Browsing by Author "Afolabi, O.A.,"
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Item Attitude of Self Ear Cleaning in Black Africans Any benefit?(Published by East African Public Health Association, Dar es Salaam, Tanzania., 2009) Afolabi, O.A.,; Kodiya, A.; Ahmad, B.M.; Bakari, A.M.,Wax removal compromises the integrity of the ear's defenses. It is a leading cause of otitis externa, Otomycosis and impaired hearing. Aims of the study are to assess the knowledge and implication of self ear cleaning among black Africans. MATERIAL AND METHODS: A prospective study carried out at the Tundun-wada community and National Ear Care Centre, Kaduna with administration of structured questionnaire after an informed consent and ethical clearance. Information retrieved includes biodata, believe, reason and object for cleaning of the ear, associated problems or benefit and examination. RESULTS: A total of 372 form the basis for the study, age range 1-76 yr with a mean age of 30.37 yr, median age 29.00 (S.D. = 13.79) and M:F ratio of 1:1. Mother responded for their children except for grown up. About 47.3% of the subjects were unemployed who were either children or complete house wife. About 90% of the subjects interviewed do self ear cleaning and over 90% believe ear should be cleaned to remove wax, because of itching in over 50% while a few is due to cosmetic reason. Cotton bud was the commonest material used for cleaning. About one-third of the subject has formed the habit unconsciously over 10 years. The entire subjects interviewed had their ear examined; about 27% had ear discharge then wax impaction in 22% then foreign body 12%. CONCLUSION: The habit of self ear cleaning should be discouraged as it is slow otologic poison with an attendant long term effect.Item An Audit of Paediatric Nasal Foreign Body in Ilorin, Nigeria.(Published by: Health and Medical Pub. Group Claremont Cape Town., 2009) Afolabi, O.A.,; Suleiman, A.O.,; Aremu, S.K.,; Eletta, A.P.,; Alabi, B.S.,.; Segun-Busari, S.,; Dunmade, A.D.; Ologe, F.E.Background. Children with nasal foreign bodies are commonly seen in everyday practice. The aim of this study was to document the pattern of foreign bodies in the nose, their treatment and outcome. Methods. This was a prospective audit of all children seen in the ear, nose and throat clinic, accident and emergency unit and emergency paediatric unit at the University of Ilorin Teaching Hospital, Nigeria, from August 2005 to July 2006. Results. Of a total of 173 patients with ear, nose and throat foreign bodies seen during the study period, 71 patients had foreign bodies in the nose. The male/female ratio was 1.5:1 and the mean age was 2.5 years (range 1 - 15 years), under-5s comprising 72% of the patients. The most common foreign bodies were grains and seeds (35%). Presentation was within 24 hours in 45% of cases, between 1 and 5 days in 27%, and longer in the rest. Of the patients 51% had inserted the foreign body into the nose themselves, and in 39% of cases this had happened at school. In most cases (68%) the foreign body had been inserted into the right nostril. Most children had an offensive nasal discharge (45%) or were asymptomatic (27%). Parents were the first to make the diagnosis in 63% of cases, and in 32% of cases removal had been attempted before presentation. Most of the foreign bodies (89%) were mechanically extracted with a Jobson-Horne probe. In 61% of cases removal was done by a senior registrar. General anaesthesia was needed in a minority of cases. Minimal epistaxis after removal occurred in 50.7%, and only 1 patient had septal perforation. Conclusion. Nasal foreign bodies are still a challenge among under-5s. Public health education is needed to make parents and caregivers aware that it is hazardous for a child to insert a foreign body into the nose. Consistent with published guidelines, the majority of cases can be managed safely with direct extraction in the office setting. With adequate training, primary health care practitioners can manage most cases successfully and will know when to refer complicated ones.Item Changing Indications for Paediatric Tracheostomy in a Nigerian Tertiary Hospital.