Endoscopic Septoplasty: A Retrospective Analysis of Indications and Outcome.

Background: Endoscopic septoplasty is a minimally invasive surgical procedure for the correction of nasal septal deformity. Globally, nasal septal surgeries are rarely performed, and in our country these procedures are even more scarcely undertaken, partly due to dearth of facilities and to some extent, the expertise of embarking on this specialised surgical procedure. Therefore, we aimed to document the indications and the outcome of endoscopic septoplasty in our environment. Materials and Methods: This was a retrospective study of all consecutive patients that had endoscopic septoplasty at a state tertiary hospital over three years period. Ethical approval was obtained before commencement of the study. Patients' medical records were retrieved. Biodata, clinical presentation, operative procedure and outcome were extracted and analyzed descriptively. Results: Fourteen patients had endoscopic septoplasty over the period under review, constituting 11 (78.6%) males and 3 (21.4%) females. Predominant clinical features were nasal obstruction (100%) and nasal septal deviation (100%). The main indication for procedure was deviated nasal septum. The outcome of the surgery was good, 2(14.3%) of the patients had nasal adhesions but no major complication was recorded. The length of hospital stay ranged between 3 and 5 days with a mean of 3.7 ± 0.9 days, and all the patients were discharged successfully. Conclusions: Endoscopic septoplasty is a safe surgery. The main indication for the procedure was deviated nasal septum, and the procedure has a favourable outcome among the operated patients.

A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers.

Objectives: Even though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample. Methods: A structured questionnaire prepared after consultation with experts in the field and guided by the "Report of the SAGE working group on vaccine hesitancy" was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine. Results: Although 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines. Conclusions: COVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

Tympanometric findings among Nigerian prison inmates: A cross-sectional survey.

BACKGROUND: Prisoners, due to confinement, are isolated from contact with society and access to many of the facilities, including medical care. There is paucity of data on the middle ear function of prison inmates in the English literature globally. We aimed to assess the middle ear function of prison inmates in Kaduna, Nigeria. PARTICIPANTS AND METHODS: This was a cross-sectional comparative study of prison inmates at the Kaduna convict prison. Ethical approval was obtained from the Kaduna State Ministry of Health and the Nigerian Prison Service. Prison inmates aged 18-55 years in the Kaduna convict prison with an equal number of age and sex-matched controls from the community were enrolled. Consent was obtained from the participants. Data were collected using a structured pre-tested questionnaire. Participants had a thorough physical examination of the ears. Tympanometry was conducted on suitable participants to assess the middle ear function. Statistical Product and Service Solutions version 20.0 was used to analyse the data. RESULTS: Four hundred and thirty inmates with an equal number of controls were enrolled for the study. The mean age for the inmates and controls was 30.2 ± 7.51 and 30.4 ± 8.02 years, respectively. There were 47 female and 383 males, with a female: male of 1:8.1. Forty-six (46/397, 11.6%) of the inmates and 15 (15/423, 3.5%) of the controls had abnormal tympanograms on the right while on the left, it was 12.4% and 3.8%, respectively. The difference between the two groups was statistically significant (χ2 = 40.071, P = 0.0001). CONCLUSION: : Middle ear abnormalities are more prevalent among prison inmates than the general population. Middle ear effusion and ossicular chain disruption were the most common middle ear abnormalities affecting the prison inmates.

Stage of chronic kidney disease and cochlear function: A cross-sectional survey.

