Background: Chronic suppurative otitis media (CSOM) is a global middle ear disease worst in developing nations of the world. The burden in our environment of repeated episodes of childhood CSOM, and the resultant difficulty in the management of these patients because of improper or inadequate treatment is quite worrisome. Aim: The aim of this study was to prospectively analyze the aspirated middle ear exudates of paediatric patients with CSOM for both facultative aerobic bacteria and fungi, with their antimicrobial sensitivity patterns. Materials and Methods: A total of 166 children clinically diagnosed with CSOM were enrolled in the study, of which 219 middle ear discharge samples were obtained using sterile disposable plastic Pasteur pipettes and cultured for microbial flora. Drug susceptibility testing for the isolated microbes was conducted using the Kirby‑Bauer disc diffusion method. Results: The ratio of facultative aerobic bacteria to fungi was 2.1: 1, while the ratio of Gram-positive to Gram-negative aerobic bacteria was 1: 1.7. The most common causative aerobic organisms isolated were Staphylococcus aureus 41/202 (20.3%), Pseudomonas aeruginosa 30/202 (14.9%), Klebsiella pneumonia 23/202 (11.4%), and Proteus mirabilis 21/202 (10.4%). Aspergillus species 47/202 (23.3%) and Candida albicans 21/202 (10.4%) were the commonest fungal isolates. The antimicrobial profile of aerobic isolates revealed maximum sensitivity to gentamycin (91.1%), ceftriaxone (90.1%), and ciprofloxacin (85.6%); while the isolated fungi were completely sensitive to all the antifungals. Conclusion: The main isolates were Gram-negative aerobic bacteria, though Gram-positive aerobes and fungi were also isolated. Their varying antimicrobial susceptibility brings to the fore, the therapeutic significance of these drugs in CSOM management.
Background: In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients' safety and surgeons' convenience. However, in some developing countries such as Nigeria, facilities and expertise for general anaesthesia are not equitably distributed. As such, they are not available in some health centers especially in the rural communities. Hence, the need to explore other suitable alternatives such as operating under local anaesthesia. Aim: This study aims to highlight the feasibility and safety of thyroidectomy under local anaesthesia at a surgical outreach in a rural community in Nigeria. Patients and Methods: The study site was conducted at Bethany Medical Centre, Gboko, Benue State, Nigeria. It was a one-week surgical outreach. Neck infiltration with local anaesthesia was carried out using 2% xylocaine with adrenaline 1:200,000 and a standard open technique was used to carry out all thyroidectomies. Results: Out of seventy (70) patients that presented during the study period, 31 (44.3%) met the inclusion criteria and were operated within the seven (7) days period. There were 3 (10.7%) males and 28 (89.3%) females. There ages ranged between 22 to 65 years, average was 43 years. The average duration of surgery was 90 minutes, and 3 days' hospital stay. Those followed up two weeks post-operation recuperated well with no notable complications. Conclusion: Thyroidectomy under local anaesthesia is safe and feasible in our rural communities and in selected cases can be a suitable alternative to general anaesthesia.
Objective: Adenoid Hypertrophy is a common childhood condition that presents with mouth breathing, nasal discharge, snoring and sleep apnea. Lateral Nasopharyngeal X-ray aids diagnosis and assessment of patency of the Nasopharyngeal air column through Adenoid Nasopharyngeal Ratio (ANR). This study aims to correlate ANR with symptoms and signs of Adenoid Hypertrophy. Material and Methods: A retrospective study conducted in the Ear, Nose and Throat/Head and Neck Surgery (ENT/HNS) Department of University of Abuja Teaching Hospital, Gwagwalada from January 2019 to December 2021. The case notes and Lateral Nasopharyngeal X-rays of 66 Children aged between 2months to 11 years, with suspected Adenoid Hypertrophy were retrieved and relevant retrieved data analyzed. Results: A total of 66 patients were enrolled into this study with 50 (75.76%) males and 16 (24.24%) females. The age range was between 2 months to 11 years, with a mean of 3.65±2.76 years. ANR ranged from 0.03 to 0.94 with mean 0.71±0.15. Out of the 66 participants, 30 (46.15%) had ANR of 0.7, while 35 (53.85%) had ANR of > 0.7. Linear regression analysis showed association between age and ANR (P < 0.05). Snoring was the most common symptom (92.42%), followed by Mouth breathing (89.39%) and Nasal Discharge (77.27%). Majority of patients (88.6%) had a Mild Symptom Score. There was no statistically significant relationship between any of the clinical features and ANR. Conclusion: There is no significant correlation between the clinical features and adenoid nasopharyngeal ratio.
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