(Port Harcourt Medical Journal. An official Journal of College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria., 2012) Okhakhu, A.L.,; Emma-Nzekwue, N.H.; Afolabi, O.A.,Background – Paediatric tracheostomy is a common surgical procedure whose indications are evolving. This study seeks to establish updated data on the indications, outcome and complications of paediatric tracheostomy as seen in a Nigerian tertiary health institution. Materials and Methods- A retrospective review of medical records of all paediatric patients who had tracheostomy at the University Of Benin Teaching Hospital Benin City between January 2004 and June 2010. Results- A total of 49 children, 25 (51%) females and 24 (49%) males had tracheostomy during the period under review. The age ranged from 11 months to 13 years with mean age of 3.5 ±2.7 years. The indications for tracheostomy were upper airway obstruction secondary to foreign body aspiration 40(81.6%), infections in 8 (16.3%) and prolonged intubation 1 (2%). When compared with a similar study 2 decades ago, a change in the indication for tracheostomy is noted and this was statistically significant with p<0.001. A large proportion of the tracheostomies were done as emergency procedures while 4(8.1%) were elective. The complications encountered were apnoea 8 (16%), accidental decannulation (extubation) 1 (2%), difficult decannulation 4 (8.1%) and tracheocutaneous fistula in 1(2%). Conclusion: The main indication for paediatric tracheostomy is relief of upper airway obstruction secondary to foreign body aspiration.Item Clinico-Pathological Pattern of Nasopharyngeal Carcinoma in Ilorin, Nigeria.(Published by Medical and Dental Consultants' Association of Nigeria., 2010) Alabi, B.S; Badmos, K.B,; Afolabi, O.A.,; Buhari, M.O.; Segun-Busari, S.Item Foreign Bodies in the Upper Aerodigestive Tract of Nigerian Children(Nigerian Journal of Surgery An Official Publication of Nigerian Surgical Research Society and Association of Surgeons of Nigeria., 2011) Alabi, B.S.,; Oyinloye, O.I.,; Omokanye, H.K.,; Aremu, S.K.,; Afolabi, O.A.,; Dunmade, A.D.,; Akande, H.J.Aim/Background This is an audit of number, nature, sites of impaction and methods of removals and treatment outcome of upper aero-digestive foreign bodies among children in an urban University hospital in Nigeria. Patients and Methods This is an 8year retrospective review of foreign body in upper aero-dgestive tract of children (January 2001 to December 2007) was conducted at the ENT department of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Case notes of the patients were retrieved and the following were data extracted: demographic, clinical, operative and outpatient visits outcome. Results 81 children aged 9months to 16years were seen (mean 4.28, SD 2.95) with 49 males and 32 females and a male: female ratio of 1.5: 1.0.The commonest age group was 9months to 4years (76.5%). Most common of impaction sites were nasal cavity in 31 cases (38.3%), oesophagus in 23 cases (28.4%), oropharynx in 16 (19.8%) and larynx in 6 (7.4%)).The commonest FBs was coins in 33 (40.7 %) in the oesophagus and 37.5% of pharyngeal FBs .Inanimate FBs in the nose constituted 31(38.3%) [Non vegetative 27(87.1%), vegetative 4(12.9 %)]. Fish bones were seen in 11 cases (13.6%) [6 in the larynx and 5 around the tonsillar fauces] and miscellaneous objects in 6 cases. Conclusion Upper aero-digestive foreign bodies are common especially among the under fours', commonest sites being the nose and pharyngooesophageal region with coins and inanimate FBs constituting about four-fifth. There is the need for parental health education on object placements, and a high index of suspicion among practitioners to facilitate early referral and avoid preventable complications.Item Otological Emergencies Among the Northern Nigerian Children.(Published by Association of Surgeon of East Africa and College of Surgeon of East, Central and Southern Africa, 2009) Afolabi, O.A.,; Kodiya, A.M.,; Bakari, A.; Ahmad, B.M.Background: Swift recognition and prompt institution of management is very crucial to successful outcome of otologic emergencies. The aim and objective of the study was to determine the spectrum of pediatric otologic emergencies in northern Nigeria. Methods: A retrospective study to review of 1497 paediatric otologic emergencies aged one month to 14 years seen at National ear care centre, Kaduna between 2002 and 2006 inclusive was done. The records of all these patients were retrieved, studied and information collected analyzed. The data extracted for analysis included – biodata, clinical presentation diagnosis and treatment outcome. Results: There were 943 male and 554 female with M: F ratio of 1.7:1. Their ages ranged from 1month to 14 years with a mean age of 4.95years (SD=4.15). A total of 928 (62%) were infants and preschool age groups (under fives). Acute suppurative otitis media was found in 573 (38.3%), was the commonest otological condition diagnosed followed by acute otitis media in 22.6% and foreign body in the ear in 222(14.8%).The least frequent were CSF otorrhea, and ramsay hunt disease which constituted 0.07%. Conclusion: Acute suppurative otitis media, acute otitis media and foreign body insertion into the ear still constitute the common otological emergencies in Northern Nigeria. These are all preventable emergencies through community health education, training of community health worker to recognize the symptom and signs of ear disease with early referral.Item Parental Satisfaction with