Analysis of sensorineural hearing loss in patients attending an otolaryngology clinic in North Central Nigeria.

Hearing loss is the third leading cause of years lived with disability. Approximately 1.4 billion people have hearing loss, of which 80% reside in low- and middle-income countries with limited audiology and otolaryngology care available to them. The objective of this study was to estimate period prevalence of hearing loss and audiogram patterns of patients attending an otolaryngology clinic in North Central Nigeria. A 10-year retrospective cohort study was carried out analyzing 1507 patient records of pure tone audiograms of patients at the otolaryngology clinic at Jos University Teaching Hospital, Plateau State, Nigeria. Prevalence of hearing loss of moderate or higher grade increased significantly and steadily after age 60. Compared to other studies, there was a higher prevalence of overall sensorineural hearing loss (24-28% in our study compared to 1.7-8.4% globally) and higher proportions of the flat audiogram configuration among the younger age patients (40% in younger patients compared to 20% in patients older than 60 years). The higher prevalence of the flat audiogram configuration compared to other parts of the world may be suggestive of an etiology specific to this region, such as the endemic Lassa Fever and Lassa virus infection in addition to cytomegalovirus or other viral infections associated with hearing loss.

Indications and outcome of pediatric tracheostomy: results from a Nigerian tertiary hospital.

BACKGROUND: There is a change in the concept of pediatric tracheostomy. This study investigates the indications and outcomes of pediatric tracheostomy in a Nigerian teaching hospital finding out whether there is also a change in the trend in our environment as compared to other centers. METHODS: A retrospective chart review of 46 patients aged between 2 months and 15 years who presented to our Otorhinolaryngological facility and had tracheostomy between January 2000 and December 2008. RESULTS: The age range was 2 months to 15 years. There were 29 males and 17 females. Thirty two (69.6%) patients were in the age range 6-10 years. Forty tracheostomies (87%) were performed as emergency while 6 (13%) as elective procedures. The commonest indication for tracheostomy was upper airway obstruction (n = 29, 63%). Transverse skin incision was employed in all the cases. No intra-operative complication was recorded. The post-operative complication rate was 15.2%. The duration of tracheostomy ranged from 5 days to 3 months. All the patients were successfully decannulated. The overall mortality was 8 (17.4%). There was no tracheostomy related mortality. CONCLUSIONS: There is no increase in the incidence of tracheostomy in patients under 1 year of age and the commonest indication for the procedure in Nigeria has remained relief of upper airway obstruction. Pediatric tracheostomy is safe when performed in the tertiary hospital setting.

The undergraduate medical student's perception of professional mentorship: Results from a developing nation's medical school.

INTRODUCTION: There are no documented formal mentoring programs for medical students in Nigeria. This study aims to determine the perception of undergraduate medical students at the University of Jos on professional mentorship, with a view to informing University authorities on creating and developing a mentoring program. MATERIALS AND METHODS: A cross-sectional study conducted in December 2017 in which self-administered questionnaires were distributed among the sixth-year medical students in a University in North-Central Nigeria, eliciting information regarding biodemographic data, knowledge of and experiences with mentoring, desired benefits of mentoring, and the willingness to participate in a mentoring relationship. Data collected was analyzed with EPI Info statistical software® version 7.2.1 (EPI Info, Center for Disease Control, Atlanta, Georgia, 2017). RESULTS: In a class of 166, the response rate was 83.5%. Mean age = 27.4 years; standard deviation = ±2.6 with a male: female ratio of 1.9:1. Moderate knowledge of mentoring was reported by 47 (44.3%). Attitude toward mentoring was very positive in 23.6%. One hundred and four (98.1%) students agreed mentoring are effective in developing potential. Nearly 95.3% agreed a mentorship program would benefit medical students with 70.8% expressing high willingness to participate. A weak positive statistical correlation between the age of students and those who expressed willingness to participate was recorded (r = 0.04; 95% confidence interval (CI) = 0.6-1.16; and P = 0.05). CONCLUSION: Sixth-year medical students of the University of Jos have a moderate knowledge of and a good attitude toward mentorship. The implementation of a formal mentoring program for medical students at the University of Jos is strongly recommended.

Environmental and Life-Style Related Risk Factors for Sinonasal and Nasopharyngeal Malignancies among a Prospective Cohort in Jos, Nigeria.

BACKGROUND: Worldwide evidence indicates that environmental and life-style related factors are associated with increased risk for cancers in the head and neck region. We aim to study the association between these risk factors and cancers in the sinonasal and nasopharyngeal regions in our environment. METHODS: Longitudinal prospective cohort study at the Jos University Teaching Hospital, Jos, Nigeria. Risk exposures were classified based on the International Agency for the Research on Cancer (IARC) classification of suspected carcinogens. Associations between variables were analyzed using logistic regression. RESULTS: We studied 44 patients with malignancies in nasopharynx (n= 24; 54.5%) and sinonasal regions (n= 20; 45.5%). Male to female ratio is 1.9:1 and mean age is 45.2 years. Alcohol was the commonest risk factor in males (n= 19; 43.2%) while cooking wood fumes were the commonest in females (n= 14; 31.8%) which was associated with increased risk for malignancies for all sites, showing ten times risk in nasal cancers (OR= 9.67; 95% CI 1.87- 9.88; p= 0.01). Tobacco was associated with elevated risk of malignancies in the nasomaxillary and nasal regions. Other risks were herbicides, pesticides, and chemical fertilizers in farmers. CONCLUSION: The significant risk exposures in females were cooking wood fumes and alcohol, tobacco, and exposure to agricultural chemicals in males. Life-style modification and environmental changes to ensure clean air in Nigeria are essential to reduce risks.

