Geriatric Otorhinolaryngology, Head and Neck Emergency in a Nigerian Teaching Hospital, Ado Ekiti

Background: Issues of geriatric otolaryngologic emergency have not been widely applied despite an increase in the geriatric population. This study aimed at determining the prevalence, sociodemographic features, etiology, clinical features, complications and sources of referral of geriatric otorhinolaryngological, head and neck emergency in our center. Materials and Methods: This was a prospective hospital-based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using a pretested interviewers questionnaire. All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts, and pie charts. Results: Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60 - 64). There were 38.6% of males with a male to female ratio of 1:1.5. The main etiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumor. Main anatomical distribution of geriatric otorhinolaryngology emergency was 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were the pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study was 15.9% sinonasal tumor, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (Conclusion: Geriatric otorhinolaryngological emergency is a common pathology associated with comorbid illnesses. Detailed clinical assessment is mandatory for effective management outcome.

A Retrospective Cross Sectional Study of Blood Culture Results in a Tertiary Hospital, Ekiti, Nigeria

The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study was done at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty one culture plates yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N = 41/313). There were 58.4% Gram negative bacilli and 41.6% Gram positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34% (14/41), Klebsiella species 22% (9/41), Enterococci 17% (7/41), Proteus species 12% (5/41), Escherichia coli 7% (3/41) and Streptococcal pneumoniae 7% (3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14% - 100% than the Gram-negative bacteria (11% - 80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone (Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Relative Impact of Oral Rehabilitation on Quality of Life and Patient Satisfaction Following Mandibular Resection in a Sub-Urban Nigerian Tertiary Hospital

Background: Resection of the mandible can lead to bony defect which has a direct bearing on the quality of life of the patient. Reconstruction of such defect is necessary to restore aesthetics but optimal functioning of the oral cavity can only be achieved with prosthodontic rehabilitation. We, hereby, report the impact of oral rehabilitation on patients’ satisfaction and quality of life after mandibular reconstruction in our institution. Materials and Method: Patients who had oral rehabilitation following mandibular reconstruction from January 2010 to December 2015 were included. Patients’ oral health related quality of life [OHRQL] before and after rehabilitation was evaluated using the head and neck module of the European Organization for Research and Treatment of Cancer [EORTC]. Oral functions and denture satisfaction were also evaluated with Visual Analogue Scale [VAS]. Data obtained were analyzed with SPSS version 20 and level of significance was set at p Result: Of the 43 patients who had mandibular reconstruction during the study period, only 21 [48.8%] had dental rehabilitation. Twelve patients [57.1%] had conventional acrylic denture, 5 had fixed denture [bridge] while 4 patients had rehabilitation with dental implants. The mean follow-up period after rehabilitation was 8.42 months [Range: 6 - 22 months]. Although, OHRQL analysis revealed an improvement following rehabilitation, only the social aspect of the evaluation was statistically significant [p p = 0.00]. On the contrary, there was no statistically significant difference in aesthetics amongst the patients regardless of type of rehabilitation [p = 0.26]. Conclusion: Findings from this study showed that there is improvement in OHRQL following dental rehabilitation. Also, Patients who were rehabilitated with dental implant had better oral function than those with fixed or conventional denture.

Prevalence of Antibodies to HIV among Students of Selected Tertiary Schools in Two Southwest States, Nigeria

Young adults generally have been identified as one of the groups of individuals who are particularly at risk of contracting HIV/AIDS and under-graduates constitute a very significant subset among these young adults. Therefore this research was designed to study the specific factors that put undergraduates in ten selected tertiary institutions in southwest Nigeria at risk of contracting HIVAIDS, as well as determine HIV prevalence in these campuses and the viral load of positive subjects. 1000 undergraduates were enrolled in the study, over a period of forty-two months. Baseline retroviral screening was carried out, using a rapid commercial test-kit, DETERMINE&reg;. Confirmatory tests were carried out on positive samples using Enzyme Immuno Assay (EIA) technique. The viral load of the positive samples was determined using Real Time PCR, while the CD4+ count was assayed using Cyflow technique. Four out of the 1000 subjects were confirmed to be positive, thus representing an overall prevalence rate of 0.4%. The CD4 count of the positive subjects were 479/L, 368/L, 420/L and 1063/L. Molecular analysis of the positive subjects’ samples using RT-PCR revealed that the level of viral RNA in two of the subjects’ was too low for detection, while the other two positive subjects had 20 cp/ml and 325 cp/ml of viral RNA in their samples. Analyses of both the negative and positive subjects’ questionnaires were carried out, so as to determine the probable risk-factors that predisposed the positive subjects to infection. Hypotheses tested at p < 0.05 revealed that there was a significant difference in the rate at which the subjects were infected with HIV among the age-groups.

