Sebaceous Carcinoma of Submandibular Gland Presenting with Upper Airway Obstruction: A Case Report and Review of the Literature

Sebaceous carcinoma (SC) of the salivary gland is a very rare tumor occurring more in the parotid gland. It is extremely rare in the submandibular gland. Only four cases of submandibular gland SC have been reported worldwide in English literature. We present the first case of submandibular gland SC in our environment and the fifth to be reported in English literature. A 55‑year‑old male farmer presented to our facility with a 10-year history of progressive, painless left submandibular mass, which worsened 4 months before presentation, associated with dysphagia to solid, muffled voice, weight loss, and upper airway obstruction. He had emergency tracheostomy and biopsy of the left submandibular mass. Histopathological examination of the mass confirmed SC. He was referred for radiotherapy but said to have died few weeks later while still preparing to travel for the radiation therapy. The rarity of these cases made the clinicopathologic pattern to be poorly understood thus making the choice of treatment option difficult. More cases need to be reported in other to develop the best treatment modalities

Trainees collaboratively investigating early career doctors' themes: a nard initiative in Nigeria

Early career doctors (ECDs) are faced with many unique challenges; this is even more pronounced in low resources setting like country Nigeria. To unravel and improve understanding of these challenges the National Association of Resident Doctors of Nigeria (NARD) initiated a trainee driven research initiative. NARD initiated the Research and Statistics Committee (RSC), a six member team derived from her membership. In an attempt to carry out her responsibility efficiently the committee created the Research Collaboration network (RCN), a 43 member team comprising ECDs from across Nigeria. The key themes to be explored under this initiative include demographic, work and psychosocial issues as it affect ECDs in Nigeria. This article is set out to describe in detail the NARD initiative in term of the structure, operational modalities and agenda for the year 2018/19.Keywords: Research, Early career doctors, Residents Doctors, Nigeria, Junior Doctor

Characteristics and Management of Childhood Tinnitus in a Developing Country

Objectives: Tinnitus is a commonly neglected otologic symptom among children in developing country. This study aimed at determining the prevalence, clinical characteristics, diagnosis and management of childhood tinnitus in a developing country. Method: This prospective hospital based study of patients’ age 18 years and below with complaints of tinnitus was conducted in Ear, Nose and Throat Department of Ekiti state UniversityTeaching Hospital,Ado Ekiti,Nigeria between April 2016 to March 2018. The parents/guardians/patients were briefed about the scope of the study. After getting oral consent, pretested interviewers assisted questionnaire was administered to collect data. Data obtained were collated and analyzed using SPSS software version 18.0 and was expressed in simple tables and charts. Results: Prevalence of tinnitus in this study was 6.2%. There were 56.1% males and male to female ratio was 1.5:1. Majority 55.3% had single episode of tinnitus and long duration (>3 months) was commonest form of tinnitus in 59.1%. Bilateral tinnitus was recorded in 68.9% while subjective tinnitus constituted 93.9%. Discrete tinnitus was commoner in 67.4%. Major causes of tinnitus were febrile illnesses, otitis media, noise exposure, unknown (idiopathic), earwax impaction and ototoxicity in 19.7%, 16.7%, 15.9%, 14.4%, 12.9% and 9.8% respectively. A commonest tympanometric finding was type A in 72.7% of patients. Commonly affected quality of life were anxiety, depression and attention problem in 51.5%, 43.2% and 40.2% respectively. Associated comorbid illnesses in this study were 50.8% sleeping disorders, 42.4% concentration disorders and 31.1% headache. Referrals were mainly from paediatrician in 44.7%. Prehospital treatment was mainly medication in 62.1%. All the patients were counselled (assured). Other treatments given were conservative treatment, surgery, ear syringing and hearing aids in 56.1%, 15.9%, 12.9% and 9.1% patients respectively. Conclusion: Childhood tinnitus is caused by preventable diseases. At presentation there were associated hearing impairment, comorbid illnesses and affectation of quality of life

Challenges of residency training and early career doctors in Nigeria study (charting study): a protocol paper

Introduction: Early career doctors (ECDs) make up a significant proportion of the workforce of medical/dental practitioners in Nigeria. ECDs play pivotal roles in the Nigerian healthcare system. However, several factors affect ECDs in their career endeavours, ranging from poor remuneration to psychosocial problems (such as burn out, job dissatisfaction, etc.). While other countries have tried to investigate these factors and their impact, no national inquiry has been done yet in Nigeria. This demonstrates the critical need to conduct a nationally representativestudy exploring these factors, such as demographic, workplace and psychosocial factors, among ECDs in Nigeria. This article is a protocol paper for the challenges of residency training and early career doctors in Nigeria study; charting study to be conducted under the auspices of the Nigerian Association of Resident Doctors of Nigeria(NARD).Methods: The Charting Study would be a mixed study design, utilizing both qualitative and quantitative study designs and access data from structured questionnaire, focus group interview and secondary data available to the association.Conclusion: The outcome of this study will provide great insight into various issues affecting ECDs in Nigeria and make necessary recommendations.Keywords: Nigeria, early career doctors, junior doctors, physicians, dentists, workplace, psychosocial issue

Health, well-being, and burnout amongst Early Career Doctors in Nigeria.

BackgroundEarly Career Doctors (ECDs) in Nigeria are faced with many individual and systemic problems, which consequently adversely affect their health, well-being, patient care and safety.ObjectiveThis study, the second phase of the Challenges of Residency Training and Early Career Doctors in Nigeria (CHARTING II) Study, sought to examine the risk factors and contributors to the health, well-being and burnout amongst Nigerian ECDs.MethodsThis was a study of health, well-being and burnout amongst Nigerian ECDs. Outcome variables included burnout, depression, and anxiety, which were respectively assessed using the Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire (PHQ-9) depression scale, and Generalized Anxiety Disorder (GAD-7) scale. The quantitative data obtained was analysed using the IBM SPSS, version 24. Associations between categorical outcome and independent variables were assessed using chi square, with level of significance set at ResultsThe mean body mass index (BMI), durations of smoking and alcohol consumption of the ECDs were 25.64 ± 4.43 kg/m2 (overweight range), 5.33 ± 5.65 years and 8.44 ± 6.43 years respectively. Less than a third (157, 26.9%) of the ECDs exercised regularly. The most common disease conditions affecting the ECDs were musculoskeletal (65/470, 13.8%) and cardiovascular diseases (39/548, 7.1%). Almost a third (192, 30.6%) of the ECDs reported experiencing anxiety. Male and lower cadre ECDs were more likely than female and higher cadre ECDs to report anxiety, burnout and depression.ConclusionThere is an urgent need to prioritize the health and well-being of Nigerian ECDs, so as to optimize patient care and improve Nigeria's healthcare indices