This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children.

Introduction The 31-day target in urgent suspicion of cancer (USOC) referrals fast-tracks patients through the cancer pathway. Local anaesthetic (LA) biopsy can be performed during an outpatient clinic and may improve pathway times. The aim of this study was to compare LA biopsy in head and neck USOC referrals with the traditional general anaesthetic (GA) pathway. Methods This was a retrospective cohort study of USOC referrals to the NHS Greater Glasgow and Clyde head and neck multidisciplinary team between 1 June 2018 and 28 December 2000, and compared pathway times in LA and GA biopsies. Results The mean number of days from clinic to biopsy was 4.4 in the LA group and 28.0 in the GA group. This was significantly faster in the LA biopsy group (p < 0.05). The overall pathway time in the LA and GA biopsy groups was 35.7 and 61.5 days, respectively, and was significantly faster in LA biopsy group (p < 0.05). Conclusions The LA cohort had significantly faster pathway times compared with GA biopsy. LA biopsy requires careful patient selection, but is an effective alternative to GA biopsy in the appropriate patient group.

Tonsillectomy is the most common operation in children in the UK, with 37 000 procedures performed between 2016 and 2017 in the UK. 1 With such a common procedure, it is important to ensure parents and patients are correctly informed of the risks involved.Personal and departmental audit data are important, of course, but in order to produce reliable estimates of uncommon complications, very large data sets are required.National audits and registries have produced useful data based on large numbers of cases, 2-5 but they rely on surgeons completing data forms for each case, and this inevitably means that some data will be lost, particularly follow-up data on complications such as readmissions and bleeds. Studies based on routine health service data 6-8 may be more complete as long as the coding of hospital episodes is accurate.Though data exist on the risks of tonsillectomy in children, the quality of the data varies. Estimates of risk for rare events such as death rely on large amounts of data, so additional studies are always useful.The purpose of this study was to produce estimates for the most important complications of tonsillectomy in children, namely readmission to hospital, surgical arrest of haemorrhage, blood transfusion and death, based on national, routinely collected data from Scotland, in order to inform decision-making in clinical practice.

AimsSub-optimal nutrition among children remains a problem across South Asia (SA). Appropriate complementary feeding practices (CFP) can greatly reduce this risk. We aimed to undertake a systematic review of studies assessing CFP in SA children aged 0– 2 years in Bangladesh, India and Pakistan.MethodsSearches undertaken between January 1990 to June 2016; MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity and Infant Care, BanglaJOL, Cochrane Library, CINAHL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CFP in SA children aged 0–2 years and/or their families. Search terms were: ‘children’, ‘feeding’ and ‘Asians’ with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).ResultsFrom 45,712 studies identified, 126 descriptive studies (105 cross-sectional, 11 cohort, 8 qualitative, 1 case-control and 1 mixed studies) were included. 73 from India, 17 Pakistan and 36 Bangladesh. Despite each adopting WHO Infant and Young Children Feeding (IYCF) Guidelines, CFP were sub-optimal in all three countries.In Pakistan, of 15 studies reporting CFP timings, 8 recorded timely initiation (between 6–9 months). Of those reporting dietary diversity, 3 of 9 studies met minimum dietary diversity requirements across 4 of 7 WHO IYCF food groups. 2 of 3 studies observed minimum meal frequency in over 50% of participants.In India 35 of 59 studies reported timely initiation of CFP. 7 of 9 studies noted minimum dietary diversity achieved between 10%–23% of the study population. 5 of 15 studies noted minimum meal frequency achieved between 25%–96% of the study population.In Bangladesh, in 13 of 36 studies timely initiation of CFP ranged from 42%–64%. 3 of 17 studies noted minimum dietary diversity achieved between 19.8%–57.7% of the study population. 1 of 7 studies noted minimum meal frequency achieved between 33%–81% of the study population.Influencing factors included poor education about CFP, cultural beliefs and socioeconomic variables.ConclusionThis is the first SR to evaluate CFP in infants in India, Pakistan and Bangladesh. There is a great need for revision of nationwide child health programmes and campaigns to change health and nutrition behaviour.

This case report presents an unusual case of chondrosarcoma arising from the cricoid cartilage of the larynx. Although these are commonly low-grade malignancies, this patient attended an outpatient respiratory clinic with acute airway obstruction, and went on to require a total laryngectomy due to the size of their tumour.