Epidemiological Review of Macular Hole in Ekiti, Southwestern Nigeria

Background: Macular hole is a known cause of central visual defect with varying etiologies in different parts of the world. It was considered an untreatable condition until 1991 when varying treatment techniques began to emerge with resultant restoration of central vision. This study was carried out to evaluate the prevalence and pattern of Macular hole in a tertiary eye centre in Nigeria. Method: This is a prospective hospital-based study over a 5 year period spanning from November 2013 to October 2018. All patients with macular hole seen within this period were included in the study. Relevant data were recorded with a structured questionnaire and analysed with SPSS version 20. Results: There were 46 eyes of 42 patients which constituted about 0.5% of all new patients seen over the study period. Male to female ratio was 1:1.3 with age ranged between 15 and 91years (mean = 61.8 ± 16.5 years). The majority of the patients (95.7%) had Idiopathic macular hole. Half of the patients (54.8%) had visual acuity less than 3/60 in the affected eye at the time of presentation. The majority (95.7%) of the patients did not accept the recommended surgical treatment option because of financial incapacitation. Conclusion: Macular hole is a disease of marked visual consequence. Available treatment option is still not within the reach of the majority because of the high cost.

Pattern of Paediatric Adenoid and Tonsillar Surgery in Ekiti

Background: Surgeries of adenoid, tonsils or both are common pediatric performed by otorhinolaryngologist, head, and neck surgeon worldwide. Clinical pattern and management varied in a different center. This study aimed at determining the rate, socio-demographic features, indications, barriers, types, complications and patients’ satisfaction with adenoid and tonsils surgery in low-income countries. Materials and Methods: This is a hospital-based retrospective study of pediatric patients who had adenotonsillectomy, adenoidectomy, and tonsillectomy in the study center. This study was carried out over a period of ten years from March 2007 to February 2017. Data for this study was obtained from the medical record department, ENT clinic operation booking register and theatre operation register. All the data obtained were statistically analyzed using SPSS version 16. The data were then expressed by descriptive statistics table, bar charts, and pie charts. Ethical clearance was sought for and obtained from the ethical committee of the institution. Results: A total of 463 patients were booked for adenoid and tonsillar surgery out of which 214 patients had surgery done during the study period. This represented 46.2% of the participants that had surgery done. Adenotonsillectomy peaked 38.3% at preschool age group: (1 - 5) years. There were 58.9% males and male to female ratio was 1.5:1. Majority 42.5% of the patients reside in the city while minority 25.7% of the patients were village dwellers. Preschool ages were the majority 40.2% while post-secondary schools ages were the minority 8.4% of the patients. The parents of the majority of the patients were 27.1% health workers and 24.8% business men, while the parent of the minority of the patients was 11.7% farmers and 16.4% industrial workers. Major indications for surgery were 52.3% obstructive sleep apnoea syndrome and 21.5% recurrent tonsillitis. Less common indications for surgery in this study were 1.4% persistent fever and 1.9% cardiopulmonary complications. There were 7.0% patients admitted as day cases and 93.0% patients admitted as an in-patient. Postoperatively, 1.4% of the day cases were admitted as inpatients while 1.9% of inpatients were treated as day cases. In this study, the established high risk factors include age less than 1 year 13.6%, Down syndrome 1.4%, craniofacial abnormalities 1.9%, malnutrition 10.7%, serum electrolyte and urea imbalance 10.3%, cardiovascular disease 3.7%, respiratory disease 7.5%, anaemia 8.9%, haemoglobinopathy 3.3% and coagulopathy 1.9%. There were no specific comorbidities that may likely influence the surgical outcome in majority 70.6% of the patients. Adenotonsillectomy was performed on 43.9% patients. Adenoidectomy only was performed on 24.8% patients. The proportion of adenoidectomy alone performed among the age group was 19.2% and 0.5% forages (1 - 5) and (16 - 18) years respectively. Conclusion: Adenoid and tonsils surgery are common pediatric otorhinolaryngologist surgical procedures faced with a different form of surgical barriers in low-income countries. These procedures were faced with a various form of risks and the cause of death in this study was cardiopulmonary complications.

