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BACKGROUND: Dentures in the oesophagus have been associated with various complications; however, Horner's syndrome following denture impaction has not been reported in our locality. CASE REPORT: Horner's syndrome developed in a 26-year-old woman following accidental swallowing of an upper denture which then became impacted in the oesophagus. The denture was retrieved via cervical oesophagotomy. The syndrome abated completely by the seventh day post-surgery. The clinical features of Horner's syndrome are discussed. CONCLUSION: Compression of the stellate ganglion, with resultant Horner's syndrome, can be associated with denture impaction in the cervical oesophagus. [ABSTRACT FROM AUTHOR]

Purpose: Sleep medicine is a rapidly growing field of Medicine globally. However, studies are lacking on the knowledge of Nigerian medical and dental students on sleep and the different types of sleep disorders. Thus, we assessed the knowledge, interest and awareness of Nigerian medical and dental students about sleep medicine. We also determined the factors associated with sleep knowledge among the medical and dental students., Methods: We conducted this cross-sectional study from June to September 2021, among medical students at the Obafemi Awolowo University, Ile-Ife, Nigeria. The students' knowledge of sleep was assessed with the Assessment of Sleep Knowledge in Medical Education (ASKME) survey. The participants were classified as having low or high scores based on the proportion who gave a correct answer to 60% of the questions., Results: Among the 488 students who completed the questionnaire, there was a male preponderance (55%). About three-quarters of the respondents (376, 77%) had a low sleep knowledge score. Age, year of study, and awareness about sleep medicine were the predictors of sleep knowledge., Conclusion: A significant proportion of the medical students had poor sleep knowledge scores. There is a need to incorporate teaching sleep medicine in the curriculum of medical students early in their training., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Advances in surgical techniques have significantly improved the safety of thyroidectomy. Quality of life issues, such as voice changes, however continue to be important considerations. This study evaluated the prevalence and determinants of voice changes following thyroidectomies for non-malignant goiters in a Nigerian Hospital., Methodology: Consecutive adults who had thyroidectomy for non-malignant goiters were evaluated. Preoperatively, each participant had laryngoscopy and voice assessment using the Voice Handicap Index-10. At surgery, the intubation difficulty score, size of endotracheal tubes, and duration of operation were recorded. Laryngoscopy and VHI-10 assessments were repeated 1 week, 1 month, and 3 months after surgery. Pre and postoperative assessments were compared., Result: Fifty-four patients completed the study. Subtotal thyroidectomy was the commonest operation performed in 17 patients (31.48%), with 14 (25.93%) having total thyroidectomy. Baseline median VHI-10 score was 6.5(IQR-10). Five patients had abnormal preoperative laryngoscopy findings (benign vocal cord lesions). Postoperatively, seven patients had endoscopic evidence of vocal cord paralysis, six were unilateral while one was bilateral. Ten patients (18.5%) had early voice changes. Median VHI-10 score at one week was significantly higher than baseline (10 vs. 6.5, p = 0.01). At 3 months, VHI-10 reverted back to baseline in five of the ten patients while five patients (9.3%) had persistent voice changes. Abnormal endoscopic findings predicted the occurrence of early postoperative voice changes., Conclusion: Thyroidectomy for non-malignant goiters is associated with transient voice changes, many of which revert to normal over time. Abnormal endoscopic findings predict its occurrence., (© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.)

Background: Access to quality and timely care prevents unnecessary deaths and morbidity from potentially curable surgical diseases. This study describes the magnitude of unmet surgical needs in a Nigerian community and describes the experiences garnered during a surgical outreach organized by a tertiary institution in an underserved community., Methods: This is a descriptive study highlighting details of a surgical outreach to a community in south-Western part of Nigeria. The project was based on a collaboration between a University Teaching Hospital (gown) and the community (town). Details of the patients' demographic and disease characteristics as well as barriers to seeking medical care were obtained. The operational workflow, treatment offered, and outcomes are highlighted. Results are presented as descriptive statistics., Results: Over a two-day period, 83 out of 3,056 patients who were screened had surgically treatable conditions (2.7%), predominantly hernias (37, 46.6%), goitres (13, 15.7%) and soft tissue swellings (9, 10.8%). The majority were adults (56, 67.5%) while 27 (32.5%) were in the paediatric age group. The mean duration of symptoms was 8.64 months ± 9.5 months. About half of the patients (46.9%) had never visited a medical facility on account of their index illnesses. Lack of funds was cited by many patients as the main reason for having not presented at a hospital. Sixty-three surgical operations were performed with no peri-operative adverse events., Conclusion: Lack of financial access was the major barrier to surgical care in the sampled community. Moving from 'gown to town' helped address a significant proportion of the unmet needs over a relatively short period. Tertiary hospitals can provide surgical oversight to communities within their jurisdiction using this approach., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2023 by West African Journal of Medicine.)

