A Challenging "Achy" Neck.

Lipomas are common benign mesenchymal tumours that may occur in many regions of the body. Giant neck lipomas are uncommon, especially when they arise from the neck and extend into the thorax. In this case report, we present a unique case of a giant submuscular lipoma involving the posterior neck triangle extending down to the scapular tip. A 43-year-old male presented with a six-month history of two slow-growing masses involving the left neck and scapular region. MRI demonstrated a single large fat suppressing lesion underlying the left trapezius muscle extending down to the scapula with homogenous signal return and smooth outline measuring 4.5x7.5 cm by 16 cm. Histology showed features consistent with lipoma. Giant lipomas in the neck post a significant diagnostic and surgical challenge. The importance of pre-operative planning and patient involvement in decision-making are essential.

Extramedullary plasmacytoma of the nasal cavity and ethmoidal sinus in human immunodeficiency virus-positive patient.

Extramedullary plasmacytoma (EMP) occurring in the nose and paranasal sinus regions are rare with a male preponderance in the fifth and seventh decades of life. We report a case of EMP of the nasal cavity and ethmoid sinus in a 28-year-old female with human immunodeficiency virus infection.

Epistaxis: The demographics, etiology, management, and predictors of outcome in Jos, North-Central Nigeria.

Background: Epistaxis, though a mere nuisance can have life-threatening consequences. This first study from Jos on epistaxis aims to determine its sociodemographic characteristics, causes, the treatment modalities and the predictors of patient outcome. Study Design: A retrospective chart review. Methods: Health records of patients that met the inclusion criteria for epistaxis at the Jos University Teaching Hospital, Jos, Nigeria, between February 2011 and December 2015 were retrieved manually using standardized codes in the International Classification of Diseases 10th revision and studied for age, gender, associated comorbidities, treatment modalities offered, and outcome of treatment. Results: We managed 154 patients. Records of 92 patients were retrievable aged between 1 and 85 years (Mean = 37.7; standard deviation ± 16.2) with male to female ratio of 2.3:1. Patients in the third decade were the largest group. The most common cause was idiopathic. Anterior nasal bleeding occurred in 51.1%, posterior nasal bleeding in 34.8%. Conservative management was effective in 84.8%. Etiological factors other than chronic liver disease and otolaryngological malignancies showed statistically significant association with good patient outcomes (P = 0.013, P = 0.044, and P = 0.026, respectively). A mortality rate of 5.4% was recorded. Conclusion: Epistaxis of idiopathic origin occurring mostly in young males is the most common with most resolving on conservative management. Early hospital presentation, normal blood pressure at presentation and all management modalities were positive predictors of outcome in our patients.

RésuméContexte: Epistaxis, bien qu'une simple nuisance peut avoir des conséquences mortelles. Cette première étude de Jos sur l'épistaxis vise à déterminer ses caractéristiques sociodémographiques, ses causes, les modalités de traitement et les prédicteurs de l'issue du patient. Conception de l'étude: Une revue rétrospective des dossiers. Méthodes: Les dossiers médicaux des patients répondant aux critères d'inclusion de l'épistaxis au Jos University Teaching Hospital, Jos, Nigéria, entre février 2011 et décembre 2015 ont été récupérés manuellement à l'aide de codes normalisés dans la 10e révision de la Classification internationale des maladies. , les comorbidités associées, les modalités de traitement offertes et les résultats du traitement. Résultats: Nous avons géré 154 patients. Les dossiers de 92 patients étaient récupérables entre 1 et 85 ans (moyenne = 37,7; écart-type = +16,2) avec un ratio hommes / femmes de 2,3: 1. Les patients de la troisième décennie étaient le groupe le plus important. La cause la plus fréquente était idiopathique. Saignement nasal antérieur est survenu chez 51,1%, saignement nasal postérieur chez 34,8%. La gestion conservatrice était efficace dans 84,8%. Des facteurs étiologiques autres que la maladie hépatique chronique et les tumeurs malignes otolaryngologiques ont montré une association statistiquement significative avec de bons résultats pour les patients (P = 0,013, P = 0,044 et P = 0,026, respectivement). Un taux de mortalité de 5,4% a été enregistré. Conclusion: L'épistaxis d'origine idiopathique survenant principalement chez les jeunes hommes est le plus commun avec le plus de résolution sur la gestion conservatrice. La présentation hospitalière précoce, la pression artérielle normale à la présentation et toutes les modalités de prise en charge ont été des prédicteurs positifs des résultats chez nos patients.

The undergraduate medical student's perception of professional mentorship: Results from a developing nation's medical school.

