Etiological Profile and Treatment Outcome of Epistaxis at a Tertiary Care Hospital in Northwestern Tanzania: A Prospective Review of 104 Cases.

Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania. This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15. A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%. Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre

Clinico-pathological profile of sinonasal masses: an experience in national ear care center Kaduna, Nigeria

<p>Abstract</p> <p>Background</p> <p>The presence of a mass in the nose and paranasal sinuses may seem to be a simple problem; however it raises many questions about the differential diagnosis. The aim of this study is to evaluate the clinico-pathological profile of sinonasal masses in our environment</p> <p>This is a retrospective analytical review of all the patients with sinonasal masses that presented to the national ear care center, Kaduna over a six year (2003-2008) period. Their biodata, clinical profile and histological diagnoses were analyzed.</p> <p>Findings</p> <p>A total of 76 patients were analyzed, age range 5 to 64 yrs with a mean age of 33.3 yr median and modal age of 35.00 (SD = 13.1 ± 1.5). Majority of the patients were in the age groups 21-50 yrs. There were 34 male and 42 female with M: F ratio of 1:1.2. The main presenting symptoms are nasal blockage 97.4% and rhinorrhea 94.7%. It was bilateral in 34 (44.7%), left side in 24(31.6%) and right side in 18(23.7%) patients. The commonest clinical diagnoses were simple nasal polyp 47(61.8%) and antrochoanal polyp 10(13.2%). About 59 (77.6%) were benign, 2 (2.6%) were malignant and 15 (19.7%) were lost to follow up. The commonest histological diagnosis is simple inflammatory nasal polyp in 28 (36.8%) patients and the least was nasal capillary hemangioma 2 (2.6%). About 55(72.4%) patients had surgical treatment.</p> <p>Conclusions</p> <p>Nasal obstruction and rhinorrhea are the commonest symptoms of presentation, simple inflammatory nasal polyp is still the commonest histological pattern seen in our environment, and surgery is still the best modality of treatment for benign tumor thus the need for advocacy for early recognition and referral to the ENT surgeon.</p

Tympanometry Patterns in a General Nigerian Elderly Population

Background: Hearing is known to deteriorate with age. A lot of research is this area has provided much of information on age-related effects on anatomy and physiology of the auditory system. There is a dearth of information on the dynamics of the middle ear of the elderly Nigerian. Most commonly used test batteries for this purpose had been Pure Tone Audiometry (PTA), Echoschreen and Brainstem evoked response audiometry (BERA). Aim: The aim of this work is to investigate the effect of age and gender on middle ear dynamics using tympanometry. Material and method and results: The present study concerns an elderly population drawn from an old people home (Little Sisters of the Poor) in Enugu. Tympanograms were obtained in elderly subjects using an Interacoustic automatic impedanz Audiometer SAT 12 Audio-Med. Three tympanometric variables were obtained: static admittance, equivalent ear canal volume and Tympanogramtric Peak Pressure (TPP). Effects of age and sex on tympanograms were determined. Patients were classified using Jerger's method into Type A, As, Ad, B, and C. Most 19 (38 ears) (76%) patient's tympanograms were classified as Type A and Type A subgroups (normal) while 12 ears (24%) had Type B. There were in all 25 patients, 8 males and 17 females ratio 1:2, aged 55 – 90 years. Mean age = 79.2 years. Conclusion: Our results confirmed that progression in age alone, or gender does not grossly affect tympanometric dynamics but diseases accompanying ageing may effect the changes. Key words: Tympanometry, elderly, Nigerian. Nigerian Journal of Otorhinolaryngology Vol.2(1) 2005: 17-2

Knowledge of secondary school students of HIV/AIDS

…………………. Ebonyi Medical Journal Vol. 5 (1) 2006: pp. 12-1

HDL-LDL Ratio: A Significant Predisposition to the Onset of Atherosclerosis

The significance of high-density lipoprotein/low density lipoprotein (HDL-LDL) ratio as a predisposing factor to the onset of atherogenesis has been studied. Standard enzymatic method using Cholesterol kit to extract cholesterol was used. HDL was analysed using standard HDL Kit and LDL concentration was derived by a standard mathematical formula. There is a significant difference between HDL and LDL concentration within the hypertensive group, whereas this is not the case with the normotensive group. HDL is responsible for reverse cholesterol transport from peripheral tissues and LDL does the opposite. It is thus clear why the overwhelming concentration of LDL in Hypertensive could be atherogenic. Key Words: Hypertension, atherosclerosis, cholesterol, lipoprotein Nig. J. Health and Biomed. Sciences Vol.2(2) 2003: 78-8

Production of Escherichia coli heat – Labile Enterotoxin (LT) in some artificial media and commercially available baby foods

