Modified surgical treatment of atrophic rhinitis

The aim of the study was to evaluate the role of alternate periods of surgical closure of the nostrils in treating patients with atrophic rhinitis. A descriptive study was conducted involving 11 patients clinically diagnosed as atrophic rhinitis who underwent surgical closure of the nostrils alternately. These patients were treated in the Department of ENT, Al-Jamhori Teaching Hospital, Mosul, Iraq during the period from April 1990 to December 2004. The parameters analyzed included age, sex, clinical presentation and residence. Moreover, evaluation of the result of alternative periodic surgical closure of the nostrils was evaluated. The study was conducted on 11 patients with atrophic rhinitis [10 females and 1 male]. The average age was 16.2 years with a range of 13.20 years. The peak age incidence was 18th year of life. The most frequent clinical presentation was nasal obstruction in spite of wide nasal cavities. There was improvement of symptoms with regeneration of the nasal mucosa in 10 [90.9%] patients. All of the patients accepted this operation as the other nostril was left open to allow for a relatively functional nasal airway. The results of this series suggest that this technique is useful in the treatment of atrophic rhinitis

Post tonsillectomy bleeding a review of 500 cases

To study the incidence of bleeding following tonsillectomy, its relation to age and sex, and the effect of different hemostatic techniques on the occurrence of bleeding. Five hundred tonsillectomies were performed in the ENT department at Al Zahrawi Teaching Hospital in Baghdad, over seven years. The incidence of post tonsillectomy bleeding and the effect of age, sex, method of hemostasis and time of bleeding were studied. The incidence of major post-tonsillectomy bleeding was 1.4%, and there was an increased incidence in patients over the age of twenty. Secondary bleeding was more common in females. Eighty percent of reactionary bleeding happened in the first six hours after surgery, and most of secondary bleeding occurred toward the end of the first week. We noticed increased severity of pain prior to secondary bleeding in a number of cases. Tonsillectomy is the most commonly performed surgical procedure. Careful assessment of patients must be performed, especially in females older than twenty in whom the frequency of bleeding is higher, possibly due to a hormonal effect. The increase in the intensity of pain a few hours prior to the onset of bleeding may give a warning to start therapy that may abort the bleeding

Malignant tumours of nasal cavity and paranasal sinuses in north of Iraq a fifteen years retrospective study

To identify the different pathological types of malignant tumors of nasal cavity and paranasal sinuses, their different clinical aspects, treatment received and prognosis in north of Iraq. Retrospective study. Files of patients treated in the hospital of oncology and nuclear medicine in Mosul over 15 years period [1980-1994]. Types, incidence, age and sex distribution, anatomical sites, clinical presentation, staging, method of treatment and prognosis. They consitiuted 0.51 percent of all malignancies and 2.13 percent of head and neck cancers. Sinus tumours affected both sexes equally as well as both sides. Nasal cavity tumours were more common in male [male/female=1.4/1] and in the right side [right/left=1.33/1]. The commonest age at presentation was the fifth decade. The most common presenting symptom was facial and nasal pain with average delay in diagnosis of about 8.5 months. Tumours of epithelial origin formed the majority of cases [85.68 percent]. All maxillary and ethmoidal cases were advanced at time of diagnosis [T3 or T4], while 60 percent of nasal cavity tumours were T1 and T2. 21.87 percent of patients had palpable cervical lymph nodes at presentation. The majority of patients received radiotherapy alone, few cases had surgery alone or both, but prognosis was generally unsatisfactory. Malignant tumours of nose and sinuses are rare in north of Iraq, are usually advanced at presentation, and carry poor prognosis

Repartition de la morbidite dans trois communautes nomades du Chari-Baguirmi et du Kanem; Tchad

Within the framework of an multidisciplinary research and action program; morbidity patterns were assessed in three nomadic communities; i.e.; Fulani; A rab cattle bre e d e rs and A rab camel breeders; l iving in Chari - B ag u i rmi and Kanem; Chad. This is the first data about the health of Chadian nomadic pastoralists who account for approximately 6of the total population. A total of 1092 women; men and children were interviewed and examined in the course of three surveys carried out by a physician during the dry and rainy season. Nomads reporting no health problems were rare. Tuberculosis was suspected in 4;6of adults after clinical examination and bronchopulmonary disorders in children less than five years of age. Febrile diarrhea was more prevalent during the wet season when access to clean drinking water was more difficult. Simple malaria was rarely diagnosed in Arabs during the dry season. In contrast simple malaria was frequent in Fulani who stay inthe vicinity of Lake Chad during the dry period. Protein-energy malnutrition was observed in only 3 of 328 children younger than 15 years of age

