Recurrent respiratory papillomatosis in Jos, Nigeria: Clinical presentation, management and outcome

Background: Recurrent respiratory papillomatosis is a benign neoplastic disease of viral aetiology which can have significant morbidity or mortality and presents great challenges in it management. This study evaluates our experience with the management of this disease.Methods: This was a 10 year retrospective review of 29 patients with histologically confirmed recurrent respiratory papillomatosis managed in the Jos University Teaching Hospital, Jos, Nigeria.Results: Twenty nine patients aged between 2 months and 45 years were studied. There were 21(72.4%) males and 8 (27.6%) females. The highest incidence (62.1%) was in children less than 10 years.The presenting features were hoarseness in all patients and dyspnea in 28 (96.6%) patients who had emergency tracheostomy. Twenty five (89.3%) patients were decannulated within 1 week. No patient had distal viral spread. Twenty three (79.3%) patients presented within 10 months of onset of symptoms and 6 (20.7%) patients after this period.All the patients had endoscopic surgical excision. The commonest site of lesions was the vocal cords in 16 (55.2%) patients and the anterior commissure in 13 (44.8%) patients. Recurrence occurred in 2 (6.9%) patients. No malignant transformation occurred.Conclusion: Conventional endoscopic surgical excision is safe and tracheostomy when needed is recommended in the  management of patients with recurrent respiratory papillomatosis

Experience with rigid esophagoscopy in jos, north-central Nigeria

Objective: Esophagoscopy whic hmay be done for either a therapeutic or diagnostic reason has remained useful in the management of esophageal diseases. This study evaluates our experience with rigid esophagoscopy with special emphasis on esophageal foreign bodies in our unit. Method: This is a six-year (January 2000 December 2005) retrospective review of cases of rigid esophagoscopy in the Ear,Nose andThroatUnit of our center. Results: Fifty-seven patients with ages ranging from 10 months 75 years were studied. There were 35 (61.4%) males and 22 (38.6%) females. Fifty-three of the patients (93%) had varying foreign bodies in the esophagus, 3 (5.2%) patients had carcinoma of the esophaguswhile 1 (1.8%) had pharyngeal pouch. The 0-10 year age group had the highest prevalence of esophageal foreign bodies (66.0%) with themiddle third of the esophagus been the commonest site of impaction (58.5%).Therewas no fatality recorded. Conclusion: Rigid esophagoscopy is a relatively safe procedure in trained hands and ideal environmentwith the necessary facilities in place.Keywords: Rigid esophagoscopy, Foreign bodies, Site of impaction

Nasopharyngeal Carcinoma: Managing Challenges in Jos, Plateau State, Nigeria

Introduction:NPC is an uncommon tumour the world over, but has a high prevalence rate in south-east Asia, some parts of the Middle East and North Africa. It has both racial and geographical variations. Common presenting symptoms include—Nasal, cervical, Otologic and Neurophthalmic. Patients presentation to health care facilities is usually late and thus with advanced disease. This study is set out to enumerate and highlight challenges with managing NPC in our centre.Method:A retrospective study, for a period of five years and is set out to look at challenges in managing NPC. Clinical and histological data of patients were reviewed. Patients with histologically confirmed NPC were included in the study and periods of symptoms before presentation, at presentation, first point of presentation, period between presentation and diagnosis, presenting symptom(s) and treatment modality were considered.Results:36 patients aged 11-80 years were reviewed with 24 males and 12 females, m:f (2:1). Major challenges seen were late presentation, long period between presentation and diagnosis, non- availability of treatment facilities in the tertiary health institutions, inability of the patients to afford and access treatment, thus resulting in poor compliance and outcome.Conclusion:Improved health care awareness is advocated for both health care providers and health care seekers regarding NPC. Adequate diagnostic tools and treatment facilities like radiotherapy should be available in all tertiary health centres to ensure improvement in survival rates. Keywords: - Nasopharyngeal Carcinoma, managing, challenges

Hypoglycaemic and Hypolipidaemic Effect of Extract of Lantana camara Linn. Leaf on Alloxan Diabetic Rats

