The continuing challenge of early detection of acute otitis media in children

Objective: The aim of the study is to highlight the clinical problem of acute otitis media in children as seen in Uyo with particular reference to difficulties of early detection over a 6 year period (1999-2004).Methodology: A six-year retrospective study (1999-2004) was carried out to evaluate the clinical presentation and early detection of acute otitis media in children. Case-notes of all children aged 2 weeks to 3 years who presented with ear aches and/or ear discharge of not more than 7 days were reviewed noting the symptoms that preceded the ear discharge and the treatment offered prior to presentation at the ENT Clinic.Results: A total of 273 children within the age range under review were seen with acute otitis media. 48.4% (132) were males and 51.6% (141) were females giving a M:F ratio of 1:1.2. Majority of the mothers (92%) actually reported to physicians while the rest (7.7%) visited chemists due to the early fever. All the mothers admitted to treating the children for malaria.Conclusion: Many clinicians consulted by children with febrile conditions miss the diagnosis of acute otitis media in the pre-otorrhoea phase. Most of such children are first treated for malaria while the ear is left to progress to discharge before attention is paid to it. The need to ensure complete examination of every febrile child, including otoscopy is highlighted. The importance of providing adequate facilities such as otoscopes in every consulting clinic cannot be over-emphasized. It will reduce the incidence of discharging ears with its attendant short and long term dangers in children.Keywords: acute otitis media, children, early detectionNigerian Journal of Otorhinolaryngology Vol. 2(2) 2005: 60-6

Pattern of Cardiothoracic Surgical Diseases in a New Cardiothoracic Surgery Unit in Nigeria

Background: Cardiothoracic surgical pathologies are available in all  geographical regions of the world. Human and material resources are necessary for prompt diagnosis and proper treatment of these cases.Methodology: Retrospective analysis of cardiothoracic surgical cases in the first five years of our new cardiothoracic surgery unit was done.Results: A total of 714 cases were seen during the study period with age range one month to 76 years with mean age of 37.12±11,24 and male  female ratio of 2:1. The yearly admissions from 2007 to 2011 were 14%, 17%, 21%, 21% and 26% respectively. Cardiovascular diseases occurred in 22.30%, with 6% of children suffering from congenital heart defect and 6% of men suffering from acquired vascular disease. Surgical complications of pleuropulmonary tuberculosis occurred in 21.4% while thoracic trauma occurred in upto 21% of the patients. Aerodigestive tract foreign bodies were encountered in 10.1% of cases and Pyogenic diseases occurred in 8.68%. Oesophageal lesions were diagnosed in 6.4% of the patients, pulmonary tumours including primary and secondary tumours were found in 4.3% while nontraumatic chest wall pathologies which included chest wall tumours, congenital deformities and chronic osteomyelities accounted for 3.2%. Mediastinal pathologies occurred in 0.98% and in the remaining 1.5% rare diseases were diagnosed such as third degree heart block,  pulmonary embolism and thoracic endometriosis syndrome.Conclusion: This study shows that cardiothoracic surgical pathologies are common in our centre with predominance of thoracic pathologies, and  therefore need to prioritize and ensure manpower development for  treatment of all kinds of thoracic pathologies