Bilastine is a non-sedating second generation H1 oral antihistamine (OAH) for treating allergic rhinitis (AR) patients. The effect of bilastine has not previously been evaluated in a meta-analysis. The aim of this review was to determine the efficacy and safety of bilastine in treating AR. An electronic literature search was performed using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Science Direct and Google Scholar up to March 2021. Randomized controlled trials comparing bilastine with placebo and standard pharmacotherapy were included. The included studies must have diagnosis of AR established by clinicians and the outcomes must have a minimum of 2 weeks of follow-up period. The primary outcomes assessed were total symptom score (TSS), nasal symptom score (NSS) and non-nasal symptom score (NNSS). The secondary outcomes were discomfort due to rhinitis, quality of life (QOL) and adverse events. The risk of bias and quality of evidence for all studies were appraised. The meta-analysis was done using Review Manager 5.3 software based on the random-effects model. The search identified 135 records after removal of duplicates. Following screening and review of the records, fifteen full-text articles were assessed for eligibility. Five trials involving 3,329 patients met the inclusion criteria. Bilastine was superior to placebo in improving TSS, NSS, NNSS, rhinitis discomfort score and QOL but has comparable efficacy with other OAHs in TSS, NSS, NNS, rhinitis discomfort score and QOL. There was no difference in adverse effects when bilastine was compared against placebo and other OAHs except for somnolence. Bilastine has fewer incidence of somnolence compared to cetirizine. The overall quality of evidence ranged from moderate to high quality. Bilastine is effective and safe in treating the overall symptoms of AR with comparable efficacy and safety with other OAHs except somnolence. Whilst bilastine has similar efficacy to cetirizine, somnolence is notably less in bilastine.

Foreign body in the tracheobronchial tree is an emergency commonly affecting the paediatric age group. A delay in diagnosis and removal may cause high morbidity and mortality. We report a case of a 1-year-6-month-old presenting with multiple peanuts aspirated into both lungs, ultimately resulting in death due to cardiopulmonary complications. The aim of the case report is to highlight the importance of thorough history-taking from parents, intraoperative suspicion of more than a single aspirated foreign body, and meticulous measurements taken to minimise extraction time.

Ingestion of foreign body is a very common reason for referral in otolaryngology practice. In most cases, it is removed in the clinic setting or under general anaesthesia. However, migratory foreign body in the throat is rare and can cause serious complications depending on the route of migration. We present a case of a migratory fish bone, which was found embedded in the right scalene muscle and was successfully removed through an external approach. The aim of this case report is to highlight the importance of a thorough history and physical examination in a patient with a foreign body in the throat, especially if the patient is still symptomatic and laryngo-oesophagoscopy findings are unremarkable. Imaging is vital to aid in the diagnosis and precisely locating the migrated foreign body eventually to avoid fatal complications.