Self Ear Cleaning: Prevalence and Profile among School Children in Ekiti, Nigeria

Background: Self-cleaning of ears with different objects is a common practice among school children with scanty report in literature. Aim: The aim of this study was to determine the prevalence and profile of self-ear cleaning among school children. Methods: It was a cross-sectional institutional-based study which was carried out among school children in Ekiti, south western Nigeria from January 2017, to March 2017. Results: A total of 174 students participated in this study. Their age ranged between 13 and 17 years. The highest number of participant was found at the age of 15 years. One hundred and eighteen (67.8%) of them had carried out self ear cleaning. Personal hygiene was the commonest reason for self ear cleaning in 28.8% of the students. Cotton buds were mostly used by the respondents in 51.7% of them. Injury to the external auditory canal (EAC) was the most recorded complications. Conclusion: The outcome of this study shows that self-ear cleaning practices were common among school children with a prevalence of 67.8%. Cotton buds were the commonest objects used. Avoidable complications were reported among respondents. There is a need to intensify efforts on public enlightenment programme and the establishment of school health programme in our various schools.

Clinico-Pathologic Study of Salivary Gland Disorders at a Sub-Urban Nigerian Tertiary Hospital: A 5 Year Retrospective Review

Background: The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic and non-neoplastic lesions is variable in different studies. Despite the relatively common nature of salivary gland disorders, there is dearth of literature on these lesions, especially in sub-Saharan Africa. We therefore embarked on this study to analyze the differential diagnosis of salivary gland lesions seen and managed at our institution. Methods: A retrospective review of salivary gland disorders that presented at our facility from January 2012 to December 2016 was done. Information on patients’ demographic details, type and location of salivary gland lesion, histologic diagnosis and treatment were retrieved and analyzed with SPSS version 20. Result: A total of 65 patients were treated for salivary gland lesions of various types during the study period. The age of the patients ranged from 3 months to 68 years [mean 33.8 &plusmn;12.3]. Neoplastic lesions [n = 39, 60.0%] were the commonest followed by sialolithiasis [n = 14, 21.5%] while mucous retention/extravasation cysts accounted for 13.9% of the cases. Pleomorphic adenoma was the predominant tumor in this series [87.2%] and the commonest site was the parotid gland [58.8%]. On the contrary submandibular gland appeared to be the commonest site for sialolithiasis [57.1%]. The majority of mucous retention/extravasation cysts occurred in the sublingual gland [55.5%]. Conclusion: Neoplastic lesions remain the commonest salivary gland disorder and pleomorphic adenoma was the most prevalent. Sialolithiasis and mucous cysts are salivary gland lesions with equally wide disease spectrum.

Clinico-Epidemiological Pattern and Treatment of Epistaxis in a Tertiary Hospital in South Western Nigeria

