RESUMEN
Aims: Narrowing of the upper airway during sleep causes snoring, hypoventilation and decreased oxygenation of the brain with recurrent arousal from sleep and a cascade of excessive daytime sleepiness, poor concentration in class and undesirable academic performance. This study determined the prevalence of day time sleepiness among students in secondary schools in Ibadan and establishes its association with body mass index, tonsil size, Mallampati score, and academic performance. Study Design: A prospective, cross sectional community based study. Place and Duration of Study: Ibadan town, Nigeria between August 2013 and July 2014. Methodology: This school-based cross-sectional study recruited the students by systematic random sampling technique. The participants answered an interviewer assisted structured questionnaire and had clinical examination for structural abnormalities of the oropharynx, Mallampati score, tonsillar grade and the BMI. The academic performances were determined using the overall mean average score of all the subjects offered during the first and second term of the academic session. The test of association between daytime sleepiness and other variables were determined. Statistical analysis of the data was done with Statistical Package for Social Sciences (SPSS) version 16. Results: There were 493 participants consisting 262 (53.1%) males and 231(46.9%) females (M: F ratio of 1.1:1), the mean age was 12.6 years + 2.6 (range = 9-17 years) and the mean BMI was 22.60 kg/m2±3.0 (range= 15.7 - 35.2 kg/m2). Daytime sleepiness was encountered in 56 (11.4%) of the students, this was association with high Mallampati score (p < 0.001), high BMI (p < 0.001), but had no association with academic performance (p = 0.54), tonsillar enlargement (p = 0.35), gender (0.82) and overnight sleeping duration (p = 0.21). Conclusion: The prevalence of daytime sleepiness among the secondary school students was 11.4%, and had no associated with academic performance. High BMI and Mallampati score were the significant risk factors identified.
RESUMEN
Background: Hearing loss following spinal anaesthesia is a known yet uncommonly reported complication. This study was aimed at determining the incidence and type of hearing loss (HL) following spinal anaesthesia (SA) and the relationship with the size of spinal needle. Methods: A prospective study of patients scheduled for spinal anaesthesia for surgery at the Operating room and Otorhinolaryngology department in a tertiary centre was undertaken. The audiometry was done and the pre- and post - anaesthesia results were compared.Results: Ninety - four ears of 47 patients; 16 males and 31 females; age range between 21 and 63 years (mean + SD= 41+5) were included. The duration of anaesthesia was between 90 and 150 minutes (mean + SD= 116+9). HL was seen in 9 ears of 7 patients (15) and tinnitus in 14 ears. The preoperative and postoperative BC PTA were 10 - 45dB (mean + SD= 26+ 5) and 25 - 65dB (mean + SD=38+5) respectively; (P= 0.02) while the preoperative and postoperative AC PTA in the early frequency range (0-100Hz) were between 5 - 45dB (mean + SD= 20+ 5) and 25 - 50dB (mean + SD=25+7) respectively; (P= 0.08). There was significant difference in the mean BC PTA between those who had procedure less than 1 hour; 37.2dB and those greater than 1 hour 38.4dB; (P=0.004). According to the Quincke needle sizes; the mean BC PTA among those who had 26G and 27G were 37.4dB and 38.1dB respectively (P=0.2). Conclusion: HL complicating SA is significant and associated with duration of procedure thus should be included in informed consent for medico-legal and ethical reasons and measures must be taken to avoid the leak of cerebrospinal fluid