Browsing by Author "Afolabi, O.A."
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Item Aural Foreign Bodies in the Children(Published by: Dept. of Pediatrics, All India Institute of Medical Sciences New Delhi, India., 2007) Ologe, F.E.; Dunmade, A.D.; Afolabi, O.A.Objective Foreign body in the ear is commonly encountered in children by primary care givers, emergency department Physicians, Pediatricians and Otolaryngologists worldwide. Methods We reviewed cases of aural foreign bodies in children seen in our centre over a five-year period with the aim of auditing our current practice and suggesting possible improvements suited for developing countries. Results Grains and seeds (27.9%), beads (19.7%), cotton wool (13.6%), paper (8.8%) and eraser (8.2%) formed the bulk of the aural foreign bodies. About 96% was removed without general anesthesia by using Jobson Horne’s probe or aural dressing forceps (73.8%) under direct vision; or by syringing (22.1%). Some 4% had to be removed in the operating theatre under general anesthesia. The complications observed include bruise or laceration and bleeding from the external auditory canal (16.3%), otitis externa (6.5%) and traumatic perforation of the tympanic membrane (1.7%). Conclusion Despite a high proportion of cases managed in the office setting, complication rates were within acceptable levels. There is need to develop practical criteria that will be beneficial to primary health care givers to determine which patients could be managed in the primary care setting with acceptable outcome.Item Challenges of Otolaryngologic Referral in a Nigerian Tertiary Hospital: An Audit.(Published by Association of surgeon of East Africa and College of Surgeon of East, Central and Southern Africa., 2010) Dunmade, A.D.,; Afolabi, O.A.; Eletta, A. P.Background: The referral system offers one strategy for making the best use of hospitals and tertiary healthcare services. The aim of this study was to analyze the referral system of patients to the otorhinolaryngologist and to examine the use of in-house referral system in the teaching hospital set up. Methods: This was a retrospective review of all patients referred to the ENT Department between January 2000 and December 2007. Data retrieved from all referral notes included the review of referral letter, demographic, referral status, clinical presentations and examination findings. These data were entered into the SPSS computer software version 11.0 and analysed Results: A total of 1402 cases were analyzed. The patients’ ages ranged from 3weeks to 90yrs, with 70.4% of cases being below 40yrs of age while 25.9% were between 40-64yrs and 3.7% were above 65yrs. The Male to female sex ratio was 1:1. The majority (70.4%) of the patients had at least primary school education. The rest (29.6%) had no formal education. Slight over half (51.5%) of the patients were unemployed. The rest were either civil servants or self employed.Out of the 1402 patients that were referred to the hospital, in-house referral accounted for 74.1%, 7.2% of came from private health facility and 4.3% were self referrals. Out of the 1038 inhouse referrals, 42.8% were from GOPD, 5.0% from Staff clinic, 13.3% from surgery, 4.7% from medicine, 3.5% from Obstetrics and Gynaecology, 10% from paediatrics and 10.4% from ophthalmology and 10.3% from ENT staffs such as residents, ENT Nurse Practitioner and ENT supporting staffs such as speech therapist and audiologist. Conclusion: The challenges of referral to the otolaryngologists are enormous thus the need to organize continuous medical education for the family physician, to make patients have confidence in the primary care physician, early referral of patients and to allow the otorhinolaryngologist to focus on the cutting edge issues of the specialtyItem Ear Disease in the Elderly Hospital Patients in Nigeria.(Published by Gerontological Society of America by C.C. Thomas, Washington DC., 2006) Ologe, F.E.,; Segun-Busari, S.,; Abdulraheem, I.S.,; Afolabi, O.A.Background. Little information is available about the pattern of ear diseases in the elderly population. Therefore, the present study aims to determine the pattern of ear diseases among elderly Nigerians, so as to provide an objective basis for cost-effective health care planning for the emerging geriatric population. Methods. A retrospective study of 320 patients aged 60 years or older presenting with ear diseases at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, between January 1996 and December 2001 was carried