Otological manifestation of temporomandibular joint disorder in Ekiti, a sub-Saharan African country

Objective: To determine the prevalence, sociodemographic features, and clinical presentation of temporomandibular joint disorder in otorhinolaryngological practice. Methods: This prospective hospital-based study involved patients diagnosed with temporomandibular joint disorder in our institution’s ear, nose, and throat department. Data for this study were obtained from the patients using pretested interviewer-assisted questionnaires. Results: The prevalence of temporomandibular joint disorder in this study was 1.3%. The study population included 17 (26.2%) male patients with a male:female ratio of 1.0:2.8. Joint disorder accounted for 75.4% of all disorders, while both mastication muscle and joint disorder accounted for 21.5%. A majority of the patients (47.7%) presented between weeks 1 and 13 of the illness. Unilateral temporomandibular joint disorder accounted for 98.5% of all disorders. The main otologic clinical features were earache and a dull tympanic membrane in 100% and 35.4% of patients, respectively. Middle ear assessment revealed type A in 73.8% of patients and type B in 20.0% according to Jerger’s classification system of tympanometry. Most patients (81.5%) were referred by their family physician. All patients had undergone prehospital treatment prior to presentation. Conclusion: Temporomandibular joint disorder is a common presentation in medical practice. Common clinical features include ear, joint, and mastication muscle disorders

Five-year analysis of clinical presentations and predictors of stroke mortality in rural Southwestern Nigeria: A retrospective observational study

Introduction: Stroke mortality and its predictors are important outcome measures in stroke epidemiological studies and clinical trials. There is an observed paucity of data regarding the clinical presentations and predictors of stroke mortality in Southwestern Nigeria. Few available related studies have centred on hospitals in the urban and sub-urban areas; however, none in the rural settings. This study, therefore, focuses on the clinical presentations and predictors of stroke mortality at the adult Emergency Centre of a tertiary hospital situated in rural Southwestern Nigeria. Methods: A retrospective survey, using data form and standardized questionnaire, was used to study the patients admitted for stroke between January 2015 and December 2019. The data were analysed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: A total of 276 patients were studied. Their mean age was 67.3 ± 11.1 years. The most common clinical presentations were hemiparesis and cranial nerve deficit. The case of fatality was 10.1%. The predictors of stroke mortality were age ≥65 years [(AOR = 12.752; 95% CI: (1.022–159.190), p = 0.048)], Glascow coma score <8 [(AOR = 50.348; 95% CI: (7.779–325.866), p < 0.001)], uncontrolled blood pressure [(AOR = 23.321; 95% CI: (2.449–221.927), p = 0.006)], presence of atrial fibrillation [(AOR = 16.456; 95% CI: (2.169–169.336), p = 0.009)], convulsion [(AOR = 25.889; 95% CI: (2.374–282.296), p = 0.008)], heart failure [(AOR = 30.284; 95% CI: (3.265–256.347), p < 0.001)], and a repeat stroke [(AOR = 32.617; 95% CI: (2.410–441.381), p = 0.009)]. Conclusion: The 7-day fatality was 10.1%. The predictors of stroke mortality were poor Glascow coma score, uncontrolled blood pressure, atrial fibrillation, heart failure, convulsion and a repeat stroke. This study strengthens the argument on the higher prevalence of stroke and its mortality in rural Southwestern Nigeria. Our findings may provide an impetus for prospective research on this outcome

Otorhinolaryngologic, head and neck presentations among patients with chronic renal disease in a developing country

Background: Data on otorhinolaryngology and head and neck diseases in patient with chronic renal disease are rare in developing African countries. This study was aimed to determine the epidemiology and management of otorhinolaryngology and head and neck diseases among chronic renal disease patient seen in our tertiary health‑care facility. Materials and Methods: This was a prospective, hospital‑based study that was conducted in the ear, nose, and throat department in a Nigerian University Teaching Hospital. Informed consent was obtained, and pretested interviewers‑assisted questionnaires were administered to each patient. Otoscopy, indirect laryngoscopy, and rhinoscopy were carried out. Renal functions were assessed by routine urine analysis and biochemical tests. Audiological tests were carried out for hearing assessment. Data collected were collated and analyzed using the SPSS software version 20.0. Results: The prevalence of chronic renal disease in otorhinolaryngology practice was 1.1%. There were 67.9% male with a male‑to‑female ratio of 2.1:1. The duration of illness was more than 1 year in 39.6% of our patients. The most common presentation was 58.5% tinnitus, 34.0% neck pain, 28.3% nasal blockage, 28.3% sore throat, 26.4% rhinorrhea/epistaxis, 18.9%% pharyngeal wall nodularity, and 15.1% enlarged neck lymph node. The most common affected organ was the ear in 90.6%. Major diagnosis was sensorineural hearing loss, rhinosinusitis, pharyngitis, and cervical adenitis in 58.5%, 30.2%, 20.8%, and 7.5%, respectively. Hearing impairment occurred in 69.8% of the patients, out of which 43.4% were found to be mild hearing loss. Only 19 (35.8%) had dialysis, while 34 (64.2%) of them had conservatively treated. Conclusion: The prevalence of chronic renal disease in otorhinolaryngological practice was 1.1%, otological presentation was the most common in 90.6% of patients and 64.2% did well on conservative treatment. Avoidable otorhinolaryngologic complications among patients with chronic renal disease were noted. Periodic otorhinolaryngology referral for review and prompt management of this complication is advised