Diabetes mellitus is a metabolic disorder with high prevalence worldwide and is a major medical concern. This study investigated the effect of extract and fractions of Lantana camara Linn. leaf on alloxan diabetes in rats. Phytochemical screening was carried out using standard qualitative procedures. The antidiabetic activity was evaluated using adult male albino rats induced with diabetes using 150mg/kg alloxan monohydrate. Daily oral administration of the extract and its fraction was via oral route for 28days.  Estimation of glucose and lipid profile of rats was done using specific laboratory kits. Weekly monitoring of fasting glucose level was done using microprocessor digital blood glucose meter and accompanying strips. Column and planar chromatography was adopted for isolation of bioactive compounds in the fractions. Detection spray tests were employed for identification of isolated compounds. Carbohydrates, cardiac glycosides, flavonoids, polyphenols, sterols, saponins, tannins and triterpenoids were present in the extract and fractions. The seventy percent ethanol extract, aqueous and n-butanol fractions of L. camara Linn .leaf exhibited significant (p<0.05) hypoglycaemic activity. Hypolipidaemic effect was also observed. Triterpenes were isolated from the aqueous and n-butanol fractions. The study provided evidence of antidiabetic action of extract and fractions of L. camara Linn. leaf . Triterpenes are possibly responsible for the hypoglycaemic activity. Triterpenes and sterols come with great hope for discovery of new drugs for treatment of diseases such as diabetes. Keywords: hypoglycaemia, hypolipidaemia, triterpenes

The challenges of managing malignant head and neck tumors in a tropical tertiary health center in Nigeria

s with 38/89 patients having cervical lymphadenopathy at presentation. Four (4.5%) patients were able to afford CT scan. Twenty eight deaths were recorded. Ten patients were lost to follow-up. CONCLUSION: The challenges faced in managing patients with head and neck malignant tumors in our environment are enormous but surmountable. Therefore urgent efforts should be made by health workers and government to ensure a better outcome for these patients

Frey Syndrome Complicating Parotidectomy: A Case Report And Review Of Literature

The parotid gland is one of the major salivary glands located on the face. It is commonly affected by diseases necessitating its surgical removal. The facial nerve is in intimate contact with this structure and can easily be damaged during operation on this gland. Parotidectomy is the surgical operation done to remove part or the whole of the parotid gland. There are several types of parotidectomies. These may be superficial, total, total conservative, radical or extended radical. A number of complications may ensue following this procedure. Frey syndrome is one of such complications but uncommon. It is therefore the aim of this paper to present this index case with a review of literature. Key words: Frey syndrome, Parotidectomy, Complication

Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria

Background: In developing countries, ear infections and deafness are usually neglected conditions due to insufficient funds, work force, facilities, and knowledge. This paper highlights the socio-economic burden of chronic suppurative otitis media on a northern Nigerian population with suggestions on ways to reduce this burden. Methods: Seventy-four patients presenting to the Otorhinolaryngology unit, Department of surgery, Jos University Teaching Hospital, Plateau state, Nigeria with chronic suppurative otitis media from June 2007 to May 2008 were evaluated for age, gender, occupation, otomicroscopy and audiologic findings, microscopy, culture and sensitivity results, cost of consultation, investigations and treatment, type of complications and the social impact on individuals. Results: Patients were aged 2 to 37 years (Mean age=9.23 years, SD=7.92). Forty-one (55.4%) patients were aged between 1 and 5 years. There were 8 (10.8%) students, 12 (16.2%) unskilled workers, 11 (14.9%) unemployed individuals and 2 (2.7%) professionals. Deafness was the commonest sequele. Minimum monthly wage was 7,500 ($47.5US). Initial cost of treatment per patient per year was 8,100 Naira ($51.3US) increasing to 73,100 Naira ($462.7US) if surgery and hearing aid was required. Eleven (15%) patients required surgery, only 2 (2.7%) patients could afford it. Four patients lost their jobs. Fourteen (18.9%) patients were lost to follow up. Conclusion: The estimated cost of treatment for chronic suppurative otitis media is higher than the monthly minimum wage for individuals in our environment where the cost of health care is the sole responsibility of the patient

Trade-Off between Steady-State Broadband Noise Levels and Time of Exposure for Zero Noise-Induced Hearing Loss

In this work expressions for damage risk criteria and trade-off between the sound pressure levels and times of exposure for zero noise-induced hearing loss were derived. The expression for the damage risk criteria was used to compute the criteria risk values at octave frequencies between 250Hz and 8000Hz for males and females. The expression for the trade-off was used to compute the maximum times of exposure for sound pressure levels from 65 dBA to 112 dBA. This trade-off between noise sound pressure levels and corresponding times of exposure obtained from this work were obtained from the damage risk criteria which were determined from empirical values. Results show that workers should not be exposed to noise levels that are more than 112 for more than one second if the workers’ hearing is to be conserved. The expression supports the Equal Energy Hypothesis (EEH) and the 3dBA exchange rate. Key Words: Trade-Off, Hearing Loss, Noise Levels, Broadband Noise, Induced noise