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

Relationship between dietary habits and nutritional status among adolescents in Abuja municipal area council of Nigeria

Background: Dietary intake assessment is essential to understanding the nutritional status. Healthy eating pattern promotes optimal health, growth and intellectual development and prevents diseases, while poor dietary eating choices may cause malnutrition.Aims: To determine the dietary eating patterns and nutritional status among adolescents in secondary schools within Abuja Municipal area council (AMAC).Subjects and Methods: crosssectional among adolescents, 10 – 19years in secondary schools within AMAC, Nigeria. Using a multistage stratified sampling technique, four urban and four rural schools, 1550 students, were enrolled. Subject’s bio data, dietary habits and knowledge of nutrition and general physical examination were obtained. Dietary assessment included intake of main meals (breakfast, lunch and dinner), skipping meals; methods used to control weight in the previous 30days; knowledge and preference of a balanced diet and food choices. Subject’s height and weight and Body Mass Index (BMI) were determined using the 2007 WHO charts. Data was analyzed using SPSS version 17 statistical package and p value less than 0.05 was significant.Results: 1550 students were recruited, males 688 (44.4%) and females 862 (55.6%); mean age 14.43±1.94 years. Of the 780 urban adolescents, 502 (64.4%) were of upper class and 68 (8.7%) lower class; and of the 770 (49.7%) rural, 206 (26.8%) and 232 (30.1%) belong to upper and lower class respectively, p=.000. Stunting 174(11.2%) and overweight 195(12.6%) were the major forms of malnutrition recorded. Food preferences was based mainly on good taste in 546 (35.2%), balanced diet 530 (34.2%); and 539 (34.8%) had good nutritional knowledge of a balanced diet. Five hundred and forty six (35.2%) admitted to taking carbonated drinks within the previous 7days and 147 (9.5%) missed breakfast, lunch and supper as single meal. Breakfast only was skipped by 71(4.6%) while 160 (10.3%) took lunch outside the home. The methods used to control weight were eating less food or fats, fasting, use of diet pills, inducing vomiting/use of laxatives. Skipping meals and taking meals outside the home was significant for the sex, (p value <0.05), school setting (p value .000) and the infrequent intake of fruits/ vegetables (p value .025). Those that skipped meals showed significant stunting (p value .009), while those who took fruits and vegetables infrequently had significant wasting (p value .049).Conclusion: poor dietary habits were identified among the adolescent. Malnutrition especially stunting and wasting was identified among those that skipped meals and took little fruits and vegetables.Key words: dietary habits, adolescent, urban, rural, prevalence, nutritional status, carbonated drinks

Assessment of the living conditions of rural based people living with HIV/AIDS with clinical presentations in Nigeria

Objective: To describe the living conditions of rural based people living with HIV/ AIDS (PLWHA) and their clinical presentationsDesign: Descriptive cross-sectional studySetting: University College Hospital, IbadanSubjects: PLWHA on anti-retroviral therapyResults: One hundred and fifty PLWHA participated. The mean age of the respondents was 28.7±8.9 years. Majority of the respondents visited had advanced disease (97%), were poor (75%) and presented with opportunistic infections such as oral candidiasis (92%), chronic diarrhoea (70%) and pulmonary tuberculosis (46%). Majority were treated for malaria (72%) and anaemia (61%). All respondents lived in homes predisposed to these opportunistic infections. They drink unsafe water and had poor disposal of their domestic wastes.Conclusion: PLWHA visited lived in homes that predispose them to various opportunistic infections. Improved living conditions and economic empowerment will improve the health conditions of PLWHA

Paediatric Otorhinolaryngological, Head and Neck Procedures in a Nigerian Tertiary Health Care Centre

Background: There is wide spectrum of paediatric otorhinolaryngology surgical conditions affecting children in developing countries. Paediatric otolaryngological surgical procedures represent a major part of all otolaryngology surgeries in developing countries. This study aimed at determining the prevalence, sociodemographic features, types of ear, nose, throat, head and neck surgical procedures, outcomes and associated complications in our center. Patients and Methods: This was a retrospective hospital based study of otorhinolaryngologic paediatric procedures. The study was carried out from August 2013 to July 2018. Data for this study was obtained from the medical record department, ENT clinic operation booking register for both minor and major surgery and theatre operation register. Data obtained were collated, documented and statistically analyzed using SPSS version 18.0. Results: Prevalence of paediatric otorhinolaryngology, head and neck procedures was 20.1%. Clinic and theatre procedures accounted for 86.7% and 13.3% respectively. Elective and emergency procedures constituted 81.8% and 18.2% respectively. There were 57.2% males with male to female ratio of 1.5:1. Otologic procedures accounted for 57.2% out of which otologic foreign body removal occurred in 20.2%. Sinonasal procedures occurred in 24.8% from which sinonasal foreign body removal occurred in 18.9%. Paediatric throat procedures occurred in 16.0% out of which adenoidectomy was performed in 6.8%. Head and neck procedures accounted for 1.9% and commonest of these was lymph nodes biopsy in 0.9%. Minor procedures in 86.7% were commoner than major procedures in 7.2%. Commonest complication from paediatric otorhinolaryngology procedures was wound infection 4.0%. Conclusion: Paediatric otolaryngology, head and neck surgical procedures are common encountered in our practice. The prevalence in this study was 20.1% with otological surgical procedures been the commonest. There are associated complications as well as greater level of our patient’s satisfaction

