Necrotizing pneumonia (NP) is a rare but serious complication that occurs after foreign body retention. We report a case of severe NP in an infant caused by foreign body retention in the airway with no choking history. After a timely tracheoscopy and effective antibiotic treatment, her initial clinical symptoms were alleviated. However, she subsequently exhibited pulmonary manifestations of necrotizing pneumonia. To reduce the risk of NP from foreign body aspiration, for patients with airway obstruction and asymmetrical opacity of both lungs, timely diagnostic bronchoscopic evaluation is essential.

BACKGROUND: Many organizations have suggested a minimum standard regarding pharmaceutical counselling for patients, which includes information about the name of the drug, the description the drug, the indication for use, how to use it, the method of treatment, precautions, adverse reactions, and any contraindications. Correspondingly, the World Health Organization (WHO) has recommended that pharmacists spend at least 3 min with each patient to provide counselling. This study aimed to evaluate the counselling practices of community pharmacists for both over-the-counter (OTC) and prescription-only medicines in the Bisha Health Directorate, Saudi Arabia.
METHODS: This was a cross-sectional study designed to evaluate simulated patient visits to observe real counselling practices of community pharmacies in the Bisha area; 73 pharmacies were visited. Two scenarios were used in this study. The first scenario was for a prescription-only medicine, and the second scenario was for an OTC medicine. The duration of counselling was recorded for every visit.
RESULTS: A total of 105 visits to the 73 pharmacies were conducted under the following scenarios: scenario 1 = 73 visits and scenario 2 = 32 visits. The average time for the simulation was 110 s for scenario 1 and 73.4 s for scenario 2. There was a statistically significant negative correlation between the duration of counselling and patient simulation visits that occurred in the morning (Spearman\'s rho = - 0.396, p = 0.001).
CONCLUSIONS: It was shown that patient counselling needs to be given greater emphasis in community pharmacies. In this study, the time spent for patient counselling failed to meet the minimum WHO standard. Thus, pharmacists must be encouraged to spend at least 3 min on patient counselling.

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OBJECTIVE: This study aims to investigate the inflential factors for visit time for tracheobronchial foreign bodies in pediatrics, and to shorten the time of diagnosis and reduce complications.
METHODS: A questionnaire survey was designed and conducted among the caretakers of children with tracheobronchial foreign bodies, and the related inflential factors for visit time were analyzed.
RESULTS: The visit time for tracheobronchial foreign body was correlated with the age of the child, the type of foreign body, the educational level of the caretaker, a history of foreign body aspiration were provided, an examination was performed during the visit, the anti-inflammatory and anti-allergic treatment, and transfer to a higher level hospital. Age, history of foreign body aspiration were provided, and anti-inflammatory and anti-allergic treatment were the independent inflential factors for the time of diagnosis (P < 0.05).
CONCLUSIONS: The visit time for tracheobronchial foreign bodies was affected by many factors. It is necessary to strengthen the publicity scope and intensity on health education for tracheobronchial foreign bodies in community doctors and parents, to shorten the time of diagnosis and reduce complications.

Much is known about racial and ethnic disparities in receipt of opioids for pain in emergency departments. Less is known about such disparities in the evaluation and management of pain in the outpatient setting.
Using the nationally representative National Ambulatory Medical Care Survey (NAMCS), we estimated disparities in visit time with physicians and opioid receipt in the outpatient setting. We focused on patients whose reason for visiting was abdominal pain or back pain. Our sample included 4,764 white patients, 692 black patients, and 682 Hispanic patients.
Back pain visits of Hispanic patients lasted 1.6 fewer minutes than those of white non-Hispanic patients (P = 0.04 for the difference). Black patients were 6.0% less likely than white patients to receive opioids for abdominal pain (P = 0.04 for the difference) and 7.1% less likely than white patients to receive opioids for back pain (P = 0.046 for the difference). Hispanic patients were 6.3% less likely than white patients to receive opioids for abdominal pain (P = 0.003 for the difference) and 14.8% less likely than white patients to receive opioids for back pain (P < 0.001 for the difference). Hispanic patients were more likely than white patients to receive nonopioids instead of opioids for both abdominal pain and back pain. Differences in opioid receipt did not narrow during the examined time period.
Identifying causes of racial and ethnic disparities in the evaluation and treatment of pain in the outpatient setting is important to improving the health and function of patients.