scholarly journals Current trends of adenotonsillar hypertrophy presentation in a developing country, Nigeria

2017 ◽  
Vol 3 (3) ◽  
pp. 501 ◽  
Author(s):  
Waheed A. Adegbiji ◽  
Shuaib Kayode Aremu ◽  
Clement C. Nwawolo ◽  
Chinyere N. Asoegwu
Keyword(s):  
Developing Country ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Developed Countries ◽  
Predisposing Factors ◽  
Upper Respiratory Tract ◽  
Female Ratio ◽  
Adenotonsillar Hypertrophy ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Adenotonsillar hypertrophy is a common paediatric disorder in Otorhinolaryngological practice worldwide. The prevalence, clinical manifestations and predisposing factors are well documented in developed countries. However, available data shows differences between the various studies. There is paucity of data from developing countries. <span lang="EN-IN">Thus, this study is aimed at assessing the age group distribution, predisposing factors, clinical manifestation and complications of adenotonsillar hypertrophy in a developing country. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">It is a prospective study of children under 10 years over a period of 24 months. Interviewer assisted questionnaire was administered. Data obtained were statistically analysed using SPSS version 18.  </span></p><p class="abstract"><strong>Results:</strong> Two hundred and fifty three, 253 subjects were enrolled into the study. Adenotonsillar hypertrophy affected all age groups studied. A high incidence was noted among the under 2 year olds. The Male: Female ratio was 2:1. Chronic cases constituted 55.7% of our study population. Common predisposing factors were atopy (73.9%), familial history (67.3%) and recurrent upper respiratory tract infection (58.2%). <span lang="EN-IN">The Commonest clinical features were snoring, noisy breathing, tonsillar enlargement and narrowing of postnasal space air column. Failure to thrive, otitis media and rhinosinusitis were the commonly associated complications observed. No death was recorded. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Adenotonsillar hypertrophy is common in our environment. It is important for all primary health care physicians, paediatricians and otorhinolaryngologists to have a clear knowledge on this ailment. Prevention or reduction in incidence is possible.</span></p>

Clinical Manifestations of Cholelithiasis in Quito, Ecuador. A Cohort Study

2021 ◽  
pp. 12
Author(s):  
◽  
◽  
Keyword(s):  
Epigastric Pain ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Abdominal Ultrasound ◽  
Common Symptom ◽  
Low Back ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Right ◽  
A Prospective Study

Introduction: A prospective study was carried out, with the aim of establishing the clinical manifestations of cholelithiasis in the population of Quito, Ecuador. Methods: During the period from January 2012 to October 2017, 534 patients were referred from different outpatient clinics of the Ecuadorian Institute of Social Security to the Batan Medical Center with the diagnosis of cholelithiasis after a clinical assessment and abdominal ultrasound, to be treated surgically. Results: Sixty-nine percent of patients were female with a male-female ratio of 1:2.21. Mean age was 44.9 years. Pain was the most common symptom in our study: 95.7%. Among these patients, pain was located in the epigastrium in 49.8%, in the right hypochondrium in 45.1% and only 0.8% had low back pain. Pain ranged from moderate and even severe. The remaining 4.3% of patients had dyspepsia or were asymptomatic. Conclusions: This finding highlights the fact that epigastric pain must be always considered as a clinical manifestation on cholelithiasis.

scholarly journals Diagnosis and Management of Hoarseness in Developing Country

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Shuaib Kayode Aremu ◽  
Waheed Atilade Adegbiji ◽  
Clement Nwawolo ◽  
Oyebanji Anthony Olajuyin ◽  
Fatai Olatoke
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Care Center ◽  
Predisposing Factors ◽  
Common Symptom ◽  
Upper Respiratory Tract ◽  
Specialist Care ◽  
Tertiary Institution ◽  
Female Ratio ◽  
Health Care Center ◽  
Tract Infections

