9 year old swallow balls .......

[Cottonmouth]

S'pore girl, 9, punctured small intestine after swallowing 14 magnetic balls​

Magnets are not toys.
Irwan Shah |

June 07, 2022, 01:53 PM

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A nine-year-old girl in Singapore became ill for two weeks after ingesting tiny magnetic balls that constricted and punctured her small intestine.


A visit to the doctor did not uncover what was wrong initially and she subsequently got sicker.
The magnetic balls were sold as a toy.

Vomited green substance​

The girl vomited a green substance on May 9, 2022, and her parents brought her to the KK Women's and Children's Hospital.
The doctor there deduced that it was a viral infection and gave her antibiotics to consume, according to The Straits Times (ST).
However, the girl began vomiting again about one-and-a-half weeks later.
This time, she was taken to the Thomson Medical Centre around May 19.
By this time, she could not even stay upright and had to be wheeled in.
Her mother, 39, said her daughter was having trouble consuming liquids and had lost 3kg by then.

Finding the cause​

Nidhu Jasm, a paediatric surgeon at Thomson Medical Centre, attended to the girl.
According to Nidhu, she asked what the girl ate, and the girl's reply was that she was unable to eat and was always vomiting.
The girl went through an ultrasound scan at first, but the result was inconclusive.
The surgeon could only see diluted bubbles.
"We didn't actually find the cause, because magnets can't be picked up on an ultrasound scan," Nidhu told Mothership.sg.

X-ray revealed cause​

An X-ray scan was done and it revealed the cause: A total of 14 magnetic balls were found in the girl's small intestine.
Each ball measured between 3mm and 5mm in diameter.
"It was sticking right next to each other, so we knew they were magnets because only magnets do that," the surgeon explained.

Emergency surgery needed​

The girl was subsequently prepped and sent for a four-hour emergency surgery to remove the magnetic balls.
"It's like porridge, and then there's metal inside it. It's very easy to pull it out and they all come together because they're stuck," Nidhu said about the surgery.
Two stretches of her small intestine, measuring 3.5cm and 6.5cm, were also cut out because it was irreversibly damaged.
Nidhu also explained that instead of following the route through the small intestine, the magnets took a "shortcut" and were stuck to one another from different parts of the intestine.
This caused a blockage that led the girl to vomit.
The strength of the magnets also caused a hole in the small intestine.
According to ST's report, Nidhu said the magnets squeezing together will blow a hole in the intestine and it usually takes a week to 10 days to manifest.
Fortunately, the girl was diagnosed in time.
She was put on a liquid diet during the first two days after surgery and was switched to a diet consisting of porridge from the third day onwards.
The girl recovered smoothly.

Magnetic balls are dangerous​

The girl's parents bought the toy, containing 216 magnetic balls, from the e-commerce site Lazada for S$17, ST reported.
They were persuaded by the girl to get it as she said her friends played with such toys too.

Magnetic balls are sold at various prices on the e-commerce site, Lazada. Screenshot from Lazada's website.

Nidhu elaborated that these magnetic toys are hazardous and dangerous when ingested.
A coin or a plastic toy will not stick to each other and will eventually be discarded naturally, said Nidhu.
However, magnets will get stuck along the way and requires surgery to get them out from the body.



Enterprise Singapore previously issued an advisory back in September 2019 about the dangers of such magnetic toys.
They can still be bought with relative ease from any e-commerce websites, such as Lazada or Shopee.
"Magnets are unique, they are not toys," stressed Naidhu.
She also told ST that the magnetic balls might go missing without any parent noticing and causing alarm, as there were hundreds of them.
The girl's parents threw the magnetic balls away following the ordeal.

 

[Leongsam]

Vomited green substance​

The girl vomited a green substance on May 9, 2022, and her parents brought her to the KK Women's and Children's Hospital.
The doctor there deduced that it was a viral infection and gave her antibiotics to consume,

If the doctor deduced that the infection was caused by a virus why on earth did he prescribe antibiotics which does absolutely nothing against viruses.

This doctor should be struck off immediately.

 

[laksaboy]

If the doctor deduced that the infection was caused by a virus why on earth did he prescribe antibiotics which does absolutely nothing against viruses.

This doctor should be struck off immediately.

Because he gets paid with every prescription given out. That's how it is these days. For the doctors in Sinkieland, they've been reduced to drug pushers and CHAS whores.

 

[Cottonmouth]

If the doctor deduced that the infection was caused by a virus why on earth did he prescribe antibiotics which does absolutely nothing against viruses.

This doctor should be struck off immediately.

Must be from a fake degree India doctor.

 

[laksaboy]

A visit to the doctor did not uncover what was wrong initially and she subsequently got sicker.
The magnetic balls were sold as a toy.

