Pattern of Foreign Bodies in the Throat

A retrospective study from January, 2001to January 2011 of  345 patients with a diagnosis of foreign body (FB) in the throat were carried out at the department of ear, nose and throat (ENT), Komfo Anokye Teaching Hospital in Kumasi, Ghana.  Therapeutic oesophagoscopy, direct pharyngoscopy under general anaesthesia and direct laryngoscopy were done on 210, 181 and 15 cases respectively.  Six cases which developed complications were transferred to the cardiothoracic centre at Korle-Bu Teaching Hospital in Accra.  Mortality rate was also low 0.7%).  Early assessment and therapy of the disorder is imperative in order to prevent the loss of life.

Trends of MENIER’S Disease In Ghana

Fifty-nine (59) patients with Menier’s disease confirmed according to defined criteria were selected from the sample of one hundred and ninety-eight (198) consecutive patients with the referral diagnosis of Meniere’s disease seen at the Komfo Anokye Teaching Hospital (KATH) in Kumasi between the period of January 2001 to January 2011.  This represents an incidence of 0.32% of the total of eighteen thousand two hundred (18,200) new clinic evaluations for all the ENT diseases during the ten year period under the review. Meniere’s disease is surely not uncommon in our subregion, the high success rate encountered after conservative treatment in our study shows that it may have a better prognosis among negroes.  Because the sensorineural hearing loss stabilizes in most cases after the first 2-3 attacks during the 3 months period in which treatment is received, subsequent investigations, especially if done by a new researcher, will not find the existence of the trial of symptoms necessary for the diagnosis of the disease.  Only eleven (11) of our patients continued to have vertiginous attacks with a progressive sensorineural hearing loss and disturbing tinnitus.  We could find any statistical evidence for smoking and alcohol as possible aetiological factors.  There was gender balance in the distribution of the disease. Key Words: Meniere’s Disease, Tinnitus, Delayed Endolymphatic Hydrops

Results of orbital cellulitis treatment

The research seeks to emphasis the importance of prompt surgical intervention in the management of complicated orbital cellulitis without over relying on CT Scans. A retrospective study that reviewed 36 patents with orbital complications arising as a result of sinusitis  were admitted to the Ear, Nose, Throat and Eye ward of the main teaching hospital of the Ashanti Region-Komfo Anokye Teaching Hospital was done. The study analysis was from January, 2007 to October, 2010. The clinical presentations, laboratory examinations,diagnoses,management methods were analyzed. Appropriate evaluation of patients with orbital inflammation included a comprehensive clinical examination and radiographic studies . The age range of the study was 1-70 years  with  males  more   than females. The commonest sinus which was infected was the ethmoid. Relying on the soft tissues x-rays, prompt clinical assessment and immediate surgical intervention in a deprived area where CT Scans and ultrasonography are scarce gives 95% cure of patients. The findings of this study suggest that surgical intervention, especially trephening of the frontal sinus is a must, to avoid potential complications such as brain abscess and vision loss in orbital abscess. KEY WORDS: Sinusitis, sinuses, orbital cellulitis

Hearing Loss in Chronic Kidney Disease

Chronic kidney disease (CKD) is assuming public health significance worldwide largely driven by the surge in diabetes mellitus, hypertension and obesity. CKD patients, particularly those from resource restraint regions of the world, face huge challenge in terms of accessibility and affordability to care. Besides these challenges in care, several other co-morbidities often exist among these patients in addition to the primary disease like diabetes and hypertension. Yet, these “subtle” co-morbidities are often overlooked by Caregivers. Hearing loss is one of such co-morbidities CKD patients face but it is often overlooked. The situation is worse among children who often cannot express themselves. The etiology of hearing loss among CKD patients are multifactorial. It is hoped that this neglected aspect of care for patients with chronic kidney disease will receive the needed attention for holistic care of the CKD patient

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Fractured tracheostomy tube – A case report of a 3-year old Ghanaian child

Introduction: We report on a 3-year old Ghanaian child who had a fractured tracheostomy tube dislodged into the left main bronchus of the tracheobronchial tree. Case history: Child was involved in a rollover road traffic collision as an unrestrained passenger in a saloon car. Her injuries required mechanical ventilation and subsequently a tracheostomy. A week after the tracheostomy, a diagnosis of a fractured tracheostomy tube was made. Discussion: Fracture of a tracheostomy tube is a rare complication, which should be considered as part of the differential diagnosis in a ventilated patient with a tracheostomy. Wound exploration through the tracheal stoma is an alternative technique that can be adopted in a restricted resource setting