Background: Hoarseness/dysphonia of voice is the most common symptom of laryngeal disorder regardless of its pathology.This study aimed at determining the sociodemographic profile, aetiology, predisposing factors, clinical profile and management of hoarseness.Materials and Methods: This study was a prospective study carried out on all patients who presented hoarseness of voice via the Ear, Nose, and the Throat at the department of a tertiary institution in Nigeria.The study was carried out between October 2015 to September 2017. Data were obtained from patients who gave consent by using pre tested interviewer assisted questionnaire. All the data obtained were analyzed using SPSS version 16.0.Results: Prevalence of hoarseness was 2.4%. There were 58.4% males with male to female ratio being 1.5:1. Housewives were involved 27.6%, Singers 21.5%, Teachers 17.3%, and Clergy 13.1%.  Main causes were 96.3% organic causes and 2.8% neurological causes. Common organic causes were 36.4% acute laryngitis, 30.8% chronic laryngitis, and 15.0% vocal nodules.Main predisposing factors were Upper respiratory tract infections 50.5%, Voice abuse 33.6%, and Laryngopharyngeal reflux 29.4%. Commonest duration of the hoarseness prior to presentation were >12 months in 29.4% and 6–9 months in 27.1%.  Main clinical features were hoarseness 78.5%, catarrh/cold 73.4%, sensation of lump in the throat 62.6%, and cough 55.6%. Prior medications before presentation to otorhinolaryngologist were local herb 84.6%, over the counter medication 48.6%, and health care center 38.3%. Specialist care was conservative/medical treatment 77.6%, surgical intervention 20.1%, and referral 2.3%.Conclusion: Prevalence of hoarseness of voice was high with associated presentation to the specialist. Organic causes are the commonest with predominant inflammatory origin. Laryngeal neoplasm with associated malignancy was significant in a numbers of patients.

scholarly journals Impact of adenotonsillectomy on acoustic parameters of voice using GRBAS scale in children

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2527-2530
Author(s):  
Adhavan I ◽  
Indu Rajkumar ◽  
Raadhika Shree N
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
Voice Quality ◽  
Failure To Thrive ◽  
Upper Respiratory Tract ◽  
Voice Change ◽  
Adenotonsillar Hypertrophy ◽  
Maxillofacial Development ◽  
Tract Infections

Adenoids and tonsils are pharyngeal lymphoid tissue aggregation. Adenotonsillar hypertrophy is usually seen in children. Enlarged adenoid and tonsillar tissue in children causes snoring, sleeping disorders, failure to thrive, frequent upper respiratory tract infections and abnormalities in maxillofacial development. Surgical treatment performed for their removal is termed as adenotonsillectomy. This is one of the most commonly performed surgical procedures in children. The present study was conducted to compare the voice change using the GRBAS scale before and after adenotonsillectomy. This is a prospective study conducted for three months at the Department of Otorhinolaryngology in our tertiary care center. Voice of 35 children with adenotonsillar hypertrophy is analyzed by GRBAS scale in three stages before the surgery, three weeks after surgery and six weeks after surgery. The resulting voice quality improvement is noted in these children after adenotonsillectomy. This study showed that surgical procedures of adenotonsillectomy do not induce drastic adjustments in sound quality and can be performed safely in children. Post-operative voice changes are a significant concern issue among the parents of the children.

scholarly journals A prospective study of intestinal obstruction in paediatric age group

2017 ◽  
Vol 4 (6) ◽  
pp. 1979
Author(s):  
Amul Bhedi ◽  
Miten Prajapati ◽  
Arnab Sarkar
Keyword(s):  
Intestinal Obstruction ◽  
Prospective Study ◽  
Hypertrophic Pyloric Stenosis ◽  
Age Groups ◽  
Total Mortality ◽  
Infants And Children ◽  
Age Group ◽  
Female Ratio ◽  
Paediatric Age ◽  
A Prospective Study

Background: Intestinal obstruction can occur at any age in the paediatric population1-4. Bowel obstruction in children differs from that in adults in terms of etiology, presentation and even the management. The aim of the study was to find out various etiologies, clinical features, outcome and mortality of paediatric age groups with intestinal obstruction and their relation to age and sex distribution.Methods: This is a prospective study of 50 cases of paediatric age group with signs and symptoms of intestinal obstruction which were admitted in Sir Sayajirao Gaekwad Hospital, Vadodara, India during period of December 2004 to November 2006. Surgical intervention was carried out where indicated otherwise patients were managed conservatively. Data was analysed in SPSS version 10 statistical software for percentage and frequencies.Results: Total 50 patients were included in the study. Among these 30 were males and 20 were females with M: F ratio of 3:2. Majority of them were 25 neonates of age group of 1-7 days (50%), followed by 7 infants of 1 months- 1 years (14%) and 18 children aged 1 years-12 years (36%).  Out of 50 patients, 41 (82%) patients had congenital causes in which 21(42%) patients had imperforate anus followed by Hirschprung’s disease in 8(16%), Meckel’s diverticulum in 6(12%), jejunal atresia in 4(8%), hypertrophic pyloric stenosis in 2 patients (4%) and 9(18%) patients had acquired causes in which intussusception was in 5(10%) patients, abdominal tuberculosis in 2(4%) and gangrenous appendix in 2(4%) patients. Total mortality was 6 out of 25 neonates and there were no mortality in infants and children groups.Conclusions: Majority of patients were neonates than infants and children with slight male preponderance with male: female ratio of 3:2. Congenital causes of intestinal obstruction were more common (82%) than the acquired causes (18%). Postoperative septicaemia was more common and overall mortality was exclusively in neonates.

scholarly journals Eosinophilic Esophagitis in a Developing Country: Is It Different from Developed Countries?

