Paediatric nasal foreign body in Calabar: A review of 5 -years experience

Background: Nasal foreign bodies are common domestic accidents in children. They can constitute a great challenge and management may require great skill. However, seldom does the Otolaryngologist keep track of the number and kinds of the foreign bodies he encounters. Objective: To evaluate cases of nasal foreign bodies among children managed in Otorhinolaryngology Department of the University of Calabar Teaching Hospital, Nigeria. Materials and Methods: A retrospective study of 215 Cases of paediatric nasal foreign bodies seen and managed in the Otorhinolaryngology Department of the University of Calabar Teaching Hospital from January 2015 to December 2018. Maximum age was 14years.The case notes of all children diagnosed with nasal foreign bodies within the period under review, from ENT Clinic, Ward and Children emergency Room were reviewed as related to age, gender, and type of foreign bodies, category of doctors, methods of removal and complications. Data were analysed and presented in descriptive, tabular and chart forms. Results: Of the 215 children, 43.7% were males and 56.3% females. The age range was 0 – 14 years, with a male: female ratio of 1:1.35.The peak age range at which nasal foreign bodies were found was 0 – 4 years (87%) and the least frequent age bracket was 10 – 14years (1.4%). Most of the children were asymptomatic (60%), and others had unilateral foul-smelling nasal discharge (40%). The most common foreign body were beads (34.9%), followed by seeds (23.2%). Most presentations were within one day (90%), followed by one week (7%). Most foreign bodies (59.5%) were inserted into the right nostril, and 40.5% into the left. No bilateral insertion was observed. Most of the foreign bodies (80%) were mechanically extracted with Jobson–Horne's probes without general anaesthesia. Mainly Registrars did most removals 65% while 25% were by Senior Registrars. Mild epistaxis was a complication in 5% of cases. Conclusion: Nasal foreign bodies are common in Calabar. The most frequently observed foreign bodies were beads and seeds. Therefore, public health education is needed for parents and caregivers. Keywords: Paediatrics, Nose, foreign bodies

Aural Foreign Bodies in Children

Background: Pediatric aural foreign bodies (FB) are relative medical emergencies. Primary care physicians, pediatricians, and otorhinolaryngologists commonly encounter them. Objective: The objective was to carry out a retrospective analysis of pediatric aural FB managed in otorhinolaryngology department of the University of Calabar Teaching Hospital, Nigeria. Materials and Methods: A total of 157 children with aural FB managed at the Department of Otorhinolaryngology, University of Calabar Teaching Hospital, Nigeria, from January 2015 to December 2018 were reviewed with regard to the type of FB, location, in the ear, methods of removal,  complications, age, and sex. Results: Of the 157 children, 54.1% were males and 45.9% females. Male: female ratio was 1.2:1. Ninety‑five (60.5%) were below the age of 5 years, 46 (29.3%) were 6–10 years of age, and 16 (10.2%) were in the age group of 11–15 years. The most common objects were beads, papers, and cotton. Most presentations (86%) were within 24 h. Seven patients (4.5%) required surgical removal under general anesthesia. Most of the patients (92.4%) had no complications. Morbidities include bleeding from the ear canal 6 (3.8%), canal abrasions/lacerations 4 (2.5%), and tympanic membrane perforations 2 (1.3%). Conclusion: Aural FBs are common conditions in children in our environment. Most of these can be successfully removed by skillful personnel,  adequate immobilization, and proper instrumentation. Pediatricians, family physicians, and other health workers should not hesitate to refer to otorhinolaryngologists, uncooperative/apprehensive children, those with a history of attempted removal by their parents or caregivers, or FB whose contour, composition and position in the canal cannot be fully assessed. Keywords: Aural, children, foreign bodie

Biomedical colonialism or local autonomy?: local healers in the fight against tuberculosis

Analiza el papel de los agentes médicos autóctonos y sus conocimientos en las campañas antituberculosas contemporáneas en el África subsahariana. Sitúa la medicina contemporánea, llevada a cabo en África en la herencia cultural de la medicina colonial, para comprender el marco histórico en el que se desarrollaron, a partir de los años setenta del siglo XX, las estrategias de la Organización Mundial de la Salud de promoción y desarrollo de las medicinas 'tradicionales'. En los proyectos sanitarios analizados, se evalúan las prácticas médicas locales y se entrenan a los agentes autóctonos para integrarlos en actividades estrictamente biomédicas: identificación de síntomas, remisión a hospitales o supervisión de tratamientos farmacológicos.The article explores the role played by indigenous medical agents, and their knowledge, within contemporary tuberculosis campaigns in sub-Saharan Africa. To understand the historical framework within which the World Health Organization devised its strategies to promote and develop traditional medicine as of the 1970s, the article contextualizes contemporary medicine as a cultural legacy of colonial medicine. Under the public healthcare projects analyzed in the article, local medical practices were assessed and indigenous agents trained so they could take part in strictly biomedical activities, like symptom identification, referrals to hospitals, or supervision of drug treatments.Trabajo realizado para la obtención del Diploma de Estudios Avanzados (DEA) en el programa de doctorado Salud: Antropología e Historia, bajo la dirección de la profesora Rosa María Medina Doménech