Objectives: Thyroglossal duct cyst (TDC) is the most common congenital anterior neck mass in clinical practice. Due to its congenital origin, presentation in adulthood is uncommon with only 7% of cases presenting in this age group. Data are therefore limited on the management of TDC in adults, particularly in Sub-Saharan Africa. This study describes the pattern of the presentation and treatment outcomes, following the management of TDC in a series of adults in a Nigerian tertiary hospital., Subjects and Methods: A retrospective review of all adult patients with TDCs over a 5-year period was carried out. Sociodemographic data, operative details, and postoperative outcomes were obtained and presented as descriptive statistics., Results: Seven adult patients, including five males and two females, were managed during the period. Their ages ranged from 19 to 60 years, with a mean of 37 ± 16.4 years. All the patients presented with anterior neck swellings which had been present for a median duration of 3 years. Cysts were located in the infrahyoid position in all instances, and all had Sistrunk operation over a mean operative time of 78 ± 16 min. There were no intraoperative complications. The mean duration of the postoperative stay was 2 days. There was no recurrence after a median follow-up period of 15 months., Conclusion: This study highlights the rarity of TDC in adults and describes a single institution's experience with the management of adult cases of TDC using the classical Sistrunk operation., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Nigerian Journal of Surgery.)

Background: Protein-energy malnutrition is a common problem in critically ill patient and it is a major cause of accelerated morbidity and mortality in this group of patients. Recent dramatic advances in both enteral and parenteral nutritional support have ensured that most of these critically ill patients are adequately nutritionally supported. Unfortunately, most of these advancements in nutritional supports are far from the reach of most patients in developing countries. In this report, we highlighted the indications, success, challenges of the use of percutaneous endoscopic gastrostomy (PEG) in Nigeria patients., Patients and Methods: All cases of PEG performed at the Endoscopy Unit of Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State from January 2011 and June 2012 were recruited into the study. The data obtained included the sociodemographic parameters, indication and duration of the procedure, complications, and follow up., Results: During the 18 months study period 645 upper gastrointestinal endoscopic procedures were performed. Majority [601(93.2%)] of the cases were for diagnostic purposes. Six (0.9%) cases of PEG were performed. Most (5 of 6) of the patients had central nervous system impairment while only one had severe chronic facial infection with naso-oral fistula. The median age of patients was 60.5 years. The entire procedure including endoscopy lasted an average of 25 minutes with a range of 12-35 minutes. Only one case had peristoma infection which resolved with antibiotics and repeated dressing with povidone iodine. There was no episode of aspiration pneumonitis or procedure related mortality. The average follow up was 6 months with variable weight gain during the follow up period., Conclusion: PEG is a simple, cost effective and safe method to rehabilitate nutritionally all chronically ill patients in less developed countries such as Nigeria. The need to increase awareness and acceptability of PEG among physicians managing such patients and the society cannot be overemphasized.