Pattern of Surgical Emergencies in Rural Southwestern Nigeria

Introduction: Considering the magnitude of deaths prevailing in the accident and emergency department (AED) in health facilities of sub-Sahara Africa, there is a need to have information on the burden of admissions and deaths due to surgical emergencies. Few studies in Nigerian hospitals in urban and suburban areas have been documented, but none in the rural setting. The objectives of this study were to ascertain the sociodemographic profile, causes and outcomes of admissions, and the pattern and causes of deaths due to surgical emergencies. Methods: A retrospective survey using a data form and a predetermined questionnaire was used to review the patients admitted for surgical emergencies at the AED of a tertiary hospital in rural southwestern Nigeria from January 2015 to December 2019. The data were analyzed using SPSS version 22.0. The results were presented in descriptive and tabular formats. Results: Surgical emergencies constituted 43.9% of all admissions. The mean age of admissions was 42 ± 16.9 years, and majorities were in the young and middle-aged groups. There were more males (66.4%) than females (33.6%). Trauma(60.9%) of which road traffic accident (RTAs)(56.0%), was the leading mechanism of trauma. The mortality rate was 5.4% and was caused majorly by RTAs (33.0%), diabetes mellitus foot ulcers (11.0%), and malignancies (9.8%). Conclusion: In this study, surgical emergencies constituted 43.9%, and a majority of the patients were male. Trauma caused by RTA is the most cause of admission. The mortality rate was 5.4%. This finding may provide an impetus for prospective research on this outcome

The Clinical Correlates And Self-Management Of Insomnia Among Patients Presenting In A Tertiary Health Institution, South West Nigeria

Background: Sleep has important biological functions that are essential for normal restorative, conservative and adaptive functions. The lack or inadequacy of it will alter these normal biological functions in man which may negatively affect various organs and systems. The knowledge of what people with insomnia are using will assist clinician on modality of approach in proper management Aim: To determine the clinical correlates of insomnia and self management among patients presenting with insomnia. Method: A descriptive cross sectional study of three hundred and seventeen adults selected through systematic random sampling technique. An interviewer administered questionnaire was used to collect the data. Result: The following clinical conditions were observed to have positive association with insomnia. This include Hypertension (X2 30.101; P value <0.001), Heart disease (X2 38.040; P value <0.001), Fall/Pains (X2 24.306; P value <0.001), Arthritis/Joint Pains (X2 28.359; P value <0.001), Depression (X2 25.277; P value <0.001), Other Psychiatric diseases (X2 42.639; P value <0.001). Over the counter medication has significant association with presence of insomnia but not with herbal usage (X2 33.399; P value <0.001). a larger proportion of insomniacs who were using over the counter medication have stopped its usage as the time of the study (X2 4.629; P value <0.039) Conclusion: Multiple clinical morbidities are associated with insomnia. The desire to improve the sleep quality and quantity of an insomniac, they tend to embark on self-management. Clinician with this understanding must therefore take proactive approach to find what type of self management the individual is using. This will help to inform, educate and counsel appropriately against dangerous steps and measures that may have been embarked upo

A 5‑year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria: A retrospective observational study

Introduction: In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED). Materials and Methods: A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats. Results: Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%. Conclusions: The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, and Systems-based practice

Blood pressure control and its associated factors among hypertensive patients in federal teaching hospital, ido- ekiti, Southwest Nigeria

Background: Hypertension is a modifiable risk factor for cardiovascular disease, stroke and renal disease worldwide. Despite improvement in treatment modality and therapeutic intervention, with proven benefits in reducing the burden of uncontrolled hypertension, majority of peoples’ blood pressure still remain uncontrolled.&nbsp;Aim: To assess the patterns of blood pressure control and its associated factors among hypertensive patients on follow-up.Setting: This study was done at the general out-patient department of Federal Teaching Hospital, Ido- Ekiti, Southwest Nigeria, which is a referral centre for private and government owned - health facility in the state and its environs.Methods: Hospital-based cross sectional study was conducted from June 4 – August 31, 2019. Systematic random sampling method was used to select the 320 participants. Semi-structured interviewer- administered questionnaire was used to seek information on participants’ socio-demographic characteristics, lifestyle changes and level of adherence to antihypertensive medication. Blood pressure was measured and recorded. Data was analyzed using SPSS 20. Multivariate logistic regression analysis was used to identify the factors associated with poor blood pressure control.Results: Mean age of the participants was 63.9± 11.5 years. 56.6% had their blood pressure controlled within the recommended limits. In multivariate analysis, civil servant (OR =45.160, 95% CI: 6.143 – 332.000) and adherence to medication (OR=15.35, 95% CI: 6.303 – 37.391) were the independent associated factors with good blood pressure control while old age (OR= 0.894, 95% CI: 0.837- 0.955) and diabetes (OR= 0.072, 95% CI: 0.016-.0,318) were independent associated factors with poor blood pressure control.Conclusions: Old age and diabetes are the predictors of poorly controlled blood pressure and therefore, clinicians and other stakeholders should provide close attention and targeted blood pressure control among this set of patients.</p