Background/Objectives: Epistaxis is a common presentation and may constitute a major challenge to the parents and the health care givers. This study aimed at determining the clinico-epidemiological pattern, presentation and etiology of epistaxis. Materials and Methods: This prospective study of all patients that presented with epistaxis via the Ear, Nose and Throat department of a tertiary institution in Nigeria. The study was carried out between June 2012 and July 2017. Data were obtained from patients who gave consent by using pre-tested interviewer assisted questionnaire. All the data obtained were analyzed using SPSS version 16.0. Results: The prevalence of epistaxis in this study was 12.2%. The peak age group was 1-10 years with epistaxis prevalence of 36.4%. The male to female ratio was 1.5:1. Anterior epistaxis was more common than posterior epistaxis accounted for 80.1% and 7.4% respectively. Single episode of epistaxis was seen in 78.4% of the patients while recurrent epistaxis occurred in 21.6%. Unilateral epistaxis was 62.5%, bilateral epistaxis was 37.5% while right nasal bleeding accounted for 35.8%. The main local causes of epistaxis were trauma 29.5%, infective rhinosinusitis 18.8% and sinonasal tumours 12.5%. Severe epistaxis requiring blood transfusion was seen in 2.8% of the patients and death was recorded in 2.3%. Majority 110 (62.5%) were managed by observation alone, 20 (11.4%) by conservative therapy and 22 (12.5%) had surgical excision. Blood transfusion was given in 5. The outcome of treatment was good recovery in 79.0% while patients’ satisfaction with treatment was noted in 84.1%. Conclusion: Epistaxis is a common sinonasal presentation with effect on quality of life. In our center commonest site of nose bleeds was local mainly from traumatic, inflammatory and neoplastic aetiology.

Prevalence and Predictors of Depression among Adolescents in Ido Ekiti, South West Nigeria

Background: Depression among adolescents has been recognized as a public health problem all over the world. In Nigeria, as in most developing countries, there is a need for more research on the epidemiology of adolescent depression as this will guide prevention, diagnosis and treatment. Objectives: The study sought to determine the one month prevalence and predictors of depression among a sample of in-school adolescents in a rural region in South West Nigeria. Materials and Methods: This was a cross sectional descriptive survey among 540 secondary school students randomly selected from the six secondary schools in the study area using a Socio demographic Questionnaire and the Patient Health Questionnaire modified for Adolescents. Subsequently, a proportion of them were interviewed with the Kiddies Schedule for Affective Disorders and Schizophrenia. Results: Data were analyzed using the SPSS version 17. Respondents were aged 10 - 19 years (mean age was 14.07 ± 1.84). The one month prevalence of depression among the study population was 16.3% (using weighting method). Logistic regression analysis showed that death of a mother (OR = 11.786, 95% CI, 1.990 - 23.184), being from a polygamous family (OR = 5.781, 95% CI, 3.253 - 24.371), low socioeconomic class (OR = 6.222, 95% CI, 4.705 - 23.379), having a single parent (OR = 2.236, 95% CI, 0.869 - 11.786), having witnessed frequent violence (OR = 12.411, 95% CI, 0.516 - 29.851) and positive history of sexual abuse (OR = 0.203, 95% CI, 0.003 - 0.529) were significantly and independently associated with depression in this sample of adolescents. Conclusion: The one month prevalence of adolescent depression within the study population is slightly higher than what has been reported in other parts of the world. Therefore, there is a need for government to design and implement policies which can help to prevent, detect early, and treat depression among youths especially in rural areas.

Knowledge and awareness of human mpox infection among healthcare workers:A cross-sectional study in southwestern Nigeria

Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.

Determining the Bulk of the Iceberg of Proteinuric Chronic Kidney Disease in School Children, in South West Nigeria

Introduction: Chronic kidney disease [CKD], as defined by the National Kidney Foundation/Kidney Disease and Outcome Quality Initiative (KDOQI) Group, refers to bilateral kidney injury and/or impaired kidney function of at least 3 months duration. Persistent proteinuria has been recognized as one of the early markers of chronic kidney disease and has been associated with persistent and progressive damage in both children and adult. This study was conducted with the aim of determining the prevalence and severity of persistent proteinuria over three months in primary school children in Ile-Ife. It was a cross-sectional study done over a period of six months. The subjects were 1335 primary school pupils, aged 6 to 14 years selected by multi stage random sampling method from twelve primary schools from a total of 96,301 pupils in the two Local Government Areas (LGA) of Ile-Ife, after meeting the recruitment criteria. The biodata, physical examination, blood pressure measurements and urine testing by dipstick were carried out on all the recruited pupils according to standard protocols while serial monitoring of proteinuria and estimated glomerular filtration rate was done for those with persistent proteinuria over 6 months. Results: Initially 34 (2.6%) of the subjects recruited had significant proteinuria with a M:F ratio of 1:1.6 following first screening and it was persistent in six (0.4%) of them subsequently over three months with a M:F ratio of 1:1.5. The severity of the persistent proteinuria was in the range of 30 mg/dL to 100 mg/dL. Three of them (50%) had worsened level of proteinuria from 30 mg/dL to 100 mg/dl on follow up. Conclusion: Children with undetected persistent proteinuria stand the risk of further glomerular damage over time.