Objective: The study objective was to assess the effect of adenoid hypertrophy on the dental arch dimensions of children in Ile-Ife, Nigeria., Methods: Ninety patients aged 3-12 years attending the Otorhinolaryngology Clinic at Obafemi Awolowo University Teaching Hospital Ile-Ife diagnosed as having hypertrophied adenoids and 90 children from the Child Dental Health Clinic were recruited as adenoid and control subjects respectively. Arch and palatal vault dimensions, including total arch length; inter-canine, inter-premolar, and inter-molar widths; palatal length; and palatal heights measured at three levels and palatal volume were determined for both groups from dental casts., Results: Maxillary arch dimensions were shorter in the adenoid group than the control group; however, only total maxillary arch length was significantly shorter (p=0.049). Mandibular arch dimensions with the exception of inter-molar width were significantly shorter in the adenoid group (p<0.05). Adenoid subjects had significantly increased palatal heights at canine, premolar, and molar levels and reduced palatal volume compared to the control subjects (p<0.05)., Conclusion: Adenoid subjects demonstrated shorter maxillary and mandibular arch dimensions compared with control subjects, with the differences being more evident in the lower arch. They also exhibited increased palatal heights at all levels and reduced palatal volume compared with control subjects., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background: Adenoid hypertrophy is one of the most common health problems affecting the paediatric population. This study aims to correlate adenoidal nasopharyngeal ratio (ANR) with symptoms of enlarged adenoids in children with enlarged adenoids., Materials and Methods: It was a year, cross-sectional, hospital-based study conducted at Lautech Teaching Hospital, Osogbo. ANR was determined by dividing adenoidal depth with nasopharyngeal depth on the plain lateral radiographs., Results: A total of 90 consecutive children consisting of 61 males and 29 females were included in the study with M:F ratio of 2.1:1. Their ages ranged from 8 months to 11 years. All the patients presented with nasal obstruction, mouth breathing and noisy breathing. Majority (64.5%) had severe obstructions with preponderance among children of 3-5 years (39.9%). Linear regression analysis showed significant association between age and ANR (t = 10.447, P < 0.001). There was high significant association (P < 0.05) between presenting symptoms and degree of nasopharyngeal airway obstruction; for snoring (r = 0.251, P = 0.000), sleep apnoea (r = 0.594, P = 0.000), nasal discharge (r = 0.314, P = 0.001), excessive daytime sleepiness (r = 0.219, P = 0.019) and failure to thrive (r = 0.240, P = 0.011)., Conclusion: Lateral X-ray of the nasopharynx is an effective tool to evaluate children with suspected adenoid hypertrophy. It correlates well with patients' symptoms and provides objective measures of adenoid hypertrophy.

Background: Nasorespiratory function and its relation to craniofacial growth are of great interest because of the basic biological relationship between form and function, and the accumulating findings of the relationship between mode of breathing, craniofacial growth and orthodontic treatment., Objectives: The aim of this study was to evaluate the effect of adenoid hypertrophy and sociodemographic variables on the occlusion of children., Methodology: A total of 180 subjects aged 3-12 years were selected at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Ninety subjects had hypertrophied adenoids while 90 normal children served as the control group. Orthodontic examinations were carried out and impressions for study models taken. Occlusion was assessed in the anterior-posterior, transverse and vertical planes., Results: Class I relationship was the most prevalent occlusion in both adenoid and control subjects (55.6% and 72.2%, respectively). The occurrence of class II division 1 was significantly higher among adenoid than control subjects (P=0.003). Posterior crossbites occurred significantly more in adenoid subjects in the 9-12 years category. In the vertical plane, the occurrence of deep bite was significantly greater in male than female adenoid subjects. Age had a statistically significant but weak correlation with anterior open bite (r=0.37). Age and BMI also had significant though weak correlations with posterior crossbite in female adenoid subjects (r=0.39 and r=0.36, respectively). Regression analysis also showed that age had a significant effect on the occurrence of anterior open bite, while BMI had a significant effect on the occurrence of class II occlusion in adenoid subjects (P<0.05)., Conclusion: The presence of hypertrophied adenoids affects the occlusion in the three planes. Age and BMI have significant effects on the occurrence of anterior open bite and class II division 1 malocclusion respectively in adenoid subjects., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr) and assigned to multilocus sequence types (MLST). Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg), exfoliative toxins (ETs) and Panton-Valentine Leukocidin (PVL) were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n = 61). Of these isolates, 7 (11.5%) were methicillin-resistant (MRSA). The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0%) followed by seb (29.5%), sea (19.7%), seh (14.7%) and sec (11.5). The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P = 0.602). PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr) showed the following distribution: agr group 1 (n = 20), group II (n = 17), group III (n = 14) and group IV (n = 10). Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes.

