S. Karunanayaka, V. V. Jayawardhane, G. Premawansa
{"title":"An unusual presentation of Behçet’s disease with inferior vena cava thrombosis and pulmonary embolism","authors":"S. Karunanayaka, V. V. Jayawardhane, G. Premawansa","doi":"10.4038/gmj.v26i2.8089","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8089","url":null,"abstract":"","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"290 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133632816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. A. Ubeysekara, N. Ranaweera, H. H. Peris, W. Wijayaratne
Introduction: Rampant use of antibiotics in animal husbandry contributes significantly to the development and spread of antibiotic resistance. This study determines the antibiotic activity in poultry feed and assesses the knowledge on feeding practices and their potential effects on antimicrobial resistance among poultry farm owners. Methods: Poultry feed available for sale in shops and ready to serve poultry feed and water samples from selected farms in Kegalle District, Sri Lanka were tested for the antibiotic activity using the agar well diffusion method against three control organisms; Staphylococcus aureus ATCC25923, Escherichia coli ATCC25922 and Pseudomonas aeruginosa ATCC27853 and the zone of inhibition around each well was measured. All farm owners were interviewed and basic details regarding the farm such as area, number of animals, water source and the awareness of farm owners regarding antibiotic use in poultry feeds and water source were obtained. Results: No antibiotic activity was detected in commercially available poultry feed in selected shops (5/5) and ready to serve poultry feed in selected farms (18/18). An antibacterial effect was detected in water samples collected from 33.33% (6/18) of farms. Seventy-eight percent (14/18) of farm owners declared that they administer different types of additives containing antibiotics along with drinking water served to animals. Forty-four percent of farm owners believe that usage of antibiotics in poultry is not a good practice and harmful for human health while a similar percentage claim that it is a favorable practice as it benefits them economically. None of the farm owners were aware that the use of antibiotics in poultry can contribute to the increasing antibiotic resistance in the community. Conclusion: Commercially available poultry feeds in shops and ready to serve poultry feeds in farms did not demonstrate any antibiotic activity. However, antibiotic activity was detected in drinking water served to animals due to incorporation of antibiotic containing additives beyond the prevailing guidelines. The awareness of farm owners on antibiotic use in poultry and its effects on the increase of antibiotic resistance in the community is unsatisfactory.
{"title":"Antibiotic use in poultry production; a cross-sectional study in a selected district in Sri Lanka","authors":"H. A. Ubeysekara, N. Ranaweera, H. H. Peris, W. Wijayaratne","doi":"10.4038/gmj.v26i2.8050","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8050","url":null,"abstract":"Introduction: Rampant use of antibiotics in animal husbandry contributes significantly to the development and spread of antibiotic resistance. This study determines the antibiotic activity in poultry feed and assesses the knowledge on feeding practices and their potential effects on antimicrobial resistance among poultry farm owners. Methods: Poultry feed available for sale in shops and ready to serve poultry feed and water samples from selected farms in Kegalle District, Sri Lanka were tested for the antibiotic activity using the agar well diffusion method against three control organisms; Staphylococcus aureus ATCC25923, Escherichia coli ATCC25922 and Pseudomonas aeruginosa ATCC27853 and the zone of inhibition around each well was measured. All farm owners were interviewed and basic details regarding the farm such as area, number of animals, water source and the awareness of farm owners regarding antibiotic use in poultry feeds and water source were obtained. Results: No antibiotic activity was detected in commercially available poultry feed in selected shops (5/5) and ready to serve poultry feed in selected farms (18/18). An antibacterial effect was detected in water samples collected from 33.33% (6/18) of farms. Seventy-eight percent (14/18) of farm owners declared that they administer different types of additives containing antibiotics along with drinking water served to animals. Forty-four percent of farm owners believe that usage of antibiotics in poultry is not a good practice and harmful for human health while a similar percentage claim that it is a favorable practice as it benefits them economically. None of the farm owners were aware that the use of antibiotics in poultry can contribute to the increasing antibiotic resistance in the community. Conclusion: Commercially available poultry feeds in shops and ready to serve poultry feeds in farms did not demonstrate any antibiotic activity. However, antibiotic activity was detected in drinking water served to animals due to incorporation of antibiotic containing additives beyond the prevailing guidelines. The awareness of farm owners on antibiotic use in poultry and its effects on the increase of antibiotic resistance in the community is unsatisfactory.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121452852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During my professional career as a clinician for nearly five decades, I have come across several instances where I felt that my role as a clinician has been a failure. I consider these instances as critical incidents that have molded my clinical practice and hopefully made me a better clinician. In this paper, I will discuss about few of those situations, narrating the experience that I lived through, highlighting where I think I went wrong and how best we clinicians should perform under such circumstances. I have divided the paper into lapses in history taking, lack of completeness in physical examination, premature closure in making a diagnosis and inadequacies in treatment, and each of these will be illustrated using a real-life scenario that I have lived through. As clinicians, we should strive for zero error, but we human beings are imperfect and often have room for improvement in the ways we act and react. In your clinical practice, irrespective of whether you experience critical incidents or not, it is always better to reflect how you could have treated each patient you have seen, better and make your practice more reflective rather than thinking in a stereotyped manner.