BACKGROUND: Studies have shown that hearing loss increases in patients with chronic kidney disease (CKD) with decreasing glomerular filtration rate. The hearing loss in CKD patients may worsen over time which in turn will negatively affect the patient's ability to effectively communicate with people, resulting in low self-esteem, social isolation, anger and depression. We aimed to assess the relationship between stage of CKD and hearing threshold in patients with CKD in Kaduna. PATIENTS AND METHODS: A cross-sectional study of patients with CKD in Kaduna. Individuals were selected consecutively using convenience sampling. Ethical approval and informed consent were obtained. The patients were grouped based on the stage of the disease. The pure tone audiometry was carried out using a Diagnostic Audiometer (Graphic Digi-IS, USA). The hearing threshold of the patients was then compared based on stage of the disease. The data collected was analysed using Statistical Product and Service Solutions, version 20. RESULTS: Sixty CKD patients (120 ears) were assessed. Their mean age was 43.2 ± 13.4 years and 70% were males. Of the 120 ears studied, 51 (42.5%) had normal hearing thresholds and 69 (57.5%) had hearing loss. Of the 69 ears with hearing loss, 11 (15.9%), 22 (31.9%) and 36 (52.2%) were in Stage III, IV and V, respectively, and the difference was statistically significant (P = 0.006). All those with Stage III CKD had mild hearing loss and the hearing loss worsen with advancing stage. Stage III CKD had significantly better hearing than those with stage IV and V (P < 0.001). CONCLUSION: Our study showed a statistically significant relationship between advancing stage of CKD and hearing loss. The hearing loss worsen with advancing stage of CKD.

Hearing threshold of deaf pupils in Kaduna metropolis, Kaduna, Nigeria: A cross-sectional survey.

BACKGROUND: Hearing loss in paediatric age group may be inherited, developmental or caused by maternal rubella. It may also be due to complications at birth or certain infections such as meningitis and measles. Ototoxicity and exposure to excessive noise also contribute significantly. Majority of hearing loss in children can be prevented primarily. We aimed to share our findings on assessing the hearing thresholds of pupils in deaf schools in Northwestern Nigeria. PARTICIPANTS AND METHODS: This was a cross-sectional study which assessed the hearing threshold of pupils in deaf schools in Kaduna metropolis, Kaduna, Nigeria. Approval was obtained from the State Ministry of Health Ethics Committee. Multi-staged sampling method was used to enrol 430 deaf pupils. Consent was obtained and a structured pre-tested questionnaire was used to generate data on the participant's biodata, history and detailed examination findings as well as pure-tone audiometry. Collated data were documented and entered into Statistical Product and Service Solutions version 20 for windows then analysed. RESULTS: Mean pure-tone average of the right ear was 103.4 ± 8.3 and the left ear was 104.3 ± 8.9. Majority had bilateral profound hearing loss (99.0%). Severe hearing loss was seen in 0.9%, whereas the remaining 0.1% had moderate hearing loss. The hearing loss sensorineural in majority (97.6%) and the remaining 2.4% had mixed hearing loss. High-frequency hearing loss predominated (98.6%). CONCLUSION: Majority of the deaf pupils had bilateral, profound, sensorineural hearing loss, involving higher frequencies.

Antibiotic Sensitivity Pattern of Bacterial Isolates in Patients with Chronic Rhinosinusitis in Kaduna, Nigeria.

Introduction A common practice in the management of patients with chronic rhinosinusitis (CRS), the empirical use of antibiotics may contribute to treatment failure and to the development of antimicrobial resistance. Objective To determine the antibiotic sensitivity pattern of aerobic and anaerobic bacteria associated with CRS. Methods This was a prospective cross-sectional study in which endoscopically guided middle meatal swabs (IBM Spss, version 16.0, Chicago, IL, USA) were aseptically taken from patients diagnosed with CRS after obtaining informed consent and ethical clearance. The samples were sent to the laboratory for qualitative and semiquantitative analysis via gram stain, aerobic, anaerobic cultures and antibacterial sensitivity tests. The collected data was analyzed using SPSS for Windows, version 16 (SPSS Inc, Chicago, IL, USA). Simple statistical parameters and paired sample t -test were used, as appropriate. Results There were 74 (56.92%) bacterial growths, out of which 55 (74.32%) were aerobic and 19 (25.68%) were anaerobic isolates, from a total of 130 patients. About 13 (17.5%-18%) of these bacterial growths yielded a mixed growth of aerobic and anaerobic isolates. The most common bacterial isolates were 26 (35.14%) Staphylococcus aureus , Haemophilus influenzae 9 (12.16%), Streptococcus viridians 8 (10.81%), and Streptococcus pneumoniae 5 (6.76%). Augmentin, ciprofloxacin, and Peflacine were found to be most effective, followed by levofloxacin, Rocephin, erythromycin and Zinat in that order. Conclusion Augmentin, ciprofloxacin and Peflacine have a sensitivity of 100%, while most of the organisms show resistance to Ampiclox, amoxicillin, and Septrin.

