Evaluation of mobile smartphones app as a screening tool for environmental noise monitoring.

Noise is a global occupational and environmental health hazard with considerable social and physiological impact and, therefore, there is a need for regular measurements to boost monitoring and regulations of environmental noise levels in our communities. This necessitates a readily available, inexpensive, and easy to use noise measuring device. We aimed to test the sensitivity and validity of mobile "smart" phones for this purpose. This was a comparative analysis of a cross sectional study done between January 2014 and February 2015. Noise levels were measured simultaneously at different locations within Abuja Nigeria at day and night hours in real time environments. A sound level meter (SLM) (Extech407730 Digital Soundmeter, serial no.: 2310135, calibration no: 91037) and three smartphones (Samsung Galaxy note3, Nokia S, and Techno Phantom Z running on Android "Apps" Androidboy1) were used. Statistical calculations were done with Pearson correlation, T-test and Consistency within American National Standards Institute acceptable standard errors. Noise level readings for both daytime and night with the SLM and the mobile phones showed equivalent values. All noise level meters measured were <100dB. The daytime readings were nearly identical in six locations and the maximum difference in values between the SLM and Smartphone instruments was 3db, noted in two locations. Readings in dBA showed strong correlation (r = 0.9) within acceptable error limits for Type 2 SLM devices and no significant difference in the values (p = 0.12 & 0.58) for both day and night. Sensitivity of the instrument yielded 92.9%. The androidboy1 "app" performance in this study showed a good correlation and comparative high sensitivity to the Standard SLM (type 2 SLM device). However there is the need for further studies.

Protocol for a comparative cross-sectional study on characterisation of auditory impairment in sickle cell disease and sickle cell trait and its impact on health-related quality of life in Nigeria.

INTRODUCTION: Sickle cell disease (SCD) and sickle cell traits (SCT) are genetically inherited red blood cell disorders common among people of African descent. Nigeria has a high prevalence of SCD, with a prevalence of 2.28%-3% and SCT, 25%-30%. Poorly managed SCD and SCT can lead to sensorineural hearing loss and health-related quality of life (HRQoL) issues. This research aims to assess these possible complications of SCD and SCT in Nigeria. METHODS AND ANALYSIS: The study will use a comparative cross-sectional design at study power 80% to investigate the association between SCD/SCT, hearing impairment and HRQoL. Participants will be divided into two groups: a cohort and a control group. Hearing levels will be assessed through audiometric assessments and categorised by type and severity of hearing impairments using WHO classifications. HRQoL will also be assessed using WHO Disability Assessment Schedule 2.0. Statistical analyses will be performed using the SAS V.9.4, with parametric or non-parametric analysis depending on the distribution. Relationship between key variables will be determined via correlational tests, χ2, Fisher's exact test and multivariable logistic regression analyses. ETHICS AND DISSEMINATION: The proposal has been fully reviewed and registered by the University of Cape Town's Faculty of Health Sciences Human Research Ethics Committee (HREC REF 228/2022) and the University of Abuja Teaching Hospital Human Research Ethics Committee (HREC/PR/2020/08/007). Information dissemination will be through conferences, peer-review publication and personal communications. The Strengthening the Reporting of Observational Studies in Epidemiology statement will be followed in writing the manuscript.

An analysis of the inclusion of ear and hearing care in national health policies, strategies and plans.

Ear- and hearing-related conditions pose a significant global health burden, yet public health policy surrounding ear and hearing care (EHC) in low- and middle-income countries is poorly understood. The present study aims to characterize the inclusion of EHC in national health policy by analysing national health policies, strategies and plans in English, French, Spanish, Portuguese and Arabic. Three EHC keywords were searched, including ear*, hear* and deaf*. The terms 'human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)', 'tuberculosis' and 'malaria' were included as comparison keywords as these conditions have historically garnered political priority in global health. Of the 194 World Health Organization Member States, there were 100 national policies that met the inclusion criteria of document availability, searchable format, language and absence of an associated national EHC strategy. These documents mentioned EHC keywords significantly less than comparison terms, with mention of hearing in 15 documents, ears in 11 documents and deafness in 3 documents. There was a mention of HIV/AIDS in 92 documents, tuberculosis in 88 documents and malaria in 70 documents. Documents in low- and middle-income countries included significantly fewer mentions of EHC terms than those of high-income countries. We conclude that ear and hearing conditions pose a significant burden of disease but are severely underrepresented in national health policy, especially in low- and middle-income countries.

