Factors contributing to poor management outcome of sinonasal malignancies in south-west Nigeria

Objective: To describe the clinico-pathologic manifestations of sinonasal malignancies, identify the contributing factors to delay in presentation and recommend ways of preventing them in a resource challenged environment.Design: A questionnaire based cross sectional descriptive study of patients with sinonasal malignancies between 2006 and 2011.Setting: Hospital based study at the Otorhinolaryngology Department, University College Hospital, Ibadan.Participants: 61 patients diagnosed with sinonasal malignancies Main outcome measures: Patients demographic and essential medical data were collected with a structured, interviewer assisted questionnaire and results analysed using descriptive statistics.Results: There were 28(45.9%) males and 33(54.I %) females; mean age 37years. The common presentations were epistaxis, nasal obstruction and facial asymmetry and 96.7% patients with squamous cell carcinoma presented in advanced disease stage (Stage 3 & 4). Over 47% patients presented a year after onset of symptoms. Factors which included  self-medication, wrong advice from relations/ friends to consult traditional  herbalist or quacks for treatment and traditional & religious beliefscontributed to delay in presentation to hospitals. High cost of medical treatment, unwelcoming attitudes of some hospital staff, lack of confidence in orthodox medicine and proximity to health facilities were reasons given for not considering hospital as the first place to seek medical treatment.Conclusion: Health education to create awareness of sinonasal malignancies and provision of affordable and accessible health facilities especially in rural areas are recommended ways to encourage patients to present early in hospitals. This will improve the management outcome and quality of life of patients with sinonasal malignancies.Keywords: Delayed presentation, Health care services, Outcome, Sinonasal malignancie

Denture impaction in the oesophagus: correlation of site and duration of impaction with sequelae

Background: Denture restores aesthesis and function of missing teeth. Accidentally swallowed denture is an otorhinolaryngology emergency. The types of denture base and oesophageal anatomy infuluence the site of impaction.Objective: To review site of denture impaction and factors associated with site of impaction. To correlate site and duration of denture impaction before removal with associated sequelae.Method: A retrospective study of 27 patients managed in Otorhinolaryngology Department of University College Hospital Ibadan, Nigeria for oesophageal partial denture impaction, between August 2006 and September 2016. The demographic and clinical data of the patients were extracted from the hospital records, and statistical tables were used to illustrate the data.Results: A total of 27 patients; 14(51.9%) males and 13(48.1%) females, (M: F, 1.1:1) were studied. The age ranged from 24 to 77 years (mean age 49.0 ± 14.2years). Dentures were worn for 3 to 30 years (mean 3.8 ± 2.3years) without follow-up visit to dentist and 85.2% were upper dentures. All patients had history of accidental ingestion of denture, and the mean site of impaction was 18.2 ± 3.2cm from upper incisor, typically at upper cervical oesophagus in elderly patients and in lower oesophagus in females. There was no association between site of denture impaction, duration of denture impaction and operative findings.Conclusion: Advanced age and female gender are associated with site of denture impaction. Late hospital presentation significantly promotes sequelae associated with management of impacted dentures. It is recommended that fundamental changes in denture designs, education on regular follow-ups and avoidance of ill-fitting dentures would reduce the prevalence of denture impaction.Keywords: Denture impaction, Health education, Oesophagus, Oesophagoscopy and Nigeri

Informed consent for surgery in Nigeria: Is the practice adequate?

To evaluate the adequacy of the use of informed consent in surgical practice from the patients’ perspective. The study was carried out in the department of Surgery, University of Calabar Teaching Hospital, Calabar, over a six-month period. A structured questionnaire was administered post operatively on patients, and parents/guardians of minors, who agreed to participate in the exercise. Data obtained included sociodemographic characteristics, description of surgery they had, whether surgical procedure was explained to them pre operatively or not, who gave the explanation, their level of understanding and their opinion on the process of obtaining the consent. Ninety one patients participated in the study. Male to female ratio was 3.8:1, with average age of 33.6 years (SD ± 13). Most of them (94.6%) had some level of formal education. Seventy nine patients (86.8%) knew the description of the surgical procedure. Pre operative explanation of the surgical procedure was given to 70.3% of the patients but 27.5% of these did not understand the explanation. A significant number of the patients (51.6%) were not satisfied with the explanation given. Even though all the patients had the consent form signed either by themselves or on their behalf by a close relative, 46.2% of them did not understand the content of the consent form and 67.1% did not understand the implication of what they had signed. The practice of informed consent for surgery is not adequate. Surgeons need to be further educated to improve their practice in this regard. The consent process needs to be simplified to enhance patients’ understanding and participation

