scholarly journals Management and Outcome of Rhinosinusitis in Nigeria

OTO Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 2473974X1668554 ◽  
Author(s):  
Olushola Abdulrahman Afolabi ◽  
Biodun Sulyman Alabi ◽  
Habeeb Kayodele Omokanye ◽  
Samuel O. Ayodele ◽  
Segun Segun-Busari ◽  
...  

Objective The aim of this study is to present the management and outcome of treatment of rhinosinusitis in Nigeria. Study Design A retrospective review of the case notes of patients with rhinosinusitis between January 2009 and December 2014. Setting Study at the University of Ilorin Teaching Hospital, Nigeria, using retrieved case notes after ethical approval was received. Subjects and Methods The information retrieved included sociodemographic data, clinical presentation, duration, endoscopic examination, and other clinical management protocols with follow-up. All information was entered into SPSS version 20 and analyzed descriptively, and results are presented in tables and figure. Results A total of 5618 patients were seen in the ear, nose, and throat clinic over the 6-year period. Of the patients, 445 had rhinosinusitis, and only 410 had complete data for analysis. Patient age ranged from 2 to 75 years (mean ± SD, 31.8 ± 1.2 years). The male to female ratio was 1.2:1. The duration of symptoms varied from 3 days to 10 years, with 78.7% having symptoms between 3 and 120 months. About 82.4% had nasal discharge, 51.3% had sneezing, 78.9% had alternating nasal obstruction, and 49.3% had nasal itch. Of the patients, 61.4% had a predisposition, of which 30.9% were allergic, 23.3% were infective, and 7.2% were vasomotor. Ethmoidal-maxillary sinuses were commonly affected radiologically. About 63% of patients had medical treatment, and only 28.7% had surgical intervention, of which 37% were scheduled for surgical treatment and 7.3% refused. Improved symptoms were noticed in 72.6% of patients, and 1.4% reported no improvement. Conclusion Rhinosinusitis is still common, affecting active males economically with more chronic cases and more allergic predisposition. Early medical management is still effective, and endoscopic sinus surgery is now a better surgical option with better outcome in 72.6%.

1989 ◽  
Vol 19 (1) ◽  
pp. 11-14 ◽  
Author(s):  
S A Bwala

The case records of 53 consecutive Nigerian inpatients with stroke in the University of Maiduguri Teaching Hospital, Maiduguri were retrospectively reviewed. The mean age at presentation was 55 years and the male to female ratio was 2.5: 1. The mean duration of symptoms before presentation was 11.1 weeks and the average duration of stay in hospital was 3 weeks. Thirty-three (63%) of the lesions were infarctive and 19 (37%) were haemorrhagic. Only 3 (6%) patients gave a history of prior transient ischaemic attacks (TIAs). Forty-two (79%) patients were hypertensive at presentation out of which 27 (64%) had the hypertension diagnosed for the first time. Four (8%) patients were non-insulin dependent diabetics. There were 11 hospital deaths (21%). Thus hypertension, more than half undiagnosed at admission, was the most common risk factor for stroke in the hospital population studied.


Author(s):  
Ibekwe Matilda Uju ◽  
O. Ikenga Victor

Background: Bleeding from the nose is one of the commonest emergencies that could present in a typical ear, nose and throat clinic. It is often a frightful experience for both the patient and relations, especially in severe cases. Aim: To determine the aetiological profile, the management and outcome in patients that presented with epistaxis in University of Port Harcourt teaching hospital.  Patients and Methods: This was a retrospective study of patients with complaints of epistaxis that were managed within the period of January 2006 to January 2018 in the Ear, Nose and Throat (ENT) department, including referrals from the accident & emergency department and children emergency ward. Data on demographics, aetiology, associated clinical features, treatment modalities and outcome of such treatments were all collated. These were analyzed using IBM statistical package for social sciences SPSSversion 20and results presented in simple descriptive tables. Results: There were altogether 196 patients studied, 95 males and 101 females, giving a male to female ratio of 1:1.06.  The age range was from 1 to 81 years. Age group 30-39 was the most affected with 22.29% Aetiological factors were; hypertension in 9.2% trauma in 11.2%, idiopathic in most; 58.2%, chronic rhinosinusitis in 18.4%. Conservative medical therapy was the commonest treatment modality; 68.38%. Anterior nasal packing in 26.5% while 4.1% had posterior packing. Anterior aspect of the nose was the commonest site of bleed recorded in 160 cases. All the patients had a favourable outcome. Conclusion: Epistaxis in this environment still presents as a common emergency and in the majority of the case, the cause is not known, however, trauma appears to be one of the commonest cause implicated in our setting. The young adults appear to be the ones mainly affected.