The Global Otolaryngology-Head and Neck Surgery Workforce.

Importance: A core component of delivering care of head and neck diseases is an adequate workforce. The World Health Organization report, Multi-Country Assessment of National Capacity to Provide Hearing Care, captured primary workforce estimates from 68 member states in 2012, noting that response rates were a limitation and that updated more comprehensive data are needed. Objective: To establish comprehensive workforce metrics for global otolaryngology-head and neck surgery (OHNS) with updated data from more countries/territories. Design, Setting, and Participants: A cross-sectional electronic survey characterizing the OHNS workforce was disseminated from February 10 to June 22, 2022, to professional society leaders, medical licensing boards, public health officials, and practicing OHNS clinicians. Main Outcome: The OHNS workforce per capita, stratified by income and region. Results: Responses were collected from 121 of 195 countries/territories (62%). Survey responses specifically reported on OHNS workforce from 114 countries/territories representing 84% of the world's population. The global OHNS clinician density was 2.19 (range, 0-61.7) OHNS clinicians per 100 000 population. The OHNS clinician density varied by World Bank income group with higher-income countries associated with a higher density of clinicians. Regionally, Europe had the highest clinician density (5.70 clinicians per 100 000 population) whereas Africa (0.18 clinicians per 100 000 population) and Southeast Asia (1.12 clinicians per 100 000 population) had the lowest. The OHNS clinicians deliver most of the surgical management of ear diseases and hearing care, rhinologic and sinus diseases, laryngeal disorders, and upper aerodigestive mucosal cancer globally. Conclusion and Relevance: This cross-sectional survey study provides a comprehensive assessment of the global OHNS workforce. These results can guide focused investment in training and policy development to address disparities in the availability of OHNS clinicians.

Migraine-associated vertigo: a review of the pathophysiology and differential diagnosis.

The clinical diagnosis of migraine-associated vertigo may be difficult because it shares features with some other clinical conditions. This communication presents a systematic review on the epidemiology and theories of pathophysiology of migraine-associated vertigo and its distinguishing features from peripheral vestibular disorders. We searched the Cochrane Library, MEDLINE, and Google scholar for all the studies on migraine-associated vertigo published in English language between 1966 and 2010. Their references were also reviewed for completion. Data from the studies were independently extracted and assessed by the three authors using standardized data forms. There was consensus between the authors on the studies in this review that met the criteria. Forty-five studies were identified and independently assessed based on the objectives of the study by the authors. All the studies discussed on the epidemiology of the migraine-associated vertigo, six discussed on the pathophysiology, while differential diagnosis were documented in thirty-two studies. In conclusion, migraine-associated vertigo is a global distinct disease entity that can be clinically distinguished from peripheral vestibular disorders. Abstinence from trigger factors remains imperative in the control, whereas some medications have been found useful in the management.

Hearing Thresholds among Individuals with Dependence on Psychoactive Substances: A Comparative Cross Sectional Pilot Study.

Background: Globally, the use of multiple psychoactive substances (MPS), either together or at different times, is on the rise. It is associated with a significant public health burden, including an increased risk for hearing impairment. This study aimed to determine the hearing thresholds among individuals with dependence on multiple psychoactive substances. Methodology: It was a comparative cross-sectional study of 41 subjects with dependence on multiple substances and an equal number of age and sex-matched comparison groups. The test group further had three subgroups, based on their predominant substances of dependence; Group I: Cigarettes, Cannabis, and Codeine; Group II: Group I substances and intravenous Pentazocine. Group III: Group II substances and intravenous Ketamine. Specific Substance Involvement scores for each of the psychoactive substances and their associated level of risk were determined, based on the ASSIST V3 questionnaire. All participants had tympanometry and pure tone audiometry. A Pure Tone Average (PTAv) was calculated. Data were analysed using SPSS 25 and statistical significance was set at a p-value 0.05. Results: There were 36 (87.8%) males and 5 (12.2%) females. The mean age of the test and comparison groups was 27.93 5.47 years and 27.98 5.70 years (p = 0.969). The mean PTAv of the test and comparison groups were 16.07 ± 5.53 dBHL and 11.01± 3.52 dBHL: (p 0.001). The p-value for the difference in the mean PTAv between sub-groups of the test group was 0.173, 0.037, and 0.719, respectively, between Group I and II, Group I and III, and Group II and III, respectively. Conclusion: Hearing thresholds were higher among individuals with dependence on MPS and statistically significant in those that were dependent on cigarettes, cannabis, and codeine. Further studies are needed on the relationship between PS and hearing loss.