out. Results, Impacted cerumen was the most common ear disease, occurring in 110 (34.4%) patients of the study population. Chronic suppurative otitis media (CSOM) was the most common infectious dise1!se:affecting 28 (8.8%) patients. Of the 88 patients with hearing loss, 63 (71.6%) had sensorineural, 20 (22.7%) had presbycusis, I (1.1%) had conductive, and 4 (4.6%) had mixed hearing loss. Conclusion. Our data suggest that impacted cerumen, hearing loss, and infections (notably CSoM), are the common ear diseases among elderly Nigerians.Item Epistaxis: A Five year Review,(Published by Medical Services Department, Saudi Arabian Armed Forces, ; Staples Printers Rochester Ltd Great Britain., 2006) Olatoke, F.,; Ologe, F.E.,; Alabi, B.S.,; Dunmade, A.D.,; Segun-Busari, S.; Afolabi, O.A.A medical emergency deserves appropriate and timely intervention. Epistaxis is one of such emergency seen by Otolaryngologists. A retrospective study carried out on patients who presented with epistaxis at the University of llorin Teaching Hospital over a 5-year (1999-2003) period. Information on these patients was retrieved from hospital's patients' attendance register and case notes after due permission from relevant hospital authorities. A total of 1153 cases of adult and pediatric emergencies were seen during the period under review; 342 (29.6%) were aural; 508 (44.1%) were nasal and 303 (26.2%) were throat related. Epistaxis constituted 46.5% of the nasal emergencies while foreign bodies in the nose constituted 20.4%, acute rhino sinusitis 11.2%, cerebrospinal fluid (CSF) rhinorrhealO.2%; nasal furunculosis 9.8% and septal hematoma/septal abscess 1.9% In conclusion, epistaxis constitutes a major ENT emergency in Nigeria; adults are dominant victims.Trauma was the most common etiological factor revealed by this study followed by idiopathic cause.Item Foreign bodies in the aerodigestive tract: time for comprehensive preventive measures(Makarere University Medical School, Kampala, Uganda, 2022) Adeoye, P.O.; Afolabi, O.A.; Omokanye, HK; Olaoye, I; Akanbi, O.R.; Segun-Busari, S; Abdulkadir, Mohammed BabaBackground: Foreign body (FB) in the aerodigestive tract presents more commonly in children and remains a surgical emergency with potential for fatal complications. Objectives: To describe management and outcomes of aerodigestive FB managed at University of Ilorin Teaching Hospital (UITH) and proffer preventive measures. Methods: A 9-year retrospective review of all patients with foreign body in the aerodigestive tract managed between March 2011 and July 2020. Results: Sixty-six patients were studied. Median age was 9years with M:F ratio =1.6:1. FB was ingested in 38(57.6%) patients, aspira tion occurred in 28(42.4%). Denture was most common FB 20(30.3%); plastic whistle/valve placed in dolls or football accounted for 4(6.1%). When ingested, FB was impacted in cervical 17(44.7%), upper thoracic 10(26.3%) and middle thoracic 2(5.3%) oesophagus. Oesophagoscopy was used in 30(8.9%) for retrieval. When aspirated, FB was located in the right bronchus 10(35.7%), left bronchus 7(25.0%), hypopharynx and trachea 2(7.1%) each, and cricopharynx 1(3.5%); no FB was found in 3(10.7%) patients. Direct Laryngos copy was the method of retrieval in 3(10.1%) patients while others had rigid bronchoscopy. Mortality rate was 1.5%. Conclusion: Children are most vulnerable group. Preventive effort should include public health education and close monitoring of children by parents and care givers during play.Item Otologic and Audiologic Evaluation among HIV Patients in Ilorin, Nigeria.(Nigerian Quarterly Journal of Hospital Medicine. Published by University of Lagos. Medical Society, Lagos, Nigeria., 2013) Alabi, B.S.; Salami, A.K.; Afolabi, O.A.; Aremu, S.K.; Olawumi, H.O.; Odeigha, L.O.; Akande, H.J.BACKGROUND: HIV infection is the highest cause of death worldwide and presenting eventually with ENT regions. OBJECTIVE: This study is to determine the prevalence of hearing loss and hearing patterns among adults Nigerians with HIV and causal relationships between CD4+ counts with the degree of hearing impairments. METHODS: This prospective study was carried out among all consecutive HIV positive patients attending the clinic at the University of Ilorin teaching hospital (U.I.T.H.), Ilorin, Nigeria between January and July, 2008. They all had audiological assessments with a pure tone audiometer within the frequency range 250 to 8,000 Hz to determine their hearing thresholds together with their CD+ counts estimations. RESULTS: 89 were