Pediatric Respirology and Critical Care Medicine

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Background: Foreign body aspiration (FBA) in children is considered one of the most important diagnostic and therapeutic challenges for physicians. Often there is no history of aspiration of foreign body in this population and these children present with a wide range of nonspecific signs and symptoms. The objective of the study was to study the diagnostic utility of chest computed tomography (CT) scan in children with suspected FBA in comparison to flexible bronchoscopy (FB) and the role of later as a therapeutic tool in the removal of airway foreign bodies. Methods: This was a prospective observational study conducted from January 2015 to August 2019. Children admitted for persistent respiratory symptoms underwent CT chest and FB for confirmation of the diagnosis and retrieval of the foreign body if present. Results: A total of 101 patients of both genders were enrolled in the study. Fifty-three participants were boys and 48 were girls. FBA was diagnosed in 53 patients on chest CT. On FB, FBA was confirmed in 55 patients. The sensitivity and specificity of chest CT in our study were 85% and 87% respectively. In 25 of these patients, removal was successfully done by the FB. Conclusion: We conclude that a Chest CT scan is inferior to FB in the diagnosis of suspected trachea-bronchial foreign bodies in children. FB as a therapeutic tool has an excellent safety record in the retrieval of airway foreign bodies in this population.

Children as such have less infection and less severe covid 19 illness. Majority will be asymptomatic or mildly symptomatic. Symptoms are nonspecific and suspect in children presenting with influenza-like illness (ILI) or children presenting with respiratory difficulty. Children with definite contact with COVID-positive patients or those who had severe illness (irrespective of COVID status) in the past 2 weeks should be subjected to test. The rest of the children may be tested if any of the following are present: 1. The presence of high-risk factor in child such as immunocompromised condition (long-term steroids, cancer chemotherapy, biological agents, and primary or secondary immune deficiency) or chronic illnesses including chronic respiratory illnesses 2. Any person in family who is at risk of developing serious illness (elderly, immunocompromised, diabetic, hypertensive, etc.,). Majority of mild to moderate illness can be managed at home with symptomatic treatment ensuring monitoring for worsening of symptoms. There is no proven benefit of antibiotics, antiviral agents, steroids, hydroxychloroquine or other anti-inflammatory agents.

SARS-CoV-2 has immensely changed the landscape in how vaccines are researched and developed. The timeline truncated for the propose of meeting the grave demand. Children stand to benefit from herd immunity for multiple reasons. Protection from SARS-CoV-2 would not only protect children from COVID but also a unique entity called Multisystem Inflammatory Syndrome in Children (MISC). Thus, it is vital that general pediatricians and practitioners who care for children to have foundational knowledge regarding the ever-expanding array of soon to be available COVID19 vaccines along with the potential pitfalls of their rushed development and implementation. This article seeks to provide a brief review of the most prominent COVID19 vaccines under development with intention for Pediatric use as well as recall historical knowledge regarding rushed development of respiratory viral vaccines that resulted in unintended consequences.

Online since 1^st July, 2016