Patients’ Perception of a Symptomatic Tinnitus among Nigerians: A multi-institutional study

Tinnitus is a very common otologic symptom presented by patients worldwide yet it’s a poorly understood disorder. This study is aimed at assessing the perception of patients of their tinnitus. A multi-center prospective study carried out in Ear, Nose and Throat Department of two tertiary health institutions in Nigeria over a period of 12 months using a semi-structured Modified Tinnitus Impairment Questionnaire (THI-12) from Greimel et al after an informed consent. Information collected is entered into SPSS statistical software version 16.0 and analysed descriptively and results presented in tables and figures.All consecutive adult patients who presented for the first time at these clinics with complaints of tinnitus were included in the study.A total of 168 patients with tinnitus consented to partake in the study comprising 38.2% males and 61.8% females with M: F ratio of 1:1.6. The age ranged from 18-80years, with a mean of 46.8 years. About 48.5% had tertiary education and 38.1% are self-employed, duration varied from 3 days to 25 years. The degree of discomfort experienced in the presence of tinnitus was said to be much in 16.2%, little in 63.2% while 17.7% experience no discomfort and no response in 2.9% patients. The degree of hearing loss varied with the severity of tinnitus however none had profound hearing loss.Tinnitus is still a problem among the sufferers as 16.2% describes it as bothersome, the need for proper evaluation of all medical problems and the need for a community-based programme to assess the degree of disability of clinical tinnitus in the population will go a long way in defining its gravity

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Pediatricotorhinola ryngological services: Any need for its establishment?

Background: the pediatric population form a significant proportion of the work load of an otolaryngologist. The pediatric population has special needs. There is paucity of data on pediatricotorhinolaryngological disorders in the South -South region of Nigeria. The pattern of pediatricotorhinolaryngological presentation at the University of Benin Teaching Hospital is presented. Methods: this was a descriptive retrospective review of the records of all patients aged 0-18 years old presenting at the ear, nose and throat outpatient clinic for the first time from January 2013 to December 2013. Data retrieved was age, sex, presenting complaint, diagnosis and treatment outcome. Results: A total of 1503 new patients were seen during the study period. Of these, 515 were aged 18 years and below. Only 486 of the pediatric patients had complete medical records and were eligible for enrollment into the study. There were 267(54.9%) males and 219 (45.1%) females. The age group most commonly affected was the 0-5years. Otologic disorders were the most prevalent condition encountered accounting for 55.8% of the cases. Adenotonsillitis was the single most common diagnosis among the children accounting for 24.5% (n=119) while adenoiditis and tonsillitis accounted for 3.4% (n=17/486) and 4.5% (n=22/486) respectively. Rhinosinusitis was the commonest nasal condition encountered in our study. Foreign bodies in the ear, nose and throat was a common feature accounting for 6.0% (n=29) of the cases. Conclusion: children form a significant proportion of the work load of an otolaryngologist. Otologic symptoms are the commonest reason for consultation while adenotonsillitis is the commonest diagnosis. There is need for the development of pediatricotorhinolaryngological services.Keywords:Pediatric, otological, rhinological, disorders, pattern

Management Outcome of Acute Complicated Juvenile Rhinosinusitis in a Low-income Setting: A Retrospective Study

Neglected or poorly contained viral rhinosinusitis in children younger than 18 years can result in acute complicated bacterial rhinosinusitis which is life-threatening and can lead to morbidity and mortality. To report demographics, the mode of clinical presentation, and management outcome of complicated acute juvenile rhinosinusitis in our environment. This is a retrospective descriptive study of  records of 20 children aged 8-18 years with acute complicated rhinosinusitis hospitalized at the University of Benin Teaching Hospital from January 2015- December 2019. Data recorded included social demographics, clinical presentations, duration of symptoms, diagnostic techniques, therapeutic management, course, and outcome, and days of hospitalization. Data were analysed with SPSS version.20.0. Results were presented in tables and figures. A record of 20 patients aged 8-18 years  were retrieved and  included in this study. The mean age was12.75 ( SD ± 2.88). Male: female ratio was 4:1.More patient presented  in January (4). Symptoms were fever, headache, and rhinorrhoea (100%), eye swelling (30%). Most symptoms occurred within 30 days. Radiological investigation was computed tomography scan. Ethmoid and maxillary sinuses were affected  in 100% of cases. Subdural empyema was the most common intracranial complication in 60%. Otorhinolaryngological and neurosurgical interventions included external frontoethmoidectomy, intranasal antrostomy, and stenting, craniotomy, and abscess drainage in 90% and 75% respectively, and repeated surgeries in 60%. Antibiotics was administered pre and postoperatively. Sixty-five percent of patients spent more than 36 days in the hospital. Management outcome was good for 90% while death occurred in 2(10%). There was a statistical significance between surgical interventions and length of hospital stay (p=0.001) at 95% confidence interval. No patient was immunocompromised. Juvenile complicated acute rhinosinusitis still ravages young lives in our environment. A high index of suspicion and urgent referral is required on the part of primary physicians, and multi-disciplinary efforts of physicians and surgeons for a good outcome. Keywords: Juvenile, complications, rhinosinusitis, intracranial, management

Prevalence and management of sore throats and tonsillitis in a boarding school in Benin City

Sore throat is a common presentation in paediatric emergency and sick bays in  schools. It is associated with acute upper respiratory tract infection, and recurrent episodes of infection may result in recurrent tonsillitis which may be complicated by sleep disorders, rheumatic heart disease and acute glomerulonephritis. Untreated or poorly treated cases can lead to recurrent episodes, absence from school and  therefore the need to study the pattern and management within the boarding schools where the parental care are lacking.Aim: Health is key determinant factor for school entry, as well as an important factor in continued participation and attainment of future goals in life. Adequate knowledge of the pattern of sore throats and its management will lead to prompt treatment, appropriate referral and early return to learning which is the objective of this study.Methods: This was a 3-month cross-sectional study using interviewer-administered Questionnaires among secondary school boarding students. Microsoft excel was used. Statistical analysis, quantitative variables were expressed in mean and  standard deviation and qualitative variables in percentages.Results: A total of 564 students were interviewed and examined. Average age was 12.8918yrs ± 1.85935. Prevalence of sore throat was 89.2% (503). Average frequency of sore throat was 2.2589 ±2.10143. Symptoms were odynophagia 92.8%, cough 50.5%, and fever 36.4%. Examination revealed signs of inflammation in 387(76.94%), cervical lymphadenopathy in 6.8%. Average tonsillar size was 1.9043 ±.94880.Conclusion: Sore Throat is common in boarding schools. Recognition of the pattern of presentation and adequate treatment will prevent complications and disruption of learning.Keywords: Sore throat, Tonsillitis, frequency, symptoms, lymphadenopath