Psychological Well-Being of Adolescents in South Western Nigeria: Its Association with Sociodemographic Characteristics and Perceived Food Insecurity

Psychological well-being (PWB) which is a measure of life satisfaction in adolescence plays a great role in their behavioral lifestyle. The aim of this study was to assess the adolescents’ psychological well-being, its association with perceived food insecurity, and their sociodemographic characteristics. Using multistage random sampling, 352 students from three secondary schools in Ado Local Government in Nigeria were recruited. A self-administered questionnaire adapted from existing literature was used for data collection. About fifty-six percent of the adolescents had high psychological well-being. Most of the students studied had a high estimate of themselves in their self-autonomy and personal growth development. While Tribe (p = 0.032), type of family (p < 0.001), present class (p = 0.039) and class repetition (p = 0.018) were significantly associated with psychological well-being of adolescents, most adolescents had a medium to high food insecurity. Self-autonomy and personal growth development in adolescents are associated with the type of family structure, the higher the social class of the family and the lower of the occurrence of repetition of a class shall be. A stable family environment is beneficial to adolescents

Prevalence, practice, determinants and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria: A community-based cross-sectional study

Objectives: Health hazards such as adverse drug reactions and prolonged morbidity are fallouts of self-medication among young people in sub-Saharan Africa. The aim of this study was to assess the prevalence, practice, determinants, and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria. Methods: This survey was a descriptive, cross-sectional study of 602 young people aged 16–24 years., who were randomly selected in the community. A predesigned self-administered questionnaire was used for data collection. The study was conducted from 1st March to 31st May 2023. The independent variables measured include the sociodemographic characteristics, while the dependent variables are the practice of self-medication and factors that predisposes to self-medication. The general characteristics of the participants were analyzed using descriptive statistics. The categorical variables were reported as frequency distribution and proportions with 95% confidence intervals and were compared using the Chi-square test or Fisher’s exact test. A p -value of <0.05 was considered statistically significant. Results: Over 30% (31.7%) of the participants engage in self-medication. A larger proportion of the people who practiced self-medication lived a trekking distance of less than 1 km from the nearest health facility with a doctor ( p  = 0.044). The practice of self-medication was statistically related with being a student when compared with gainfully employed and unemployed people ( p  = 0.006). Fever (39.8%), abdominal pain (17.3%) and headaches (16.2%) were the topmost three ailments that necessitated self-medication. Antimalarials (44.0%), antibiotics (25.1%), and antipyretics (16.8%) were high on the list of drugs used for self-medication. Headache (34.0%) was the most common adverse reaction from self-medication among the participants studied. Conclusion: Adverse reactions and drug addiction were negative fallouts of self-medication, which can affect the health of young people as they grow into adulthood. Therefore, monitoring of drug outlets must be taken seriously by government agencies to prevent the worsening of the negative effects of self-medication

Pattern of admissions and outcome in the children emergency department of a tertiary health institution in Southwestern Nigeria: A four-year review

Introduction: Pediatrics and adolescents are susceptible to illnesses that often necessitate emergency attention. Morbidity and mortality from illnesses in these ages have attracted much interest globally, particularly in Africa. Knowledge of pattern and outcomes of admissions may guide policy and interventions especially in resource constrained settings. The study aimed to determine the pattern of admissions, outcomes and seasonal variations of conditions that presented at the children emergency of a tertiary health institution over a four-year period. Methods: A retrospective descriptive study of children emergency admissions from January 2016 to December 2019. Information obtained included age, diagnosis, month and year of admission, and outcome. Descriptive statistics were used to describe the demographic characteristics and Chi-squared test to assess their associations with the diagnoses made. Results: There were 3,223 admissions. There were more males (1866; 57.9%) and more toddlers (1181; 36.6%). The highest number of admissions were observed in the year 2018 (951; 29.6%) and during the wet season (1962; 60.9%). There was an overall mortality rate of 7%; complicated malaria, gastroenteritis and meningitis were the leading causes of death. Malaria (χ2 = 135.522, p value < 0.001), and gastroenteritis (χ2 = 130.883, p value < 0.001) were predominant among the toddlers while sepsis (χ2 = 71.530, p value < 0.001) and pneumonia (χ2 = 133.739, p value < 0.001) were more among the infants. Typhoid enteritis (χ2 = 26.629, p value < 0.001) and HIV (χ2 = 16.419, p value = 0.012) were commoner among the early adolescents. Conclusion: The major causes of death in the study area are preventable with more of these amongst the children under the age of 5 years. There are seasonal and age-related patterns to admissions and the need for policy formulations and emergency preparations to be tailored towards these observed patterns through the year