Browsing by Author "Dunmade, A.D."
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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 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 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.