ABSTRACT
BACKGROUND: Subjective plain radiographic evaluation of the nasopharynx has been a widely adopted technique. Although it has its own limitations, its ease of interpretation and simplicity are some of its advantages. AIM: To investigate the reliability, using kappa, in subjectively reporting plain nasopharyngeal radiographs in children with symptoms suggestive of enlarged adenoids. METHODS: This was a retrospective study of the clinical records, and plain X-rays of the nasopharynx of paediatric patients with clinical features of adenoid hypertrophy in a Nigerian Tertiary Health Institution from January 2008 to December 2008. RESULTS: Fifty-one children with a mean age of 3.4 years; standard deviation of 2.772 was studied. They had an age range of 2 months to 12 years. Most (66.6%) of the children studied were in the age bracket 0-4 years. The inter-rater reliability between the two Otolaryngologists, and that between an Otolaryngologist and a Radiologist using kappa statistics were 0.6696, 95% CI (0.5035-0.8357; p<0.05) and 0.8182, 95% CI (0.7073-0.9291; p<0.05) respectively. While the kappa intra-rater reliabilities for the two Otolaryngologists were 0.6931, 95% CI (0.5473-0.8389) and 0.9591, 95% CI (0.9033-1.000). CONCLUSION: There was a high level of agreement among trained raters, in subjectively interpreting plain nasopharyngeal radiographs in children with suspected adenoidal obstruction.
Subject(s)
Nasopharynx/diagnostic imaging , Adenoids/pathology , Child , Child, Preschool , Female , Humans , Hypertrophy , Infant , Male , Nigeria , Observer Variation , Radiography , Reproducibility of Results , Retrospective StudiesABSTRACT
OBJECTIVE: To evaluate the effectiveness of acupuncture, as compared with physiotherapy, in the management of chronic neck pain. DESIGN: Seventy adult patients with non-inflammatory neck pain of >6 weeks duration and with no abnormal neurology were randomly assigned to receive either of the treatments. Thirty-five patients were included in each group. OUTCOME MEASURES: Pain by visual analogue scale and neck pain questionnaire, improvement in range of movement of neck relative to baseline, and well-being (general health questionnaire). Measurements were recorded at the start of treatment, at 6 weeks and at 6 months. RESULTS: Both treatment groups improved in all criteria. Acupuncture was slightly more effective in patients who had higher baseline pain scores. CONCLUSIONS: Both acupuncture and physiotherapy are effective forms of treatment. Since an untreated control group was not part of the study design, the magnitude of this improvement cannot be quantified.