Hearing loss among adolescents on antiretroviral therapy: a need for periodic hearing assessment

Background: Human immunodeficiency virus-infected adolescents have insufficient CD4 T cell count, and despite attaining viral suppression with HAART regimen, some experience significant hearing loss.Objective: To determine the association between the hearing thresholds in HIV positive adolescent on highly active antiretroviral therapy and CD4 T cell count.Method: In this cross-sectional study, 63 adolescents receiving highly active antiretroviral therapy had pure tone audiometry and hearing thresholds determined using standard method. Additional data collected using proforma include biodata type of HAART regimens, treatment duration, the nadir and current CD4-cell count (cells/ml) and viral load (copies/ml) levels. These clinical parameters were correlated with hearing thresholds. Statistical analysis done included univariate analysis and multivariate logistic regression using Statistical Product and Service Solutions (SPSS version 20) and level of statistical significance was determined at P < 0.05.Results: There were 63 participants comprising of 26 (41.3%) males and 37 (58.7%) females, age ranged from 13 – 17 years (mean age 14.7years ± 1.65). Hearing loss was found in 20.6% adolescents and was predominantly sensorineural hearing loss. There was asoociation between hearing threshold, nadir CD4 count and viral load, but not with gender, current CD4 count and viral load, HAART regimen, and treatment duration.Conclusion: The high prevalence of adolescents with hearing impairment showed that there might be an association with the disease and/its treatment hence the need for inclusion of periodic hearing evaluation in the routine clincal care of HIV-infected adolescent on HAART.Keywords: Adolescents, CD4 nadir, HIV, Sensorineural hearing loss, Nigeri

Conventional and microwave pyrolysis remediation of crude oil contaminated soil

The Nigerian economy has relied heavily on crude oil production since independence in 1960. As a consequence, it has seen an influx of multinational petroleum companies with oil exploration and associated activities having significant environmental impacts, particularly oil leakage and spillage into soil and the overall degradation of the ecosystem in the Niger Delta area. This study aims to find a viable solution to the remediation of polluted soil by comparing two thermal remediation techniques, namely microwave pyrolysis and traditional pyrolysis, which has been investigated using a Gray-King retort. The polluted soil was first examined to ascertain the distribution of the soil organic carbon (SOC) with 78% found to be solvent extractable in dichloromethane/methanol, while 95 % was thermally labile and removed under hydropyrolysis (HyPy) conditions at 550 °C. The remaining 5 % of the SOC was composed of a recalcitrant residue being defined as the black or stable polyaromatic carbon fraction. The solvent extractable organic matter (EOM) was then further separated into the maltene (free phase) and asphaltene (bound phase) fractions together for comparison with a sample of Nigerian crude oil provided by the Shell Petroleum Development Company (SPDC), Nigeria. The Nigerian crude oil is a light crude oil with the percentage of maltene (95.2 %) was far higher than the asphaltene (4.8 %). A closer margin was observed in the percentage between the maltene (88.3 %) and asphaltene (11.7 %) in the soil EOM due to biodegradation. The biomarker profile of the EOM was compared with that of a Nigerian crude oil to confirm that the EOM contains the crude oil in the soil. Their biomarker profiles revealed that the source inputs were terrigenous from deltaic settings, of Late Upper Cretaceous age and deposited under oxic conditions. Oleanane (a pentacyclic triterpene, abundant in oils from the Niger Delta) was present in both the crude oil and EOM and the hopane and the sterane distributions (m/z 191 and m/z 217 respectively) were similar in every respect, which indicates that the probable source of the pollutant crude oil in the soil is similar in composition to the Nigerian crude oil. Accordingly, the polluted soil was treated with microwave pyrolysis and Gray-King pyrolysis to remove the crude oil pollutant. The maximum average recovered products from the thermal remediation process with Gray-King pyrolysis is 99.4 % TOC and maximum crude oil pollutant removed by Gray-King pyrolysis was 85.3 % TOC with maximum oil recovery of 70 % TOC from all the different treatment conditions, while the shortest treatment time condition gave the lowest gas yield of 10.2 % TOC. This implies that 100 % removal with respect to EOM and 89 % removal with respect to HyPy as discussed above. Furthermore, the polluted soil was also treated with microwave pyrolysis with maximum pollutant removal of 77 % TOC, which is 98.7 % removal with respect to EOM and 81 % with respect to HyPy. In conclusion, Gray-King pyrolysis removed more of the soil organic carbon than microwave pyrolysis, but the latter does have advantages regarding operability and greater output within a short treatment time