Otorhinolaryngological Manifestation of Allergy in South Western Nigerian Children

Background: Allergy is a systemic, chronic and recurrent disorder of otorhinolaryngological importance. This disorder is often neglected with late presentation in paediatric age group. This study aimed at determining the prevalence, sociodemographic features, trigger factors, clinical features, complications, quality of life, associated comorbid illnesses and treatment outcome among children. Materials and Methods: This was a prospective hospital based study of children with allergy in our center. The study was carried out over a period of one year from May 2017 to April 2018. Data were obtained by using pretested self-administered questionnaire. Data obtained were documented, collated and analyzed by using SPSS version 18.0 Results: Prevalence of allergy in this study was 8.6%. There were 60.2% male with male to female ratio of 1.5:1. There was positive family history of allergy in 55.9% patients. Perennial allergy was the commonest in 68.3% of the children. Major forms of allergens were 71.5% inhalant and 9.7% ingestant. The common self-reported trigger factors were dust, cold weather and smoke in 58.1%, 41.9% and 22.0% respectively. Major associated comorbid illnesses in this study were 43.5% adenotonsillar hypertrophy. Commonest allergic symptoms were runny nose in 38.7%. The commonest affected organ was nose in 46.8%. Commonly affected quality of life was 22.6% irritability, 20.4% absenteeism, 19.9% sleep disruption and 12.9% impaired social life. Common complications were 48.9% secondary infection, 46.2% otitis media/externa, 44.1% injury, 42.5% foreign body impaction and 40.3% pharyngitis. Treatment of allergy leads to improvement and recovery from the clinical features in 52.2%. No significant improvement in 47.8%. Conclusion: Allergy is a systemic disease affecting ear, nose and throat. It affects all paediatric age group with associated comorbid illnesses, complications and affectation of quality of life at presentation in majority of the patients

The Chronic Discharging Ear in the Tropics: A useful management guide for primary care physicians

BackgroundEar discharge is a common encounter in otorhinolaryngology clinics in the tropics. It is particularly prevalent in developing countries with the under-five being mostly at risk. Primary care physician are often the first point of call and major source of referrals. Although, ear discharge is both a symptom and sign of disease but not a diagnosis; accurate diagnosis and initial management and/or promptness of referral decision by the primary care physician have a bearing on the outcome. There are many areas of controversies, insufficient evidence and limited knowledge about inflammation and infection of the ear and how they can be treated in the face of rising bacteria resistance to antimicrobial agents. Nevertheless, little has changed in the core principle of management and indications for referral to the otorhinolaryngologist. We review current literature and published peer reviewed studies in Medline, Embase, PubMed, and Cochrane Database of systematic reviews for articles in English language to highlight the clinical features and possible management of the (non-wax, non-CSF) discharging ear where resources are deficient.Keywords: ear discharge, primary care, tropics, otitis media, otitis externaSavannah Journal of Medical Research and Practice 2017;6(2):01-0

Grassroots Women Empowerment and Participation in Fish Farming: A Survey of Women in Selected Communities in Lagos State, Nigeria

In Lagos State, serious emphasis have thus been placed on women empowerment through fish farming entrepreneual scheme that simultaneously address households food security and poverty challenges. The study covered two grassroots fishery communities (Epe and Badagry). These communities were purposively selected. 102 women fish farmers were drawn from the two communities with simple random sampling. Also, 14 women fish farmers were purposively selected for focus group discussion (FGD) in each of the communities. The result shows that a considerable majority of the women engaged in full-time fish farming; in addition to their traditional fish processing and marketing roles. The women now increasingly share their families’ economic burden. The test of hypothesis shows that a significant relationship does exist between the women income generated from fish farming and their participation in family decision making process. The study recommends agricultural loan (credit) facilities that could help the women to expand their fish farming enterprises. Institutional supports of the extension agents are other capacity building mechanism required to invigorate the fish farming entrepreneurial scheme for socio-economic empowerment of the women at the grassroots

Vagal cervicomediastinal neurofibroma in neurofibromatosis type 1 mimicking pulmonary tuberculosis in infancy: a case report

No Abstract. Nigerian Journal of Paediatrics Vol. 31(4) 2004: 140-14