The predictive factors of primary head and neck cancer stage at presentation and survival in a developing nation's tertiary hospital.

BACKGROUND: Stage of head and neck cancers at presentation is a strong determinant of outcomes. OBJECTIVE: To evaluate predictors of stage of head and neck cancers at presentation and survival in a Nigerian tertiary hospital. PATIENTS AND METHODS: Health records that met the inclusion criteria for head and neck cancers were retrieved using the International Classification of Diseases, 10th revision and analyzed with associations between variables modeled using logistic regression analysis. RESULTS: From a record of 487 head and neck neoplasms, 129 (26.5%) were malignant of which 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13-85 years (mean = 51 years; standard deviation = ±16 years). Alcohol (odds ratio = 1.99; 95% confidence interval = 1.08-3.69; p = 0.02) and tobacco exposure (odds ratio = 3.07; 95% confidence interval = 1.32-7.16; p = 0.01) were associated with increased odds for advanced tumor stage at presentation. Stage IV cancer (hazard ratio = 1.44; 95% confidence interval = 1.80-2.59), alcohol (hazard ratio = 2.19; 95% confidence interval = 1.18-4.10) and tobacco use (hazard ratio = 3.40; 95% confidence interval = 1.22-8.74) were associated with increased hazards for death. CONCLUSION: Alcohol, tobacco use and smoke from cooking wood are predictive factors for advanced HNC stage at presentation. Stage IV cancer, alcohol and tobacco use were associated with an increased hazard for death.

The epidemiology, treatment, and determinants of outcome of primary head and neck cancers at the Jos University Teaching Hospital.

INTRODUCTION: This study aims to evaluate the epidemiology, treatment, and factors that determine the outcomes of head and neck cancers (HNC). PATIENTS AND METHODS: Retrospective analytical review of HNC managed at the Jos University Teaching Hospital between May 2007 and April 2017 using the International Classification of Diseases version 10. RESULTS: Of 487 head and neck neoplasms, 129 (26.5%) were malignant and 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13 years to 85 years (mean = 51 years; standard deviation = ±16.0 years). The most common presenting feature was nasal obstruction (n = 47; 38.5%). The most common tumor site was the nasopharynx (n = 34; 27.9%). Mean duration of symptoms was 13.3 months. Alcohol (P = 0.02), cigarette smoking (P = 0.01), and cooking wood smoke (P = 0.01) were associated with advanced tumor stage. Squamous cell carcinoma was the most common histological type. Posttreatment complication rate was 47.5%. Lost to follow-up rate was 55.7%. The lungs were the most common distant metastatic site. The case fatality rate was 18.0%. CONCLUSION: HNC constitutes almost a quarter of head and neck tumors affecting twice the number of males in their sixth decade with nasopharyngeal cancers being the most common in both genders. Several modifiable variables are noted to target appropriate future cancer education for lifestyle modification, screening for early detection and treatment.

Management of suicidal cut throat injuries in a developing nation: three case reports.

INTRODUCTION: Suicidal cut throat injuries are either unreported or fortunately rare in our country. The management of these injuries requires a multi-disciplinary approach. CASE PRESENTATIONS: This paper presents our experiences with managing three unemployed adult Nigerian males - two of Hausa ethnicity and one from the Tiv ethnic group presenting with cut throat injuries following suicidal attempts. CONCLUSION: The purpose of these reports is to emphasize that suicidal cut throat injuries do occur in our environment and there is a need for the collaboration of the otorhinolaryngologist, anesthesiologist and psychiatrist in the effective management of these patients. We recommend the socioeconomic improvement of individuals as a way of reducing the incidence of these injuries as unemployment was cited as a motivating factor for suicide in our patients. Ways must also be found to identify the many people in society without mental disorders who are at risk of suicidal behaviors.

Endobronchial metallic foreign body in a Nigerian child: management difficulties and the need for caution: a case report.

INTRODUCTION: Endobronchial metallic foreign bodies are serious injuries best treated by rigid bronchoscopy as quickly as possible to avoid life threatening respiratory sequelae. CASE PRESENTATION: We report the case of a 13-year-old male Nigerian child of the tangale ethnic group who aspirated a metallic foreign body, highlighting the "difficulties" encountered in managing this patient. CONCLUSIONS: There is a need to adequately equip our hospitals for the management of this otherwise straight forward case and alleviate the sufferings of our people. Parents and guardians should exercise caution in the handling of their children/wards.