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   2021| July-September  | Volume 5 | Issue 3  
    Online since August 1, 2022

 
 
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ORIGINAL ARTICLE
Mouth breathing during sleep and persistence of OSA after adeno-tonsillectomy in non-obese children
Brigitte Kim-yook Fung, Mei-yee Lau, Shuk-yu Leung, Rebecca Suk-yin Wong, Ka-li Kwok, Daniel Kwok-keung Ng
July-September 2021, 5(3):48-52
DOI:10.4103/prcm.prcm_17_21  
Objective: To evaluate the relationship between the percentage of total sleep time with mouth breathing (SMBP) and post-adeno-tonsillectomy apnea-hypopnea index (AHI) in non-obese children. Materials and Methods: Non-obese obstructive sleep apnea (OSA) children with pre- and post- TandA PSG done between August 2011 and February 2019 were reviewed and mouth breathing during sleep was manually scored. Percentage of total sleep time with mouth breathing (SMBP) was calculated. Its correlation with post-operative AHI >1.5/h was studied. Results: Fifty-nine children were included in the analysis and 47 of the study group (79.7%) were male. The mean age at pre-operative PSG was 9.2+/-3.1 years. The mean AHI dropped from 8.3+/-19.8 to 4.1+/-11.6 (P < 0.001). Thirty-one (50.8%) were cured of OSA defined as AHI<=1.5/h. There was a statistically significant positive correlation between post-operative log-transformed AHI and log-transformed SMBP (r=0.265, P = 0.044). The optimal SMBP for detecting residual OSA was 10.5%. The sensitivity, specificity, positive predictive value, negative predictive value and Youden Index were 0.86, 0.37, 0.57, 0.73 and 0.23, respectively. Post-operative children with SMBP >10.5% had higher risk for residual OSA (OR 4.2, 95%CI: 1.2–15.0, P = 0.029). Conclusion: Obstructive sleep apnea children with mouth breathing for more than 10.5% of total sleep time are more likely to have residual OSA after TandA.
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EDITORIAL
The last mile of COVID-19?
Yu-Tsun Su
July-September 2021, 5(3):41-41
DOI:10.4103/prcm.prcm_9_22  
  921 148 -
REVIEW ARTICLE
Spontaneous pneumomediastinum in children
Yen-Jhih Liao, Yung-Feng Huang, Bao-Ren Nong
July-September 2021, 5(3):42-47
DOI:10.4103/prcm.prcm_13_21  
Scarce studies about spontaneous pneumomediastinum (SPM) in pediatric patients are published because of lower incidence in a child than an adult. This article is a literature review of pediatric SPM, discussing about aspects of incidence rate, epidemiology, pathophysiology, diagnosis, management, and prognosis about pediatric SPM. In conclusion, SPM is usually a benign disease and treatable with only supportive care. However, poorer prognosis is noted; if it is complicated with other underlying diseases or complications, then aggressive treatment might be needed.
  923 137 -
INVITED COMMENTARY
Diagnostic tests for COVID-19
Rina Triasih
July-September 2021, 5(3):53-54
DOI:10.4103/prcm.prcm_16_21  
  638 91 -