ABSTRACT
Background: Cerumen is a natural substance secreted by sebaceous and ceruminous glands in the outer third of the external auditory canal (EAC). It serves by preventing infections, moisturizing the ear canal, and acting as a barrier against insects and water. Impacted cerumen affects approximately 6% of the general population, 10% of children, and over 30% of the elderly. Symptoms of impacted cerumen include tinnitus and hearing loss. In children, it can hinder language and speech development, while in adults, it can lead to depression, embarrassment, career limitations, and occupational stress. Treatment methods for impacted cerumen include the use of cerumenolytics (e.g., 3% hydrogen peroxide), syringing, manual removal, and microsuction under microscopic guidance. Objectives: This study intends to determine the prevalence of impacted cerumen in patients attending the ENT department, describe the management modalities of impacted cerumen and determine the outcomes of management of impacted cerumen. Methodology: A cross-sectional, hospital-based study was conducted for six months from December 2022 to May 2023. All patients attending Ear nose and Throat (ENT) clinic were included. Participants with impacted cerumen were consented and assessed using a structured questionnaire, followed by audiological examination with pure tone audiometry. Management outcomes were recorded immediately and on seventh day post-treatment. Data were analyzed using SPSS version 25.0, and audiometric data compared using an unpaired sample t-test. Results: The study included 1,717 participants, of whom 161 had impacted cerumen, with median age of 19 years (IQR: 12-28 years). Those over 50 years old were 85, (52.8%), and 82 (50.9%) were males. The prevalence was 9.4%. Treatment methods included microsuction 53.4%, manual removal under microscopic guidance 11.2%, and a combination of microsuction and cerumenolytics 35.4%. There was a significant improvement in symptoms following cerumen ...

ABSTRACT
Background: Epiploic appendagitis is a rare cause of acute abdominal pain due to ischemia or inflammation of the epiploic appendages, small fat filled structures along the colon. Because of its clinical presentation often mimicking more common conditions such as appendicitis or diverticulitis, it can be a diagnostic challenge. The appendix is equally uncommon in a subhepatic location, and this atypical location adds further to the diagnostic difficulty. Early recognition and treatment are important to prevent complications and to ensure effective treatment. Case Presentation: A non-hypertensive, non-diabetic male presented with a 3-day history of continuous right upper quadrant pain, accompanied by nausea and vomiting. Physical examination revealed right upper quadrant tenderness with rebound tenderness, while laboratory tests showed elevated inflammatory markers. Ultrasound findings included a non-compressible, edematous blind loop in the subhepatic region measuring 9.2 mm in diameter. It is surrounded by stranded mesenteric fat, echogenic mesocolic fat, colonic wall edema, and a minimal free fluid collection. Based on these findings, subhepatic acute appendicitis with associated acute epiploic appendagitis was diagnosed. The patient underwent emergency laparoscopic appendectomy and removal of the inflamed epiploic appendages. Intraoperative findings confirmed a suppurative appendix in the subhepatic region and thickened epiploic appendages surrounded by inflamed tissue. Histopathological analysis corroborated features of subhepatic appendicitis and epiploic appendagitis. Conclusion: The diagnostic and surgical complexities of subhepatic appendicitis and epiploic appendagitis are illustrated in this case. Laparoscopic surgery remains a safe and effective treatment and imaging is important in identifying atypical presentations. Management of atypical acute abdominal pain presentations requires awareness of these conditions.

ABSTRACT
Introduction: Leprosy is an endemic chronic bacterial infection caused by Hansen's bacillus (HB) and favorised by promiscuity and precariousness. The objective of this study is to describe the epidemiological profile of leprosy in Zinder. Patients and method: this was a descriptive and analytical study on an exhaustive sample including patients treated with leprosy in Zinder-town from 2016 to 2020. Epidemiological data were collected through leprosy media. Results: a total of 129 cases were collected on 16686 consultations, i.e. a frequence of 0,8 per 100. The patients’ mean age was 37.07 ± 15.51 years, with extremes of 8 and 87 years. Patients in the 24 to 35 years old group were predominant with a rate of 25.60%. The sex ratio (M/F) was 1.11. Housewives and farmers were the majority accounting for 43% and 32.8% of the cases respectively. The majority of patients (74.2%) live outside the city of Zinder and 62.79% of them live more than 9.3 miles away from their care centers. Bascilloscopy performed in 65.11% of new cases and was positive in 60.46% of patients. The multibacillary forms represented 94.6% and the new cases with a second-degree disability represented 37.98% of the sample. Conclusion: Leprosy is common in Zinder with a predominance of the multibacillary form. Patients with second-degree disability accounted for 37.98%. This requires a large-scale intensification and extension of the implementation of leprosy control strategies in Zinder.

ABSTRACT
Background: Adenoid and tonsils which play a protective role against infections in healthy individuals may become a reservoir for pathogenic microorganisms. Infection of the adenoid and palatine tonsils continue to be a major burden among children in our environment. Bacteria colonize the surface and core of the adenoid and tonsils. In University of Port-Harcourt Teaching Hospital, there is a practice of taking surface swab of palatine tonsils for microscopy, culture and sensitivity to guide antimicrobial therapy which may not reflect the core pathogens. There may be a difference between surface and core aerobic bacteriology of adenoid and tonsils hence this study. Aim: To compare surface versus core aerobic bacteria of adenoid and tonsillar tissues in children undergoing adenotonsillectomy at University of Port-Harcourt Teaching Hospital. Materials and Methods: This was a hospital based cross-sectional study involving fifty(50) paediatric participants aged 3-7years undergoing adenotonsillectomy. Informed consent was sought from patient’s caregiver and a pretested proforma was used to recruit the participants for the study. Surface swabs of the tonsils and adenoid were taken following general anaesthesia and orotracheal intubation in the theatre. The core tissue specimens of adenoid and tonsils were collected after adenotonsillectomy. The core specimens and surface swabs were sent immediately to microbiology laboratory for processing. Isolation of bacteria by Gram staining and biochemical testing was done, followed by susceptibility testing and beta-lactamase production detection. Results were analyzed using the Statistical Product and Service Solutions (SPSS) version 20. Pearson’s chi square statistics was used to determine the difference in the bacteriology between the surface and core of the adenoid and tonsils. A p-value of less than 0.05 was considered statistically significant. Results: In the demographic characteristics of the study group, age range less ...

ABSTRACT
Background: Endometriosis is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterus. Serum biomarkers such as CA 125 and CA 19-9 have been proposed as diagnostic tools, though their correlation with disease severity remains unclear. The aim of this study was to evaluate the correlation between serum levels of CA 125 and CA 19-9 with the severity of endometriosis, and to assess their potential as noninvasive biomarkers for predicting the stage of the disease. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, BSMMU, Dhaka, from June 2019 to December 2020. A total of 80 patients diagnosed with endometriosis were included. Serum levels of CA 125 and CA 19-9 were measured and correlated with the clinical stage of the disease. Results: The mean age of the participants was 29.24±5.11 years. Serum CA 125 was elevated in 50% of patients, with a mean value of 70.59±74.108 IU/ml, while CA 19-9 was elevated in 48.8%, with a mean value of 58.40±77.67 IU/ml. A positive correlation was observed between serum CA 125 and CA 19-9 levels with the severity of endometriosis (rs=0.531, p<0.001 for CA 125; rs=0.435, p<0.001 for CA 19-9). Conclusion: Serum CA 125 and CA 19-9 levels are significantly correlated with the severity of endometriosis. These markers can serve as valuable noninvasive tools for assessing disease stage and severity in clinical practice.