Background: Protein-energy malnutrition is a common problem in critically ill patient and it is a major cause of accelerated morbidity and mortality in this group of patients. Recent dramatic advances in both enteral and parenteral nutritional support have ensured that most of these critically ill patients are adequately nutritionally supported. Unfortunately, most of these advancements in nutritional supports are far from the reach of most patients in developing countries. In this report, we highlighted the indications, success, challenges of the use of percutaneous endoscopic gastrostomy (PEG) in Nigeria patients., Patients and Methods: All cases of PEG performed at the Endoscopy Unit of Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State from January 2011 and June 2012 were recruited into the study. The data obtained included the sociodemographic parameters, indication and duration of the procedure, complications, and follow up., Results: During the 18 months study period 645 upper gastrointestinal endoscopic procedures were performed. Majority [601(93.2%)] of the cases were for diagnostic purposes. Six (0.9%) cases of PEG were performed. Most (5 of 6) of the patients had central nervous system impairment while only one had severe chronic facial infection with naso-oral fistula. The median age of patients was 60.5 years. The entire procedure including endoscopy lasted an average of 25 minutes with a range of 12-35 minutes. Only one case had peristoma infection which resolved with antibiotics and repeated dressing with povidone iodine. There was no episode of aspiration pneumonitis or procedure related mortality. The average follow up was 6 months with variable weight gain during the follow up period., Conclusion: PEG is a simple, cost effective and safe method to rehabilitate nutritionally all chronically ill patients in less developed countries such as Nigeria. The need to increase awareness and acceptability of PEG among physicians managing such patients and the society cannot be overemphasized.

A 40 year old female Nigerian with uncontrolled diabetes mellitus was referred to a teaching hospital with four week history of facial rash that progressed to extensive ulceration of the mid face and bilateral visual loss. She had complete nasal bridge collapse, nasopalatal fistula with black eschars on the mucosa and markedly elevated fasting blood sugar. Her blood glucose was controlled on insulin, She had surgical debridement and histopathological study done revealed fungi hyphae. Systemic antifungal (ketoconazole) was given. Subsequently, she made a slow but steady progress and her wound became clean with healthy granulation tissue. Rhinocerebral mucormycosis still remains a poorly understood disease with high mortality rate. Presently, the triad of clinician's awareness, prompt initiation of treatment and timely surgical intervention represent the effective way of managing the disease.

Objectives: This study aimed to determine the prevalent age, pattern of presentation, histopathology type, and outcome of management of laryngeal carcinoma in our environment., Design and Setting: This was a 10-year retrospective study carried out at a teaching hospital., Materials and Methods: Records of patients managed for laryngeal carcinoma from January 1994 to December 2004 were reviewed. Only 13 cases with tissue diagnosis were included in this review. The age, sex, occupation, presentation, use of cigarette and alcohol, investigations, histology, outcome of management, and duration of follow-up were extracted and analyzed., Results: The patients had a mean age of 69.9 years (range 38-88 years) and a male-to-female ratio of 12:1. Histopathology was squamous cell carcinoma in all. Symptoms included hoarseness in voice and breathlessness in all, cough in 7 (53.8%), weight loss in 7 (53.8%), and otalgia in 6 (46.2%). Two patients indulged in alcohol and two were also regular cigarette smokers. All the patients presented with stage IV disease and in respiratory distress necessitating emergency tracheostomy. Seven (53.8%) patients had total laryngectomy plus postoperative radiotherapy while 2 (15.4%) had pharyngolaryngectomy, thyroidectomy, radical neck dissection plus postoperative radiotherapy and thyroxine supplement. Surgical complications included pharyngocutaneous fistula in 2 (15.4%) patients, pharyngeal stenosis, stomal stenosis, and hypocalcemia with hypothyroidism in 1 patient each. The fistulae were managed conservatively and prognosis was good despite late presentation., Conclusion: Laryngeal carcinoma mainly occurs in males. Presentation is late with hoarseness in voice and breathlessness in our community. Soft-tissue neck x-ray is a useful diagnostic tool. Scarce radiotherapy centers, ignorance, local taboo, poverty, and poor recognition by primary healthcare providers have a negative impact on its management. Laryngeal carcinoma should be excluded when managing elderly patients for bronchial asthma.

