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