs. Additionally, the focusability of high-power (∼45–55 TW) flat-top laser pulses after spectral broadening in thin films is found to be largely maintained, showing only modest decreases in the energy contained in the central part of the focal spot. In light of these findings, TFC offers a method for moving toward single-cycle pulse durations at significantly higher energies than those found at present, and if beam instabilities can be mitigated, maybe even higher intensities