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Abdulrahman Al-Hussaini ◽  
Toufic Semaan ◽  
Imad El Hag
Keyword(s):  
Saudi Arabia ◽  
Developing Country ◽  
Eosinophilic Esophagitis ◽  
Failure To Thrive ◽  
Developed Countries ◽  
Response To Therapy ◽  
Dietary Manipulation ◽  
Older Children ◽  
Allergy Testing ◽  
Food Sensitization

Background and Objective. Despite the extensive reporting of eosinophilic esophagitis (EoE) from industrialized developed countries, reports from developing countries are rare. The aim of our study was to determine the epidemiological, clinical, and endoscopic features of EoE and response to therapy in children and adults from a developing country, Saudi Arabia.Methods. We identified patients diagnosed with EoE in our center from 2004 to 2011. EoE was defined as esophageal mucosal infiltration with a peak eosinophil count ≥15 eosinophils/high-powered field.Results. Forty-five patients were diagnosed with EoE (37 children and 8 adults; 36 males; median age 10.5 years, range from 1–37 years). Feeding difficulty, vomiting/regurgitation, and failure to thrive predominated in young children, whereas dysphagia and food impactions predominated in older children and adults. Allergy testing revealed food sensitization in 12 of 15 patients (80%); 3 responded to elemental formula, while 8 failed to respond to dietary manipulation after the allergy testing. Thirty-nine patients achieved remission by swallowed inhaled fluticasone. The majority of patients experienced a recurrence of symptoms upon the discontinuation of fluticasone.Conclusion. Our data indicate that EoE is increasingly recognized in Saudi Arabia and show many similarities to data from North America and Europe.

scholarly journals Clinical and epidemiological features of infections caused by HHV-6A and HHV-6B

2018 ◽  
Vol 20 (3) ◽  
pp. 239-243
Author(s):  
Maria Yu. Lysenkova ◽  
N.V. Karazhas ◽  
Tayana N. Rybalkina ◽  
P.A. Veselovsky ◽  
E.M. Burmistrov ◽  
...  
Keyword(s):  
Acute Infection ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Culture Method ◽  
Febrile Seizures ◽  
Incidence Rates ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Detection Rates ◽  
Ebv Infection

Objective. To determine the detection rates of HHV-6A and HHV-6B compared to other herpes viruses in children of different age groups. Materials and Methods. A total of 128 patients with symptoms of respiratory viral infections (RVI) aged from 1 to 16 years and 101 otherwise healthy children. A comprehensive examination of the patients, including ELISA, indirect immunofluorescence assay, rapid culture method, PCR, and determination of nucleotide sequences of HHV-6 was performed. Children positive for HHV-6 markers (antibodies, early and late antigens) and positive for HHV-6 DNA were selected into one group (n=59), of which 14 children aged from 3 to 10 years were healthy and 45 children (<3 years of age [20 children] and ≥3 years of age [25 children]) had clinical manifestations of RVI. Results. The incidence rates of acute HHV-6 infection and HHV-6 reactivation were similar between healthy children and children with RVI symptoms (21.9% each). The active Epstein-Barr Virus (EBV) infection took a second place among examined children: acute EBV infection and EBV reactivation were determined in 19 (14.8%) and 10 (7.8%) children, respectively. The incidence rates of HHV-6A and HHV6B among children with RVI symptoms were similar (55.5% and 42.2%, respectively) whereas HHV-6B was predominant in healthy children (85.7%). The HHV-6A was more common (70%) in children under 3 years of age, but HHV-6B was more frequent (67%) in children aged 3 years and older. The most often initial manifestations of HHV-6A infection were acute fever and catarrhal syndrome; whereas HHV-6B was found more frequently in otherwise healthy children. A sudden exanthema and febrile seizures were significantly more common symptoms in children with HHV-6A infection, whereas tonsillar enlargement with exudate and swollen lymph nodes were observed more frequently in children with HHV-6B infection. Conclusions. HHV-6A more often causes acute infection in children less than 3 years of age, which is characterized by fever, febrile seizures, rash (roseola), and upper respiratory tract infection with significant catarrhal syndrome. HHV-6B more often causes acute infection in children aged 3 years and older and is rarely presented with specific symptoms of HHV-6 infection, such as sudden exanthema and febrile seizures. HHV-6B is characterized by lymphoid tissue proliferation (tonsillar enlargement and lymphadenopathy) and hepatomegaly in all age groups of children.

