Comparative Analysis of Salivary Glucose and Electrolytes in Diabetic Individuals with Periodontitis

Background : A high incidence of periodontal disease has been reported among diabetics, however the role of saliva in the occurrence of this oral disease in these patients is yet to be understood.Objective: To determine the effects of type-2 diabetes and periodontal disease on salivary flow rate and biochemical composition.Design: A prospective study involving 40 adult human subjects divided equally into four groups of diabetics with periodontitis (group 1), diabetics without periodontitis (group 2), non diabetics with periodontitis (group 3) and non diabetics without periodontitis (group 4).Methodology: Saliva samples were collected and analyzed for salivary glucose, total protein, calcium, sodium, potassium, chloride and bicarbonate. Salivary flow rates were also determined. Results: Salivary glucose and potassium levels were significantly higher (P = 0.002 and 0.04 respectively) in diabetic patients regardless of periodontal disease (mean = 100.7 ± 9.33 mg/dl; 111.5 ± 32.85 mg/dl and 23.79 ± 5.19 mg/dl; 22.9 ± 6.25 mg/dl respectively) compared with non diabetic participants (mean = 80.5 ± 30.85 mg/dl; 62.5 ± 31.89 mg/dl and 19.23 ± 5.04 mg/dl; 17.74 ± 4.68 mg/dl respectively). In contrast, there was no significant difference in saliva flow rates and levels of total protein, Na+, Ca++, Cl- and HCO3- between the groups.Conclusion: Salivary glucose and potassium levels were significantly higher among diabetics with or without periodontitis compared with non-diabetics with or without periodontitis. However, biochemical composition of saliva in diabetic individuals has probably little role in their susceptibility to periodontitis.Keywords: periodontitis, type 2 diabetes mellitus, salivary electrolytes, salivary glucos

Effect of Spinal Anaesthesia on Hearing Threshold

Background: Hearing loss following spinal anaesthesia is a known yet uncommonly reported complication. This study was aimed at determining the incidence and type of hearing loss (HL) following spinal anaesthesia (SA) and the relationship with the size of spinal needle.Methods: A prospective study of patients scheduled for spinal anaesthesia for surgery at the Operating room and Otorhinolaryngology department in a tertiary centre was undertaken. The audiometry was done and the pre- and post – anaesthesia results were compared.Results: Ninety – four ears of 47 patients, 16 males and 31 females, age range between 21 and 63 years (mean + SD= 41± 5) were included. The duration of anaesthesia was between 90 and 150 minutes (mean ± SD= 116+9). HL was seen in 9 ears of 7 patients (15%) and tinnitus in 14 ears. The preoperative and postoperative BC PTA were 10 – 45dB (mean ± SD= 26± 5) and 25 – 65dB (mean ± SD=38±5) respectively, (P= 0.02) while the preoperative and postoperative AC PTA in the early frequency range (0-100Hz) were between 5 – 45dB (mean ± SD= 20± 5) and 25 – 50dB (mean ± SD=25±7) respectively, (P= 0.08). There was significant difference in the mean BC PTA between those who had procedure less than 1 hour, 37.2dB and those greater than 1 hour 38.4dB, (P=0.004). According to the Quincke needle sizes, the mean BC PTA among those who had 26G and 27G were 37.4dB and 38.1dB respectively (P=0.2).Conclusion: HL complicating SA is significant and associated with duration of procedure thus should be included in informed consent for medico-legal and ethical reasons and measures must be taken to avoid the leak of cerebrospinal fluid

Assessment of quality of chloroquine tablets sold by drug vendors in Abeokuta, Nigeria

No Abstract. Tanzania Health Research Bulletin Vol. 8(1) 2006: 45-4

General and regional anaesthesia for the thyroidectomy in rural/semi-urban Nigerian centres