Update on first African clinical trial on earpopper for the treatment of otitis media with effusion [FCT/UATH/HREC/PR/330].

Background: Otitis media with effusion (OME) is a middle ear condition characterized by the accumulation of serous fluid. It is common, though not exclusive; among children with its attendant developmental consequence if missed or untreated in early life. OME could be managed surgically, pharmacologically, or physiologically. EarPopper is a medical device developed for physiologic management of OME, Eustachian tube dysfunction, and related problems. We aim to ascertain the suitability/efficiency of EarPopper® device for the treatment of OME in our setting. Methodology: This is a prospective interventional study of volunteers diagnosed with OME from four (4) medical centers in Abuja. Pneumatic otoscopy, video-otoscopy, tympanometry, and pure-tone audiometry were done to confirm the diagnosis. Serial EarPopper sessions were performed twice weekly for 2-12 weeks, and outcome was assessed using patients' reports. The reports include the EarPopper scoring system (ESS) and audiometric parameters (before and after therapy). Results: Forty-five patients (17 males and 28 females) aged between 3-56 years were enrolled. Thirty-five were diagnosed with bilateral OME and 10 unilateral. All patients had Type-B tympanometry tracing with mild-to-moderate conductive hearing losses and ESS of between 2.45% and 84%. Out of the 45 participants, 32 (71.1%) completed the treatment, whereas 13 (28.9%) were lost to follow-up. Duration of EarPopper treatment ranged from 2 to 12 weeks. The outcome revealed improvement in 26/32 (81.3%) with significant reduction in ESS (1% to 9.8%). Six patients 6/32 (18.9%) had persistence symptoms. These 18.9% had the propensity to progress to chronic OME. Conclusion: This study highly suggests good prospect in using EarPopper for the management of OME among Africans.

Résumé Contexte: L'otite séreuse est une affection de l'oreille moyenne caractérisée par l'accumulation de liquide séreux. Cette condition est courante chez les enfants (mais pas exclusivement) avec des conséquences développementales qui s'élabore si la diagnostique est manquées ou non traitées pendant les premières années de vie. L'otite séreuse peut être prise en charge chirurgicalement, pharmacologiquement ou physiologiquement. " EarPopper " est un appareil médical développé pour la gestion physiologique de l'otite séreuse, du dysfonctionnement de la trompe d'Eustache et des problèmes associés. Nous visons à déterminer la convenance/l'efficacité de l'appareil EarPopper® pour le traitement de l'otite séreuse dans notre environnement. Méthodologie: Il s'agit d'une étude interventionnelle prospective sur des volontaires ayant reçu un diagnostic de l'otite séreuse dans quatre (4) centres médicaux à Abuja. Une otoscopie pneumatique, une vidéo-otoscopie, une tympanométrie et une audiométrie tonale ont été réalisées pour confirmer le diagnostic. Des sessions EarPopper® en série ont été effectuées deux fois par semaine pendant 2 à 12 semaines, et les résultats ont été évalués à l'aide des rapports des patients. Les rapports incluent le système de notation EarPopper® (ESS) et les paramètres audiométriques (avant et après la thérapie). Résultats: Quarante-cinq patients (17 hommes et 28 femmes) âgés de 3 à 56 ans ont été inclus. Trente-cinq ont reçu un diagnostic de l'otite séreuse bilatérale et 10 unilatérales. Tous les patients avaient un tracé tympanométrique de type B avec des pertes auditives de transmission légères à modérées et une ESS comprise entre 2,45 % et 84 %. Sur les 45 participants, 32 (71,1 %) ont terminé le traitement, tandis que 13 (28,9 %) ont été perdus de vue. La durée du traitement EarPopper® variait de 2 à 12 semaines. Les résultats ont révélé une amélioration dans 26/32 patients (81,3%) avec une réduction significative de l'ESS (1% à 9,8%). Six patients (6/32 ; 18,9 %) on présentaient avec des symptômes persistants. Ces 18,9% avaient une propension à évoluer vers une otite séreuse chronique. Conclusion: Cette étude suggère fortement de bonnes perspectives d'utilisation d'EarPopper® pour la gestion de l'otite séreuse chez les Africains. Mots-clés: EarPopper®, l'otite séreuse, tympanométrie.