Implementation of An Aggressive Risk Stratified Treatment Protocol for Children and Adolescents with Acute Lymphoblastic Leukemia in a Developing Country

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 876-876
Author(s):  
Samar A. Muwakkit ◽  
Carol Al-Aridi ◽  
Ahmad Samra ◽  
Raya Saab ◽  
Rami Mahfouz ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Developing Country ◽  
Lymphoblastic Leukemia ◽  
Tumor Lysis Syndrome ◽  
Treatment Protocol ◽  
Developed Countries ◽  
Limited Resources ◽  
Secondary Malignancy ◽  
Female Ratio

Abstract Abstract 876 Background: Acute lymphoblastic leukemia (ALL) represents about 25% of all pediatric cancers. With modern risk adapted therapy over 80% of children with ALL are cured in developed countries. In countries with limited resources, however, therapy results for pediatric ALL are still not encouraging. We herein describe our experience in adopting an aggressive ALL protocol and the results and complications of using this risk-adapted protocol for treating children with ALL at a tertiary referral center in Lebanon. Patients: From May 2002 to August 2009, 110 consecutive patients 1–21 years of age with newly diagnosed ALL received the CCCL ALL protocol which was based on the St. Jude Children's Research Hospital Total XV Study. Patients were classified into one of three categories: low, standard, or high risk. Results: The clinical and laboratory characteristics of patients are presented in Table 1. The median age at diagnosis was 5 years 5 months. The male to female ratio was 1.5. Forty-six patients received the standard/high risk arm and 64 received the low risk arm. One patient (0.91%) died during induction therapy. Relapse occurred in 7 (6.4%) patients; 2 patients with T-cell ALL and WBC count >100 × 109/L developed CNS relapse during maintenance therapy, and 5 patients developed bone marrow relapse. During induction chemotherapy, patients had the following complications: 17 (15.4%) patients developed febrile neutropenia, 12 diarrhea, 6 tumor lysis syndrome, 1 typhlitis, 2 SIADH, and 2 hypertension. In addition, one patient had nasal septal aspergillosis, 1 influenza A infection, 2 sinusitis, 4 extremity cellulitis, 1 orbital cellulitis, 3 thrombosis (1 femoral line and 2 extremity). Complications during consolidation and maintenance included fever and neutropenia, pneumonia, recurrent otitis media, sinusitis, cellulitis of the face, herpes zoster, diarrhea, as well as gram positive and gram negative septicemia. Two patients died of Escherichia coli (ESBL) septic shock. Cytomegalovirus (CMV) retinitis was diagnosed in 4 patients; all were treated with gancyclovir. One patient developed PML (progressive multi-focal leukoencephalopathy). Three patients developed PRES (posterior reversible encephalopathy syndrome). Five patients developed sagittal sinus thrombosis and 5 developed pancreatitis secondary to L-asparaginase. Eight (7.3%) patients died, 4 (3.6%) of whom were in remission. None of the patients developed a secondary malignancy. The median follow up of the patients was 37.7 months (range 1.7–89.3) and the estimated mean survival time was 82.4 months (95% CI: 77.8–87.0). The 5-year overall survival and event-free survival were and 88.4% and 79.5%, respectively (Figure 1 & 2). Conclusions: Our results are comparable to those in developed countries in spite of the limited resources and the relatively low socioeconomic status of the Lebanese population. This treatment protocol was effective in improving the survival rates of children with ALL at our institution. Despite the fact that we had significant toxicity, there was a great advance in outcome reflected in the prolonged survival and improved cure rates. An aggressive risk stratified ALL protocol may be implemented successfully in a developing country but the toxicity profile may be completely different and more severe compared to that of developed countries. Disclosures: Muwakkit: Children's Cancer Center of Lebanon: Research Funding.

scholarly journals Cardiorespiratory evaluation of brachycephalic syndrome in dogs

2018 ◽  
Vol 38 (6) ◽  
pp. 1130-1136 ◽  
Author(s):  
Raphaela A.M. Canola ◽  
Marlos G. Sousa ◽  
Jaislane B. Braz ◽  
Wilmer Alejandro Z. Restan ◽  
Diego I. Yamada ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Clinical Manifestations ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Indirect Measurement ◽  
Upper Airway Obstruction ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Arterial Blood ◽  
A Prospective Study

