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The article offers information on a medical research conducted at a primary school in Nigeria related to the diagnosis and treatment of cerumen impaction, an ear disease which causes pain and otitis externa. As mentioned, the otoscopy research indicates a major problem of impaction of earwax in primary school children. There is lack of knowledge about the symptoms and diagnosis of the diseases which leads delay in disease management and causes hearing impairment in children.

Background: Brain abscess in children is a neurosurgical emergency with potentially catastrophic outcome despite the advances made in neuroimaging techniques and antibiotic therapy. Symptoms are nonspecific and may vary with the child's age, location, size, numbers and stage of abscess, and the primary source of infection. Treatment is usually with broad-spectrum antibiotics in combination and surgical evacuation in most cases or antibiotics alone in selected cases with clear-cut indications. This study was to document clinical characteristics, etiological factors, and spectrum of bacteriologic agents responsible for pediatric brain abscess in an African city, the challenges and management outcome over the study period., Methods: This was a retrospective study over an 11-year period involving 89 children who presented with brain abscess. Information of interest was extracted from the medical records of each participant. The results from data analysis were presented in charts and tables., Results: Eighty-nine children aged 0.85-15.7 years (median age of 6.4 years) met the inclusion criteria. The male-to-female ratio was 1.8:1. Headache (80%), fever (78%), and hemiparesis (78%) were the most common symptoms. Brain imaging deployed was CT scan in 56 (63%), MRI in 9 (10%), and transfontanel ultrasound scan in 24 (27%) children. Seventy-one (80%) children had antibiotics with surgical evacuation while 18 (20%) children received only antibiotics. In 19 (27%) children, the culture of the abscess was negative. In 53 (75%) children, Gram-positive aerobic organisms were isolated. A total of 75 patients (84%) had a favorable outcome., Conclusion: Pediatric brain abscess still poses significant public health challenge, especially in resource-limited regions. Successful management of brain abscess requires high index of suspicion for early diagnosis, referral, and intervention., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Surgical Neurology International.)

Background: Halitosis is a common medico social symptom among children., Aim: To determine the clinical, epidemiological patterns, aetiology and psycho-social issues of halitosis among children in a tertiary hospital in Nigeria., Methodology: This was a prospective hospital based study of children with complaints of halitosis. The study was carried out in Ear, Nose & throat Department, Ekiti State University Teaching Hospital, Ado Ekiti over a period of two years, (October 2015 to September 2017). Consent was obtained from the parents/guardian. Data was obtained by using pretested interviewer assisted questionnaire.All the data obtained were collated and analyzed by using SPSS version 16.0. Ethical clearance was obtained from the ethical committee of the institution., Results: The prevalence of halitosis in this study was 6.8% and there were 58.5% males and 41.5% females with a male to female ratio of 1.5:1. Their age ranged from 1 year - 18 years with a mean of 9.48 ± 5.84 SD years.Sources of referral for the otorhinolaryngology, head and neck care were mainly from general practitioners (52.3%) and from pediatricians (24.6%). Halitosis was noticed by family members in 50.8% and from family friends in 23.1%. Nasal and throat diseases in 49.2% and 29.2% respectively were the commonest otorhinolaryngology, head and neck disorders that were responsible for halitosis. The major causes were rhinosinusitis in 24.6%, impacted nasal foreign body in 23.1% and adenotonsillar hypertrophy in 18.5%. Associated disabilities in children and family with halitosis include social withdrawal in 35.4%, low social interaction in 32.3% and depression in 29.2%. Acute halitosis (<3/12) accounted for 50.8% while chronic halitosis (>3/12) accounted for 49.2%. In all, fifty four (83.1%) of the patients were successfully treated., Conclusion: Bad breath is a common ear, nose and throat symptom in children it is commonly due to nasal and pharyngeal diseases which are amenable to treatment.

Background: Penetrating anterior neck injuries are potentially life threatening and the causes vary across countries of the world. Studies in Nigeria have been mainly isolated case reports and few retrospective studies., Aim: The aim of this study was to assess the causes, severity and management outcome of patients treated in our centre., Methodology: This is a retrospective study of penetrating anterior neck injuries treated at the Lagos University Teaching Hospital over a 25-year period. The case records were retrieved and demographic data as well as the causes, site, extent of injuries and treatment outcome were analyzed., Results: The mean age of the 39 patients in this study was 30.5yrs ± 7.9 SD with a male: female ratio of 6.8:1. Inflicted cut throat injuries accounted for 46% followed by vehicular accidents in 21%. Zone II site of the neck was the commonest site of injury 61.6% of the patients; while 71.8% of the patients presented within 24hrs of the injury, 46% of them had immediate blood transfusion. Tracheostomy was the main method of securing the airway. Primary soft tissue repair was performed on all the patients. Laryngopharyngeal repair was done in 61.5%. Peri-operative mortality was 7.7% and 83.3% had prolonged hospital admission with wound infection in 27.8% and laryngotracheal stenosis in 22.2% as the commonest complications., Conclusion: This study has shown that penetrating anterior neck injuries is not uncommon in Nigeria and commonly due to cut throat and vehicular accidents. Proper documentation and following established management protocols will improve outcome.

