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  • ISSN: 2378-9409
    Current Issue
    Volume 5, Issue 1
    Case Report
    Amit Goyal, Sujoy Banik*, Harsh Sapra, and DhrubaLahkar
    Background: High flow nasal cannula (HFNC) has various physiological effects, mainly dead space washout, alveolar recruitment, more accurate FiO2 along with greater humidification and mucociliary function, during oxygen therapy. However, this high flow may act as a force against ciliary motion, interfering with the mucus expulsion.
    Case report: A 73 year old male with history of left lateral medullary syndrome, was admitted with acute infarct in posterior limb of right internal capsule. His chest X-ray (CXR) showed haziness in right lower lung zone and PaO2 was 72.4 mmHg. He was started on six liters of oxygen through face mask, antibiotics and antiplatelets.
    On day three, he had fall in SpO2 with PaO2 45.6 mmHg. Patient was put on HFNC with improvement in SpO2 98%, PaO2 73.7 mmHg.
    Next day, CXR showed complete collapse of right lung with SpO2 94%, PaO2 69.3 mmHg. Patient was intubated and bronchoscopic lavage was done showing secretions plugging distal airways. Repeat CXR was normal. Patient was later tracheostomized and weaned.
    Discussion: HFNC improves mucociliary clearance; however, its use can be hazardous in elderly patients with poor pulmonary defense due to weak cough. Our patient had poor cough owing to recurrent stroke and we assume that high flows may have worked as a force against ciliary motion, interfering with the mucus expulsion.
    Conclusion: Although HFNC has been successfully used for various conditions, we believe that more experience and data is required to identify the correct patient population and timing of escalation and de-escalation of therapy.
    Review Article
    Monmart Melanie, Doucet Jean, Kadri Nadir, and Zulfiqar Abrar-Ahmad*
    We describe a clinical case of a 69-year-old woman with severe hyponatremia, for whom an investigative review was performed, resulting in an extremely rare diagnosis which was the sinonasal teratocarcinosarcoma.
    Editorial
    Bienvenu Bongue*, David Hupin, and Nathalie Barth
    The therapeutic and preventive effects of physical activity on the general health of the elderly have been proven beyond doubt: stamina, balance, muscle strength (2), extension of the socializing network, improvement in quality of life, self-esteem, body image, mortality, life expectancy. Considered today as a treatment in itself, physical activity has shown how effective it is in primary, secondary and tertiary prevention even at a very advanced age. In a recent study, Raffin et al. [1],
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