Interaction of Glucose/Sucrose Binding Lectin Isolated from Nigeria Wild Bean with <i>E. coli</i>and <i>S. aureus</i>

Lectin purified from wild underutilized local bean—Otili, Feregede, Pakalai was comparatively characterized and further evaluated for interaction with gastrointestinal bacteria—Esherichia coli and Staphylococcus aureus. The purified lectin in all the bean samples showed to be glucose and sucrose binding. The hemagglutinating activity, was non selective to type of blood group (A, B, AB and O). Anti-bacteria interaction with Escherichia coli showed clear zone of inhibition of about 1.5 ± 0.5 mm with lectin from Feregede and Otili while there was slight agglutination with lectin from Pakala. Staphylococcus aureus sensitivity to the lectin extracted from Otili with clear zone of inhibition of 2.0 ± 0.5 mm was also found in the control chloramphenicol. However there was pronounced agglutination with lectin from Feregede and Pakala with Staphylococcus auereus. This may be a clear indication that lectin from local underutilized wild bean understudy will agglutinate and interact with a gram positive bacteria more than gram negative bacteria.

Comparative Effects of Selected Underutilized Wild Beans on Plasma Lipid Profile and Liver Function of Rats Fed with High Fats Diet

Dietary fiber content of beans is known to be responsible in the management of metabolic syndrome by delaying the degree of glucose as fuels, changing fat utilization, and controlling appetite through increased satiety, thus lowering the risk of cardiovascular diseases. Hence some selected varieties of underutilized wild beans were evaluated to study their anti-lipidemic effects. Prior to this, attempts were made to ferment the non-digestible fractions of the beans with fermentable micro-organism and the respective gut metabolites were determined. Lipid profile result carried out in the blood showed high density lipoprotein to be significantly (p ≤ 0.05) high in Pakala group with a value of 2.2 ± 0.02 compared to other groups. While for low density lipoprotein (LDL);rats with Otili in their diet had the highest LDL with a value of 0.45 ± 0.01. However, the group of rats fed with Feregede had the least cholesterol level compared to other groups of rats fed with respective wild beans and the negative control group. Otili had the highest ALP with value of 89 ± 1.0. Otili group also had a significant lower value of both aspartate amino transferase and alanine amino transferase. The biochemical indices reported in this study vary from one type of wild bean to another.

The Best Central Adiposity Index in the Prediction of Cardiovascular Risk Factors in South-Western Nigeria

Objective: To determine the best index of central obesity that predicts cardiovascular risk factors (general obesity and hypertension). Methods: A cross-sectional study involving nine hundred and sixteen (443 males and 473 females) participants of a community health survey in Sagamu and Remo-North Local Government Areas of Ogun State, Nigeria. The body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) of the participants were determined by standard protocols. Pearson correlation between BMI and the three central obesity indices was determined. The area under curve (AUC) on the ROC was used to determine the best measure of central obesity which identified individuals with general obesity and hypertension. Results: WHtR and WC were better than WHR at detecting the presence of both general obesity and hypertension in both males (WHtR vs WHR {difference in areas = 0.131} p < 0.0001;WC vs WHR {difference in areas = 0.132} p < 0.0001), and females (WHtR and WHR {difference in areas = 0.214} p < 0.0001;WC and WHR {difference in areas = 0.205} p < 0.0001). Conclusions: WHtR is as good as WC but better than WHR in identifying individuals with cardiovascular risk factors, and may also be a good criterion to diagnose metabolic syndrome.