Background: Assessment of clinical skills is essential in medical education. Ideally marks should be based on the student's competence alone. The limitations of the traditional long case examinations such as the patient and examiner variability are well known. The objective structured clinical examination (OSCE) was designed to overcome these limitations. Studies comparing the OSCE and the traditional long case examination in the same group of students are very sparse., Aim: To compare the objective structured clinical examination (OSCE) and the traditional long case examination by determining their correlations with other forms of assessment in undergraduate surgery., Setting: This study was carried out at the College of Medicine, University of Lagos, Nigeria., Methodology: The results of 612 undergraduate students in our medical school of the University of Lagos, Nigeria over a period of 4 years (2012-2015) were analysed. The scores in the long case examination , objective structured clinical examination (OSCE) , multiple choice questions and Essays were analysed and compared using the Pearson's Correlation co-efficient. SPSS version 17 software was used and a P-value < 0.01 was regarded as statistically significant., Results: Overall, there was a statistical significant positive correlation among most forms of assessment. The OSCE and the long case examination had a correlation of 0.374. Compared with the long case examination, the OSCE had a higher correlation with all other forms of assessment. The total clinical score (the sum of all long case examination and OSCE) however performed better than the OSCE or the long case examination alone as it had the highest correlation with all other forms of assessment., Conclusion: The OSCE has been shown to be better than the long case examination as an indicator of the student overall knowledge of surgery as it had a superior correlation with other forms of assessments. The total clinical score was however the best indicator of the student overall knowledge in Surgery as it had the best correlation with other forms of assessment. We recommend and encourage institutions that presently combine the OSCE and the long case examination to carry out similar analysis such as ours to determine the desirability of combining LCE and OSCE rather than outright replacement of LCE with OSCE.

Background and Aim: Earwax impaction is a common ear disorder with presentation worldwide. This study aimed at determining the clinical presentation, patients' perception of earwax, and its predisposing factors among Nigerians., Materials and Methods: This prospective study was conducted on consented patients with diagnosis of earwax impaction at the Ear, Nose, and Throat Clinic of the University Teaching Hospital, Ado Ekiti, Ekiti state, south west, Nigeria. The research was carried out over a period of one year (April 2008 and March 2009). All consented patients were told about the aim and scope of the study and their biodata were taken. Detailed history of the presenting complaints and otological complaints were taken and all data entered into structured questionnaires. Full-ear examination and otoscopy were performed and our findings were documented. From all these exercise, data obtained were collated and statistically analyzed., Results: A total of 437 patients were diagnosed with earwax impaction and prevalence of 20.1% was found. There was 52.2% male preponderance with male to female ratio of 1:1. Bimodal peak age distribution of patients was found at the extreme ages of life. Most common sources of our patients referrals were 39.6% general medical practitioners with least from 6.2% self-reporting. Common presentations were 277 (63.3%) hearing loss, 268 (61.3%) earache (otalgia), and 234 (53.5%) tiinitus. Unilateral earwax impaction, 75.1% was more common than bilateral earwax impaction. Right ear was more affected than left ear. Recurrent earwax impaction of 66.1% was found in our study. About 382 (87.4%) believed earwax was due to dirt or dust. Most common predisposing factors among our patients were self-ear cleaning., Conclusion: Common predisposing factor of this high recurrent earwax impaction were wrong perception and preventable self-ear cleaning with indiscriminate objects including cotton tip swab. This condition could be reduced by health education of the community.

Background: Allergic rhinitis (AR) and asthma are different manifestations of allergic disease of the airway. Both can exist together or as separate disease entity in an individual. However, it is not known if the coexistence of the two diseases can make asthmatic control difficult or not in the black population., Objective: To determine the prevalence of allergic rhinitis in asthmatics and its effects on bronchial asthmatic control among adult Nigerians.., Design: A prospective case-control study., Setting: Lagos University Teaching Hospital, Lagos, Nigeria., Subjects: Cases were 160 adult patients with confirmed bronchial asthma and controls were 160 subjects without bronchial asthma., Methods: Structured questionnaire adapted from the European Community Respiratory Health Survey was applied. Allergic rhinitis was clinically diagnosed if watery rhinorrhea, nasal blockage, and excessive bout of sneezing, itching of eye, ear, nose or throat were present., Results: Amongst the asthmatics, 133 (83%) had concomitant allergic rhinitis while 30 (19%) controls had allergic rhinitis(x(2)=137.81, p<0.001). Seventy eight (59%) cases with allergic rhinitis had uncontrolled asthma while 9 (33%) cases without allergic rhinitis had uncontrolled asthma (x(2) = 8.8731, p=0.012)., Conclusion: The prevalence of allergic rhinitis among adult asthmatics was high and the co-existence of allergic rhinitis was significantly associated with poor asthmatic control.

Background: Otitis media (OM) is a major health problem in both developed and developing countries., Objective: To determine the pattern of bacterial isolates in patients with chronic suppurative otitis media(CSOM) in Ilorin, Nigeria., Methods: A prospective study carried out in University of Ilorin Teaching Hospital, Nigeria among consenting patients with CSOM attending the ENT clinic over a period of 7months. Informed consent was obtained from the patients or caregivers and approval for the study obtained from ethical committee. Structured questionnaire was administered and microbiological analysis done, data obtained was entered into SPSS statistical software and results presented in tables and figures., Results: A total of 134 patients aged 5-64yrs with chronic suppurative otitis media were interviewed with a mean age of 17.0 (S.D. =15.1±1.30). About 55.2% of the respondents were under 10yrs. Seventy-two (53.7%) of the respondents were males with M:F=1.2:1. The gram stain showed predominantly gram negative organisms (71.6%). Pseudomonas aeruginosa was the commonest middle ear pathogenic organism identified and the sensitivity pattern highly favoured ciprofloxacin, Conclusion: CSOM is still a childhood problem among the under tens' more prevalent among males and the commonest agent is Pseudomonas aeruginosa. Ciprofloxacin is still the most sensitive antibiotics in vitro.