CHRONIC SUPPURATIVE OTITIS MEDIA IN SCHOOL PUPILS IN NIGERIA

ABSTRACTObjective: To compare the prevalence of CSOM among two population of school children.Design: A survey-demographic data collection and otoscopy - was carried out amongthe two populations of school children.Setting: A rural government primary school and an urban private primary schoolParticipants: Six hundred and ninety nine school pupils in the rural school and twohundred and seventy pupils in the urban school.Results: Six percent (6%) of the pupils in the rural schools had CSOM as evidencedby persistent perforation of tympanic membrane of more than three months duration.No tympanic membrane perforations were observed in the children in the urban schoolat the time of this study. The difference in the prevalence of CSOM between the twopopulations is statistically significant (P<0.001).The difference in socio-economic status between the two populations is statisticallysignificant in relation to the prevalence of CSOM in the two populations. The poorerrural population had a significantly higher prevalence of CSOM (P<0.001).Conclusion: The two study populations are just 7km. apart geographically but thereis a world of difference in their socio-economic status, availability of social infrastructureand health facilities. This presumably had reflected in the marked difference in theprevalence of CSOM between the two study populations. A collective effort ofgovernment and well meaning indigenes of rural communities in Nigeria can helppromote the socio-economic status and enhance the availability of social infrastructureand health facilities of rural areas. This we hope will lead to a decline in the prevalenceof CSOM in the rural areas

BACTERIOLOGY OF CHRONIC SINUSITIS IN ILORIN, NIGERIA

A prospective study of the bacteriology of 120 patients with chronic sinusitis and 55 control subjects seen between January 1995 and December 1998 in the Ear, Nose and Throat (ENT) Diseases Clinic of University of Ilorin Teaching Hospital, Ilorin, Nigeria was made. Whereas all cultures from the control group yielded only Staphylococcus (63.6% Coagulase positive and 36.4% Coagulase negative), cultures of patients with chronic sinusitis yielded Staphylococcus aureus (48.1%), Escherichia coli (20.4%), Klebsiella spp. (20.4%), Streptococci (7.4%) and Streptococcus pneumoniae (3.7%). The isolates were 100% sensitive to Ofloxacin, while penicillin was the least effective antimicrobial agent across board. It was concluded that because of the difficulty in differentiating pathogenic organisms from commensals, the result of nasal swabs should be interpreted with caution. However, non-otolaryngologists involved in the management of the vast majority of patients with chronic sinusitis should request a carefully obtained posterior nasal mucosal swab. (Af J Clinical & Exp Microbiology: 2003 4(2): 91-97

Vagal reflex stimulation complicating retrieval of an unusual foreign body from the laryngotracheal lumen: Case report

Foreign body impaction in the aero digestive tract is a life-threatening emergency, particularly in the paediatric age group. Removal under general anaesthesia poses both surgical and anaesthetic challenges and this may rarely result in mortality. We report a case of a 4 year old boy with an unusual foreign body (FB) impacted in the laryngotracheal causing difficult intubation and precluding tracheostomy with attendant vasovagal reflex stimulation and cardiac arrest. Clinical presentation and radiological evaluation of the patient were highlighted with a review of pertinent literature. We conclude that dis-impacting a foreign body in the trachea could potentiate bradycardia and cardiac arrest; co-existing hypercarbia and/or sepsis increase the risk and worsen the prognosis

Lifelong occupational exposures and hearing loss among elderly Latino Americans aged 65–75 years

OBJECTIVE: The purpose of this study is to determine the relationship between occupational exposures and hearing among elderly Latino Americans. DESIGN: A descriptive, correlational design used for this secondary analysis with the data from the Sacramento Area Latino Study of Aging (SALSA). STUDY SAMPLE: A total of 547 older adults were included. RESULTS: A majority of participants (58%) reported occupational exposures to loud noise and/or ototoxic chemicals. About 65% and over 90% showed hearing loss at low and high frequencies, respectively. Participants with occupational exposure to loud noise and/or ototoxic chemicals were, significantly, two times more likely to have hearing loss at high frequencies compared to those without exposure (OR = 2.29; 95% CI: 1.17 – 4.51, p = .016), after controlling for other risk factors of hearing loss such as age, gender, household income, current smoking, and diabetes. However, lifelong occupational exposure was not significantly associated with hearing loss at low frequencies (OR = 1.43; 95% CI: 0.94 – 2.18, p = .094). CONCLUSION: Lifelong occupational exposure to loud noise and/or ototoxic chemicals was significantly associated with hearing loss among elderly Latino Americans. Healthy work life through protection from harmful auditory effects of occupational exposures to noise and chemicals will have a positive impact on better hearing in later life

The Susy Safe project overview after the first four years of activity

Objectives: to collect relevant, up-to-date, representative, accurate, systematic information, related to foreign bodies (FB) injuries. Methods: The "Susy Safe" registry, a DG SANCO co-funded project gathering data on choking in all EU Countries and beyond, was established in order to create surveillance systems for suffocation injuries able to provide a risk-analysis profile for each of the products causing the injury. Main findings after 4 years of activities are resumed here. Results: 16,878 FB injuries occurred in children aged 0-14 years have been recorded in the SUSY SAFE databases; 8046 cases have been reported from countries outside EU. Almost one quart of the cases involving very young children (less than one year of age) presented a FB located in bronchial tract, thus representing a major threat to their health. Esophageal foreign bodies are still characterizing injuries occurred to children younger than one year, in older children the most common locations are the ears and the nose. FB type was specified in 10,564 cases. Food objects represented the 26% of the cases, whereas non-food objects were the remaining 74%. Among food objects, the most common were bones, nuts and seed, whereas for the non-food objects pearls, balls and marbles were observed most commonly (29%). Coins were involved in 15% of the non-food injuries and toys represented the 4% of the cases. Conclusions: this data collection system should be been taken into consideration for the calculation of the risk of injuries in order to provide the EU Commission with all the relevant estimates on FB injurie

Symptoms associated with button batteries injuries in children: An epidemiological review

Objectives: To provide an epidemiological framework of symptoms related to Foreign Body (FB) injuries due to Button Battery (BB). Methods: Data on BB ingestion/inhalation have been obtained from the ButtonBatteryDB. The ButtonBatteryDB is a database collecting information on BB injuries in children (0-18 years of age). Data on 348 BB injures have been derived from the Registry of Foreign Body Injuries "Susy Safe" (269 cases) and from published scientific literature reporting case reports of FB injuries (79 cases). Results: Most of injured children were male and BBs were found more often in the mouth/esophagus/stomach (ICD935) and in the nose (ICD932). Analyzing symptoms related to BB located in the esophagus/mouth/stomach, we found that children had higher probability of experiencing dysphagia (30.19%, 95% C.I. 17.83-42.55), fever and cough (26.42%, 95% C.I. 14.55-38.28), compared to the other symptoms. Referring to the probability that symptoms occurred simultaneously, fever and cough are more likely (3.72%, 95% C.I. 1.0-6-43) to jointly showing up in children with BB in mouth/esophagus/stomach (ICD935), followed by fever and dysphagia (2.66%, 95% C.I. 0.36-4.96) and by fever and irritability/crying, fever and drooling, dysphagia and irritability/crying (2.13% C.I. 0.00-4.19, 95% C.I.). Conclusions: These findings provide new insight in clinical presentation of BB injuries: the identification of unique patterns of symptoms related to BB injuries is useful to perform an early diagnosis (and to guarantee a prompt medical reaction), also when the injury is un-witnessed. © 2015 Elsevier Ireland Ltd