1985 ◽  
Vol 63 (5) ◽  
pp. 669-675 ◽  
Author(s):  
Ronald Reimer ◽  
Burton M. Onofrio

✓ The authors review 32 cases of spinal cord astrocytoma in patients under 20 years of age who were treated at the Mayo Clinic between 1955 and 1980. There was a 1.3:1 male to female ratio. Twenty patients were between 6 and 15 years of age at the time of diagnosis. The duration of symptoms prior to definitive diagnosis varied from 5 days to 9 years, with an average of 24 months. The most common symptoms were pain (62.5%), gait disturbance (43.7%), numbness (18.8%), and sphincteric dysfunction (18.8%). The most common neurological findings were a Babinski response (50.0%), posterior column sensory dysfunction (40.6%), and paraparesis (37.5%). A median follow-up period of 8.6 years (range 0.8 to 25.5 years) revealed that the survival time diminished with increased histological grade of the astrocytoma (p < 0.001). The development of postlaminectomy spinal deformities represented a serious postoperative complication. This occurred in 13 patients and was first recognized between 8 and 90 months postoperatively. Six deformities occurred following cervical laminectomy, and eight patients required at least one orthopedic procedure. It is crucial to follow these patients for an extended period of time to watch for postoperative spinal deformities.


BMJ Open ◽  
2013 ◽  
Vol 3 (7) ◽  
pp. e002552 ◽  
Author(s):  
Simone Georges El Khouri Miraglia ◽  
Mariana Matera Veras ◽  
Luis Fernando Amato-Lourenço ◽  
Fernando Rodrigues-Silva ◽  
Paulo Hilário Nascimento Saldiva

2015 ◽  
Vol 8 ◽  
pp. CMED.S31756 ◽  
Author(s):  
Nasrullah K. Ghuman ◽  
Loai M. Saadah ◽  
Majdi S. Al Najjar ◽  
Duha Y. Shaheen ◽  
Shady I. AM ◽  
...  

Objective To measure effectiveness of liraglutide in reducing glycated hemoglobin (HbA1C), weight, and systolic blood pressure (SBP) in Emirati patients. Design A retrospective cohort study. Setting Endocrinology clinic in a 300-bed military hospital. Patients A total of 152 patients who qualified for liraglutide between September 21, 2012, (first patient visit) and May 5, 2014 (last patient visit). Methods Team collected demographic and clinical data using a standard form. Data keeper performed univariate analyses to measure the effect of liraglutide in reducing the three outcomes of interest; namely, HbA1C, weight, and SBP. Results One hundred patients had at least the first visit in the clinic and 98 patients came for a second follow-up visit while on the medication. Adherence of clinicians to the internal criteria for prescribing liraglutide was 92%. Patients' ages were 47.9 ± 11.7 years. Male-to-female ratio was almost 1:1. Overall, in the paired analyses, HbA1C decreased from first to second visits (8.7 ± 1.9 vs. 7.6 ± 1.8, P < 0.0001) and remained unchanged in subsequent visits (eg, in visit 3, HbA1C was 7.4 ± 1.8). Patients lost an average of 1.3 kg between the first and second visits (99.3 ± 19.3 vs. 98.0 ± 19.5, P = 0.0003). The reduction in SBP between visits 1 and 2 was less (130.9 ± 15.8 vs. 129.9 ± 16.5, P = 0.5896). ANOVA yielded a significant reduction in HbA1C at 4 months and 6 months ( P values < 0.05). SBP dropped by about 3.6 mmHg and weight by about 2.3 kg ( P values > 0.05). Conclusions Liraglutide is effective in reducing HbA1C, weight, and to a lesser extent, SBP in Emirati patients.


1998 ◽  
Vol 16 (1) ◽  
pp. 70-77 ◽  
Author(s):  
M M Cheung ◽  
J K Chan ◽  
W H Lau ◽  
W Foo ◽  
P T Chan ◽  
...  

