Pattern of head and neck cancers among patients attending Muhimbili National Hospital Tanzania

Background: It is estimated that there are more than 640,000 new cases and 350,000 deaths due to head and neck cancers (HNCA) each year worldwide. Lack of baseline data in Tanzania concerning head and neck malignancies makes it difficult to appreciate the pattern and magnitude of the problem in the country. The objective of this study was to determine the pattern of head and neck cancers among patients attending the Otorhinolaryngology Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania.Methods: All inpatients and outpatients with histologically proven malignant lesions in the head and neck region who attended the Otorhinolaryngology department of Muhimbili National Hospital between 1st July 2012 and 31st January 2013 were enrolled in the study. A special designed questionnaire was used for data collection. Clinical examination, computed tomography scan and/or magnetic resonance image were done accordingly, followed by fine needle aspiration cytology and/or tissue biopsy. Results: A total of 113 patients, 75 (66.3%) males and 38 (33.7.0%) females with a male to female ratio 2:1 were involved in the study. The mean age at the time of diagnosis was 51±18. Patients below age of 40 years accounted for 28.4% of all head and neck cancer patients. The commonest observed anatomical location was nasal and paranasal sinuses (23.9%) followed by the larynx (20%). Carcinoma accounted for 94% of head and neck cancers in which squamous cell carcinoma was the most frequent (74%). Lymphoma (2%) was the least frequent histological variant encountered. Nasal and paranasal sinuses had the most histological variations of all anatomical locations of head and neck cancer.Conclusion: This study shows a significant number of head and neck cancer patients in a younger generation and a high magnitude of sinonasal cancerrelative to other head and neck cancer

Lupus Vulgaris of the External Nose in a Paediatric Patient: A Case Report from Muhimbili National Hospital, Tanzania

Lupus vulgaris is the most common form of cutaneous tuberculosis which usually occurs in patients who have been previously sensitized to Mycobacterium tuberculosis.[1] We present a case of a 4-year-old girl who was diagnosed to have lupus vulgaris clinically and was then confirmed histopathologically. On local examination, the patient had irregularly  bordered, well demarcated, whitish to reddish lesion on her external nose. The histopathological examination showed many dermal stromal  granulomas of epithelioid cells, many multinucleated giant cells of Langhans type. This case report is therefore to emphasize on the importance of early diagnosis of lupus vulgaris of the external nose both clinically and on histopathological basis so as to avoid its destructive consequences which are mainly erosion of the external nose, nasal cavity and the face and in rare occasions, possible development of a carcinoma of squamous cell type.________________________________________________________________________Key words: Lupus vulgaris, external nose, Tanzani

The Relationship Between Central Auditory Tests and Neurocognitive Domains in Adults Living With HIV

Objective: Tests requiring central auditory processing, such as speech perception-in-noise, are simple, time efficient, and correlate with cognitive processing. These tests may be useful for tracking brain function. Doing this effectively requires information on which tests correlate with overall cognitive function and specific cognitive domains. This study evaluated the relationship between selected central auditory focused tests and cognitive domains in a cohort of normal hearing adults living with HIV and HIV– controls. The long-term aim is determining the relationships between auditory processing and neurocognitive domains and applying this to analyzing cognitive function in HIV and other neurocognitive disorders longitudinally. Method: Subjects were recruited from an ongoing study in Dar es Salaam, Tanzania. Central auditory measures included the Gap Detection Test (Gap), Hearing in Noise Test (HINT), and Triple Digit Test (TDT). Cognitive measures included variables from the Test of Variables of Attention (TOVA), Cogstate neurocognitive battery, and Kiswahili Montreal Cognitive Assessment (MoCA). The measures represented three cognitive domains: processing speed, learning, and working memory. Bootstrap resampling was used to calculate the mean and standard deviation of the proportion of variance explained by the individual central auditory tests for each cognitive measure. The association of cognitive measures with central auditory variables taking HIV status and age into account was determined using regression models. Results: Hearing in Noise Tests and TDT were significantly associated with Cogstate learning and working memory tests. Gap was not significantly associated with any cognitive measure with age in the model. TDT explained the largest mean proportion of variance and had the strongest relationship to the MoCA and Cogstate tasks. With age in the model, HIV status did not affect the relationship between central auditory tests and cognitive measures. Age was strongly associated with multiple cognitive tests. Conclusion: Central auditory tests were associated with measures of learning and working memory. Compared to the other central auditory tests, TDT was most strongly related to cognitive function. These findings expand on the association between auditory processing and cognitive domains seen in other studies and support evaluating these tests for tracking brain health in HIV and other neurocognitive disorders

Noise Induced Hearing Loss Among Music Employees In Dar Es Salaam

Fifty-two musicians and music employees were studied to find out the effects of noise on their hearing thresholds. Their age range was 20 -59 years with a mean age of 35.7 years. There were 47 males and 5 females. Their average threshold of hearing was 29.9 dBA. There was no significant difference in noise induced hearing loss (NIHL) among musicians playing different instrument

Management of peritonsillar abscess

This retrospective study compared immediate operation of a peritonsillar abscess (quinsy tonsillectomy) with immediate incision and drainage or permucosal aspiration followed by interval tonsillectomy. The study consisted of 148 cases treated from 1976 to 1994. Patient&apos;s ages ranged from 1 to 70 years (mean 28.7 years). There were 81 males and 67 females. Quinsy tonsillectomy was performed in 59 patients and permucosal aspiration or incision and drainage in 89 patients. The results showed that quinsy tonsillectomy had no significantly greater complications than permucosal aspiration and incision and drainage. The procedure of quinsy tonsillectomy was less difficult than interval tonsillectomy and constituted a one-stage curative operation. Hospitalization was reduced significantly (p<0.01) when compared to interval tonsillectomy