Prevalence of Otolaryngological diseases in Nigerians

Background: To study the prevalence of Otolaryngological (ORL) diseases in a tertiary hospital.Methods: Five hundred patients that were first attendee at the ORL clinic of the Obafemi Awolowo University teaching hospital Ile-Ife were randomly selected from the clinic lists. The age, sex, presenting complaints, and the diagnosis were noted. Analysis of the data were done using SPSS version 10.0Results: The age ranges of ENT clinic attendee were 10 days – 95years with a mean age of 30.5 ± 22.7years. There were 315 males and l85 females with a male to female ratio of 1.7:1. Diseases of the ear was the most common 51.8% (n=259), nasal and paranasal sinuses diseases accounted for 26% (n=130), pharyngeal diseases was found in 10.6% (n=53), laryngeal disease accounted for 3% (n=15). Oral cavity lesions were seen in 1.4%. (n=7) and Head and Neck tumors were found in 7.2% (n=36) these were made up of malignant (n=30) and benign (n=6) tumors.Conclusion: Ear diseases were the most in this work and oral cavity lesions being the least common. The peak age incidence was in the 0-9years. There is a need for manpower development in otological and paediatric otolaryngological surgery

Tongue Entrapment in an Aluminium Milk Can: An Unusual Cause of Tongue Injury

Peri-oral injuries are common findings in paediatric patients; however, tongue injury following entrapment in bottles and cans is rare and has not been reported in our locality. A case of a 9- year old previously healthy female child who got her tongue tightly entrapped in an half opened aluminium milk can while in school is hereby presented. This case highlights the result of careless and often dangerous play and misadventures of children and the challenge of management. It calls for vigilance and close supervision of children by caregivers at home and at school. Early presentation, immediate intervention and treatment can prevent grave consequences

Etiological Profile and Treatment Outcome of Epistaxis at a Tertiary Care Hospital in Northwestern Tanzania: A Prospective Review of 104 Cases.

Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania. This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15. A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%. Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre

Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania

<p>Abstract</p> <p>Background</p> <p>Road traffic crash is of growing public health importance worldwide contributing significantly to the global disease burden. There is paucity of published data on road traffic crashes in our local environment. This study was carried out to describe the injury characteristics and outcome of road traffic crash victims in our local setting and provide baseline data for establishment of prevention strategies as well as treatment protocols.</p> <p>Methods</p> <p>This was a prospective hospital based study of road traffic crash victims carried out at Bugando Medical Centre in Northwestern Tanzania between March 2010 and February 2011. After informed consent to participate in the study, all patients were consecutively enrolled into the study. Data were collected using a pre-tested questionnaire and analyzed using SPSS computer software version 15.0.</p> <p>Results</p> <p>A total of 1678 road traffic crash victims were studied. Their male to female ratio was of 2.1:1. The patients ages ranged from 3 to 78 years with the mean and median of 29.45 (± 24.22) and 26.12 years respectively. The modal age group was 21-30 years, accounting for 52.1% patients. Students (58.8%) and businessmen (35.9%) were the majority of road traffic crash victims. Motorcycle (58.8%) was responsible for the majority of road traffic crashes. Musculoskeletal (60.5%) and the head (52.1%) were the most common body region injured. Open wounds (65.9%) and fractures (26.3%) were the most common type of injuries sustained. The majority of patients (80.3%) were treated surgically. Wound debridement was the most common procedure performed in 81.2% of the patients. The complication rate was 23.7%. The overall average length of hospital stay (LOS) was 23.5 ± 12.3 days. Mortality rate was 17.5%. According to multivariate logistic regression analysis, patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with long bone fractures stayed longer in the hospital and this was significant (P < 0.001) whereas the age of the patient, severe trauma (Kampala Trauma Score II ≤ 6), admission Systolic Blood Pressure < 90 mmHg and severe head injury (Glasgow Coma Score = 3-8) significantly influenced mortality (P < 0.001).</p> <p>Conclusion</p> <p>Road traffic crashes constitute a major public health problem in our setting and contribute significantly to unacceptably high morbidity and mortality. Urgent preventive measures targeting at reducing the occurrence of road traffic crashes is necessary to reduce the morbidity and mortality resulting from these injuries. Early recognition and prompt treatment of road traffic injuries is essential for optimal patient outcome.</p

Citywide Trauma Experience in Mwanza, Tanzania: A Need for Urgent Intervention.