Validation of the Decision model of the Burden of Hearing loss Across the Lifespan (DeciBHAL) in Chile, India, and Nigeria.

Background: There is no published decision model for informing hearing health care resource allocation across the lifespan in low- and middle-income countries. We sought to validate the Decision model of the Burden of Hearing loss Across the Lifespan International (DeciBHAL-I) in Chile, India, and Nigeria. Methods: DeciBHAL-I simulates bilateral sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) acquisition, SNHL progression, and hearing loss treatment. To inform model inputs, we identified setting-specific estimates including SNHL prevalence from the Global Burden of Disease (GBD) studies, acute otitis media (AOM) incidence and prevalence of otitis-media related CHL from a systematic review, and setting-specific pediatric and adult hearing aid use prevalence. We considered a coefficient of variance root mean square error (CV-RMSE) of ≤15% to indicate good model fit. Findings: The model-estimated prevalence of bilateral SNHL closely matched GBD estimates, (CV-RMSEs: 3.2-7.4%). Age-specific AOM incidences from DeciBHAL-I also achieved good fit (CV-RMSEs=5.0-7.5%). Model-projected chronic suppurative otitis media prevalence (1.5% in Chile, 4.9% in India, and 3.4% in Nigeria) was consistent with setting-specific estimates, and the incidence of otitis media-related CHL was calibrated to attain adequate model fit. DeciBHAL-projected adult hearing aid use in Chile (3.2-19.7% ages 65-85 years) was within the 95% confidence intervals of published estimates. Adult hearing aid prevalence from the model in India was 1.4-2.3%, and 1.1-1.3% in Nigeria, consistent with literature-based and expert estimates. Interpretation: DeciBHAL-I reasonably simulates hearing loss natural history, detection, and treatment in Chile, India, and Nigeria. Future cost-effectiveness analyses might use DeciBHAL-I to inform global hearing health policy. Funding: National Institutes of Health (3UL1-TR002553-03S3 and F30 DC019846).

Third force in the treatment of COVID-19: A systematic review and meta-analysis.

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV2) depends on RNA-dependent RNA polymerase (RdRp) enzyme complex for its genomic replications and thus can be inhibited by nucleoside analogues. An example is Remdesivir, which is a non-obligate chain terminator of RdRp. Therefore, we investigate the activities of Remdesivir against COVID-19. METHOD: This is a systematic-review and meta-analysis of the literature on the effectiveness of Remdesivir in the management of COVID-19 through MEDLINE (from Jan 2019 to January 2021), EMBASE (from Jan 2019 to January 2021), Publics Ovidius Naso (Ovoid), Database of Abstracts of Reviews of Effects and the Cochrane Central Register of Controlled Trials in Issue 1 of 12, January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was applied and the questions generated in conformity with the participants, interventions, comparisons, outcomes, and study design (PICOS). Statistical analysis was performed in Stata v. 12.1 (StataCorp, Texas USA). RESULTS: The outcome of the reviewed relevant journals and the cross-references including clinical trials, systematic reviews and metanalysis were documented. Out of 569,000 articles, 11 roundly-suited the inclusion criteria. The comparative effects of Remdesivir on death (OR = 0.79; 95% CI = 0.57, 1.08) and recovery (OR = 2.22; p5% CI = 1.80, 2.73) were calculated. CONCLUSION: Remdesivir is useful in the treatment of COVID-19 especially the severe disease. However, it should be used with caution since all the adverse effects are not known. We recommend Remdesivir as an alternative/third-force in the treatment of severe and critical COVID-19.

Telemedicine in Otorhinolaryngological Practice during COVID-19 Pandemic.

Coronavirus-19 pandemic has impacted significantly on global social, economic, financial, and health institutions. Otolaryngologic (ORL) practice has also been affected by the scourge with the need for modification of practice. The risks of contracting COVID-19 with the regular "patient-doctor physical contact" method of management of cases in ORL practice are high, given the routine examination of nose and throat. The desirability of telemedicine in the handling of most patients is appealing despite the limitations in the technology, especially in the developing countries like Africa. Therefore, otorhinolaryngologists in Sub-Saharan Africa, within limits of applicability, should leverage on telemedicine in their clinical practice during this COVID-19 pandemic and beyond. COVID-19, being a disease of second chance, has provided us with the opportunity to harness this technologically driven method of supportive care in our clime.