Objectives: To determine the prevalent age, frequency, pattern ofpresentation, investigations and outcome of management of laryngeal carcinoma in our environment., Design: 10 year retrospective study (January 1994 to December 2003)., Setting: Teaching hospital., Subjects: 13 patients with tissue diagnosis managed for laryngeal carcinoma., Main Outcome Measures: The age, sex, occupation, presentation, use of cigarettes and alcohol, investigations, tissue diagnosis, outcome of management and duration of follow up were extracted from hospital records and analysed., Results: The age of patients ranged 38 to 88 years (median 69, male: female ratio=12:1). The histopathology was squamous cell carcinoma in all. Common symptoms included hoarseness of voice and breathlessness in all the patients, cough and weight loss in seven patients and otalgia in six. Only one patient indulged in alcohol while two were regular cigarette smokers. All the patients presented in stage IV with respiratory distress necessitating emergency tracheostomy in all. Seven patients had total laryngectomy plus post-operative radiotherapy while two patients had pharyngo-laryngectomy, thyroidectomy and radical neck dissection plus post-operative radiotherapy and thyroxine supplement. Post operative complications included pharyngocutaneous fistula in two patients, pharyngeal stenosis, stoma stenosis, and hypocalcaemia with hypothyroidism in one patient each. The fistulae were management conservatively. Prognosis was good despite late presentation., Conclusion: Laryngeal carcinoma occurs predominantly in males. Presentation is late with hoarseness of voice and breathlessness in our community. Soft tissue neck X-ray is a useful diagnostic tool. Scarcity of radiotherapy centres, ignorance, local taboos, poverty and poor recognition by general medical practitioners negatively affected management of the patients. Laryngeal carcinoma should be excluded when managing elderly patients for bronchial asthma.

Background: Epistaxis is a common otolaryngological emergency and is often due to lesions within or around the nose and systemic conditions. Controlling epistaxis presents a challenge in the underdeveloped, resource-poor centres where there are limited facilities., Objective: To describe the aetiopatogenesis of epistaxis in our hospitals., Methods: This was a retrospective review of the cases of epistaxis managed at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile Ife, over a three-year period: January 2003 - through December, 2005. Information on sociodemographic characteristics, clinical presentation and management of epistaxis was obtained from the hospital records both in the accident and emergency units and the ENT outpatient clinic., Results: A total of 106 cases were managed during the period. The peak age incidence was in the 21-40-year group. There was a significant male preponderance, ratio 3.4:1. Trauma contributed to 75 (70.9%) of the cases managed. Maxillofacial injuries were the most common injury encountered (50.7%). This was mainly secondary to the road traffic accident (RTA). Malignant neoplasms were the second most common aetiological factor seen in this study while idiopathic causes were the third most common. There were two cases with systemic problems associated with renal failure. Nasal packing was adequate to control the epistaxis in most cases. Nasal packing was done with gloved finger cots and vasellinated gauze. Two patients (1.9%) had external carotid artery ligation. Eleven patients (10.4%) received blood transfusion., Conclusion: Epistaxis is a common presentation of head and neck trauma. Non-surgical control of epistaxis (nasal packing) is adequate in many cases. Reducing the incidence of trauma from RTA will reduce the incidence of emergency epistaxis in our centers.

Background: This study describes the pattern of idiopathic infranuclear facial palsy (facial neuropathy) and highlights the role of human immunodeficiency virus (HIV)/AIDS in its occurrence and management., Patients and Methods: This study conducted in Ile-Ife, Nigeria, assessed individuals with idiopathic facial neuropathy seen at the neurology; maxillofacial surgery; and ear, nose and throat outpatient clinics between 1994 and 2006., Results: Eighty-eight patients with idiopathic facial neuropathy were seen during the 13-year study period. Forty-six (52.3%) were males, and the age range was 15 to 76 years, with a median of 35.5 years and interquartile range of 24.5 to 54 years. The right side was affected in 59.1%, compared with 40.9% on the left side. Twenty-six patients (29.5%) were HIV positive at presentation: 16 males, 10 females; mean age for HIV-positive patients was 29.15 +/- 8.12 years and 44.39 +/- 18.48 years for HIV-negative patients. There was a significant relationship among the status of the patients and the severity at presentation (p = .035), treatment given (p = .019), and the occurrence of flu-like symptoms (p = .004)., Conclusion: A high index of suspicion of seroconversion is essential in patients presenting with idiopathic facial neuropathy since it has implications for management. Serological testing for HIV, especially in patients at risk and those with history of recent flu-like symptoms, is recommended.