Let's see which career politician starts agitating for the sale of certain 'toys' to be restricted or taxed. In the name of 'protecting the children'.

 

[Leongsam]

Because he gets paid with every prescription given out. That's how it is these days. For the doctors in Sinkieland, they've been reduced to drug pushers and CHAS whores.

Depending upon his diagnosis there are anti virals that can be prescribed to reduce symptoms or shorten the infection.

https://my.clevelandclinic.org/health/drugs/21531-antivirals

 

[sweetiepie]

If the doctor deduced that the infection was caused by a virus why on earth did he prescribe antibiotics which does absolutely nothing against viruses.

This doctor should be struck off immediately.

Need loctor @nayr69sg inputs.
My uncle think maybe the antibiotics was for secondarlee preventive measures.

 

[Leongsam]

Need loctor @nayr69sg inputs.
My uncle think maybe the antibiotics was for secondarlee preventive measures.

Why Doctors Prescribe Antibiotics—Even When They Shouldn’t​

Behavioral science-based strategies can help reduce inappropriate use​

© Getty Images

For many common infections, clear guidelines exist for when antibiotics should be used and when they should not. For example, antibiotics cannot cure viral illnesses like the flu or the common cold, so there is no benefit to taking them for these conditions. Further, unnecessary use of antibiotics puts patients at risk for avoidable adverse effects. And yet, inappropriate antibiotic prescribing continues to be prevalent in the U.S.

Recent research from the Centers for Disease Control and Prevention and The Pew Charitable Trusts shows that nearly 1 in 3 antibiotics prescribed at outpatient facilities—including physician’s offices, emergency departments, and hospital-based outpatient clinics—is unnecessary, amounting to 47 million prescriptions a year.

So why is there so much inappropriate prescribing of these lifesaving drugs? Many factors drive this unnecessary use, including:

• Patient satisfaction and pressure. Patients or their families may expect to get a prescription at an office visit, whether or not an antibiotic is necessary. And even when there is no expectation of antibiotics from patients or their families, doctors may think there is. Studies show that physicians can be affected by this pressure—real or perceived—and as a result are more likely to prescribe antibiotics.
• Time constraints. In outpatient settings, doctors often have limited time to see patients, diagnose their illnesses, and formulate a treatment plan. Interviews with doctors reveal that they may quickly prescribe antibiotics because they want to avoid lengthy explanations of why the drugs are not needed and because a shorter office visit allows them to see more patients. In at least one study of general practitioners, busier physicians who see more patients prescribed antibiotics at a higher rate than did their less busy colleagues.
• Decision fatigue. The process of repeatedly diagnosing and treating large numbers of patients may also affect a doctor’s capacity to make consistent prescribing decisions. This decline in decision-making abilities after having to make repeated treatment choices is known as decision fatigue and may contribute to inappropriate antibiotic use. For example, a recent study showed that as their workdays wore on, physicians became significantly more likely to prescribe antibiotics to patients with acute respiratory infections—conditions for which these drugs are only rarely recommended.
• Uncertain diagnoses. Patients with viral and bacterial infections often have similar symptoms—congestion, cough, sore throat—making it difficult for physicians to differentiate between the two in the absence of a diagnostic test. In these cases, doctors may go ahead and prescribe antibiotics because they perceive the risk of not prescribing them as greater than that from unnecessary antibiotic use.
• Assuming that other doctors are the problem. In some cases, even when doctors agree that antibiotic overuse is a major problem or know that the drugs are not appropriate for a specific condition, they may not think their individual practices, or those of peers in the same medical specialty, contribute significantly to the problem. Rather, studies show that physicians attribute inappropriate prescribing to other clinicians or blame other areas of medicine.

Understanding the underlying behavioral drivers that contribute to inappropriate antibiotic prescribing can help guide the development of effective antibiotic stewardship. And some researchers have already started integrating behavioral science techniques into stewardship strategies, with some encouraging findings.
For example, one study showed that physicians whose offices displayed a “commitment poster” explaining their pledge to follow guidelines for appropriate antibiotic prescribing and the reasons why the drugs are not always needed, had a 20 percent lower rate of inappropriate prescribing than those not displaying a poster. Other studies using interventions that target behavioral drivers have also shown promise. One required that doctors provide a justification in the patient chart when antibiotics were prescribed for conditions for which antibiotics are not indicated, and another ranked physicians based on their level of inappropriate prescribing (i.e., those with higher rates of inappropriate prescribing were told they were “not a top performer”). Both led to significant reductions in inappropriate prescribing compared with conventional approaches.