Antibiotic sensitivity pattern of bacterial isolates in patients with chronic rhinosinusitis in Kaduna, Nigeria

Introduction: A common practice in the management of patients with chronic rhinosinusitis (CRS), the empirical use of antibiotics may contribute to treatment failure and to the development of antimicrobial resistance. Objective: To determine the antibiotic sensitivity pattern of aerobic and anaerobic bacteria associated with CRS. Methods: This was a prospective cross-sectional study in which endoscopically guided middlemeatal swabs (IBMSpss, version 16.0, Chicago, IL, USA) were aseptically taken from patients diagnosed with CRS after obtaining informed consent and ethical clearance. The samples were sent to the laboratory for qualitative and semiquantitative analysis via gram stain, aerobic, anaerobic cultures and antibacterial sensitivity tests. The collected data was analyzed using SPSS for Windows, version 16 (SPSS Inc, Chicago, IL, USA). Simple statistical parameters and paired sample t-test were used, as appropriate. Results: There were 74 (56.92%) bacterial growths, out of which 55 (74.32%) were aerobic and 19 (25.68%) were anaerobic isolates, from a total of 130 patients. About 13 (17.5%- 18%) of these bacterial growths yielded a mixed growth of aerobic and anaerobic isolates. Themost common bacterial isolates were 26 (35.14%) Staphylococcus aureus, Haemophilus influenzae 9 (12.16%), Streptococcus viridians 8 (10.81%), and Streptococcus pneumoniae 5 (6.76%). Augmentin, ciprofloxacin, and Peflacine were found to bemost effective, followed by levofloxacin, Rocephin, erythromycin and Zinat in that order (AU)

Pattern of otitis externa in Kaduna Nigeria.

INTRODUCTION: Otitis externa (OE) is an inflammation or infection of the external auditory canal (EAC), the auricle, or both this condition has been reported to be found in all age groups. The aims and objectives were, study/determine the prevalence of Otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna, study the pattern of presentation among patients with otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna, and evaluate the choice of drug treatment for otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna. METHODS: Data of patients diagnosed with otitis externa between January 2009 and March 2013 were extracted from the recorded cases of ear disease seen within the same period. The ages, sex/ gender, complains(symptoms), duration of symptoms, clinical examination findings, diagnosis, mode of drug treatment, number of visits and complication records were extracted from the case notes of the patients and analyzed descriptively using SPSS (Statistical package for Social Sciences) version. RESULTS: Out of 13,328 cases of ear diseases seen within the period under review, 133 cases were diagnosed with otitis externa across all age groups. Hospital prevalence stands at 1.0%. There were 81(60.9%) males and 52(39.1%) females in ratio 1.5:1. Children age 0-15 constitute 55(41.3%) while young adults and adults were 78(58.6%). The minimum age at presentation was one year, while maximum age was 64 years. Mean age was 24 years with a standard deviation of ± 1.12 Years. Ear pain as only presenting symptom was the major complain found in this study accounting for 68(51.1%). Acute diffuse otitis externa was the commonest diagnosis accounting for 101(75.9%) and associated clinical findings ranging from tragal tenderness, hyperaemia and oedema of ear canal in 57 (54.9%). Ear swab was not routinely done and only 6(15.8%) of the discharging ears had microscopy done and the organisms were Pseudomonas spp and klebsiella. Empirical treatment was the commonest treatment modality and about 91% of the patients had complete symptom resolution by second visit. Complication was observed in only one case of necrotizing otitis externa who was retro-viral positive. CONCLUSION: Otitis externa accounted for small fraction of cases seen in our clinic (1%). Acute diffuse otitis externa is the commonest diagnosis made with symptoms ranging from ear pain, ear discharge, hearing loss and itchiness. Most patients were treated empirically with significant success within first two visits. No major complication was recorded within the period under study.