Post-Adenotonsillectomy in the Developing World(Published by Elsevier, Amsterdam., 2009) Afolabi, O.A.,; Alabi, B.S.,; Ologe, F.E.,; Dunmade, A.D.; Segun-Busari, S.Aim/background: Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures by the otolaryngologists in the pediatric population. The aim of this study is to evaluate parental expectation and satisfaction following tonsillectomy with or without adenoidectomy. Materials and methods: Hospital-based prospective study of all consented parents whose children had tonsillectomy with or without adenoidectomy over a period of 13 months (February 2008 to February 2009) using a cross-sectional method. Pre- and post-surgical questionnaire-based Interview was conducted for them and information retrieved included biodata, pre- and post-surgical symptoms on follow-up in the clinic of obstructive sleep apnoea, snoring, mouth breathing and rhinorrhea, parental expectation and satisfaction after surgery. All data were entered into statistical data using SPSS version 11 and analyzed and the results are presented in tables and figures. Results: A total of 29 patients had adenotonsillar surgery, who were within the age range of 1.50–14 years with a mean age of 5.50 (SD = 4.06 0.75). M:F ratio was found to be 3:1 (22 males and 7 females). Parents were satisfied with the expected outcome in terms of symptoms post-operatively in 96.6% while only one 3.4% were not satisfied. Conclusion: Majority of the parents (96.6%) were satisfied with the expectation of immediate resolution of symptoms; however, obstructive adenotonsillar hypertrophy remains an important problem to be solved to achieve total parental satisfaction in adenotonsillar operations.Item Pattern of Bacterial Isolates in the Middle Ear Discharge of Patients with Chronic Suppurative Otitis Media in a Tertiary Hospital in North Central Nigeria(Published by Faculty of Medicine, Makerere University Kampala, Uganda, 2012) Afolabi, O.A.,; Salaudeen, A.G.,; Ologe, F.E.,; Nwabuisi, C.; Nwawolo, C.C.Background Otitis media (OM) is a major health problem in both developed and developing countries. Objective To determine the pattern of bacterial isolates in patients with chronic suppurative otitis media(CSOM) in Ilorin, Nigeria. Methods A prospective study carried out in University of Ilorin Teaching Hospital, Nigeria among consenting patients with CSOM attending the ENT clinic over a period of 7months. Informed consent was obtained from the patients or caregivers and approval for the study obtained from ethical committee. Structured questionnaire was administered and microbiological analysis done, data obtained was entered into SPSS statistical software and results presented in tables and figures. Results A total of 134 patients aged 5–64yrs with chronic suppurative otitis media were interviewed with a mean age of 17.0 (S.D. =15.1±1.30). About 55.2% of the respondents were under 10yrs. Seventy-two (53.7%) of the respondents were males with M:F=1.2:1. The gram stain showed predominantly gram negative organisms (71.6%). Pseudomonas aeruginosa was the commonest middle ear pathogenic organism identified and the sensitivity pattern highly favoured ciprofloxacin Conclusion CSOM is still a childhood problem among the under tens' more prevalent among males and the commonest agent is Pseudomonas aeruginosa. Ciprofloxacin is still the most sensitive antibiotics in vitro.Item Pattern of Chronic Suppurative Otitis Media at the National Ear Care Centre Kaduna, Nigeria.(Published by Faculty of Medical Sciences, University of Jos, Nigeria., 2010) Bakari A, Adoga, A.A.,; Afolabi, O.A.,; Kodiya, A.M.; Ahmad, B.M.Background: Chronic suppurative otitis media constitutes a major cause of otorhinolaryngological clinic visits in Nigeria, therefore it is pertinent to determine the local pattern of presentation in order to achieve adequate treatment, avoid complications and provide records for future references. Methodology: A retrospective review of patients presenting with chronic suppurative otitis media to the out-patient clinic of the National Ear Care Center, Kaduna within a period of 1 year. Results: One hundred and forty six patients presented, accounting for 3.8% of the total number of patients and 6.6% of all otological cases. One hundred and twenty eight (87.7%) case notes were retrievable and studied. Patients were aged 1 year to 82 years (mean=19.2 years) with 67 males and 61 females giving a gender ratio of 1.1:1. Children under 10 years constituted the majority (n=64). Tympanic membrane perforation was central in 117 (67.6%), marginal in 38 (22%) and attic in 18 (10.4%) patients. Positive culture occurred in 75 (58.6%), no growth in 22 (17.2%) patients and there was no record of ear swab or culture in 31 (24.2%) patients. Bacterial isolates were Klebsiella specie (n=31, 41.3%), Escherichia coli (n=22, 29.3%), Streptococcus