Ear Foreign Bodies: Observations on the Clinical Profile in Sokoto, Nigeria

Background/objectives: Ear foreign bodies are common otorhinolaryngological emergencies which must be removed otherwise they may present with various complications. This paper reviews cases of ear foreign bodies seen over a seven year period from January 1995 to December 2001 in the Ear, Nose and Throat (ENT) department of Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Method: This is a retrospective study of all case folders of patients who presented with ear foreign bodies whose clinical features and management modalities were analyzed . Results: The total number of patients reviewed were 207.There were 126 males (60%) and 81 females (40%) with a male to female ratio of 1.5:1. Their ages ranged from 1 to 65 years with 61.8% being children under 10 years old. Agricultural seed was the commonest documented foreign body (15%). Deliberate insertion by patients accounted for 70% of the cases while accidental insertion accounted for 30%. Ear foreign bodies became complicated in 41 patients (19.8%) at presentation one of them requiring a major surgical operation (posterior tympanotomy) to remove the foreign body. About 99.5% of the foreign bodies were removed through the per meatal approach with 79.8% being carried out by the nurses and doctors who had received basic training to do so. Conclusion: Ear foreign bodies may become complicated and so needs to be removed using standard methods which should be carried out by those specially trained to do so.Introduction/Objectif: Des corps \ue9trangers dans l\u2019oreille sont des situations fr\ue9quents d\u2019oto-rhino-laryngologie d\u2019urgence qui doivent \ueatre enlev\ue9s sinon, ils peuvent pr\ue9senter des complications divers. Ce document passe en revue les cas des corps \ue9trangers d\u2019oreille vus pendant une dur\ue9e de sept ans allant de janvier 1995 au d\ue9cembre 2001, dans le D\ue9partement du nez, de l\u2019oreille, et de la gorge (ONG) Centre hospitalier Universitaire d\uf9 Usman Danfodiyo, Sokoto, Nigeria. M\ue9thode: Il s\u2019agit d\u2019une \ue9tude r\ue9trospective des dossiers de tous les cas de patients qui ont pr\ue9sent\ue9 des corps \ue9trangers de l\u2019oreille dont les caract\ue9ristiques cliniques et les modalit\ue9s de gestion ont \ue9t\ue9 analys\ue9s. R\ue9sultats: Le nombre total de 207 patients ont \ue9t\ue9 examin\ue9s. Il y avait 126 hommes soit 60% et 81 du sexe f\ue9minin soit 40% avec une proportion hommes / femmes de 1:5:1. Leur \ue2ge varie entre 1 \ue0 65 ans avec 61,8% \ue9tant des enfants \ue2g\ue9s de moins de 10 ans. De semences agricoles a \ue9t\ue9 le corps \ue9tranger la plus fr\ue9quente (15%). D\u2019insertion d\ue9lib\ue9r\ue9e par les patients repr\ue9sentaient 70% des cas, alors que l\u2019insertion accidentelle repr\ue9sentaient 30%. Corps \ue9trangers de l\u2019oreille est devenue compliqu\ue9e chez 41 des patients soit 19,8%, pendant pr\ue9sentation et un patient n\ue9cessitant une op\ue9ration chirurgicale importante (post\ue9rieur tympanotomie) afin d\u2019enlever le corps \ue9tranger. Environ 99,5% des corps \ue9trangers ont \ue9t\ue9 enlev\ue9s par le biais de l\u2019approche par meatal avec 79,8% r\ue9alis\ue9s par les infirmi\ue8res et les m\ue9decins qui ont re\ue7u une formation de base pour cette op\ue9ration. Conclusion: Les corps \ue9trangers de l\u2019oreille peuvent devenir complique et doit \ueatre enlev\ue9 en utilisant des m\ue9thodes standard qui doivent \ueatre men\ue9es par ceux sp\ue9cialement form\ue9s pour cette op\ue9ration

Lateral rhinotomy-a review of 38 operations from Sokoto Nigeria

Aims And Objectives: Intranasal tumours are likely to be incompletely excised if pernasal excisional biopsy alone is used. There are several other approaches for the removal of intranasal tumours one of which is lateral rhinotomy. This paper reviews 38 lateral rhinotomies performed in 30 patients in Sokoto Nigeria, over a 41/2 year period. Patients And Method: The record of 30 patients who underwent 38 lateral rhinotomies in Sokoto were reviewed. The indications for lateral rhinotomy, operative findings and histology results were analysed over a 41/2 year period. Results: 38 lateral rhinotomies were performed in 30 patients. There were 19 males (63.3%) and 11 females (36.7%) with a male to female ratio of 1.7:1. Their ages ranged between 6yrs and 65yrs. 29 patients (96.7%)had 37 lateral rhinotomies performed on them as a result of intranasal neoplasm while one (3.3%) had lateral rhinotomy performed for removal of local Arrow foreign body in the orbit and infratemporal fossa. Operative findings indicated that in only 8 surgeries (21.1%) were intranasal tumours confined to the nasal cavities, while in 27 surgeries (76.3%) intranasal tumour had extended beyond the nasal cavity. Conclusion: Lateral rhinotomy provides excellent exposure to intranasal tumours more than all other approaches in achieving tumour free margin during excisional biopsy pending the outcome of histology report with acceptable cosmetic results

Persistent Post-traumaticdacrocystitis and epiphora following unusual impacted metallic fragments foreign body in the left ethmoido-orbital region

Dacryocystitis is inflammation of the lacrimal sac which is located between the medial canthus of the eyes and the bridge of the nose and occurs following obstruction of the nasolacrimal duct. We report a case of persistent post-traumatic dacrocystitis and epiphora with unusual impacted metallic fragment of a motor bike brake handle in the left ethmoido-orbital region, following collision with a fast-moving motor bike in a child, which was neglected for 6 months. The patient had left ethmoido-orbital exploration, foreign body removal and dacryocystorhinostomy at the same sitting. He recovered uneventfully and has remained symptom free

Genetic studies in the nigerian population implicate an MSX1 mutation in complex oral facial clefting disorders

BACKGROUND: Orofacial clefts are the most common malformations of the head and neck with a World-wide prevalence of 1/700 births. They are commonly divided into CL(P) and CP based on anatomical, genetic and embryological findings. A Nigerian craniofacial anomalies study “NigeriaCRAN” was set up in 2006 to investigate the role of gene-environment interaction in the etiology of orofacial clefts in Nigeria. SUBJECTS AND METHODS: DNA isolated from saliva from the Nigerian probands was used for genotype association studies and direct sequencing on the cleft candidate genes: MSX1, IRF6, FOXE1, FGFR1, FGFR2, BMP4, MAFB, ABCA4, PAX7 and VAX1, and the chromosome 8q region. RESULTS: A missense mutation A34G in MSX1 was observed in nine cases and four hap map controls. No other apparent etiologic variations were identified. A deviation from HWE was observed in the cases (p= 0.00002). There was a significant difference between the affected side for unilateral CL (p=0.03) and, between bilateral clefts and clefts on either side (p=0.02). A significant gender difference was also observed for CP (p=0.008). CONCLUSIONS: The replication of a mutation previously implicated in other populations suggests a role for the MSX1 A34G variant in the etiology of CL(P)

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study.

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care