{"title":"Compromising patient safety: Lessons learnt from some critical incidents","authors":"P. L. Ariyananda","doi":"10.4038/gmj.v26i2.8069","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8069","url":null,"abstract":"During my professional career as a clinician for nearly five decades, I have come across several instances where I felt that my role as a clinician has been a failure. I consider these instances as critical incidents that have molded my clinical practice and hopefully made me a better clinician. In this paper, I will discuss about few of those situations, narrating the experience that I lived through, highlighting where I think I went wrong and how best we clinicians should perform under such circumstances. I have divided the paper into lapses in history taking, lack of completeness in physical examination, premature closure in making a diagnosis and inadequacies in treatment, and each of these will be illustrated using a real-life scenario that I have lived through. As clinicians, we should strive for zero error, but we human beings are imperfect and often have room for improvement in the ways we act and react. In your clinical practice, irrespective of whether you experience critical incidents or not, it is always better to reflect how you could have treated each patient you have seen, better and make your practice more reflective rather than thinking in a stereotyped manner.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121324137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Save the children from screen overuse","authors":"N. Liyanarachchi","doi":"10.4038/gmj.v26i2.8085","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8085","url":null,"abstract":"","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"2003 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125779260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Wijayasiri, S. Wimalasekera, S. Sivayogan, H. Waidyasekara, Y. Ishikawa
Introduction: Despite regular training Sri Lankan runners do not perform well in international sports arena. The performance of a runner is determined by cardiopulmonary fitness level. However, little is known about the cardiopulmonary fitness levels of Sri Lankan runners. Thus, the present study was conducted to assess the status of the cardiopulmonary fitness of a group of Sri Lankan national level and university level male long distance runners and sprinters. Methods: A descriptive cross-sectional study was conducted to determine the baseline data using interviewer administered questionnaire and clinical examination of 95 male runners [national level long distance runners (n = 27), national level sprinters (n = 27), university level long distance runners (n = 20), university level sprinters (n = 21)] and age and sex matched control subjects (n = 41). Cardiopulmonary exercise fitness was assessed by a fully automated Cardiopulmonary Exercise Testing (CPET) machine. Results: The CPET parameters such as VO , peak workload, exercise duration, heart rate at rest (HR ) and 2max rest at peak (HR ), systolic blood pressure at rest (SBP ), and at peak (SBP ), diastolic blood pressure at peak rest peak rest (DBP ), and at peak (DBP ) amongst Sri Lankan national level runners indicated minimal improvement rest peak when compared to Sri Lankan university level runners. Further, most of the CPET parameters of Sri Lankan runners were lower when compared with those parameters of runners from the Asian region. Conclusions and recommendations: Cardiopulmonary fitness of Sri Lankan long distance runners and sprinters is low. Thus, training protocols are needed to be modified in accordance with the baseline CPET parameters to attain optimal cardiovascular remodelling to enhance he performance of Sri Lankan runners.