Objective: To evaluate the feasibility and benefits of regional anaesthesia (RA) for thyroidectomy in rural/semi-urban centres.Design: A prospective study.Settings: Missionary Hospital Saki,Nigeria and Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.Subjects: One hundred and seventy five patients with goitre.Results: The average time for the anaesthetists to put patients to sleep was 4.06±1.02 minutes, while it took 17.8±2.9 minutes to give the regional block. Post operative laryngeal complications in RA group were very minimal, while in general anaesthesia (GA) group, there were significant complications in 32 (36%) patients laryngeal oedema 15 (17%), erosions in 10 (11%) and ulcer in seven (8%). Cost of surgery in GA was thrice as much as in RA group. Thirty one (35%) with GA had steam inhalation for sore throat. It was possible to converse (laryngeal nerve monitoring) with the patient during operation but not possible with GA group. There was early discharge of patients in RA group.Conclusion: Regional/local anaesthesia is feasible for some cases of thyroidectomy with a lot of advantages and specifically allows surgeons to converse with the patients during operation -direct laryngeal and other nerve monitoring. Despite advancement in cuff design a lot of lesions still occur from endotracheal intubations

Microbiological and chemical assessment of spring water from a rural setting in Ondo State Southwest, Nigeria

Assessment of spring water from Ikare-Akoko, a rural setting in southwest, Nigeria for microbial and chemical contaminants was carried out. Total heterotrophic bacteria count of 4.0 x 106 CFU/mL was highest during the peak of the rainy season in Omi-idu spring (Igbede community) while the lowest population of 0.14 x106 CFU/mL was in Agadagidi spring (Ishakunmi community). The highest coliform population of 2.8 x 106 CFU/mL was at Isunpaiye (Oyinmo community), while the lowest value of 0.19 x106 CFU/mL was recorded at Agadagidi (Ishakunmi). The multiple tube fermentation technique was employed to determine the most probable number (MPN) of coliforms per 100 mL of water sample. The highest MPN/100 mL value of 76 ± 2.1 for coliforms was recorded at Isunpaiye while the lowest value of 5.1 ± 2.1 was in Agadagidi spring. Physico-chemical properties of the spring waters were mostly within the WHO benchmark for potable water. Arae had the highest total dissolved solids (TDS) value of 969 mgL-1 (benchmark, 500 mg/L), total hardness values were normal except at Arae (260 mg/L). Heavy metals levels in the spring water were generally low except in Omi-idu spring.Key words: Rural setting, spring water, heterotrophic bacteria, coliform bacteria, physico-chemical properties, heavy metals

Improvised venous canula myringostomy in acute otitis media: Analysis of outcome in Nigeris

Background: This case control study was based on the hypothesis that myringostomy done on an a bulging but inflamed tympanic membrane before perforation might improve healing of the middle ear and tympanic membrane, thus reducing the probability of progression to chronic suppurative otitis media.Our objective was to compare outcome of tympanic membrane healing in acute otitis media (AOM) patients who had myringostomy and those presenting with perforation and suppuration. In this study we also examined the suitability of a venous canula as an improvisation in the absence of conventional myringostomy tube.Methods: This prospective study, carried out in the Otolaryngology Unit, Department of Surgery, Federal Medical Center, Lokoja between February 2006 and August 2008, included consecutive AOM patients who presented with excruciating otalgia and bulging, hyperaemic tympanic membrane and another group with ruptured tympanic membrane both within 2 weeks duration. The patients with bulging tympanic membrane had venous canula myringostomy done in the local anaesthesia and the canula was kept in situ until the ear became dry and until the myringostomy site closed up. While the group with tympanic membrane perforation at presentation had ear suction toileting and daily ear dressing, until ear became dry. The 2 groups were followed up daily to determine duration of stay of the improvised myringostomy tube and the closure of the myringostomy site or tympanic membrane perforation and they were compared using Pearson’s correlation test at 0. 05 significance.Results: Subjects comprised of 42 AOM (15 males and 27 females (M: F = 1.7:3) and 26 with tympanic membrane perforation (11 males and 15 females), aged between 3 years to 48 years (mean+ SD = 13+ 6 years). Relief of otalgia was seen all the subjects in the myringostomy group (100%).The mean number of days to achieve dry ear after myringostomy tube was 3 days after myringostomy while it was 3 weeks in the perforation group (P = 0.002). The mean number of days to achieve closure of the myringostomy was 3.7 days after dryness while among the perforation group, it was 3 months (P= 0.000).Conclusion: Venous canula, which is cheap and readily available, could be an improvisation for myringostomy in AOM; and this aided early relief of otalgia, resolution of disease and significant reduction in treatment durations