Systematic Review and Meta-analysis of Smell and Taste Disorders in COVID-19.

OBJECTIVE: Loss of smell and taste are considered potential discriminatory symptoms indicating triaging for coronavirus disease 2019 (COVID-19) and early case identification. However, the estimated prevalence essential to guide public health policy varies in published literature. This meta-analysis aimed to estimate prevalence of smell and taste loss among COVID-19 patients. DATA SOURCES: We conducted systematic searches of PubMed, Embase, Web of Science, and Google Scholar databases for studies published on the prevalence of smell and taste loss in COVID-19 patients. REVIEW METHODS: Two authors extracted data on study characteristics and the prevalence of smell and taste loss. Random-effects modeling was used to estimate pooled prevalence. Subgroup analysis and meta-regression were conducted to explore potential heterogeneity sources. This study used PRISMA and MOOSE guidelines. RESULTS: Twenty-seven of 32 studies reported a prevalence of loss of smell, taste, or both from a combined sample of 20,451 COVID-19 patients. The estimated global pooled prevalence of loss of smell among 19,424 COVID-19 patients from 27 studies was 48.47% (95% CI, 33.78%-63.29%). Loss of taste was reported in 20 studies and 8001 patients with an estimated pooled prevalence of 41.47% (95% CI, 3.13%-31.03%), while 13 studies that reported combined loss of smell and taste in 5977 COVID-19 patients indicated a pooled prevalence of 35.04% (95% CI, 22.03%-49.26%). CONCLUSIONS: The prevalence of smell and taste loss among COVID-19 patients was high globally, and regional differences supported the relevance of these symptoms as important markers. Health workers must consider them as suspicion indices for empirical diagnosis of severe acute respiratory syndrome coronavirus 2 infection.

Sensorineural hearing loss (SNHL) as an adverse event following immunization (AEFI): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data.

This is a Brighton Collaboration case definition of the term "Sensorineural Hearing Loss" to be utilized in the evaluation of adverse events following immunization. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of vaccines for Lassa Fever and other emerging pathogens. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and define levels of diagnostic certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network.

Correlating the site of tympanic membrane perforation with Hearing loss.

BACKGROUND: It is recognized that the size of tympanic membrane perforation is proportional to the magnitude of hearing loss, however, there is no clear consensus on the effect of the location (site) of the perforation on the hearing loss. Hence the study is set to investigate the relationship between the location of perforation on TM and hearing loss. METHODS: A cross-sectional prospective study of consecutive adult patients with perforated TM conducted in the ENT clinic of University College Hospital Ibadan between January 1st 2005 and July 31st 2006. Instruments used for data collection/processing include questionnaires, video and micro-otoscopy, Pure tone audiometer, image J and SPSS packages. RESULTS: Sixty-two patients (22-males, 40-females), aged 16-75 years (mean = 35.4 +/- 4) with 77 perforated ear drums were studied and 15(24.2%) had bilateral TM perforations, 21 (33.9%) right unilateral and 26(41.9%) left unilateral. The locations of the TM perforations were 60(77.9%) central, 6(9.6%) antero-inferior, 4(5.2%) postero-inferior, 4(5.2%) antero-superior and 3(3.9%) postero-superior respectively with sizes ranging from 1.51%-89.05%, and corresponding hearing levels 30 dB - 80 dB (59% conductive and 41% mixed). Fifty-nine percent had pure conductive hearing loss and the rest mixed. Hearing losses (dBHL) increased with the size of perforations (P = 0.01, r = 0.05). Correlation of location of perforations with magnitude of hearing loss in acute TM perorations was (P = 0.244, r = 0.273) and for chronic perforations (p = 0.047 & r = 0.31). CONCLUSION: The location of perforation on the tympanic membrane (TM) has no effect on the magnitude of hearing loss in acute TM perforations while it is significant in chronic ones.

Migraine and Meniere's disease: two different phenomena with frequently observed concomitant occurrences.