{"title":"Physiological profile of Sri Lankan male long distance runners and sprinters competing at national level and university level; a descriptive study","authors":"K. Wijayasiri, S. Wimalasekera, S. Sivayogan, H. Waidyasekara, Y. Ishikawa","doi":"10.4038/gmj.v26i2.8087","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8087","url":null,"abstract":"Introduction: Despite regular training Sri Lankan runners do not perform well in international sports arena. The performance of a runner is determined by cardiopulmonary fitness level. However, little is known about the cardiopulmonary fitness levels of Sri Lankan runners. Thus, the present study was conducted to assess the status of the cardiopulmonary fitness of a group of Sri Lankan national level and university level male long distance runners and sprinters. Methods: A descriptive cross-sectional study was conducted to determine the baseline data using interviewer administered questionnaire and clinical examination of 95 male runners [national level long distance runners (n = 27), national level sprinters (n = 27), university level long distance runners (n = 20), university level sprinters (n = 21)] and age and sex matched control subjects (n = 41). Cardiopulmonary exercise fitness was assessed by a fully automated Cardiopulmonary Exercise Testing (CPET) machine. Results: The CPET parameters such as VO , peak workload, exercise duration, heart rate at rest (HR ) and 2max rest at peak (HR ), systolic blood pressure at rest (SBP ), and at peak (SBP ), diastolic blood pressure at peak rest peak rest (DBP ), and at peak (DBP ) amongst Sri Lankan national level runners indicated minimal improvement rest peak when compared to Sri Lankan university level runners. Further, most of the CPET parameters of Sri Lankan runners were lower when compared with those parameters of runners from the Asian region. Conclusions and recommendations: Cardiopulmonary fitness of Sri Lankan long distance runners and sprinters is low. Thus, training protocols are needed to be modified in accordance with the baseline CPET parameters to attain optimal cardiovascular remodelling to enhance he performance of Sri Lankan runners.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129210354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In their paper on the physiological profile of male long-distance runners and sprinters, Wijayasiri et al., focuses on Sri Lankan athletes of two different types of running events and their cardiopulmonary fitness. Structured exercise and training bring about enhanced performance. The use of unauthorized enhancement medication with the connivance of medical doctors, sport bodies and in some instances states has become a dangerous trend in the world. It is abhorrent from a sporting perspective; unethical from a professional perspective and harmful to health of athletes from a medical perspective.
{"title":"Towards frontiers of human endurance: Evolving role of sports medicine","authors":"S. Goonesinghe, E. Waidyarathne","doi":"10.4038/gmj.v26i2.8084","DOIUrl":"https://doi.org/10.4038/gmj.v26i2.8084","url":null,"abstract":"In their paper on the physiological profile of male long-distance runners and sprinters, Wijayasiri et al., focuses on Sri Lankan athletes of two different types of running events and their cardiopulmonary fitness. Structured exercise and training bring about enhanced performance. The use of unauthorized enhancement medication with the connivance of medical doctors, sport bodies and in some instances states has become a dangerous trend in the world. It is abhorrent from a sporting perspective; unethical from a professional perspective and harmful to health of athletes from a medical perspective.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116222053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Piyasiri, A. Kirubaharan, I. Nanayakkara, J. Jayasekara, M. Galhenage, P. Sapukotana
She was afebrile on admission, however, developed redness and swelling at the cannula site few days later. Next day, she fell in the hospital toilet and landed on the infected forearm. This toilet was a squatting type with water sourced from the local municipal council supply. There was no visible faecal contamination. Three days later, she developed severe infection with blister formation at the infected site with high fever spikes (Figure 1). There was no history of any local treatment to the site including ayurvedic preparations or salt.