Pharyngo-cutaneous fistula post total-laryngectomy: A local experience

Background: Pharyngo-cutaneous fistula is a major complication of total laryngectomy. Despite its significant impact on the patients' nutrition and management outcome, there is lack of consensus for recognising high-risk patients and factors associated with fistula formation. Hence, this study was aimed at determining the incidence of pharyngocutaneous fistula and factors associated with fistula formation.Methods: A retrospective collection of data on all cases of laryngeal cancer diagnosed histologically and had total laryngectomy, in the  Otorhinolaryngology Department of a tertiary centre in Southwestern, Nigeria, from 2007 – 2016. The data collected includeage, gender, tumour stage, tracheostomy, adjuvant therapy extent of laryngectomy procedure and factors for pharyngo-cutaneous fistula.Results: Forty-two patients had total laryngectomy, male to female ratio was 7.4:1 and mean age was 52.3 ± 2.1 years. All patients had pathological diagnosis of stage 3 (83.3%) and stage 4 (16.7%) laryngeal cancer, respectively. The incidence of pharyngo-cutaneous fistula was11.9% and the factors related to fistula formation were prior radiotherapy treatment and diabetes. Age, gender, neck dissection procedures, site of primary tumor and emergency tracheostomy did not contribute to fistula formation. Spontaneous fistula closure was achieved in all cases except one patient who had surgical closure.Conclusion: Pharyngo-cutaneous fistula formation post-surgery is related to the presence of co-morbidities. The high percentage of spontaneous closure underscores the need for a conservative management approach. Keywords: Laryngeal Cancer, Laryngectomy, Neck dissection, Pharyngo-cutaneous fistula, Post-surgery, Radiotherap

Towards A Creative Use of Social Media Tools in the Delivery of Academic Library Services in Nigeria

Social media tools have obviously brought about a paradigm shift in the delivery of library services in Nigeria. The paper explores the applicability of various social media tools in the library and how social media tools have proven useful in academic libraries. Aside from the benefits of social media tools in academic libraries, the paper highlighted the potential challenges of using social media tools in library services in academic libraries, in particular, the lack of awareness of the university\u27s social media accounts among library users. Despite the identified challenges of social media tools for academic library service delivery, the paper concludes that utilization of social media tools remains a boon for library service delivery in this 21st century