BACKGROUND: Some variants of migraine could be indistinguishable from Meniere's disease, and this has prompted suggestions of possible association between the two disease entities. AIM AND OBJECTIVES: This study aims at determining the prevalence of migraine among Meniere's patients and a possible linkage between the two diseases in our environment. METHODOLOGY: A 10-year retrospective study of patients diagnosed with Meniere's disease using American Academy of Otorhinolaryngology criteria, including those that had associated migranous symptoms in accordance with the International Headache Society (IHS) diagnostic criteria for migraine, between 1996 and 2005. The prevalence of migraine in the Meniere's patients was also compared with lifetime prevalence recorded from a previous population-based study within the same setting. The statistical difference was tested with a Z nonparametric test (significance at P < 0.05). Epicalc2000 and SPSS 11 were used for the statistical analysis. RESULT: A total of 25 patients representing 0.22% of the 11,463 ear, nose and throat outpatients seen within the study period met the diagnostic criteria for Meniere's disease. There were nine (36%) males and 16 (94%) females. Their ages ranged 27-65 years, mean 45.25 years +/- 11.05. Eight (32%) met IHS criteria for migraine. There is a statistically significant difference between the prevalence of migraine in Meniere's patients and migraine in the overall population (32% vs. 5.3%, P = 0.000). CONCLUSION: The significant preponderance in the prevalence of migraine in Meniere's disease suggests a link between the two diseases. However, more molecular or genetic studies are needed to unveil this phenomenon.

ENT Outreach in Africa: Rules of Engagement.

To address inequality of access to ear, nose, and throat (ENT) care, there must be significant and sustained investment in education and training of surgeons, audiologists, speech therapists, clinical officers, anesthetists, and specialized nurses engaged in ENT in sub-Saharan Africa and other developing nations. Outreach by ENT surgeons from developed countries is essential if we are to address the critical lack of access to ENT care in SSA. However, it should be based on mutual respect, shared values, aspirations, a desire to create a durable and sustainable impact, and internationally accepted best practice. In this article, we propose rules of engagement for outreach projects in SSA and other developing countries to optimize their contributions by making them useful, sustainable, productive, and developmental. These proposed rules of engagement are based on our personal experiences and observations-good and bad-of outreach activities in our countries.

Tympanic membrane perforation among adults in West Africa.

CONTEXT: The knowledge of variations of the tympanic membrane (TM) perforations with the climatic changes in the West African subregion would help clinicians in its prevention and management. OBJECTIVE: To analyze the pattern of clinical presentations and associated features of TM perforation in adults in West Africa. DESIGN: A prospective study. SETTING: Tertiary referral centre, University hospital. PATIENTS OR OTHER PARTICIPANTS: Thirty-five (35) consecutive adults with TM perforations during a 1-year period had clinical evaluation of each TM using head mirror, video otoscopy, and micro-otoscopy. MAIN OUTCOME MEASURES: Clinical presentations and associated features of TM perforations. RESULTS: Thirty-five patients, 20 (57%) men and 15 (43%) women, with 42 perforated TMs were examined. Twenty-eight (80%) patients had unilateral perforations. Infection was responsible for 90.5% of cases, and trauma was responsible for the rest. Locations of perforations were central (29; 69.1%), anteroinferior (4; 9.5%), posteroinferior (4; 9.5%), anterosuperior (3; 7.1%), and posterosuperior (2; 4.8%). The sizes of the perforations ranged from 1.2 to 83.2%. Large sizes of 25% and more were found to occur in humid and wet seasons, and also, clinical presentations of otorrhea (65.6%), otalgia (51.5%), tinnitus (37.1%), and ear itching (34.4%) seemed to worsen. CONCLUSION: Most TM perforations result from infection and are preventable via appropriate health education. Posterosuperior perforation is rare, and this is probably one of the factors making choleasteatoma uncommon in West Africa. Approximately 83.3% of TM perforations measure more than 25% in size and appear during the wet humid season of the year. These findings are important for both local and foreign otolaryngologists who may be practicing in this subregion of the world.

Nasal septal teratoma in a child.

BACKGROUND: Teratoma is a rare developmental neoplasm that arises from totipotential tumor stem cells. Head and neck teratomas constitute about 10% of all cases. Only two cases of mature teratoma of the nasal septum have previously been documented in the world literature. CASE PRESENTATION: We present a case of histologically confirmed mature teratoma arising from the nasal septum in an eighteen month old Nigerian female who presented with a history of noisy breathing associated with recurrent rhinorrhea since birth. Physical examination revealed obstruction of the right nasal cavity by a pale fleshy mass. She underwent a total surgical excision and to date, after thirty one months follow-up, she is free from recurrence. CONCLUSION: The prognosis for benign teratoma of the nasal septum is good following total surgical excision.