Deciding whether or not to prescribe an antibiotic can be a complex process, during which physicians are influenced not only by medical information, but also by their interactions with patients, the uncertainties that surround medical decision-making, and the organizational challenges of delivering care in busy outpatient settings. By understanding the factors that affect physicians’ antibiotic prescribing decisions and applying concepts from the social and behavioral sciences, inappropriate prescribing can be reduced—which in turn can reduce the threat of resistance.
David Hyun, M.D., works on The Pew Charitable Trusts’ antibiotic resistance project.

 

[sweetiepie]

Why Doctors Prescribe Antibiotics—Even When They Shouldn’t​

Behavioral science-based strategies can help reduce inappropriate use​

© Getty Images

For many common infections, clear guidelines exist for when antibiotics should be used and when they should not. For example, antibiotics cannot cure viral illnesses like the flu or the common cold, so there is no benefit to taking them for these conditions. Further, unnecessary use of antibiotics puts patients at risk for avoidable adverse effects. And yet, inappropriate antibiotic prescribing continues to be prevalent in the U.S.

Recent research from the Centers for Disease Control and Prevention and The Pew Charitable Trusts shows that nearly 1 in 3 antibiotics prescribed at outpatient facilities—including physician’s offices, emergency departments, and hospital-based outpatient clinics—is unnecessary, amounting to 47 million prescriptions a year.

So why is there so much inappropriate prescribing of these lifesaving drugs? Many factors drive this unnecessary use, including:

• Patient satisfaction and pressure. Patients or their families may expect to get a prescription at an office visit, whether or not an antibiotic is necessary. And even when there is no expectation of antibiotics from patients or their families, doctors may think there is. Studies show that physicians can be affected by this pressure—real or perceived—and as a result are more likely to prescribe antibiotics.
• Time constraints. In outpatient settings, doctors often have limited time to see patients, diagnose their illnesses, and formulate a treatment plan. Interviews with doctors reveal that they may quickly prescribe antibiotics because they want to avoid lengthy explanations of why the drugs are not needed and because a shorter office visit allows them to see more patients. In at least one study of general practitioners, busier physicians who see more patients prescribed antibiotics at a higher rate than did their less busy colleagues.
• Decision fatigue. The process of repeatedly diagnosing and treating large numbers of patients may also affect a doctor’s capacity to make consistent prescribing decisions. This decline in decision-making abilities after having to make repeated treatment choices is known as decision fatigue and may contribute to inappropriate antibiotic use. For example, a recent study showed that as their workdays wore on, physicians became significantly more likely to prescribe antibiotics to patients with acute respiratory infections—conditions for which these drugs are only rarely recommended.
• Uncertain diagnoses. Patients with viral and bacterial infections often have similar symptoms—congestion, cough, sore throat—making it difficult for physicians to differentiate between the two in the absence of a diagnostic test. In these cases, doctors may go ahead and prescribe antibiotics because they perceive the risk of not prescribing them as greater than that from unnecessary antibiotic use.
• Assuming that other doctors are the problem. In some cases, even when doctors agree that antibiotic overuse is a major problem or know that the drugs are not appropriate for a specific condition, they may not think their individual practices, or those of peers in the same medical specialty, contribute significantly to the problem. Rather, studies show that physicians attribute inappropriate prescribing to other clinicians or blame other areas of medicine.

Understanding the underlying behavioral drivers that contribute to inappropriate antibiotic prescribing can help guide the development of effective antibiotic stewardship. And some researchers have already started integrating behavioral science techniques into stewardship strategies, with some encouraging findings.
For example, one study showed that physicians whose offices displayed a “commitment poster” explaining their pledge to follow guidelines for appropriate antibiotic prescribing and the reasons why the drugs are not always needed, had a 20 percent lower rate of inappropriate prescribing than those not displaying a poster. Other studies using interventions that target behavioral drivers have also shown promise. One required that doctors provide a justification in the patient chart when antibiotics were prescribed for conditions for which antibiotics are not indicated, and another ranked physicians based on their level of inappropriate prescribing (i.e., those with higher rates of inappropriate prescribing were told they were “not a top performer”). Both led to significant reductions in inappropriate prescribing compared with conventional approaches.

Deciding whether or not to prescribe an antibiotic can be a complex process, during which physicians are influenced not only by medical information, but also by their interactions with patients, the uncertainties that surround medical decision-making, and the organizational challenges of delivering care in busy outpatient settings. By understanding the factors that affect physicians’ antibiotic prescribing decisions and applying concepts from the social and behavioral sciences, inappropriate prescribing can be reduced—which in turn can reduce the threat of resistance.
David Hyun, M.D., works on The Pew Charitable Trusts’ antibiotic resistance project.

My uncle agree with the article. But my uncle will think more towards the seriousness of the sickness during the time of visits.
In this case was a punctured small intestine I.e verlee serious. Hence weighing by benefits should give antibiotics.

 

[LexLuthor]

Swallow balls ? Too young to be doing that, but great potential nevertheless.