Bacteriological agents of chronic discharging ears and their antibiotic sensitivity pattern in Ido – Ekiti, Nigeria

Aims and Objectives: To identify bacterial agents of chronic discharging ear and determine their antibiotic sensitivities pattern in Ido – Ekiti, Nigeria. Patients and Methods: Swab specimens of each chronically (>8 weeks) discharging ears of patients with chronic suppurative otitis media (CSOM) presenting to the Ear, Nose and Throat (ENT) clinic of the Federal Medical Centre, Ido Ekiti were bacteriologically cultured aerobically and the antibiotic sensitivity pattern of the recovered organisms determined by the modified Kirby-Bauer disc-diffusion method over a three year period starting from January 2005. Results: Seventy eight patients with CSOM whose age ranged between 3 months and 85 years were seen during the study period with 73.1% of them having unilateral disease and majority were children <15 years (71.8%). Out of 99 ear swabs that were examined, 87.9% were culture positive with 90.8% yielding a single isolate. Coliforms (34.7%) were the most frequent isolated group of organisms. Other isolates included Staphylococcus aureus (26.3%), Proteus spp (24.2%), Pseudomonas spp (9.5%) and Klebsiella spp (5.3%). Sparfloxacin and ciprofloxacin showed highest activity on all the isolates unlike cefuroxime and ceftiaxone to which all isolates were resistant. Conclusion: Chronic discharging ear is caused by bacteria agents most sensitiv

Clinico-pathological pattern of nasopharyngeal carcinoma in Ilorin, Nigeria

Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high.The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria.This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991WHOclassification. A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable riskfactors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by welldifferentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%).Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. Early diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease

Pre-Operative Vocal Cord Palsy in Goitre Patient

Objectives: Determine the prevalence of vocal cord palsy and the relative prevalence of asymptomatic vocal cord palsy in pre-operative goitre patients using flexible fibreoptic laryngoscope (FFL) as a laryngeal  visualisation technique.Design: Hospital-based, cross-sectional study conducted throughout 2011 on consecutive, consenting pre-operative goitre patients referred to the E.N.T Department, University of Ilorin Teaching Hospital. Ilorin, Nigeria.Setting: University of Ilorin Teaching Hospital (U.I.T.H) Ilorin is a 600-bedded tertiary institution, serving primarily patients from Kwara State.Subjects: One hundred and ten consenting patients, age 16 and above- whose cooperation could easily be gained for an awake-laryngoscopy procedure.Results: Mean age, 42.98 ± 14.71. Female: Male = 4.5:1. Palsy rate was 2.9% and 25% in benign and malignant goitre respectively. Hoarseness was reported by 3(2.7%) patients with vocal cord palsy (p 0.001). Asymptomatic palsy was 40%.Conclusion: The prevalence of pre-operative vocal cord palsy was 4.5%; Relative prevalence was 2.9% and relative prevalence was 25% in benign and malignant goitre respectively

Uncommon complications of Otitis media in a tertiary center: A Case Series

Background: The aim is to report cases of unusual and infrequent complication of otitis media in North-central Nigeria, as well as evaluate their outcome. We present 7 case reports of patients with unusual complications from otitis media in our setting.Case 1: A fifteen year old Yoruba girl presented at the Accident and emergency of our hospital with a 2 week history of left sided ear ache, 10 day history of left sided ear discharge and 3 day history of jaw and neck stiffness. There was a positive history of use of ‘Turari’ locally prepared perfume and application of an ear drop from a local chemist. Caregiver said patient was fully immunized. Examination revealed a young girl, conscious and alert, not pale, anicteric with stiff neck, positive and rigid joints on movement.Case 2: An 8 year old Yoruba girl presented first to the eye clinic with 2 days history of swelling of the right eye, associated pain, reduction in vision and eyelid swelling without eye discharge or itch. There was a of purulent ear discharge 8 days prior to eye symptoms. No history of trauma was obtained. Examination revealed proptosis with zygomatic abscess extending to the post-auricular. She had incision and drainage with systemic and topical antibiotics for ear dressing. Outcome was uneventful.Conclusion: The unusual complication of otitis media still occurs in our environment usually due to late presentation and contamination of wound. Prevention is still the best option.  Keywords: Otitis Media, Complications, Otogenic Tetanus, Ophthalmic, Proptosi