Knowledge and care seeking practices for ear infections among parents of under five children in Kigali, Rwanda : a cross-sectional study

Background: Infections affecting the middle ear are a common childhood occurrence. Some cases may present with ear discharge through a tympanic membrane perforation which may heal spontaneously. However, up to 5% or more cases of those affected have persistent ear discharge. A number of barriers contribute towards delayed presentation at health facilities for treatment of ear infections. We conducted a study to evaluate parents’ and caregivers’ knowledge and care seeking practices for ear infections in children under five in Gasabo district in Kigali, Rwanda. Methods: Parents/guardians (n = 810) were interviewed using a structured questionnaire to elicit their knowledge of ear infections in children under five and their attitude to seeking care for their children. Results: The mean age of the respondents was 31.27 years (SD = 7.88, range 17–83). Considering an average of knowledge parameters which included causes, symptoms, prevention, treatment and consequences of ear infections, we found that 76.6% (622) of respondents were knowledgeable about ear infections. We defined a positive practice as seeking medical treatment (community health workers or health facility) and this was found in 89.1% (722) respondents. Correlating knowledge with choice of seeking treatment, respondents were 33% less likely to practice medical pluralism (OR = 0.33, CI 0.11–0.97, P = 0.043) if they were familiar with infections. Moreover, urban dweller were 1.7 times more likely to know ear infections compared to rural dwellers (OR = 1.70, CI 1.22–2.38, P = 0.002). Conclusion: The majority of respondents had good knowledge and positive attitudes and practices about ear infection. However, medical pluralism was common. There is need to improve the community’s awareness and access to primary health care facilities for the care of ear infections especially in rural areas of Rwanda

Otorhinolaryngologic emergencies in Nigeria, Sub-Saharan Africa: Implication for training

Background: The anatomy and function of the ear, nose and throat (ENT) make pathologies potentially catastrophic. Reports on the epidemiology of otolaryngologic emergencies put the prevalence at between 30 and 80%. There are however very few studies from the developing countries. This study was aimed at determining the magnitude and spectrum of otolaryngologic emergencies in a teaching hospital in a developing country in sub-Saharan Africa..Methods: This was a two year retrospective review done at the Department of Otorhinolaryngology in the University College Hospital, Ibadan, Nigeria. The clinical records of patients managed as emergencies between July 31, 2001 and 30 June, 2003, were reviewed and the biodata, diagnosis and treatment were extracted and analysed.Results: Emergencies constituted 22% of the 2544 cases reviewed. The top five diagnoses were recurrent otitis media (24%), foreign bodies in the orifices (21.0%), head and neck trauma (20%), epistaxis (16%) and chronic sinusitis (8.8%). Children accounted for over 40% of the study population, although there was a peak in the third decade due to trauma. More than 80% of the cases were referred by general practice doctors. Only 41% of the cases were managed surgically, the rest required only conservative treatment.Conclusion: The greater proportion of the cases referred as emergencies did not require surgical intervention and could have been managed conservatively by the referring doctors. It is recommended that the curriculum of otolaryngology posting for general practice trainees should be reviewed so as to increase the duration of exposure from the present one month. This will enable general practitioners to be more adept at instituting the conservative management of otolaryngologic emergencies