Incidence, causes and factors associated with torso injury in Cameroon: A community-based study.

BACKGROUND: Morbidity and mortality linked to injury has become an increasingly important public health concern worldwide, especially in developing countries. Despite the potentially severe nature of torso injury, little is known about the population-based epidemiology of torso injury in sub-Saharan Africa. OBJECTIVES: To determine the incidence, identify common mechanisms, and assess the socioeconomic consequences of torso injury in Cameroon. METHODS: We performed a torso injury sub-analysis of a larger descriptive cross-sectional community-based study on injury epidemiology in the preceding 12 months in the Southwest region of Cameroon. Sampling was done using the three-stage cluster sampling technique. The differences between groups were evaluated using χ² and adjusted Wald tests. RESULTS: We identified 39 cases of torso injuries out of 8 065 participants, providing a yearly incidence estimate of 488 (95% confidence interval (CI) 356 - 668) per 100 000 person-years. Road traffic injury was the most common mechanism of torso injury. The median (interquartile range (IQR)) cost of treatment for torso injury was USD58 (10 - 137), over four times the median (IQR) cost for non-torso injury at USD12 (3 - 43) (p=0.0004). About half of affected households (51%) reported being unable to afford necessities such as rent and food after injury v. 33% of households with members with non-torso injuries (p=0.018). CONCLUSION: Torso injuries have an incidence of 488/100 000 person-years, and road traffic injuries account for the majority of the injuries. Road traffic control measures and trauma care strengthening may reduce the impact of torso injuries and injuries in Cameroon.

Role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery.

OBJECTIVE: To study the role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery. STUDY DESIGN: Prospective, randomized, controlled trial. SETTING: Tertiary care referral centre. PATIENTS: Thirty patients were selected suffering long-term problems with bilateral chronic rhinosinusitis, with no relief obtained from medical therapy. Patients requiring revision sinus surgery or having acute upper respiratory tract infection were excluded. INTERVENTIONS: Diagnostic nasal endoscopies and non-contrast computerized tomography of nose and paranasal sinuses were undertaken and, following confirmation of the diagnosis, functional endoscopic sinus surgery (FESS) was carried out bilaterally using the Messerklinger technique. On completion of the surgery, a cotton wick soaked in mitomycin C was placed in one or other side of the nose in the middle meatus. Follow up was for three months and patients were assessed for subjective and objective improvement in their symptoms. RESULTS: Post-operatively, of the 11 (36.6 per cent) patients complaining of persistent nasal obstruction, nine had complaints limited to the control side only (p=0.005). Out of the nine (30 per cent) patients complaining of recurrent nasal discharge, eight had complaints on the control side and only one reported discharge from both sides (p=0.006). CONCLUSION: Mitomycin C may be topically applied in post-operative FESS cases to reduce adhesion formation and hence the need for revision surgery.

Comparative study of endoscopic aided septoplasty and traditional septoplasty in posterior nasal septal deviations.

Patients with deviated nasal septum are advised surgery, which has seen several modifications since its inception. This recent technique of using nasal endoscopes gives better illumination and access to posterior septal deviations. The aim of the study was to identify the nasal septal pathology in relation to lateral nasal wall in a precise way and to correct this with minimal exposure, limited manipulation and least resection. Twenty five patients underwent endoscope aided and 25 conventional septoplasty. Results were graded on subjective and objective improvement. Endoscopic aided septoplasty (Otolaryngol Head Neck Surg, 1999; 120, 678; Laryngoscope 1994, 104, 1507; J Laryngol Otol 1998, 112, 934; Ear Nose Throat J 1997, 76, 622) was found to be safe, effective and conservative approach with better patient compliance, shorter recovery time and greater stability of remaining septum.

A rare case of Rosai-Dorfman disease of the paranasal sinuses.

An unusual case of a 6-year-old male child presenting with a history of bilateral nasal obstruction of 3 years duration is reported. Endoscopic surgery was performed and the specimen sent for histopathological examination. The report revealed the surprise diagnosis of Rosai-Dorfman disease. This case of isolated extranodal involvement (paranasal sinuses) by this disease is presented and the literature available reviewed.

Functional endoscopic sinus surgery results in 69 patients.

Sixty nine patients with sinonasal symptoms were subjected to diagnostic endoscopy. Functional endoscopic sinus surgery was done subsequently for chronic sinusitis in 42 patients, for ethmoidal polypi in 18 patients and for antrochoanal polypi in 9 patients. A follow up of 18 to 36 months ( mean 27 months) reveals a success rate of 84% in the overall study, 81.5% in patients with chronic sinusitis alone, 87.5% in ethmoidal polypi and 100% in patients with antrochoanal polyps.

Intramuscular haemangioma of head and neck region.

Intramuscular haemangiomas are rare benign haemangiomas occurring within the skeletal muscle. These are uncommon tumours in the head and neck region and occur most frequently on the trunk and extremities. Fewer than 80 cases of intra-muscular haemangioma in the head and neck region have been reported in the literature. A case of intramuscular haemangioma of the sternocleidomastoid muscle is presented. The review of occurrence and natural history of such tumours is described and clinical and radiological presentation, histological classifications and treatment modalities are discussed.

Tuberculosis of tongue.

Oral lesions of tuberculosis are rare and when present they are usually secondary to pulmonary tuberculosis. Persistent painful oral ulcer may be the only symptom for which the patient seeks advice. In the absence of clinical features of any systemic disease, these lesions may be misdiagnosed. Histopathological examination in such cases must be performed so as not to miss some rare conditions.

Hemifacial microsomia.

Congenital abnormalities of face emerge as a constellation of malformation of structures which arise from the first and the second branchial arch and the intervening first pharyngeal pouch and the primordia of the temporal bone. When fully expressed, a patient with hemifacial microsomia [Syn: otomandibular dysostosis] exhibits usually unilaterally under developed external or middle ear, mandible, zygoma, maxilla, temporal bone, facial muscles, muscles of masticiation. Many cases however, have been reported where the syndrom is not fully expressed (Crabb 1965).