specie (n= 8, 10.8%), Staphylococcus aureus (n=7, 9.3%), Pseudomonas aeruginosa (n=6, 8%) and Proteus specie (n=1, 1.3%). Antimicrobial sensitivity was highest to the quinolones (57.9%). Ninety-four (73.4%) patients achieved dry ears in the first month. The complication rate was 6.3%. Conclusion: We recommend the quinolone antibiotics as first line drugs in treatment of chronic suppurative otitis media and continuing medical education of general practitioners and pediatricians especially those practicing in the rural areas on the management of CSOM is important to improve the outcome.Item Penetrating Aero‑digestive Fish bone injury(Published by Faculty of Medical Sciences, University of Jos. Jos, Nigeria., 2013) Afolabi, O.A.,; Bolaji, Adebola, S.O., B.O.,; Ogah, S.A.; Ologe, F.E.,The aim of the report is to re‑emphasize how dangerous fish bone impaction in the esophagus could be and that a combination of pointing sign with radiographic features improves the specificity of the diagnosis. A 45‑year‑old male civil servant presented with 4 days history of fish bone impaction in the throat while taking meal containing fish with accidental ingestion of fish bone. This was associated with odynophagia, dysphagia, drooling of saliva, failed attempted dislodgement with swallowed boluses and positive pointing sign. Neck X‑ray showed prevertebral widening and radio‑opaque tracheoesophageal penetrating foreign body. He had endoscopy under general anesthesia with retrieval of the fish bone. Laryngo‑ esophagoscopy showed a laceration in the esophageal mucosal, which penetrated into the laryngeal inlet. This case report re‑emphasizes the danger of attempting to dislodge such sharp foreign bodies with boluses of food.Item Retropharyngeal Abscess in Diabetics: A Challenge.(Published by iConcept Press. Hong Kong, China, 2014) Afolabi, O.A.,; Fadare, J.O.,; Ogah, S.A.; Oyewole, E.O.Item Survey of Ototopical Self-Medication among Patients attending ENT and Family Medicine Departments in a Nigerian hospital.(Published by European Society of General Practice Amersfoort, The Netherlands., 2011) Afolabi, O.A.,; Ehalaiye, B.F.,; Fadare, J.O.,; Abdur-Rahman, A.B.; Ehalaiye, D.N.Background: Ototopical self-medication is a common practice in Nigeria. Objective: The aim of the study was to establish the proportion of patients with otological problems that practice ototopical self-medication. Methods: A 12-week cross-sectional study of all the new patients attending the general outpatient (also called family medicine (FM)) and ear, nose and throat (ENT) departments of a Nigerian specialist hospital was carried out. A semi-structured questionnaire was used to obtain information on bio data, practice of ototopical self medication among new patients with otological problems, the drugs used and the reasons for engaging in the practice. The results were analysed using SPSS version 11 and presented in Tables. Results: Out of 3276 patients that visited the hospital during the study period, 402 had otological problems. Of these, 125 (31%) used ototopical self-medication, giving a hospital incidence of 3.8%. 115 (92%) patients consented to fill in the questionnaire on the self-use of ototopical agents. Otalgia was the most common indication (27%) for ototopical self-medication. Gentamycin and Chloramphenicol topical agents were the most commonly used by the study participants. A total of 39 participants (34%) reported to have used non-prescribed self-medication because it was time saving. In 69 of the participants (60%), the drugs were self recommended while chemists and nurses recommended their use in 23 (20%) and 22 (19%) participants, respectively. Conclusion: In Nigeria, there is a need for public enlightenment and health education about the possible drawbacks of this practice .Item Vagal Reflex Stimulation Complicating Retrieval of An Unusual Foreign Body From The Laryngotracheal Lumen: Case Report.(Published by Society of Egyptian Anaesthesiologists, 2015) Omokanye, H. K.; Alabi, B. S.,; Ige, O.A.,; Afolabi, O.A.,; Omotosho, W,; Iyanda, N. O.; Ologe, F. E.Foreign body impaction in the aero digestive tract is a life-threatening emergency, particularly in the paediatric age group. Removal under general anaesthesia poses both surgical and anaesthetic challenges and this may rarely result in mortality. We report a case of a 4 year old boy with an unusual foreign body (FB) impacted in the laryngotracheal causing difficult intubation and precluding tracheostomy with attendant vasovagal reflex stimulation and cardiac arrest. Clinical presentation and radiological evaluation of the patient were highlighted with a review of pertinent literature. We conclude that dis-impacting a foreign body in the trachea could potentiate bradycardia and cardiac arrest; co-existing hypercarbia and/or sepsis increase the risk and worsen the prognosis.