evaluated in the age range of 18 to 56 years (Mean 36.4 years, SD of 8.82) and the modal age group was 21-39 years (59.6%), 40-56 years (38.2%).There were 51 males (57.3%) and 38 females (42.7%) with a male/female ratio of 1.3:1.0. Otological symptoms included tinnitus (15.7%), vertigo (15.7%), otalgia (14.6%) and hard of hearing (10%). Examinations showed bilateral serous Otitis media (glue ear) in 58 patients (65.1%) with no affectation of the facial nerves. PTA showed mixed, conductive and SNHL in 32 patients (36%), 20 patients (22.5%), 9 patients (10.1%) respectively and only 15(16.9%) had normal hearing thresholds. The CD4+ counts ranged between 12 to 616. CD4 counts with hearing loss mostly < 300mm3. CONCLUSION: The prevalence of hearing loss is 87% among HIV infected patients, mostly mixed HLwith causal relationships between reduced CD4+ counts of less than 300/mm3 with severity of hearing loss. The hearing loss can interfere with the communication and specific knowledge vital to the development of best practices towards ensuring the inclusion of hearing impaired in HIV/AIDS prevention and treatment programmes.Item Otological Findings Among Nigerian Children with Sickle Cell Anaemia.(Published by Elsevier, Amsterdam., 2008) Alabi, B.S.; Ernest, S.K.; Eletta, P.,; Owolabi, O.A.,; Afolabi, O.A.; & Suleiman, O.A.BACKGROUND/AIM: Various degrees of hearing loss have been associated with sickle cell anaemia, especially of the sensorineural type (SNHL). However, there is little information on hearing pattern among sickle cell children in Nigeria. This study is to determine the prevalence of sensorineural hearing loss (SNHL) among children with sickle cell anaemia (SCA). PATIENTS AND METHODS: Eighty (80) stable children aged 4-15 with Hbss attending the pediatric sickle cell clinic and also 60 control patients with HbAA, matched for age, sex at the pediatric general medical clinic of the University of Ilorin teaching hospital, Ilorin, Nigeria, all had prospective study of their pure tone audiological assessment (PTA) and tympanometric evaluations done over a year period. RESULTS: Their age range was 4-15 years with a mean of 9.4 for the Hbss and 9.7 for the control group. The male/female ratio was 1.3:1 and 1.5:1 for SCA and control subjects respectively. 25 subjects (50 ears) had abnormal audiograms among the SCA subjects and OME was the cause in 22 subjects and only three (3) had mild SNHL which was bilateral. However, in the control group 15 had abnormal audiograms and all were due to OME and none had SNHL. OME was bilateral in 19 subjects with SCA, two on the left and only one on the right. In the control group, 11 of the OME was bilateral and only four were on the left side. The prevalence of SNHL was 3.8% and OME was 27.5%. CONCLUSION: We have found a prevalence rate for SNHL of 3.8% for 80 subjects with HbSS, and all cases have been a mild bilateral high frequency SNHL. Our findings suggested that SNHL is uncommon in early childhood, specifically during the years of language acquisition and early schooling. This could mean an age dependant prevalence rate of SNHL among SCA patients. However, no difference in the incidence of OME among both groups which can lead to educational difficulties from the resultant speech and language defects.Item Patients’ Perception of a Symptomatic Tinnitus among Nigerians: A multi-institutional study(Published by the College of Medicine and Allied Health Sciences, University of Sierra Leone., 2015) Okhakhu, A.O; Afolabi, O.A.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 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.Item Socioeconomic Challenges of Chronic Suppurative Otitis Media Management in State Tertiary Health Facility in Nigeria.(Published by Egyptian Society of Ear, Nose, Throat and Allied Sciences, Egypt., 2014) Afolabi, O.A.; Fadare, J.O.; Omokanye, H.K.; Olatoke, F.; Odi, T.O.; Saka, M.J.; Adaranijo, R.K.Chronic suppurative otitis media (CSOM) is a serious health care concern worldwide due to its substantial financial and non-financial burden. The aim was to determine the socio-economic challenges of CSOM in developing economy. Methods It is a nine month prospective study of all patients with a diagnosis of CSOM seen at Kogi State Specialist Hospital in north-central Nigeria. A semi-structured questionnaire was used to collect relevant information from patients/caregiver after an informed consent and ethical clearance obtained from relevant authorities. Information retrieved included socio-demographic data, site