Trauma remains a leading cause of morbidity and mortality in resource limited countries. There is paucity of published reports on trauma care in Tanzania, particularly the study area. This study was carried out to describe our experiences in trauma management outlining the etiological spectrum, injury characteristics and treatment outcome of trauma patients at our local setting and compare our results with those from other centers in the world. A descriptive prospective study of trauma patients was conducted at Bugando Medical Centre from April 2010 to March 2012. Statistical data analysis was done using SPSS software version 17.0. A total of 5672 trauma patients were enrolled in the study. The male to female ratio was 2.3: 1. The majority of patients were in the 2nd decade of life. Road traffic accident was the most common cause of trauma accounting for 60.7% of cases. The majority of patients (76.6%) sustained blunt injuries. Musculoskeletal (68.5%) and head/neck (52.6%) were the most frequent body region injured. Soft tissue injuries (open wounds) and fractures were the most common injuries accounting for 82.8% and 76.8% respectively. Majority of patients (74.4%) were treated surgically with wound debridement (94.0%) being the most frequently performed procedure. Postoperative complications were recorded in 31.5% of cases.The overall median duration of hospitalization was 26 days (range 1 day to 144 days). Mortality rate was 16.7%. Patients who had polytrauma, burn injuries and those who had tetanus and long bone fractures stayed longer in the hospital and this was statistically significant (P < 0.001), whereas the age > 65 years, severe trauma, admission Systolic Blood Pressure < 90 mmHg, presence of tetanus, severe head injury, the duration of loss of consciousness, the need for intensive care unit admission and finding of space occupying lesion on CT scan of the brain significantly influenced mortality (P < 0.001). Trauma resulting from road traffic accidents remains a major public health problem in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of road traffic accidents is necessary to reduce the incidence of trauma in this region

Epistaxis in Nigerians: A 3-year experience

Background: Epistaxis is a common symptom encountered in otolaryngological practice.This study was aimed at analyzing the aetiology, treatment and management outcome of the patients who presented with epistaxis at Obafemi Awolowo University Teaching Hospital, Ile – Ife, Nigeria.Methods: This is a prospective study of all consecutive patients that presented with epistaxis to our emergency rooms and ENT clinics from January 2003 to December 2005. Evaluation of patient included a detailed history taking and clinical examination. Control of epistaxis was obtained by treatment ranging from cauterization, anterior nasal packing to arterial ligation. Analysis was done using SPSS11.Results: A total of 106 patients who had on-going epistaxis were enrolled for the study. Eighty- two (77.4%) were male and 24 patients (22.6%) were female. Peak age incidence was in the age group 21- 40 (53.8%). Epistaxis was less common in the extremes of life. The most common aetiology was trauma (70.8%) Others included nasopharyngeal carcinoma, sinonasal carcinoma, sinusitis and allergic rhinitis. Majority of the patients (79.1%) were managed by nasal packing. All patients with atraumatic epistaxis (29.2%) had previous history of nasal bleeds. Blood transfusion was needed for 20 (18.9%) patients. The complication and mortality rates as a result of epistaxis were 1.9% (2 patients) and 0.9% (1 patient) respectively. Mean hospital stay was 5days ± 2.68.Conclusion: Most epistaxis patient can be managed by a non-interventional method. Surgical Interventional treatment should only be used following failure of adequate non-interventional treatment. Complication rate was low

Aetiology of vertigo in a Nigerian tertiary health facility, a multidisciplinary approach

Background: Vertigo is one of the most challenging problems faced by the otolaryngologist in every day practice. The aim of this study is to investigate the aetiology, and the clinical course of vertigo in our setting. Materials and methods: Forty-six consecutive patients attending the ENT Clinic of a Nigerian tertiary health institution with the chief complaints of vertigo were prospectively studied. The patients' history, clinical examination, the results of the laboratory investigations as well as the diagnostic imaging findings and the treatment modalities were reviewed. The patients were followed up for a minimum of 24 months.Results: There were 27(58.7%) males and 19(41.3%) females. The incidence of Vertigo was found to increase with age with a peak incidence in the 6th decade of life. The aetiologies of vertigo were found to be: Infectious diseases of the ear in 9(19.6%), Neoplasm 8(17.4%), Menieres 8(17.4.3%), Metabolic diseases 5(10.9%), while vascular disorders were found in 4(8.7%). Trauma occurred in 4(8.7%), Ocular pathology in 3(6.5%), while Vestibulotoxicity was found in 2(4.3%). Others include, Psychogenic causes in 2(4.3%) and vestibular neuronitis was the least found in 1(2.2%) of the patients. Laboratory investigations were unremarkable in all of the cases. Fasting blood sugar was found to be elevated in one of the patients with Diabetes and VDRL tests was found to be positive in the only patients with Otosyphilis. Electrocardiography (ECG), Vanyl Mandelic Acid (VMA), and thyroid function tests were normal in those patients where these investigations were indicated. Radiological investigations were helpful in detecting Temporal bone and cerebello-pontine angle tumours. Treatment consisted of labyrinthine sedative, the treatments of the primary cause and physiotherapy. Mortality was found in 2.2% of the patients. Conclusion: Infective ear diseases, Menieres' and neoplasms were found to be common. Vertigo in our centre represents an extremely broad spectrum of diagnosis. A thorough and a multidisciplinary evaluation of a vertiginous patient in a tertiary centre is hereby advocated.Keywords: vertigo, tertiary health institution, Nigeria Nigerian Journal of Otorhinolaryngology Vol. 2(2) 2005: 54-5