Effect of wooddust inhalation on blood rheology

Occupational exposure to wood dust may bring about some changes in blood indices of humans, especially in developing countries where use of protective gadgets like face masks are not in use. This study is aimed at evaluating changes in blood cell indices, haemostasis and CD 4 count on occupationally exposed workers to wood dust. This randomized study consisted of one hundred (100) male sawmill workers who have been exposed to wood dust by working in these environments without any form of protective masks, for over two years as test subjects and fifty male individuals randomly selected who were not exposed to wood dust as controls. Blood samples were obtained from these workers and analysed for complete blood count using PCE ­ 210N haematology analyser, prothnumbin time test (PTT) and activated partial thromboplastin (APTT) were manually done using commercially purchased kit and CD4 count was performed using the flow cytometry method. Haemoglobin, haemcitrocrit and granutocyte levels increased significantly in test subjects when compared with control subjects (P= 0.037, P=0.026, p=0.0005. Mean lymphocyte levels decreased significantly in test when compared to control subjects (P=0.028). while there were no changes in the other CBC parameters, PT, APTT and CD4 counts in test when compared with control subjects. This suggest that inhalation of wood dust increases haemotocrit, haemoglobin and granulocyte levels, decreased lymphocyte count and a longer exposure time to wood dust significantly affects these parameters. This may imply there is an increased rate of blood flow in the circulation of these individuals

Foreign Body Aspiration and Tuberculosis: Possible Misdiagnosis

Childhood tuberculosis (TB) is common in developing countries whereas foreign body aspiration is relatively less frequently diagnosed. This report is of a child contact (same household) of a smear-positive index case who presented with suggestive clinical features; and was admitted as a case of pulmonary TB; but subsequently found to have an aspirated foreign body was accounting for his symptoms. Due to the similarity in the clinical features of a delayed clinical presentation of foreign body aspiration with pulmonary TB; clinicians attending to children with chronic respiratory pathology in a TB-endemic area should be mindful of the possibility of a foreign body in the airway and should always carefully review chest radiographs

Evaluation of Inhaler Techniques among Asthma Patients Seen in Nigeria: An Observational Cross Sectional Study

Background: An Adequate and an effective dose of inhalation drugs can be administered only if the correct inhaler-specific technique is followed by asthma patients. There is paucity of data on this subject among Nigerians and Africans. Aims: This observational study was to assess the inhaler techniques among asthma patients in Nigeria and also to identify the factors related to an inaccurate or poor inhaler use. Subjects and Methods: Consenting asthma patients on inhalers; who attended medical out-patients clinic; of two university hospitals in Nigeria were asked to use their inhalers while an inhaler-administration checklist was used to assess each patients inhaler technique. Information on demographics; asthma symptoms history and history of technique education were obtained. Data was analyzed using standard statistical methods. Results: A total of 140 asthma patients participated out of which 75 were females. All the patients used pressurized metered dose inhalers (pMDI) type; 51 of them used dry powder inhalers (DPI) in addition. For pMDI; 22.1 (31/140) completed all required steps while 37.3 (19/51) did so for DPI (P = 0.04). Patients with higher educational qualification (P 0.01) and those with less frequent asthma symptoms (P 0.01) are more likely to use the pMDI inhalers more accurately while patients who have been taught previously by a Doctor were more likely to use the DPI better. Conclusion: Majority of asthma patients use their inhalers inaccurately. Patient-dependent factors were identified as the cause of incorrect technique of inhaler use. Asthma patients on inhalation medications should have routine assessment of their inhaler technique at every visit and corrected if found to be poor

Assessment of Inhalation Technique among Asthmatic Children and their Carers at the Kenyatta National Hospital; Kenya

The aim of this study was to evaluate the correctness of use of pressurised metered-dose inhalers and spacer devices and to determine the common errors in the inhalation technique and factors associated with incorrect technique. The descriptive cross-sectional survey took place in the Kenyatta National Hospital; Nairobi; Kenya. Eighty-two asthmatic children aged 6 months to 12 years (median age 45 months; 56males) on inhaler medications and their carers were recruited into the study and assessed for correctness of inhalation technique. Of the 82 subjects; only 37 (45.1) performed all the essential steps of the inhalation technique correctly. The commonest errors were failure to take adequate breaths after actuation of inhaler (45) and not shaking the inhaler before use (18). The characteristics of correct and incorrect users are mainly similar. It was concluded that the majority (55) of asthmatic children and their carers do not perform the inhalation technique correctly

Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital; Accra; Ghana

BACKGROUND: Foreign body inhalation; a surgical emergency requiring prompt management to avoid morbidity and mortality ; poses a diagnostic and management challenge to otolaryngologists. OBJECTIVE: To assess the pattern of foreign body inhalation at the ENT Unit Korle Bu Teaching Hospital Accra; Ghana. METHODS: The theatre records of patients managed for foreign body inhalation from Ist January 2003-31st December 2006 at the ENT Unit of the Korle Bu Teaching Hospital Accra; Ghana were studied with respect to age; sex; clinical presentation; types of foreign bodies removed; location of foreign bodies; and outcomes of the laryngoscopy or bronchoscopy procedures.RESULTS: There were forty patients with an age range of seven months to 15 years with a mean age of 4.78 years and a peak age incidence at zero-four year age group. The commonest inhaled foreign bodies included groundnuts in five (12.5) patients; fish bones in six (15) patients; plastic materials in five (12.5) patients; metal material in five (12.5) patients and seeds in five (12.5) patients. The common clinical presentations included respiratory difficulty; irritating cough; choking; painful swallowing and whistling sound during breathing. Foreign bodies were localized in the right main bronchus in 27 (67.5) patients; and in the left main bronchus in ten (25) patients and in the larynx in three (7.5) patients. One patient died during bronchoscopy and another patient had bronchotomy for failed bronchoscopy. CONCLUSION: The peak age of occurrence of forein body inhalation is in the zero-four year age group. The commonest inhaled foreign bodies are groundnuts; fish bones; plastic materials; metal materials and seeds. Majority of inhaled foreign bodies tend to localise in the right main bronchus

Predictors of mortality in paediatric burns at Ibadan, Nigeria

Burn injury constitutes a major cause of trauma related morbidity and mortality. Improvements in care have resulted in reduced mortality in the burn patient significantly. The aim of this study was to determine the outcome and management of burns in children. This was a prospective study of children aged 0-13 years, managed in the burns unit of University College Hospital, Ibadan, Nigeria, between January 2001 and September 2003. There were 62 patients, 42 (67.7%) were females and 20 (32.3%) were males (Male: Female= 1:2. Their ages ranged between 1month and 13 years (mean = 4.8 ± 3.8 years). Majority of the patients (56.5%) were below 4 years of age. Burn was caused predominantly by flame (57%), followed by inhalation injury in 43.5% of the patients. The percentage total burn surface area (%TBSA) ranged between 1%and 95%(mean 29.7%± 22.8%), and 41.4% of the patients sustained amajor burn (TBSA= 30%). Infective complications were present in 37% of patients. The overall mortality was 33.9%, and occurred in those patients with %TBSA of 14 95% (mean = 48.8%). Mortality rate was 62.9% among those that had inhalation injury compared with 11.4% in those without inhalation injury. There was no mortality in those patients whose %TBSAranged between 1 and 32%(mean = 17.5%). Percentage of the total body surface area burnt and the presence of inhalation injury were important predictors ofmortality in childhood burns injury