Serum Magnesium Levels in Healthy Pregnant and Pre-Eclamptic Patients <br/>—A Cross-Section Study

Background: Pre-eclampsia complicates 2% - 8% of pregnancies. Various efforts have been put forward for its prevention and treatment. Magnesium sulphate is presently the recommended drug for the prevention and treatment of eclampsia and severe pre-eclampsia. Objectives: The study aimed to compare the serum magnesium in a healthy pregnant women and pre-eclamptic women. It determined demographic characteristic of the study population and recommended the prophylactic usage of magnesium sulphate in pregnancy in our environment. Method: This was a prospective case control study comparing the serum magnesium levels in pre-eclampsia and normal pregnancy tertiary hospitals. The women who satisfied the inclusion criteria were recruited in the two groups (seventy five in the healthy pregnant women and seventy five in the pre-eclamptic women). The blood samples were collected and analysed for the serum magnesium and urine sample for urinalysis. Result: Total of 150 patients comprises 75 normal pregnant women and 75 cases of pre-eclampsia. The mean serum magnesium in the normal pregnant women was 0.73 (±0.14) mmol/L while in preeclampsia the level was 0.58 (±0.17) mmol/L. This is statistically significant (t = 6.120, p = 0.000). There was significance difference in the mean age of patients with pre-eclampsia and normal pregnancy. The mean parity in the pre-eclampsia was 0.80 and in the normal pregnancy was 1.4 and was statistically significant (t = 3.40, p value < 0.001). The mean gestational age of the pre-eclamptic was 36.5 weeks while it was 28.7 weeks in the normal pregnant women (t = 10.80, p = 0.000). Conclusion: The findings in this research work revealed that the pre-eclamptic women have lower serum magnesium level compared to the normal pregnant women, and it may therefore be interesting to do a larger multicenter study with possibility of developing a marker for this disease of theories.

Evaluation of the Impact of Tinnitus on Health-Related Quality of Life amid Sawmill Workforces

Background: Tinnitus is the phantom aural perception of sound lacking an exterior stimulus, a sub-type of auditory hallucination and it is a common sensation among noise-exposed employees. It is a symptom, not an illness. Tinnitus can be extremely perplexing for its subjects and it may perhaps dis-turb their health-related quality of life (HR-QoL) if exposed to extreme noises in many ways. Objective: This study is intended to discover the effects and pattern of tinnitus on health-related quality of life (HR-QoL) amid noise-exposed saw mill workforces. Method: This study was a prospective and public-centered cross-sectional study, including 510 sawmill personnel. 510 directorial staff was used as the control. Health-related quality of life (HR-QoL) of all subjects was assessed with the WHO Quality of Life brief questionnaire. Self-reported tinnitus morbidity was assessed by means of the Tinnitus Handicap Inventory. A correlation was established amid health-related quality of life scores and tinnitus severity scores. Result: There were 510 sawmill employees enlisted into the study, out of which 490 were men and 20 were women with control of the same age and sex. The mean age was 36.85 ± 7.68 years for the sawmill workers and 35.75 ± 8.65 years for the control group (t = 1.02, P = 0.275). The mean tinnitus score for the sawmill workers was 20.80 ± 2.56. Out of the 510 sawmill workers, 52 (10.2%) had tinnitus and one of the controls had tinnitus. The mean health-related quality of life scores were 62.20 ± 8.62 and 72.56 ± 5.98 for the sawmill workers and control group respectively. There was a substantial and remarkable difference between the health-related quality of life of the sawmill workers and the control group (P Conclusion: The prevalence of tinnitus from this study was found to be 10.20% and an upsurge in tinnitus rigorousness was seen to be related with a substantial drop in physical, psychological and social domains of the health related quality of life. We highly endorse hearing conservation programmes and use of personal protective equipments for sawmills workers which will aid to decrease the effects of exposure to loud noise. Those sawmill labors already having tinnitus must attempt to go for treatment.

Fecal Metabolomes in Response to Feed Supplemented with Fermented <i>Parkia biglobosa</i>and <i>Sphenostylis stenocarpa</i>in Obese Rats