PURPOSE To study the clinical features and outcome for primary non-Hodgkin's lymphomas of the nose/nasopharynx (NNP-NHLs) according to immunophenotype. PATIENTS AND METHODS One hundred thirteen Chinese patients with primary NNP-NHLs that belonged to the categories E, F, G, or H according to the Working Formulation (WF), with full immunophenotypic data and complete clinical follow-up data, were analyzed in this retrospective study. RESULTS Ninety (79.6%) patients had localized (stage I or II) disease, while 23 (20.4%) had stage III or IV disease. The lymphomas in 51 (45.1%), 24 (21.3%), and 38 (33.6%) patients showed natural killer (NK)/T- (CD56-positive), T-cell, and B-cell immunophenotype, respectively. Seventy-three patients (65.8%) achieved a complete remission, of whom 34 (46.6%) subsequently relapsed. The median follow-up time for those alive was 88 months. The 5-year actuarial disease-free and overall survival rates were 34.4% and 37.9%, respectively. Multivariate analysis showed that only stage and immunophenotype were significant for survival. NK/T lymphomas were distinctive among the three immunophenotypes in the following aspects: the highest male-to-female ratio, more frequent involvement of the nasal cavity alone, higher risk of dissemination to the skin, more frequent development of hemophagocytic syndrome, and the worst prognosis (overall median survival, 12.5 months). CONCLUSION The three immunophenotypes studied are shown to exhibit different clinical patterns. Since the NK/T phenotype carries the worst prognosis, patients who present with NNP-NHL should have their tumors analyzed for CD56 expression.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Xiaohua Jiang ◽  
Qi Huang ◽  
Jianguo Tang ◽  
Matthew R. Hoffman

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.


2016 ◽  
Vol 130 (9) ◽  
pp. 873-877 ◽  
Author(s):  
E Agalato ◽  
J Jose ◽  
R J England

AbstractBackground:Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.Method:Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.Results:A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.Conclusion:Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.


2016 ◽  
Vol 12 (2) ◽  
pp. 40-43
Author(s):  
Sanjay Singh ◽  
Harikant Sah ◽  
Amar Keyal

Background & Objectives: To evaluate the visual outcomes of children presenting with unilateral traumatic cataract.Materials & Methods: We conducted a retrospective study of 111 children (70 males and 41 females) below 16 years of age who were diagnosed with unilateral traumatic cataract between June 2013 and May 2015 and who underwent surgical intervention and completed at least six months follow up at Paediatrics department (supported by ORBIS International), R. M. Kedia eye hospital, Birganj, Nepal. Data regarding demographic profile, causative agent, clinical course and visual outcomes were recorded.Results: There was a male predilection with a male to female ratio of 1.70:1. The age group more frequently affected was five to nine years (58.5%). Commonest causative agent was trauma with wooden stick in 20 eyes (18%) followed by firecrackers in 15 eyes (14%) and pen in 11 eyes (10%). Pre-existing posterior capsular defects were observed intraoperatively in six eyes. Anterior uveitis was evident in 21 cases and Posterior capsular opacification in 10 eyes. Best corrected visual acuity of 6/6-6/60 at six months was achieved in 91 cases (81%). Duration between injury and cataract surgery did not affect the final visual outcome of traumatic cataract patients.Conclusion: The best possible visual outcome of traumatic cataract depends on its management and its complication. Ocular trauma and traumatic cataract formation can be avoided by taking protective measures in sports, work and patient education.JCMS Nepal. 2016;12(2):40-3


2019 ◽  
Vol 6 (1) ◽  
pp. 71
Author(s):  
Kiran Grandhi ◽  
Jayasri Helen Gali ◽  
Kokiwar P. R.

Background: Tracheal strictures are known to recur after dilatation, so they need stenting to prevent recurrence. The objective was to study role of air way stenting (Duman- silica stent) in benign stricture trachea management.Methods: A hospital based prospective study was carried out among 15 cases (as these cases are very rare, author could study only 15 cases) presented with various clinical features suggestive of tracheal strictures. They were examined and managed by putting tracheal stent for up to eight months period. All cases were followed at regular intervals till 14months after the stent was placed. The outcome was studied.Results: The tracheal strictures have been found to be more in the age group of 25-30 years.  The male to female ratio was 4:1 i.e. for everyone female case there were four male cases. Thus, the tracheal strictures have been more common among the males compared to the females. All of the patients presented with severe stridor, breathing difficulty, and poor exercise tolerance. Most common cause of tracheal stricture was prolonged mechanical  ventilatory support >8 days due to organo phosphorus poisoning in past 3months and all of them were males.  All cases had good outcome at the end of 14months of follow up. All cases had normal findings. No one developed foreign body reaction, nor did no one develop granuloma formation at the stent site. After stent removal flexible bronchoscopy repeated after 3rd month and 6th month.Conclusions: Tracheal stenting is very useful procedure in the management of air way strictures.


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