ABSTRACT: Brachycephalic syndrome (BS) in dogs is characterized by the combination of primary and secondary upper respiratory tract abnormalities and may result in significant upper airway obstruction. It can trigger inspiratory dyspnea, culminating in secondary respiratory distress, soft tissue edema, upper airway obstruction, turbulent airflow, inspiratory noise, and even death. These changes lead to increased resistance of the air passages, which can cause elevation of pulmonary pressure and clinical manifestations attributable to pulmonary hypertension. The consequence is right-sided cardiac remodeling (Cor pulmonale) with possible progression to right congestive heart failure. To investigate the effects of BS on the cardiovascular system, 28 animals were recruited for a prospective study and assigned to either the Brachycephalic Group (BG), composed of 22 French bulldogs with BS or the Control Group (CG), which was composed of 6 healthy Beagle dogs. All animals underwent a detailed physical examination, as well as laboratory analyses, electrocardiography, echocardiography, chest radiography and indirect measurement of systemic arterial blood pressure. The most relevant finding was a lower PaO2 (90.6±12.9mmHg) in BG as compared to CG (104.9±5.2), (p≤0.05), possibly attributable to hypoventilation due to anatomical alterations.

scholarly journals Pattern Of Sexually Transmitted Infections And Sexual Behavior In Patients With Genital Symptoms

2016 ◽  
Vol 12 (1) ◽  
pp. 20-27
Author(s):  
M Gyawalee ◽  
DB Pokhrel
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviour ◽  
Age Groups ◽  
Life Time ◽  
Developed Countries ◽  
Median Number ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sexually Transmitted ◽  
Monogamous Relationship

Background: Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability, economic loss and death throughout the world. Despite the availability of effective treatment and preventive measures, incidence of STIs is increasing even in developed countries. STIs, acting as a facilitator for the spread of HIV have become a globally important issue at present context. Objectives: To determine the pattern of sexually transmitted infections along with their sexual behaviour in patients presenting with genital symptoms. Material and Methods: A cross sectional, descriptive study was carried out in the department of dermato-venereology, TUTH. During one year period, a total of 130 consecutive cases were enrolled in this study. The diagnosis of infections was made clinically with relevant laboratory investigations and they were interviewed for their sexual behaviour after taking consent and assuring confidentiality. Results: The average age of this population was 27.84 years. Majority belonged to age group 15-24 years, with male to female ratio of 3.19:1. Many (52.3%) were married. The most common infection was condyloma accuminata (29.2%). The mean age of sex debut was 18.95 years and majority (50.8%) belonged to 15-19 years group. The median number of life time partners was 2.0. Only 43 (33.1%) were on monogamous relationship. The 15-34 age groups had maximum number of sexual partners.  Married person living singly had more frequent extramarital contact. Only 10 (7.7%) used condom consistently. Conclusions: Younger people should be educated about monogamous relationship along with correct and consistent use of condom for the prevention of STIs DOI: http://dx.doi.org/10.3126/njdvl.v12i1.10592 Nepal Journal of Dermatology, Venereology & Leprology Vol.12(1) 2014 pp.20-27

CHARACTERISTICS OF DEMOGRAPHIC AND CLINICAL MANIFESTATIONS OF TRAUMATIC IN PATIENTS ADMITED AT THONG NHAT HOSPITAL

2017 ◽  
pp. 116-121
Author(s):  
Bao Huy Le ◽  
Cong Thuyen Le ◽  
Van Quang Hoang ◽  
Tran Quang Trinh ◽  
Ngoc Thong Vo
Keyword(s):  
Emergency Medicine ◽  
Hypovolemic Shock ◽  
Clinical Manifestations ◽  
Extremity Injury ◽  
Female Ratio ◽  
Common Cause ◽  
Male Female Ratio ◽  
Trauma Brain Injury ◽  
A Prospective Study ◽  
Glasgow Score

Background: Trauma is the most common cause of death in labor population. Polytrauma, especially hypovolemic shock and trauma brain injury, has higher mortality rate than the others. Objectives: We conducted this study to determine demographic, cause and clinical manifestations of traumatic inpatients at Thong Nhat hospital. Method: A prospective study was done on traumatic patients at department of Emergency Medicine from January to June 2016. Results: 672 traumatic patients were enrolled, The mean age was 48.84, male : female ratio 2:1. Labor population was prominant with 67.7%. Traffic accident was 306 cases (45.2%). The common traumatic sites were extremity injury, head trauma with 61.9%; 23.5%, respectively. ISS and Glasgow score indicated the prediction to mortality. Death and severe disability were 1.9%. Conclusions: Traumatic patients were young, mainly in labor population. Male was more common than female.Traffic accident was common cause. Extremity injury was the most common traumatic site. Key words: Trauma patient, ISS score, Deparment of Emergency Medicine

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