and duration of discharge, the financial cost of various stages of treatment and follow up. Result Eighty-two new patients were seen during the study period aged 2–56 years with a mean age was 8.84 years, male:female ratio of 2.2:1. About 84.1% of the patients were from within the town. The average cost of consultation per visit was 150 NGN (US$1.00). The recorded cost of outpatient medical management with basic investigation was about 14,550.00 NGN (US$97) while those requiring rehabilitation was 85,100 NGN (US$567.3). The average cost of medication and ear dressing was 2475.00 ± 82.6 NGN (US$17) and 750 NGN (US$5) respectively. None was operated. Conclusion The socioeconomic cost of CSOM is still very high both financially and non-financially. Children are at the receiving end, there is a need for capacity building to reduce the cost burden and out of pocket expenses through health insurance scheme will go a long way.Item Socioeconomic Status and Hearing Loss in Chronic Suppurative Otitis Media in Nigeria.(Published by the Liverpool School of Tropical Medicine by Academic Press, London., 2007) Lasisi, O.A.,; Suleiman, O.A.; Afolabi, O.A.Background: Hearing loss is reported in about 50% of cases of chronic suppurative otitis media (CSOM). Aim: To report the prevalence, type and severity of hearing loss in CSOM and identify risk factors. Methods: A prospective study of hearing loss in CSOM was undertaken in University College Hospital, Ibadan, two general hospitals and two primary health care centres, all in densely populated, semi-urban areas in south-west Nigeria. Controls were selected from school children, hospital workers’ children and children whose parents were visiting the hospitals, all of whom claimed that there had been no episode of otitis media in the past. An oral questionnaire was administered to all, followed by audiometry and examination of the ear, nose and throat in study children. Results: There were 189 CSOM subjects and 100 controls aged between 4 and 150 months [mean (SD) 59.25 (44.55), 173 girls and 116 boys, M:F 1.5:1]. The prevalence of hearing loss in CSOM was 89/189 (47%) and was conductive in 73/89 (82%) and sensorineural (SHL) in 16/89 (18%). Of the subjects with hearing loss, 72% had had otitis media during the 1st year of life. Of the 89, 61 (69%) were of low social class, 13/37 (35%) were middle class and 15/63 (24%) upper class. The duration of CSOM ranged from 4 weeks to 12 years [mean (SD) 4 yrs (2.04)] and from 5 to 12 years in those with SHL [mean (SD) 9 yrs (6.21)]. There was significant correlation between socio-economic status and hearing loss (r50.138, p50.02) while no correlation was found with upper respiratory infection (r50.054, p50.36), age of onset (r50.037, p50.62) or frequency of attacks (r520.068, p50.35). Conclusion: About one fifth of patients with CSOM have SHL. Early diagnosis and management of CSOM is imperative to improve outcome. CSOM is strongly associated with low socio-economic status.Item Traumatic Brain Injury and Metabolic Dysfunction Among Head Injured Patients in a Tertiary Hospital in North-Central Nigeria.(Published by the College of Medicine and Allied Health Sciences, University of Sierra Leone, 2015) Olayaki, L.A; Yusuf, A.S; Adeleke, N.A,; Abolude, N.A,; Odetayo, F,; Biliaminu, S.A.; Afolabi, O.A.Traumatic Brain Injury (TBI) is a common health problem which is one of the main causes of chronic disability and it is associated with hormonal and metabolic disorders. This work was carried out to investigate the relationship between some stress hormones (i.e. prolactin and cortisol) and plasma glucose level in TBI patients. Twenty-five TBI patients were included in the study consecutively. All patients underwent basal hormonal and plasma glucose evaluation within 24 hours of admission. One of the patients died during the acute phase. The results of the study show that prolactin and glucose levels were positively correlated with the Glasgow Coma Scale (GSC). Cortisol levels were observed to be highest in the moderate TBI group with GSC score of 9-13. The results also showed that 80% (20 patients) of the patients were age 40 years and below and 84% (21 patients) were males. In conclusion, present data show that prolactin, cortisol and plasma glucose are disturbed in TBI. The disturbances in the levels of prolactin and glucose are related to the severity of TBI. However, there is no direct relationship between cortisol and severity of TBI. Our results also show that TBI is more common in males and young people.