Conventional and microwave pyrolysis remediation of crude oil contaminated soil

The Nigerian economy has relied heavily on crude oil production since independence in 1960. As a consequence, it has seen an influx of multinational petroleum companies with oil exploration and associated activities having significant environmental impacts, particularly oil leakage and spillage into soil and the overall degradation of the ecosystem in the Niger Delta area. This study aims to find a viable solution to the remediation of polluted soil by comparing two thermal remediation techniques, namely microwave pyrolysis and traditional pyrolysis, which has been investigated using a Gray-King retort. The polluted soil was first examined to ascertain the distribution of the soil organic carbon (SOC) with 78% found to be solvent extractable in dichloromethane/methanol, while 95 % was thermally labile and removed under hydropyrolysis (HyPy) conditions at 550 °C. The remaining 5 % of the SOC was composed of a recalcitrant residue being defined as the black or stable polyaromatic carbon fraction. The solvent extractable organic matter (EOM) was then further separated into the maltene (free phase) and asphaltene (bound phase) fractions together for comparison with a sample of Nigerian crude oil provided by the Shell Petroleum Development Company (SPDC), Nigeria. The Nigerian crude oil is a light crude oil with the percentage of maltene (95.2 %) was far higher than the asphaltene (4.8 %). A closer margin was observed in the percentage between the maltene (88.3 %) and asphaltene (11.7 %) in the soil EOM due to biodegradation. The biomarker profile of the EOM was compared with that of a Nigerian crude oil to confirm that the EOM contains the crude oil in the soil. Their biomarker profiles revealed that the source inputs were terrigenous from deltaic settings, of Late Upper Cretaceous age and deposited under oxic conditions. Oleanane (a pentacyclic triterpene, abundant in oils from the Niger Delta) was present in both the crude oil and EOM and the hopane and the sterane distributions (m/z 191 and m/z 217 respectively) were similar in every respect, which indicates that the probable source of the pollutant crude oil in the soil is similar in composition to the Nigerian crude oil. Accordingly, the polluted soil was treated with microwave pyrolysis and Gray-King pyrolysis to remove the crude oil pollutant. The maximum average recovered products from the thermal remediation process with Gray-King pyrolysis is 99.4 % TOC and maximum crude oil pollutant removed by Gray-King pyrolysis was 85.3 % TOC with maximum oil recovery of 70 % TOC from all the different treatment conditions, while the shortest treatment time condition gave the lowest gas yield of 10.2 % TOC. This implies that 100 % removal with respect to EOM and 89 % removal with respect to HyPy as discussed above. Furthermore, the polluted soil was also treated with microwave pyrolysis with maximum pollutant removal of 77 % TOC, which is 98.7 % removal with respect to EOM and 81 % with respect to HyPy. In conclusion, Gray-King pyrolysis removed more of the soil organic carbon than microwave pyrolysis, but the latter does have advantages regarding operability and greater output within a short treatment time

Makerspaces Realities in Nigerian Academic Libraries

Makerspaces and varying new technologies are exciting services now being offered in libraries, particularly academic libraries. The paper focuses on the reality of maker space in academic libraries in Nigeria. Creativity and innovation are the biggest parts of makerspace thus; implementing makerspaces programs into academic libraries also allows students to engage in critical thinking and active learning outside of the classroom. The paper examined the concept of makerspaces as a learning space as well as the value of maker space in academic libraries. The paper itemized steps to developing a successful makerspaces in academic libraries in Nigeria. Also, the paper identified the perceived challenges of creating makerspace in academic libraries in Nigeria, notable among them are technophobia, funding challenges, inadequate spaces, among others; the paper concluded the need to have makerspaces in academic libraries in Nigeria and the need for stakeholders in the educational sector to maximally support and embrace this innovation

Review on the Fate of Contaminants in the Niger Delta Environment

Niger Delta environment had suffered from impacts of waste over the years. The significant wastes in the region are crude oil and municipal wastes. Studies have shown the effect and fate of contaminants in the environment and human life. This paper reviews the impact and fate of contaminants in the Niger Delta environment with the focus on crude oil waste and municipal waste. The substantial quantities of waste generated resulted from unreasonable consumption and production, non-compliance to environmental laws and regulations, migration to urban cities, and sporadic expansion of unregulated industrial operations. These contaminants affect various life forms, natural resources, and increase the rate of global warming. It is of urgent importance for concerted efforts from corporate bodies, government, and individuals to ensure proper implementation of effective, safe management of waste. This review used Niger Delta environmental contaminant analysis and remediation case studies to highlight the fate of organic and inorganic contaminants and their associated adverse effects on the environment. This review contains secondary data from online journal articles, radio, symposium, doctoral thesis, organisations, and websites. Keywords: Crude oil, Heavy hydrocarbons, Spills, Dumpsite, Pesticides, Fate, contaminants, Toxic, Degradation. DOI: 10.7176/JEES/10-5-05 Publication date:May 31st 202