IntroductionAlthough Laryngeal papillomatosis is a rare disease and can be conventionally managed through surgical excision as well as adjuvant therapy yet Laryngeal papillomatosis has high tendency to recur raising its prevalence in the community, airway involvement warrants dangerous complications requiring emergency tracheostomy, especially if clinical course is poorly understood and misdiagnosis is common. The study aims to determine the prevalence, clinical features, risk factors and recurrence of Laryngeal Papillomatosis among patients attending ENT department at KCMC from 2005 to 2015.MethodsThis was a 10 year experience/ Descriptive hospital based cross-sectional study conducted based on patients' medical record at KCMC. Information was recorded into data collection sheets, entered and analyzed through SPSS version 20, summarized and presented in tables and charts, proportions and percentage used to compare groups.Results51 patients were identified over the 10 years study period corresponding to a prevalence of 0.09%. 26 were males and 25 females, ages ranging from 1 to 67 years. The median age of onset was 6 years. Children less than 5 years accounted for 19 (37.3%) and 58.8% had repeated surgeries. Clinical presentation ranged from hoarseness in 43 (84.3%) patients to weight loss 3 (5.9%) and 96.1% showed complete or partial presence of the clinical triad of risk factors.ConclusionLaryngeal papillomatosis is a rare disease that carries severe morbidity due to its highly recurring nature. It is primarily a paediatric disease, generally affecting more males; its clinical features highly resemble other airway obstructive diseases and therefore a careful thorough clinical evaluation is required in order to correctly diagnose Laryngeal papillomatosis.
The current global pandemic caused by coronavirus has uncovered multiple symptoms, including sudden hearing loss in either one or both ears, with different outcomes. We present a 68-year-old female with sudden onset bilateral hearing loss, fever, generalized body weakness, and gastrointestinal disturbances. She tested positive for severe acute respiratory syndrome coronavirus 2, was isolated, and was treated with a variety of medications for 5 days before being discharged home to self-isolate. The audiological assessment revealed both sensorineural and conductive hearing loss with a progressive favorable outcome on follow-up visits, with resolution occurring approximately 2 months after the onset. The majority of cases have reported sensorineural hearing loss. However, this case is one of the few that has reported mixed hearing loss. This report highlights an alternate clinical feature of the coronavirus that requires a comprehensive audiological examination by clinicians to ensure proper identification and treatment.
Background: Surgical site infections are dreaded by many as they impose a greater economic costs, morbidity and mortality that in developing countries place a burden on an already burdened healthcare system. In Tanzania previously studies done in different centers reported high rates of Surgical Site Infection. This study aimed to quantify in a low income, tertiary hospital, the rate of Surgical Site infections, microorganisms implicated and their respective sensitivity pattern to local antibiotics, and associated perioperative risk factors in electively operated surgical and gynecological patients at Kilimanjaro Christian Medical Centre.Method: 301 patients admitted for elective procedures in the surgical and gynecological units were enrolled consecutively after consenting for the study. A standardized data collection form was used to record patients' information on perioperative risk factors. Patients were followed up in surgical outpatient clinic up to one month post discharge. Swabs from wounds showing signs of infection were taken for culture and sensitivity and processed at the laboratory as per standard operating procedures.Results: Out of a total of 301 patients, 181 patients were from general surgical ward and 115 from gynecological wards. Females were more than males (3:1) with most, 43.9% within the age group 40 to 60 years. Overall, 21.3% of the patients developed surgical site infection. 71 organisms were isolated, S. Aureus species were the leading cause of surgical site infections making 52% of the total isolates. Most of the gram positive organisms were resistant to ampicillin, the common antibiotic used in the gynecology unit. Contaminated wounds were 10 times more likely to develop surgical site infections, and clean contaminated wounds fi ve times when compared to clean wounds. Duration of procedure, Surgeons skills, wound class and number of people in theater showed signifi cant association with surgical site infection, however only wound class and duration of procedure remained statistically signifi cant after a multivariate analysis.
Conclusion:We found an SSI rate of 21.3%, slightly higher than previous studies in the same center. The wound class and duration of procedure remained signifi cant risk factors after logistic regression analysis. As with other studies, S. Aureus was the most common causative organism for SSI isolated from our study.
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