General and regional anaesthesia for the thyroidectomy in rural/semi-urban Nigerian centres

Objective: To evaluate the feasibility and benefits of regional anaesthesia (RA) for thyroidectomy in rural/semi-urban centres.Design: A prospective study.Settings: Missionary Hospital Saki,Nigeria and Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.Subjects: One hundred and seventy five patients with goitre.Results: The average time for the anaesthetists to put patients to sleep was 4.06±1.02 minutes, while it took 17.8±2.9 minutes to give the regional block. Post operative laryngeal complications in RA group were very minimal, while in general anaesthesia (GA) group, there were significant complications in 32 (36%) patients laryngeal oedema 15 (17%), erosions in 10 (11%) and ulcer in seven (8%). Cost of surgery in GA was thrice as much as in RA group. Thirty one (35%) with GA had steam inhalation for sore throat. It was possible to converse (laryngeal nerve monitoring) with the patient during operation but not possible with GA group. There was early discharge of patients in RA group.Conclusion: Regional/local anaesthesia is feasible for some cases of thyroidectomy with a lot of advantages and specifically allows surgeons to converse with the patients during operation -direct laryngeal and other nerve monitoring. Despite advancement in cuff design a lot of lesions still occur from endotracheal intubations

Assessment of quality of chloroquine tablets sold by drug vendors in Abeokuta, Nigeria

No Abstract. Tanzania Health Research Bulletin Vol. 8(1) 2006: 45-4

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

Perceived Factors Influencing the Choice of Antenatal Care and Delivery Centres among Childbearing Women In Ibadan North South-Western, Nigeria

The aim of the study was to investigate the supposed factors apart from socioeconomic influencing the choice of antenatal care and delivery centres among childbearing women in Ibadan North Local Government Area of Oyo State. Data were obtained through the administration of two hundred and thirty-one (231) copies of structured questionnaire to childbearing women in four antenatal centres normally utilized in the area. Data obtained were analyzed using descriptive and inferential statistical tools. The Chi Square result indicated that awareness of ANC significantly influenced place of delivery (p<0.05), while the result of Pearson’s correlation indicated a low negative and insignificant association between distance and utilization of ANC and delivery services (r-Value = -0.04, p>0.05). The study revealed that husband’s decision or preference of ANC and privacy constituted the prominent factors that influenced the choice of ANC as well as place of delivery. It further revealed that the highest patronage of ANC and delivery centres was achieved with distance of <5km, while the lowest patronage was achieved when the approximate distance was > 10km. Based on the findings of the study, it was recommended that husbands should be encouraged and educated on the need to give their wives free hand in deciding places of ANC and delivery centres.Keywords: Antenatal Care, Utilization, Socioeconomic Characteristics, Childbearing Wome

Significant sequelae after bacterial meningitis in Niger: a cohort study

Beside high mortality, acute bacterial meningitis may lead to a high frequency of neuropsychological sequelae. The Sahelian countries belonging to the meningitis belt experience approximately 50% of the meningitis cases occurring in the world. Studies in Africa have shown that N. meningitidis could cause hearing loss in up to 30% of the cases, exceeding sometimes measles. The situation is similar in Niger which experiences yearly meningitis epidemics and where rehabilitation wards are rare and hearing aids remain unaffordable. The aim of this study was to estimate the frequency of neuropsychological sequelae after acute bacterial meningitis in four of the eight regions of Niger

Otolaryngological manifestations of HIV/Aids: A review

No Abstract.Annals of Ibadan Postgraduate Medicine Vol. 3 (1) 2005: pp. 33-3

Variability and correlation studies in seed quality of West African Okra (Abelmoschus caillei (A.Chev.) Stevels) accessions

No Abstract.Nigerian Journal of Genetics Vol. 19 2005: pp. 9-2

Squamous Cell Carcinoma of the Mastoid - A Report of Two Cases

Malignant tumours of the mastoid are rare, the majority being squamous cell carcinomas. We report two cases whose clinical presentation mimicked mastoid abscess with intracranial complications. The first case is a twenty year Nigerian lady who presented to the Emergency Room of the Otorhinolaryngology Department with a one month history of headache, low grade fever, left facial palsy, neck stiffness and left post-auricular swelling on a background of left chronic suppurative otitis media since childhood. An initial diagnosis of meningitis and mastoid abscess secondary to chronic suppurative otitis media was made but histology of the mastoid specimen revealed keratinizing squamous cell carcinoma, which was treated with palliative primary radiotherapy. The second case is a 45-year old man with a chronic mastoiditis and mastoid abscess that was later found to be suamous cell carcinoma of the mastoid and was managed with combination of surgery and radiotherapy. The report highlights advanced stage of the disease at presentation, and discusses the etiology and management. To the best of our knowledge, these are the first cases of this entity to be documented in Africans

Otorhinolaryngologic emergencies in Nigeria, Sub-Saharan Africa: Implication for training

Background: The anatomy and function of the ear, nose and throat (ENT) make pathologies potentially catastrophic. Reports on the epidemiology of otolaryngologic emergencies put the prevalence at between 30 and 80%. There are however very few studies from the developing countries. This study was aimed at determining the magnitude and spectrum of otolaryngologic emergencies in a teaching hospital in a developing country in sub-Saharan Africa..Methods: This was a two year retrospective review done at the Department of Otorhinolaryngology in the University College Hospital, Ibadan, Nigeria. The clinical records of patients managed as emergencies between July 31, 2001 and 30 June, 2003, were reviewed and the biodata, diagnosis and treatment were extracted and analysed.Results: Emergencies constituted 22% of the 2544 cases reviewed. The top five diagnoses were recurrent otitis media (24%), foreign bodies in the orifices (21.0%), head and neck trauma (20%), epistaxis (16%) and chronic sinusitis (8.8%). Children accounted for over 40% of the study population, although there was a peak in the third decade due to trauma. More than 80% of the cases were referred by general practice doctors. Only 41% of the cases were managed surgically, the rest required only conservative treatment.Conclusion: The greater proportion of the cases referred as emergencies did not require surgical intervention and could have been managed conservatively by the referring doctors. It is recommended that the curriculum of otolaryngology posting for general practice trainees should be reviewed so as to increase the duration of exposure from the present one month. This will enable general practitioners to be more adept at instituting the conservative management of otolaryngologic emergencies

Case Report: Open Mastoidectomy and temporalis flap in the control of chronic otorrhoea

No Abstract Supplie