Seroprevalences des maladies zoonotiques chez les pasteurs nomades et leurs animaux dans le Chari-Baguirmi du Tchad

The sero p revalences of brucellosis and Q-fever we re eva l u ated in humans and live s t o ck in three Chadian nomadic commu n i t i e s ; i . e. ; Fulani cattle bre e d e rs and A rab camel and cattle bre e d e rs. The survey was carried out in 1999 and 2000. The total number of human sera and animal sera tested were 911 and 1 637; respectively; for antibodies against Brucella spp. and 368 and 613; respectively; for Coxiella burnetii. Sixteen brucellosis positive human sera resulted in a seroprevelance rate of 2. Male participants were significantly more often brucellosis seropositive than females. No association was found between brucellosis serostatus and physical findings or reported symptoms. Positive brucellosis serology was more frequent in c attle (seropreva l e n c e;7) than in camels (1.4) and small ruminants (0.5). Fifteen human sera from 11 A rab camel bre eders and 4 Arab cattle breeders were positive for Q-fever (seroprevalence below 1). Being a camel breeder was a significant risk factor for Q-fever seropositivity. Camels had the highest Q-fever seroprevalence (73) among livestock species

Taux sérique de rétinol chez les femmes nomades pastoralistes tchadiennes en relation avec la teneur en rétinol et en carotène dans le lait de leur bétail

Dans le cadre d'une étude sur le statut sanitaire des pasteurs nomades et de leur bétail exécutée en étroite colla-boration entre les services de santé publique et vétérinaire tchadiens,le taux de rétinol sérique humain a été analysé en cor-rélation avec celui contenu dans le lait du bétail. Parmi les femmes examinées (n = 99),43% (IC95% 33 - 54 %) étaient défi-c i t a i resen rétinol (tauxde0,35µmol/Là0,7µmol/L) et 17% (IC95% 10 -26%) sévèrement défi c i t a i resen rétinol (tauxinféri e u rà0,35µmol/L). Aucunedesfemmesinterrogées(n=87)n'indiquaituneconsommation defruitset seulesdeux avaientconsommédeslégumesfraisau coursdesdern i è res 24 heures. Lelait était donc pratiquement la seule source devitamineA pour ces popu-lations. Parmi le bétail,les chèvres (n=6) avaient les taux moyens de rétinol les plus élevés dans leur lait (329 ± 84 µg/kg),sui-vies des bovins (n=25; 247 ± 32 µg/kg) et des dromadaires (n=12; 120 ± 18 µg/kg). Les concentrations de rétinol dans le sérumhumain dépendaient de manière significative de la concentration de rétinol dans le lait du bétail (pente partielle 0,23; inter-valle de confiance de 95% 0,008 - 0,47). Notre étude confirme que le lait de chèvre et de vache est une source importante devitamine A chez les pasteurs nomades. Par ailleurs,la promotion de la consommation de légumes verts,de fruits et de sup-pléments vitaminés reste nécessaire pour lutter contre les carences en vitamine A

Approche novatrice des vaccinations en sante publique et en medecine veterinaire chez les pasteurs nomades au Tchad: Experiences et couts

The purpose of this report is to describe a network of public health care workers; veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been va c c i n ated befo re. The objectives of the project we re to provide human vaccination in conjunction with existing ve t e ri n a ry serv ices; to evaluate the feasibility and limitations of such campaigns; to determine wh at other services could be provided concurrently; and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a s e ries of 12 vaccination campaigns in the Chari-Baguirmi and Kanem distri c t s ; more than 2100 children; 2100 women and 52000 c attle we re fully immu n i ze d. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e. ; personnel; transportation and cold chain costs ex cluding vaccine costs) was 15in Gre d aya where 3 out of 6 campaigns were carried out together with veterinarians and 4in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative; appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities; vaccination can be provided to nomadic children and women in countries with limited resources