The production of thermolabile (LT) enterotoxin on some artificial media and commercially available baby foods was studied. Staples medium, Casamino-acids-yeast extract (CA-YE) medium, Tryticase soy broth (TSB) and Syncase medium were evaluated for their ability to support the production of LT toxin. Also, nine commercially available baby foods were evaluated as substrate for LT – toxin production. Rabbit toxicity indices (RTI) showed that the staples medium served as the best artificial medium for toxin production (RTI=1.9) followed by CA-YE (RTI=1.2). Three (NA, CER and BOC), out of nine baby food brands examined supported LT-toxin production with NA giving the highest yield of toxin (RTI=2.2) determination of the electrolyte content of aspirated diarrhoeal fluid showed significant secretion of sodium (Na +) and potassium (K +) electrolytes into the fluid. These results suggest that some baby foods, when prepared and stored under non-hygienic conditions could permit growth of, as well as toxin production by toxin production bacteria and pose a health hazard for the infant population. Bio-Research Vol. 3(1) 2005: 56-6

Anthropometrical Profiles Of The Frontal Sinus In Population Of Southeast Nigerians

The anthropometrical profiles, function and variation of frontal sinus have been poorly understood. Understanding these are important in sinus operation and in paleontology, to understand the puzzle of the meaning of the supra orbital development. In the present study radiographs of 74 males and 46 females of south east Nigerians were measured from 18th August 2003 to 12th July 2004. The subject age ranges from 9 to 75 years. The mean length, width and height of frontal sinuses were 35.36mm, 63.87mm and 12.93mm for males and 28.70mm, 60.73mm and 10.35mm for females respectively. Thus values for the dimensions of the frontal sinus were higher for males than females. The study revealed that most of the female frontal width values fall above the mean in the distribution while most values for anthropometrical profiles of both sexes fall below the mean. This study is important to otorhinolaryngologist in the evaluation of the sinuses. Key words: Anthropometrical profile, frontal sinus, paleontology. Journal of Experimental and Clinical Anatomy Vol. 4 (1) 2005: 42-4

Age And Sex Related Variations In The Maxillary Sinuses Of South East Nigerians

Craniofacial growth is believed to be a multifactorial process involving both genetic and epigenetic factors and how epigenetic functional matrices stimulate the transduction of regulatory signals. This study tested the relationship between the variation in maxillary sinus dimensions with sex and age. Lateral and anteroposterior radiographs of 74 males and 46 female of South Eastern Nigerians taken from 18th August 2003 to 12th July 2004 with ages ranging from 9-75 years were measured. The length, width and height of the sinus were measured using defined anatomical landmarks and analyzed. Data were analyzed using excel package of a tabletop computer, employing chi square test (X73178) to determnie the association between sinus dimensions and age oer sex. The evidence to associate maxillary sinus dimensions with age and sex was lacked. Thus establishing values for age and sex were not possible. Therefore prediction on the dimensions of maxillary sinus giving the age or sex of individual is statistically unreliable. Key words: Age, Sex, Maxillary Sinus, Pneumatization Journal of Experimental and Clinical Anatomy Vol. 4 (1) 2005: 33-3

Complementary roles of hysterosalpingography and transabdominal ultrasonography in the assessment of the uterus among women with infertility in a developing nation

Background: The uterus plays a vital role in female infertility. In our environment, it is commonly separately examined with either transabdominal ultrasonography (TAUS) or hysterosalpingography (HSG) which are cheap and readily available. A concurrent use of the two procedures might have a complementary effect with a good outcome especially in a developing economy where three dimensional (3-D) ultrasound, sonohysterography and magnetic resonance imaging (MRI) which are more sensitive are neither readily available nor affordable.Objectives: To document the uterine, tubal and adnexal lesions diagnosed using each of the two procedures and to check if the procedures can complement each other in a poor resource economy.Methodology: This is a six month, paired group and analytical observational study of 200 women with infertility. HSG was booked in keeping with the ten-day rule and TAUS was performed on the same day before HSG. Statistical Package for Social Sciences, version 21 was used for the analysis. Ρ ≤ 0.05 was considered statistically significant.Results: With TAUS evaluation, 158(79%) of the subjects appeared normal. Fibroids were detected in 39(19.5%) subjects, and in 37(94.9%) of this subset, they were localized. Intrauterine adhesions were seen in 0(0%), endometrial polyp in 1(0.5%), and endometrial hyperplasia in 2(1%). With HSG, 149(74.5%) appeared normal. Fibroids were detected in 27(13.5%) and in 19(70.4%) of this subset, they were localized. Intrauterine adhesions were seen in 23(11.5%), endometrial polyp in 1(0.5%) and endometrial hyperplasia in 0(0%). With HSG, tubal occlusion was seen in 63(31.5%), peritubal adhesions in 34(17%), hydrosalpinges in 5(2.5%) and loculated spill in 7(3.5%). None of these were seen with TAUS. With TAUS adnexal masses were in 12(6%) and with HSG they were demonstrated in 2(1%). There was significant difference between TAUS and HSG findings with regard to detection of fibroids, localization of fibroids, detection of tubal lesions and detection of adnexal lesions.Conclusion: The two modalities played important complementary roles since TAUS was able to detect more lesions on the wall of the uterus and in the adnexae, while HSG was able to detect more intracavitory and tubal lesions. The combined study is recommended especially in a poor resource economy where other more sensitive modalities are neither available nor affordable