Quality of life in patients with head and neck cancers.

OBJECTIVE: The aim was to assess the psychosocial effects on the quality of life (QOL) of adults with head and neck cancer (HNC) and any gender variations with predictive factors that may influence QOL. PATIENTS AND METHODS: This was a three-month descriptive and prospective evaluation of QOL in 50 adult patients with HNC who were still on treatment but had spent a period of at least four weeks from commencement in a tertiary hospital. MAIN OUTCOME RESULTS: There were 32 males and 18 females with a mean age of 47.74 years. Females had higher mean scores than males in all domains except pain domain, global and general questions. There was no significant difference in the mean score between the genders in all the domains: overall bother, overall satisfaction, response to treatment, site with QOL and health-related QOL (HRQOL). Pain domain correlated significantly with eating and emotion but weakly with stage of the disease. The predictive factor for overall bother was mainly emotion domain, while site of lesion with QOL was for overall satisfaction, response to treatment and HRQOL. CONCLUSIONS: Pain, which is a major problem experienced by these patients with HNC, requires more attention by the caregiver in order to improve their QOL.

Validation of The 3-Question Headache Screen in The Diagnosis of Migraine in Nigeria.

BACKGROUND: Migraine is a chronic episodic disorder that is still under-diagnosed and undertreated. A rapid diagnostic method is desirable so that treatment can be initiated early. We compared the 3-question headache screen with the International Headache Society (IHS) criteria in the diagnosis of migraine among Nigerians. METHODS: Using a multi-stage sampling technique, 1513 respondents were screened for migraine using both the IHS criteria and the 3-question headache screen. A statistical comparison of the two diagnostic methods was then done by determination of kappa coefficient, sensitivity and specificity. RESULTS: The prevalence of migraine obtained using the IHS criteria was 9.6% (95% CI, 8.1%-11.1%) while it was 8.3% (95% CI, 8.1%-8.5%) with the use of the 3-question headache screen. There was a good agreement between the IHS criteria and the 3-question headache screen (k=0.68, p<0.001). The 3-question headache screen had a sensitivity of 66.2% (95% CI, 58.5%-73.9%), specificity of 97.8% (95% CI, 97.0%-98.6%), positive predictive value of 76.2% (95% CI, 68.8%-83.6%) and a negative predictive value of 96.5% (95% CI, 95.5%-97.5%). CONCLUSION: The 3-question headache screen is sensitive and specific in making a rapid diagnosis of migraine among Nigerians. Its use is thus encouraged so that appropriate management of the condition can be initiated early in order to reduce associated disability.

The post-Ebola virus disease scourge in Nigeria: Individual levels of preparedness among physicians in the Federal Capital Territory Abuja.

BACKGROUND: Ebola virus disease (EVD) is a viral hemorrhagic illness with great propensity for spread across international borders. The latest outbreak in the West African region, which involved Nigeria, was the worst among previously documented 25 outbreaks since discovery in 1976. The Nigerian response toward attaining Ebola free status was phenomenal and a case study for most nations. However, the persistence of EVD in West Africa is still a risk to recurrence, hence, the need to assess the level of consciousness of Nigerian physicians towards this. METHODOLOGY: A cross-sectional study utilizing the instrument of a pretested semi-structured questionnaire was conducted among physicians practicing within the federal capital city of Nigeria. General knowledge, treatment, prevention, and reporting of EVD were assessed and appropriate statistical analyses done using SPSS 20. RESULTS: Of the 101 respondents, 45% and 87% showed excellent level (>80% score) of "general knowledge" and "reporting" on EVD, respectively. However, only 51% respondents had good (60-80%) knowledge on EVD treatment. Three percent correctly identified the "EVD helpline" phone-numbers for reporting suspected cases. Furthermore, 43.6% admitted the availability of personal protective equipment (PPE) in their hospitals while 35.6% had witnessed a demonstration of the use. The distribution of the PPEs appeared skewed - 74.4% (teaching-hospitals), 16% (private-hospitals), and the primary health care centers (9.6%). CONCLUSION: A majority of the physicians showed good level of preparedness as it relates to general knowledge on EVD, knowledge on good clinical practice, use of protocols and standard precautions and PPE. The identification of deficits in knowledge on treatment of EVD and flow path for the notification of suspected cases requires urgent redress given the risk of re-occurrence in the country.