Background and Objective: We report 4 patients who presented with a rare type of vault fracture. This form of fracture has only been described in few instances in the literature., Case Description: All the patients presented with elevation of free skull fracture fragments. The etiologies were assault (1 patient), domestic accident (1 patient), and road traffic accident (2 patients). All the fractures were compound as in previously reported cases. Delay in surgery resulted in cerebral abscess in 1 patient. Surgery was performed in all the patients: wound debrident, duroplasty, and reduction of fracture in 3 patients and craniotomy with excision of abscess in 1 patient. Two of the patients did well after surgery. The patients with abscess died 9 days after surgery. Another patient developed CSF fistula after surgery, and died of aspiration while waiting for the closure of the fistula., Conclusion: Elevated skull fractures in our series were all compound fractures. Both long, sharp objects as well as blunt objects can cause this injury. Delay in surgery could result in intracranial sepsis. We suggest that this fracture should be included in the classification of skull fractures.

Background: Acute Otitis media is one of the most common childhood infections. It is responsible for every third visit to a pediatrician in a developed world. However, in Nigeria there is scanty knowledge about the incidence of Acute Otitis Media (AOM)., Objective: This study aimed at determining the incidence of AOM among under five year old children presenting with pyrexia, and to compare the incidence of AOM as a cause of pyrexia with the incidence of malaria in pyrexic children., Design: It is a cohort study of 200 children of between the ages of 2 weeks and five years with a rectal temperature of 38 degrees C and above, seen over a period of 3 months., Setting: The study was conducted at the Obafemi Awolowo University Teaching Hospital (OAUTHC) Comprehensive Health Centre, Eleiyele, and the children emergency room of the OAUTHC, Ile-Ife., Patients and Methods: A questionnaire to collect information on the demographic data was administered to each mother/guardian of the patient. Otoscopic examination using a battery-operated hand held otoscope and magnifying lenses were done in addition to general systemic physical examination. Thin and thick blood smears were made for malaria parasite. The dried slides were examined under the microscope using the X 100 objective. Sixteen of the patients' slides were lost after processing., Results: Out of the 200 patients that were studied, 58 (29%) had AOM. The highest incidence was recorded in the age group 12-24 months while the least age of occurrence was found to be the age group 4-5 years. Malaria parasitemia was found in 81 (43.5%) while 21 (25.9%) of those with parasitemia also had AOM. But 76 (36%) of the study population had neither AOM nor malaria parasitemia., Conclusion: Acute Otitis media was found in 29% of under five years old presenting with pyrexia. It was found to be highest in the first and second year of life, and was found to be least in the 5th year of life. Malaria was found in 81 (43.5%) of the children, and 21 (10.5%) of the children had malaria with a co-existing AOM.

Background: Otitis media is one of the most common childhood infections. There are however very few community based studies on the prevalence of this disease in Nigeria children., Objectives: To establish the community prevalence of otitis media: and to identify associated environmental and the host risk factors in Nigerian children., Setting: A semi urban community of Ife Central Local Government area of Osun State, Southwestern part of Nigeria., Material and Methods: Thirty enumeration areas within the study location were randomly picked and their boundaries were defined with the assistance of the National Population Commission (NPC) Officials. Households were used as sampling units within the area. Children aged 1 day old-12 years in each selected household were identified. A questionnaire was administered to the mother/guardian of each child. Otoscopic examination, in addition to the general physical examination was carried out on each child. The data were analyzed using simple descriptive statistics, correlation and multivariate regression technique., Result: 600 children aged 0-12 years were investigated. There were 299 males and 301 females. The prevalence of otitis media was found to be 14.7%. This comprises of acute otitis media (AOM) in 11.8%, chronic suppurative otitis media (CSOM) in 2.5%, while Otitis media with effusion (OME) was diagnosed in less than 1%. The peak age of incidence was found to be in the age group 1-4 years 55 (9.2%), while the least age of occurrence was found to be in the age group less than 1 year 10 (1.7%). There was no statistical association between the duration of breastfeeding practice and occurrence of otitis media among the subject (P>0.05). There was no statistical association between the occurrence of otitis media and immunization (p>0.05). However there were 3 children who had otitis media associated with measles infection. A highly significant association was shown between exposure to household cooking fuel (wood smoke) and the occurrence of otitis media (P<0.05). Mother's educational status, number of children sleeping in the same room greater than four was found to demonstrate a strong association with the occurrence of Otitis media (p<0.05)., Conclusion: Otitis media is prevalent among Nigeria children and it is found to occur more in children of mothers with lower educational status and in number of children greater than 4 sleeping in the same room. A strong association was found between exposure to wood smoke in the living environment and the occurrence of otitis media.

