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3 results

  • Routine saliva testing for the identification of silent coronavirus disease 2019 (COVID-19) in healthcare workers

  • Part of
  • Kevin Zhang, Affan Shoukat, William Crystal, Joanne M. Langley, Alison P. Galvani, Seyed M. Moghadas
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 10 / October 2021
    Published online by Cambridge University Press:
    11 January 2021, pp. 1189-1193
    Print publication:
    October 2021
    • Article
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      • Open access
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  • Objective:

    Current COVID-19 guidelines recommend symptom-based screening and regular nasopharyngeal (NP) testing for healthcare personnel in high-risk settings. We sought to estimate case detection percentages with various routine NP and saliva testing frequencies.

    Design:

    Simulation modeling study.

    Methods:

    We constructed a sensitivity function based on the average infectiousness profile of symptomatic coronavirus disease 2019 (COVID-19) cases to determine the probability of being identified at the time of testing. This function was fitted to reported data on the percent positivity of symptomatic COVID-19 patients using NP testing. We then simulated a routine testing program with different NP and saliva testing frequencies to determine case detection percentages during the infectious period, as well as the presymptomatic stage.

    Results:

    Routine biweekly NP testing, once every 2 weeks, identified an average of 90.7% (SD, 0.18) of cases during the infectious period and 19.7% (SD, 0.98) during the presymptomatic stage. With a weekly NP testing frequency, the corresponding case detection percentages were 95.9% (SD, 0.18) and 32.9% (SD, 1.23), respectively. A 5-day saliva testing schedule had a similar case detection percentage as weekly NP testing during the infectious period, but identified ~10% more cases (mean, 42.5%; SD, 1.10) during the presymptomatic stage.

    Conclusion:

    Our findings highlight the utility of routine noninvasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities.

  • The ancient practice of sutra neti leading to velopharyngeal stenosis: case report

  • H Tiwana, R S Virk, V Gautam
  • Journal:
    The Journal of Laryngology & Otology / Volume 133 / Issue 8 / August 2019
    Published online by Cambridge University Press:
    07 June 2019, pp. 730-732
    Print publication:
    August 2019
  • Background

    An ancient yoga technique called sutra neti, which is extensively used in India to keep the sinuses healthy, led to complete velopharyngeal stenosis in a 67-year-old male patient who presented with bilateral nasal obstruction, mouth breathing, anosmia and a change in voice.

    Method

    The patient was diagnosed by nasal endoscopy using a zero-degree Hopkins rod endoscope, and adhesions were released using coblation.

    Results

    The patient had post-operative alleviation of symptoms and a patent velopharyngeal inlet on examination.

    Conclusion

    Vigorous sutra neti can lead to velopharyngeal stenosis. Release of the stenosis is then required to cure the nasal blockade.

  • Flexible nasopharyngoscopy for fish bone removal from the pharynx

  • A. T. K. Choy, P. G. C. Gluckman, M. C. F. Tong, C. A. Van Hasselt
  • Journal:
    The Journal of Laryngology & Otology / Volume 106 / Issue 8 / August 1992
    Published online by Cambridge University Press:
    29 June 2007, pp. 709-711
    Print publication:
    August 1992

  • The use of flexible nasopharyngoscopy with biopsy forceps for the removal of fish bones found in the oropharynx and hypopharynx is described. One hundred and sixty-eight patients with ingested fish bones in the upper aero-digestive tract were studied over a 12-month period. Of these, 73 percent were removed per-orally, or by indirect laryngoscopy. Fifteen percent were removed using the fibreoptic nasopharyngoscope. Twelve percent required a general anaesthetic and rigid oesophagoscopy for removal of fish bones at or below the level of the cricopharyngeus muscle. The technique has proven to be quick, well tolerated and low in morbidity. It is invaluable in patients in whom indirect laryngoscopy is unsatisfactory.