INTRODUCTION: There are no documented formal mentoring programs for medical students in Nigeria. This study aims to determine the perception of undergraduate medical students at the University of Jos on professional mentorship, with a view to informing University authorities on creating and developing a mentoring program. MATERIALS AND METHODS: A cross-sectional study conducted in December 2017 in which self-administered questionnaires were distributed among the sixth-year medical students in a University in North-Central Nigeria, eliciting information regarding biodemographic data, knowledge of and experiences with mentoring, desired benefits of mentoring, and the willingness to participate in a mentoring relationship. Data collected was analyzed with EPI Info statistical software® version 7.2.1 (EPI Info, Center for Disease Control, Atlanta, Georgia, 2017). RESULTS: In a class of 166, the response rate was 83.5%. Mean age = 27.4 years; standard deviation = ±2.6 with a male: female ratio of 1.9:1. Moderate knowledge of mentoring was reported by 47 (44.3%). Attitude toward mentoring was very positive in 23.6%. One hundred and four (98.1%) students agreed mentoring are effective in developing potential. Nearly 95.3% agreed a mentorship program would benefit medical students with 70.8% expressing high willingness to participate. A weak positive statistical correlation between the age of students and those who expressed willingness to participate was recorded (r = 0.04; 95% confidence interval (CI) = 0.6-1.16; and P = 0.05). CONCLUSION: Sixth-year medical students of the University of Jos have a moderate knowledge of and a good attitude toward mentorship. The implementation of a formal mentoring program for medical students at the University of Jos is strongly recommended.

The epidemiology, treatment, and determinants of outcome of primary head and neck cancers at the Jos University Teaching Hospital.

INTRODUCTION: This study aims to evaluate the epidemiology, treatment, and factors that determine the outcomes of head and neck cancers (HNC). PATIENTS AND METHODS: Retrospective analytical review of HNC managed at the Jos University Teaching Hospital between May 2007 and April 2017 using the International Classification of Diseases version 10. RESULTS: Of 487 head and neck neoplasms, 129 (26.5%) were malignant and 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13 years to 85 years (mean = 51 years; standard deviation = ±16.0 years). The most common presenting feature was nasal obstruction (n = 47; 38.5%). The most common tumor site was the nasopharynx (n = 34; 27.9%). Mean duration of symptoms was 13.3 months. Alcohol (P = 0.02), cigarette smoking (P = 0.01), and cooking wood smoke (P = 0.01) were associated with advanced tumor stage. Squamous cell carcinoma was the most common histological type. Posttreatment complication rate was 47.5%. Lost to follow-up rate was 55.7%. The lungs were the most common distant metastatic site. The case fatality rate was 18.0%. CONCLUSION: HNC constitutes almost a quarter of head and neck tumors affecting twice the number of males in their sixth decade with nasopharyngeal cancers being the most common in both genders. Several modifiable variables are noted to target appropriate future cancer education for lifestyle modification, screening for early detection and treatment.

Identifying Risk Factors for Morbidity and Mortality in Patients with Primary Head and Neck Cancers in a Nigerian Population.

BACKGROUND: The risk factors for head and neck cancers (HNC) vary in different parts of the world. OBJECTIVES: To identify the risk factors for HNC and the correlation between these factors and the involved anatomical sites. METHODS: We retrieved and analyzed health records of patients that met the inclusion criteria for HNC managed at our facility in a 10-year period using the International Classification of Diseases (ICD) version 10. RESULTS: We studied 122 patients with a male to female ratio of 2.1:1 aged 13 years to 85 years (mean = 51 years). Alcohol (P = .02), cigarette smoking (P = .01), and cooking wood smoke (P = .01) were associated with advanced tumor stage. CONCLUSIONS: The strongest risk factors for HNC are alcohol, tobacco, HIV, agricultural chemicals, and cooking wood fumes in both sexes in their sixth and seventh decades.

Pediatric otorhinolaryngology emergencies at the Jos University Teaching Hospital: Study of frequency, management, and outcomes.

BACKGROUND: Studies from Nigeria on pediatric otorhinolaryngology (ORL) emergencies are rare in literature with most focusing on emergencies involving individual systems. OBJECTIVE: The aim of this study is to determine the prevalence of all ORL emergencies among children in our region to provide a baseline data for future health planning. PATIENTS AND METHODS: This is a 1-year retrospective cross-sectional study of patients aged 16 years and below presenting to the Accident and Emergency Department of the Jos University Teaching Hospital, Jos, Nigeria. RESULTS: A total of 203 otolaryngology emergencies were attended of which 129 (63.5%) were pediatric emergencies. Records of 87 patients were retrievable with age range 2 months to 15 years (mean 3.44 years; standard deviation ± 3.35). There were 55 males and 32 females with a male to female ratio of 1.7:1. The majority of cases were aged under 5 years (64; 73.6%). Acute tonsillitis accounted for 32 (36.7%) cases with 6 (6.9%) having peritonsillar abscesses. Acute pharyngitis accounted for 11 (12.6%) presentations followed closely by foreign bodies (FBs) in the ear with 10 (11.5%) presentations. FB in the throat occurred in 4 (4.6%) patients who had removal under general anesthesia. Three (3.4%) cases of maxillofacial injuries occurred as a result of insurgent terror attacks and 3.4% presented following corrosive substance ingestion. Conservative management was commenced in 76 (87.4%) patients, 23 (26.4%) had surgery with 68 (78.2%) admitted and discharged, 18 (20.7%) treated as outpatients, and 1 (1.1%) died on admission. Otolaryngologists attended most (95.4%) patients. CONCLUSION: Pediatric ORL emergencies are common in our region involving a wide range of pathologies. Expansion is required in the ORL training of the emergency room physician to enhance emergency services.