Traumatic Tympanic Membrane perforation: An aetiological profile

<p>Abstract</p> <p>Background</p> <p>Traumatic perforation of the tympanic membrane may be due to direct or indirect source. The aim of the study is to profile the various aetiologies of traumatic tympanic membrane perforation in Ilorin, north central Nigeria.</p> <p>A retrospective review of 64 patients seen at the University of Ilorin Teaching hospital, Ilorin, Nigeria over a ten year period (January 1998 to Dec 2007) with history of traumatic tympanic membrane perforation from various causes, these also included multiply injured patients with bleeding from middle ear as part of their presentations. The data retrieved included the biodata, the clinical presentations, source of injury, the clinical findings and the treatment outcome. The data were entered into an SPSS version 11 computer soft ware and analyzed descriptively.</p> <p>Findings</p> <p>Sixty four (64) ears were analysed, Age range 6 months to 50 yrs, mean age of 29.2 yrs 7.9% of them were ≤5 years, 29.7% between 21-34 years, and 37.7% were 35 years and above. The male to female ratio was 2.5:1.0. Commonest aetiology was from slaps, then road traffic injury (RTI) in 35.9% and 23.5%, Majority of the slap injury were from fights (30.5%), security agents, senior students and cultists at schools (17.4% each). Sudden hearing loss was a typical presentation (95.3%), majority of the patient defaulted from follow up once the symptoms of bleeding and pain subsided. Only 7.8% had neomembrane formation on follow up</p> <p>Conclusion</p> <p>Traumatic perforation of the tympanic membrane is an uncommon injury that is under-reported, there is the need to educate on alternative punitive measure among students and security agents, unskilled removal of foreign body, early identification, evaluation and referral of patients reduces the attendant morbidity.</p

Chloroquine-induced Acute Dystonic Reactions after a Standard Therapeutic Dose for Uncomplicated Malaria

Acute dystonic reactions (ADR) are extrapyramidal effects that usually occur after the initiation of a wide variety of drugs or triggering factors besides neuroleptics. We report the case of a 54-year-old man who was admitted with an approximately 10-hour history of muscle twitching around the eyes, face and neck after he took the first dose of oral chloroquine phosphate (1 g [600 mg base]) prescribed for uncomplicated malaria. He was given intravenous diazepam (10 mg statum) followed by 10 mg of oral diazepam 3 times a day. The symptoms improved within 30 minutes of treatment, and he was discharged 14 hours later after a complete recovery

Knowledge, attitude, perceptions of adult males towards childhood immunizations in southwest Nigeria

Background: Immunisation is a cost effective public health intervention in reducing morbidity and mortality from vaccine preventable diseases worldwide. In Nigeria, childhood immunisation against poliomyelitis is still bedeviled by setbacks which are multifactorial. Objectives: The objective of the study was to determine the knowledge, attitude and perceptions of adult males towards childhood immunizations in Nigeria. Methods: The research was a descriptive crosssectional study of adult males in the Ido-Osi local government area of Ekiti state, southwest Nigeria. Multistage sampling method was used to select 320 adult males for the study, and a pre-tested semi-structured questionnaire was used to collect quantitative data. Statistical analysis was done using the Epi Info 4. P value <0.05 was considered asstatistically significant. Results: Mean age (±SD) of the respondents was 48.4±12.6 years with range of 20-95 years. About half (50.6%) of the respondents were in the age group 40-59 years. 79.7% were married while only 2 were single with about two-thirds of the married respondents in monogamous family type. 82.3% were willing to support childhood immunization. The association between respondents’ religion and education, and willingness to support childhood immunization was found to be statistically significant: (x 2 =51.53; df=6; p=0.0000) and (x 2 =65.48; df=6; p=0.0000) respectively. Conclusion: The study showed that the knowledge of adult males about childhood immunization was high. The perception of childhood immunization as a means of protection from certain illnesses was also common and most men were willing to support it. The support for childhood immunization was significantly affected by religionand level of education