Knowledge and risk factors of intestinal parasitic infections among women in Makurdi,Benue State

ObjectiveTo assess women's perceptions and risk factors that could expose them to intestinal parasitic infections in Makurdi, Benue State, Nigeria.MethodsA total of 750 faecal samples were collected from women at different reproductive stages (pre-menstrual, menstrual and post-menstrual), and the faeces were tested by the formol ether concentration technique.ResultsA total of 426 (56.8%) samples were found positive for various intestinal parasites with hookworm (4.8%), Ascaris lumbricoides (9.3%), Taenia sp (2.1%), Entamoeba histolytica (18.9%) and Entamoeba coli (21.6%). Women at pre-menstrual and post-menstrual stages recorded higher prevalence rates with 72.8% and 63.9%, respectively. No significant difference in prevalence was observed between women at different reproductive stages and women infected by different parasites (χ² = 30.6, P > 0.05). Sweet things, rotten fruits and improperly cooked meat were perceived as the causes of intestinal parasitic infections among the pre and post menstrual women. Sources of drinking water like river, well, water bought from vendors and patronizing food vendors were observed as risk factors contributing to the prevalence of intestinal parasitic infections among women. Factors like not washing hands before eating and after defaecation, use of leaves and ordinary papers for cleaning after defaecation were also observed to be contributing to the prevalence of intestinal parasitic infections.ConclusionsPersuasive health education and rigorous hygiene measures should be employed in schools, maternity clinics and among the populace to reduce transmission and infection with intestinal parasites.     

Bullet and Blast ENT Injuries in Counter-Insurgency Area

Background

Many ENT injuries are not recognized easily, but they have the potential of increasing the morbidity.

Methods

ENT injuries managed in two tertiary care Level-IV hospitals between 2006 and 2007 were studied with a view to formulate strategy in efficient management of these cases.

Result

Emergency bags did not carry readymade packs to control nasal bleeds. Routinely screening of ears in all blast injury cases in the ‘Blast Injury Program’ helped in early identification of hearing loss. Lack of sufficient stenting of nasal cavities resulted in severe nasal stenosis which was difficult to repair. Splinters lodged in pharyngeal wall escaped detection, resulting in concealed haemorrhage and shock.

Conclusion

Nasal packs and epistaxis catheters must be included in emergency bags to minimize blood loss at first contact. Screening for ear trauma in all blast injuries increases detection rate and is beneficial to the soldier. Stenting of injured nasal cavities and early transfer to a tertiary care hospital could reduce morbidity. Plain radiography of head and neck areas could help detect splinters in vital areas and guide management.Key Words: Combat injuries ENT, Blast injuries ear     

Impact of Endoscopic Sinus Surgery on Symptom Manifestation of Chronic Rhinosinusitis

Background

Rhinosinusitis is a significant health problem which results in large financial burden on society. The study evaluated the prevalence and severity of individual symptoms of chronic rhinosinusitis (CRS) and the impact of endoscopic sinus surgery (ESS) on the symptoms and medication used in patients with CRS.

Methods

Patients with refractory CRS were assessed prospectively with ESS intervention. We studied the symptoms, change in medical therapy, complications of surgery and effect of other factors like smoking, polyposis and asthma on endoscopy and computed tomography scan scores.

Result

A total of 81 patients underwent ESS for CRS. Post nasal drip (95%), headache (91%), nasal discharge (90%) and nasal obstruction (86%) were the commonest symptoms. Postoperatively, the highest improvement was seen in nasal blockage (87.2%), postnasal drip (84.4%) and headache (82.4%). Endoscopy scores were significantly worse in patients with polyps, asthma and smoking. A significant reduction in use of antibiotic and antihistaminics was seen post surgery. Seven patients who had extensive polyposis preoperatively, had recurrence and required revision surgery. Nasal synechiae formation and mild bleeding were the minor complications.

Conclusion

Endoscopic sinus surgery results in significant improvement in the symptoms of patients with CRS alongwith a definitive decrease in antibiotic and antihistaminic requirement. We conclude that ESS is an effective treatment for CRS in those who fail to respond to medical treatment.Key Words: Chronic rhinosinusitis, Endoscopic sinus surgery     

Hot beverages and oesophageal cancer risk in western Kenya: Findings from the ESCCAPE case–control study

Oesophageal squamous cell carcinoma (ESCC) has markedly high incidence rates in Kenya and much of East Africa, with a dire prognosis and poorly understood aetiology. Consumption of hot beverages—a probable carcinogen to humans—is associated with increased ESCC risk in other settings and is habitually practiced in Kenya. We conducted a case–control study in Eldoret, western Kenya between August 2013 and March 2018. Cases were patients with endoscopically confirmed oesophageal cancer whose histology did not rule out ESCC. Age and sex-matched controls were hospital visitors and hospital out and in-patients excluding those with digestive diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for self-reported drinking temperatures; consumption frequency; mouth burning frequency and hot porridge consumption using logistic regression models adjusted for potential confounders. Drinking temperature association with tumour sub-location was also investigated. The study included 430 cases and 440 controls. Drinkers of ‘very hot’ and ‘hot’ beverages (>95% tea) had a 3.7 (95% CI: 2.1–6.5) and 1.4-fold (1.0–2.0) ESCC risk, respectively compared to ‘warm’ drinkers. This trend was consistent in males, females, never and ever alcohol/tobacco and was stronger over than under age 50 years. The tumour sub-location distribution (upper/middle/lower oesophagus) did not differ by reported drinking temperature. Our study is the first comprehensive investigation in this setting to-date to observe a link between hot beverage consumption and ESCC in East Africa. These findings provide further evidence for the role of this potentially modifiable risk factor in ESCC aetiology.