Background: In Nigeria record of incidence and pattern of Head and Neck malignancies is scanty. In our Hospital, there had been no prior published report on this subject., Objective: To study the pattern of occurrence of Head and Neck malignancies treated in Obafemi Awolowo university Hospitals Complex, Ile Ife, Nigeria., Methods: medical records of patients with histopathologically confirmed head and neck malignancies over a 10 year period (1989--1998) were analyzed., Main Results: Three hundred and thirteen (313) cases, made up of 184 (59%) males and 129 (41%) females were found. The most common sites for head and neck malignancies were found to be in the oral cavity (36.8%), the neck (26.8 %), the thyroid (13.7 %), and the esophagus (5.1%). The paranasal sinuses and the ear were the least affected anatomical sites with one (0.3 %) of cases each. The histopathological tumour types found in this work were lymphoma (40.26%), squamous cell carcinoma (25.23%), sarcoma (2.6%), while many other minor histopathological variants accounted for 31.9%. Lymphoma was the most common in children, while carcinoma was found in, and forms the most common histopathological variant of head and neck malignancies in the older age group., Principal Conclusions: There is a high incidence of childhood head and neck malignancies found in this study in contrast to the Western literature where the highest incidence is found in the older age group and the elderly. Jaw malignancies constituted the most common malignancies of the oral cavity. Lymphoma and thyroid malignancies are relatively common in our center.

Objective: To evaluate the pattern and outcome of management of retained oesophageal foreign bodies in children., Design: Retrospective study., Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, January 1991 to December 2000., Subjects: One hundred and eight paediatric patients, aged 0-14 years managed for retained oesophageal foreign bodies., Intervention: The foreign bodies were removed endoscopically, using either a larynoscope or a rigid oesophagoscope, under general anaesthesia., Results: There were 108 patients, with a mean age of 3.0 +/- 0.8 years and age range of 23 days to 14 years. The male to female ratio was 1.5: 1. Sixty four (59.3%) patients were within 1-5 year age group. Coins constituted 79.6% of the retained foreign bodies. Over 90% of patients presented within the first four days of the incidence. The dominant complaints were drooling of saliva in 37 (40.2%) and difficulty in swallowing in 35 (38.1%) patients. The commonest sites of the foreign body retention were the upper third of oesophagus 52(48.2%) and the hypopharynx 36(33.3%). The main complications following the foreign body removal were oesophageal perforations 4(3.7%) and lacerations 16(15%)., Conclusion: Retained oesophageal foreign body is a common childhood health hazard. Early diagnosis and prompt skillful removal are necessary for a satisfactory outcome.

The incidence of acute otitis media (AOM) in a comprehensive healthcare setting was investigated in Ile-Ife, Nigeria. Out of the 617 children examined, 53 (11.64 per cent) suffered from the condition based on the criteria used. Staphylococci constituted the predominant organisms associated with the condition with Staphylococcus aureus (25.0 per cent) being the most frequent single microbe recovered from the subjects. This was followed by Proteus mirabilis (16.2 per cent), Staphylococcus sp. (8.8 per cent), Streptococcus pneumoniae (8.8 per cent), Pseudomonas aeruginosa and Haemophilus influenzae (7.4 per cent each). Most isolates tested were multiply resistant to the antibiotics commonly employed in treating infections caused by these organisms. The study highlights the prevalence of multi-resistant organisms amongst the subjects and recommends prompt therapeutic intervention to avert ineffectiveness of antibiotics when used in treating infections caused by these organisms in the community.