The ubiquitous consumption of junk foods has drastically contributed to the exponential rise in the incidence of obesity. Hence, the present study explores the therapeutic effect of selected indigenous wild bean Sphenostylis stenocarpa (Otili) and condiment fermented Parkia biglobosa (Iru) on obese rats. The rats were fed with a high fat diet for four weeks and the gut microbiota was monitored every other day throughout the period of the experiment. Then, the fecal metabolome was analysed by Gas Chromatography Mass Spectroscopy (GC-MS). Although there was a decrease in the mean weight of rats treated with fermented iru compared with those given Otili, it was not statistically significantly (p ≤ 0.05). The organisms identified from the fecal samples of the fermented Iru groups are Proteus vulgaris, Bacillus cereus and Esherichia coli while those identified from the Otili group include Escherichia coli, and Citrobacter Freundii. However, further study revealed that Otili and Iru had a similar faecal metabolome. Medium chain fatty acids, such as Decanoic acid, Octanoic acid, ethyl tetradecanoate, Hexadecanoic acid, Methyl tetradecanoate, 9-Hexadecanoic acid, Hexadecnoic acid, cis-10-Hepadecanoic acid, are the most common compounds found in this study. This suggests the fact that the associated gut microbiota from breakdown of respective food samples must have actively mediated in their roles of ameliorating the effect of obesity.

Solitary Plasmacytoma of the Zygoma in a 70-Year-Old Nigerian: A Case Report and Review of Literature

Purpose: Solitary bone plasmacytoma [SBP] is a localised variant of plasma cell tumor which commonly affects the axial skeleton but rarely found in the maxillofacial region. We hereby report an unusual case of solitary plasmacytoma of the right zygomatic bone in a 70-year-old Nigerian. Case Report: The patient presented with a painless right zygomatic swelling of 2 years duration. Examination showed that the swelling was of mixed consistency [mostly bony but firm in some areas] and it measured about 8 × 8 cm. Radiographic examination revealed an osteolytic lesion over the right zygoma with involvement of the apex and lateral wall of the antrum. An initial working diagnosis of ossifying fibroma was made and the patient was scheduled for surgery. Histological staining with H & E and immunohistochemistry of the surgical specimen however confirmed a diagnosis of SBP. Serum monoclonal protein and Bence Jones proteinuria was negative throughout the follow up period. Conclusion: SBP of the maxillofacial region is amenable to surgery combined with postoperative radiotherapy. However, prognosis can be worsened with tumor recurrence or dissemination into MM. Thus patients with SBP must be closely followed up after treatment so that immediate therapeutic steps can be taken if recurrence or systemic dissemination is encountered.

Analgesic Efficacy of Paracervical Block for Manual Vacuum Aspiration of Incomplete Abortions: A Randomized Controlled Trial

Introduction: Pain control during Manual Vacuum Aspiration is one of the most important aspects of postabortion care. This study assessed the analgesic efficacy, requirement for additional analgesia, and overall satisfaction using Paracervical blocks of 1% lignocaine compare with normal saline as placebo among women undergoing manual vacuum aspiration for incomplete abortion in OAUTHC, Ile-Ife. Methods: This was a double blind randomized controlled trial that occurred between January 2019 and February 2020. We randomized one hundred and twenty eligible women equally into 2 groups. Group A received paracervical block using 1% lignocaine while those in group B received paracervical block using normal saline as placebo. We obtained ethical clearance from the Ethics and Research Committee of the hospital. Preoperatively, we obtained relevant data and evaluated the degree of anxiety and pain on a visual analog scale (VAS). Intraoperative pain was evaluated from 2 viewpoints: that of the external observer on a 0 - 4 scale and that of the patient scale of 0 - 10 in the immediate postoperative period, followed by overall satisfaction at the point of discharge. We analyzed the data using SPSS version 20. Paired T test, independent T test Chi square, and Fishers’ exact tests were applied for continuous and categorical variables as appropriate. P value < 0.05 was considered as statistically significant. Results: The Intra-operative and Postoperative VAS was significantly higher in the placebo group compared to the analgesia group (t = -3.39, CI -4.11 - -2.69. P < 0.05 intra-operative, t = 7.18, CI 2.62 - 4.61. P < 0.05 post-operative). The need for additional analgesia and mean VAS of those in the placebo group was significantly higher than that of the study group with higher overall satisfaction rate in the study group (t = 7.18. CI 2.62 - 6.71. P < 0.0001). Conclusions: Paracervical block with 1% lignocaine is more effective in reducing pain during manual vacuum aspiration compared to placebo. It has added advantage of a higher overall satisfaction rate and reduced need for additional analgesia.