{"title":"Bacterial wound infections leading to bacteraemia with Vibrio vulnificus and Morganella morganii; two unusual cases","authors":"D. Piyasiri, A. Kirubaharan, I. Nanayakkara, J. Jayasekara, M. Galhenage, P. Sapukotana","doi":"10.4038/gmj.v26i1.8082","DOIUrl":"https://doi.org/10.4038/gmj.v26i1.8082","url":null,"abstract":"She was afebrile on admission, however, developed redness and swelling at the cannula site few days later. Next day, she fell in the hospital toilet and landed on the infected forearm. This toilet was a squatting type with water sourced from the local municipal council supply. There was no visible faecal contamination. Three days later, she developed severe infection with blister formation at the infected site with high fever spikes (Figure 1). There was no history of any local treatment to the site including ayurvedic preparations or salt.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127644594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Australia deals with suicides: lessons learnt and implications for Sri Lanka","authors":"A. Chandrasiri","doi":"10.4038/gmj.v26i1.8076","DOIUrl":"https://doi.org/10.4038/gmj.v26i1.8076","url":null,"abstract":"","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125569212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. C. Perera, S. K. Ekanayaka, N. Chandrasiri, K. Jayatilleke, J. Kottahachchi
Introduction: Healthcare-associated infections are common problems found in healthcare systems in most of the countries. Proper use of antiseptics and disinfectants is useful in reducing the magnitude of such infections. The aim of this study was to evaluate the bactericidal effect of different concentrations of selected antiseptics and disinfectants. Methods: Bactericidal activity of different concentrations of antiseptics and disinfectants; isopropyl alcohol, povidone iodine, chlorhexidine gluconate, sodium hypochlorite, hypertonic saline, peracetic acid and mixture of 2-aminoethanol, dodecyl dimethyl ammonium chloride, potassium carbonate & bis(3-aminopropyl) dodecylamine were evaluated against nine strains of American Type Culture Collections and 11 strains isolated from the hospitals. Bacterial suspensions were prepared equal to 0.5 McFarland turbidity standards and 100 μl of each was mixed with 3 ml of antiseptic/ disinfectant solution. After desired contact time (1 minute, 15 minutes and 24 hours), 20 μl of reaction mixer was transferred into 4 ml of sterile physiological saline, mixed well and 20 μl of solution was evenly spread throughout Muller Hinton agar/ blood agar plates. Growth control was done using 3 ml of distilled water instead of 3 ml of antiseptic/ disinfectant solution. All plates incubated at 35oC ± 2oC for 18 – 24 hours. Colonies were counted and reduction percentage was calculated. Results: All concentrations of isopropyl alcohol, povidone iodine, chorhexidine, sodium hypochlorite, peracetic acid and the mixture of 2-aminoethanol, didecyldimethylammonium chloride, potassium carbonate and bis(3-aminopropyl)dodecylamine showed 100% bactericidal activities against all tested bacterial strains in1-minute contact time. Bactericidal activity of hypertonic saline was varied against tested bacterial strains with higher bactericidal activity against Gram positive organisms than Gram negative organisms. Conclusions: Currently using concentrations of antiseptics and disinfectants evaluated in this study have 100% bactericidal activity other than hypertonic saline.
{"title":"In-vitro evaluation of bactericidal activity of antiseptics and disinfectants commonly used in healthcare settings","authors":"K. C. Perera, S. K. Ekanayaka, N. Chandrasiri, K. Jayatilleke, J. Kottahachchi","doi":"10.4038/gmj.v26i1.8079","DOIUrl":"https://doi.org/10.4038/gmj.v26i1.8079","url":null,"abstract":"Introduction: Healthcare-associated infections are common problems found in healthcare systems in most of the countries. Proper use of antiseptics and disinfectants is useful in reducing the magnitude of such infections. The aim of this study was to evaluate the bactericidal effect of different concentrations of selected antiseptics and disinfectants. Methods: Bactericidal activity of different concentrations of antiseptics and disinfectants; isopropyl alcohol, povidone iodine, chlorhexidine gluconate, sodium hypochlorite, hypertonic saline, peracetic acid and mixture of 2-aminoethanol, dodecyl dimethyl ammonium chloride, potassium carbonate & bis(3-aminopropyl) dodecylamine were evaluated against nine strains of American Type Culture Collections and 11 strains isolated from the hospitals. Bacterial suspensions were prepared equal to 0.5 McFarland turbidity standards and 100 μl of each was mixed with 3 ml of antiseptic/ disinfectant solution. After desired contact