Inhalation of a foreign body into the respiratory passage can be a serious and sometimes fatal childhood accident. In this paper we analyse the management of 223 children with laryngo-tracheo-bronchial foreign bodies. Children below three years of age were found to be the most vulnerable. The majority of the patients were boys. Over a quarter of the patients did not present with a history of inhalation. Only 52 per cent reported within 24 hours of inhalation. Endoscopic removal was possible in all but nine cases. One hundred and forty eight (66.4 per cent) of the recovered foreign bodies were organic in origin, the majority of them being peanuts. In one hundred and five (47.1 per cent) the objects found their way into the right bronchial tree. There were two deaths. The modalities of diagnosis and management are discussed.

It is postulated that primary prevention as a practical policy in tackling RF and RHD can be recommended.

This study was performed to differentiate serologically between patients with hydatid disease which is active, and which has been successfully cured. A total. of 18 cases was included. Pre-treatment serum samples were collected before surgery or chemotherapy. Post-treatment serum samples were collected at various intervals (3 days, 7 days, 1 month, 6 months, 1 year and 2 years) after surgery or chemotherapy. These sera were tested for the presence of circulating hydatid antigen (CAg) by bacterial co-agglutination (Co-A) and counter-current immunoelectrophoresis (CIEP) tests, and for circulating hydatid antibodies (CAb) by indirect haemagglutination assay (IHA). Ten and eight sera, respectively, were positive out of 11 pre-operative and pre-chemotherapeutic sera tested for CAg by the Co-A and CIEP tests. Post-operative sera collected from these cases did not show any CAg by the CIEP test. However, CAg was detected by Co-A in three and four serum samples collected on the third and seventh day, respectively, after surgical removal of the cyst. However, the CAg levels in these post-operative sera showed a gradual decline by the seventh day and were completely absent in the serum specimens collected 1 month after surgery and 6 months after chemotherapy. All the post-operative serum samples except two, collected 2 years after surgical removal of the cyst, in seven cases of old hydatid disease, were negative for CAg by both the CIEP and Co-A tests. Unlike the CAg profile, no marked differences were noted between the CAb profile of the pre-and post-treatment sera, as shown by the IHA test. Even 1 year after surgery or chemotherapy, two sera showed a marginal decrease in their CAb titre. CAb at varying titres was still detectable in all seven serum samples from old cases of hydatid disease, even 2 years after surgical removal of the cyst. This study shows the value of serial pre-and post-operative or chemotherapy estimation of CAg by Co-A and CIEP as an index of cure or of continuing hydatid infection.

Corrosive strictures of the oesophagus are common and being long and dense frequently require surgical replacement of the oesophagus. Presently available techniques of oesophagocoloplasty are associated with a significant mortality and major morbidity, such as a high rate of ischaemic necrosis of the colon, cervical salivary fistula or oesophagocolic stenosis.A method of mid-colon oesophagocoloplasty using an isoperistaltic colonic segment from the midascending to the mid-descending colon is reported. The procedure was carried out in 33 patients. The conduit was placed retrosternally in 27 patients and subcutaneously in the rest. The essential steps of the procedure are simultaneous neck and abdominal dissection, near-total mobilization of the colon from the ileocaecal segment to the sigmoid colon and sequential clamping of ileocolic, right colic and usually the middle colic vessels leaving the left colic vessels as the major vascular pedicle. The divided ileum is used to pull the colon into position thus avoiding traumatization of the colon and leaving the whole length of the mobilized colon available for anastomosis. A wide side to side oesophagocolic anastomosis in the neck, resection and discarding of the bulky terminal ileocaecal segment after completion of the cervical anastomosis, closure of the terminal end of the colon and its placement adjacent to the hypopharynx and end to side cologastric anastomosis complete the procedure. There was no mortality and there was no instance of colonic necrosis. The procedure restored an ability to eat normal food in 93.9% of patients compared to only 39.2% of patients with bougienage.The major advantages of this procedure are a uniformly adequate length of colon, excellent vascularity, avoidance of a potentially ischaemic colonic end in the oesophagocolic anastomosis, with its attendant sequelae such as cervical fistulae or oesophagocolic stenosis, low incidence of complications and the possibility of easy correction of oesophagocolic stenosis should it occur after the procedure. Cervical fistulae occurred in 10 patients and spontaneously closed in nine. Cervical anastomotic stenosis occurred in only one instance. The functional results and complication rate reported here are superior to most other series of oesophagocoloplasty for corrosive strictures reported in the literature. The operation is technically easy and is a significant improvement on existing methods of oesophageal replacement.

Hydatid antigen was demonstrated for the first time in the urine of patients with hydatid disease by countercurrent immunoelectrophoresis (CIEP). The antigen was detected in the concentrated urine of 7 of 16 (43.75% positive) patients with surgically confirmed hydatid disease, 4 of 10 (40% positive) patients with ultrasound-proven hydatid disease (daughter cysts or prominent septation and hydatid sands demonstrated by ultrasound), and 8 of 14 (57.14% positive) patients with clinically diagnosed (presumptive) hydatid disease. No antigen was detected in the concentrated urine from 24 patients with parasitic diseases other than hydatid disease. However, antigen was detected in 2 (8% false positive) of 25 concentrated urine samples collected from healthy control subjects (blood donors and students). These result suggest that the detection of hydatid antigen in the urine by CIEP is a simple, rapid, and noninvasive method of diagnosis of hydatid disease.