Yemisi Bola Amusa

Characterization of Colonizing Staphylococcus aureus Isolated from Surgical Wards' Patients in a Nigerian University Hospital

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.

Oesophageal denture impaction producing Horner's syndrome: a case report.

BACKGROUND Dentures in the oesophagus have been associated with various complications; however, Horners syndrome following denture impaction has not been reported in our locality. CASE REPORT Horners 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 Horners syndrome are discussed. CONCLUSION Compression of the stellate ganglion, with resultant Horners syndrome, can be associated with denture impaction in the cervical oesophagus.

Correlation between adenoidal nasopharyngeal ratio and symptoms of enlarged adenoids in children with adenoidal hypertrophy.

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.

Dental Arch Dimensions of Nigerian Children with Hypertrophied Adenoids

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.

Hearing profile in children with allergic rhinitis

Objective We carried out this study to determine the profile of hearing of children with allergic rhinitis compared with normal controls. Patients and methods Children with allergic rhinitis between the ages of 4 and 16 years attending the Otorhinolaryngology Clinics as well as age-matched and sex-matched controls were recruited into this study. We obtained the participants’ bio data, symptoms and duration using a structured interviewer questionnaire. We then carried out a pure tone audiometry on the participants. The degree of hearing loss was determined on the basis of the WHO standard classification. Results We recruited 99 children with clinical evidence of allergic rhinitis and an equal number of healthy controls completed the study. The mean age was 9.19±3.98 years in the test participants and 9.35±4.05 years in the controls, respectively. Mild hearing loss on the right side was more than twice as common among patients, 24 (24.2%), compared with the controls, 11(11.1%). Left-sided mild hearing loss was more than four times more prevalent among patients with allergic rhinitis, 26 (26.3%), compared with the controls, six (6.1%). Hearing threshold worse than 25 dB hearing level in the better-hearing ear was found to be significantly more prevalent among patients compared with the controls. Conclusion We could conclude that hearing is significantly worse in allergic children compared with controls, with disabling hearing loss being more significantly associated with allergic rhinitis.

The psychosocial consequences of severe deafness and the modifying effect on the socioeconomic position in a special education institution setting: A pilot study

Objective: To study the psychosocial consequences of severe deafness and the effects on the socioeconomic position of the affected individuals. Methods: A cohort study of a deaf student attending a special education secondary school for the deaf and some of their teachers were randomly selected for the study. Sociodemographic characteristics, self-reported deafness, employment situation, and financial conditions, psychosocial consequences such as social isolation, denial of privileges, educational attainment, the level of achievement, and satisfaction with life were assessed using a semi-structured questionnaire. Results: All the participants had severe to profound hearing loss, and all of them could communicate by sign language. Adverse psychosocial consequences were found in this study population. A significant percentage was not satisfied with their current placement. A significant percentage reported limitation in their achievements and more than a third of them admitted to having been denied privileges as a result of being deaf. Social isolation was a major source of worry for 70% of the respondents and close to 40% admitted to being angry mainly because of the attitude of the society towards them. Underemployment was found in 44%, of the sampled population. Conclusion: Hearing impaired individuals are faced with economic and psychosocial adverse consequences. Labor market and educational policies must take into consideration these challenges to integrate this segment of our population into the active, productive sector of the economy.

Occlusal characteristics of children with hypertrophied adenoids in Nigeria

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.