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Objectives: The clinical variables that are predictive of aspiration pneumonia are not clear in the pediatric population. This study was conducted in order to identify the demographic, clinical, and radiological risk factors for the development of aspiration pneumonia in children referred to the dysphagia clinic.Methods: A retrospective analysis of medical records of 88 children referred to the dysphagia clinic who had undergone videofluroscopic swallow study (VFSS).Results: Oropharyngeal dysphagia was found in 61.3% (54 of 88). Incidence of aspiration pneumonia was 39.8% (35 of 88).Conclusion: Respiratory symptoms such as cough, choking, excessive secretions, and pharyngeal dysmotility other than aspiration in VFSS were not predictors of pneumonia. Infants and children with laryngotracheal anomalies, demonstrable aspiration in VFSS, and major cardiac illness are at risk of presenting with aspiration pneumonia. Whether gastroesophageal reflux disease (GERD) or esophageal dysmotility are causative of aspiration in the rest of the population needs to be investigated by future prospective studies.

The study considered the feasibility and impact of interdisciplinary telemedicine discussions in the management of post-treatment dysphagia in patients with head and neck tumors. This is a retrospective analysis of patients with persistent dysphagia after treatment for head and neck pathology, at an institute in India. The cases were discussed in the telemedicine meeting conducted between host institute and a second unit in the United States. A monthly meeting was organized, using an internet-based video conference system. The ongoing swallowing problems and management were presented, and through discussions, a plan for further management was formulated and carried out. The Functional Oral Intake Scale (FOIS) was measured before and after the implementation of the plan. Twenty-six patients were discussed, out of which, 22 were head and neck malignancies. The recommendations concurred with that of the host unit in 18, differed for three and additive in five patients. The pre-treatment mean FOIS was 1.46 with a standard deviation of 0.989 and post-treatment mean improved to 3.92 with a standard deviation of 1.809 (p < 0.0001). The present study supports the success of an interdisciplinary telemedicine meeting to manage difficult cases of dysphagia in head and neck. The outcome in terms of the FOIS score improved significantly after implementing them. In addition to the direct patient benefits, the meeting helped to facilitate interdepartmental collaboration between two units treating similar sets of patients across the globe, in specialized clinical areas like dysphagia management.

Background: Antenatal depression is associated with several adverse maternal outcomes, perinatal outcomes, lower academic achievements in adolescence, and future mental health problems for the mothers. Early identification and effective treatment of depression in antenatal women can also improve perinatal outcomes. Aim: This study aims to understand the prevalence of antenatal depression and anxiety disorder, along with associated factors, among antenatal women attending the outpatient clinic of the obstetrics department in a tertiary care hospital. Methods: A cross-sectional design was employed for determining the prevalence, while a case-control framework was used for analysis of the associated factors. Semi-structured sociodemographic pro forma, Patient Health Questionnaire (PHQ-9) Tamil version, and Generalised Anxiety Disorder (GAD-7) Tamil version were administered to antenatal women after obtaining informed consent. Those who scored above 10 points on the PHQ-9 or above 9 points on the GAD-7 were interviewed using the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview schedule, by a psychiatrist, for confirming the diagnosis. Results: In our sample, 22% of the participants were diagnosed with depression, and 23% with generalized anxiety disorder (GAD). Twenty-eight participants (13.4%) had both depression and GAD. Antenatal depression was associated with alcohol use in the spouse (P < 0.015), physical violence (P < 0.026), low perceived social support from the in-laws (P < 0.039), and pressure to have a male child (0.001). Antenatal GAD was associated with low perceived social support from the in-laws (P < 0.039) and pressure to have a male child (P < 0.041). Conclusion: The occurrence of depression and generalized anxiety disorder is high in antenatal women. Our study identified relevant psychosocial factors that may be potential targets to develop effective interventions.