time (1 minute, 15 minutes and 24 hours), 20 μl of reaction mixer was transferred into 4 ml of sterile physiological saline, mixed well and 20 μl of solution was evenly spread throughout Muller Hinton agar/ blood agar plates. Growth control was done using 3 ml of distilled water instead of 3 ml of antiseptic/ disinfectant solution. All plates incubated at 35oC ± 2oC for 18 – 24 hours. Colonies were counted and reduction percentage was calculated. Results: All concentrations of isopropyl alcohol, povidone iodine, chorhexidine, sodium hypochlorite, peracetic acid and the mixture of 2-aminoethanol, didecyldimethylammonium chloride, potassium carbonate and bis(3-aminopropyl)dodecylamine showed 100% bactericidal activities against all tested bacterial strains in1-minute contact time. Bactericidal activity of hypertonic saline was varied against tested bacterial strains with higher bactericidal activity against Gram positive organisms than Gram negative organisms. Conclusions: Currently using concentrations of antiseptics and disinfectants evaluated in this study have 100% bactericidal activity other than hypertonic saline.","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134640530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vomiting is common in children. Vomiting or emesis, is the actual oral expulsion of gastrointestinal contents as a result of contractions of the gastrointestinal and the thoracoabdominal wall musculature (1). Vomiting centre in medulla oblongata comprises of reticular formation and the nucleus of the tractus solitarius. Motor pathways descend from vomiting centre trigger vomiting when stimulated. These efferent pathways travel th th th th th within the 5 , 7 , 9 , 10 , and 12 cranial nerves to the upper gastrointestinal tract, within vagal and sympathetic nerves to the lower tract, and within spinal nerves to the diaphragm and abdominal muscles. The vomiting centre can be activated directly by irritants or indirectly following input from four principal areas: gastrointestinal tract, cerebral cortex and thalamus, vestibular region, and chemoreceptor trigger zone (CRTZ) (1). Local causes such as gastrointestinal infection or obstruction, pharyngitis and systemic causes such as sepsis, increased intracranial pressure and chemotherapy can give rise to repeated episodes of vomiting by triggering the vomiting centre. Oesophageal food bolus is a rare cause of vomiting in children (2). One study had estimated that the incidence of upper gastrointestinal food bolus impaction is 13 per 100,000 populations (3). More than 80% of children with oesophageal food bolus impaction have an abnormality in the oesophagus (2). We describe a case of a toddler with recurrent vomiting due to oesophageal food bolus impaction. Case presentation
{"title":"Recurrent vomiting in a toddler; oesophageal food bolus impaction","authors":"V. P. Sinhabahu, S. Jamison, S. Cunninghams","doi":"10.4038/GMJ.V26I1.8081","DOIUrl":"https://doi.org/10.4038/GMJ.V26I1.8081","url":null,"abstract":"Vomiting is common in children. Vomiting or emesis, is the actual oral expulsion of gastrointestinal contents as a result of contractions of the gastrointestinal and the thoracoabdominal wall musculature (1). Vomiting centre in medulla oblongata comprises of reticular formation and the nucleus of the tractus solitarius. Motor pathways descend from vomiting centre trigger vomiting when stimulated. These efferent pathways travel th th th th th within the 5 , 7 , 9 , 10 , and 12 cranial nerves to the upper gastrointestinal tract, within vagal and sympathetic nerves to the lower tract, and within spinal nerves to the diaphragm and abdominal muscles. The vomiting centre can be activated directly by irritants or indirectly following input from four principal areas: gastrointestinal tract, cerebral cortex and thalamus, vestibular region, and chemoreceptor trigger zone (CRTZ) (1). Local causes such as gastrointestinal infection or obstruction, pharyngitis and systemic causes such as sepsis, increased intracranial pressure and chemotherapy can give rise to repeated episodes of vomiting by triggering the vomiting centre. Oesophageal food bolus is a rare cause of vomiting in children (2). One study had estimated that the incidence of upper gastrointestinal food bolus impaction is 13 per 100,000 populations (3). More than 80% of children with oesophageal food bolus impaction have an abnormality in the oesophagus (2). We describe a case of a toddler with recurrent vomiting due to oesophageal food bolus impaction. Case presentation","PeriodicalId":194530,"journal":{"name":"Galle Medical Journal","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116103779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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