Necrotizing fasciitis of the head and neck is a rare and potentially fatal disease. It is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue resulting in tissue necrosis and likely death. It is commonly of dental or pharyngeal origin. Factors affecting the success of the treatment are early diagnosis, appropriate antibiotics and surgical debridement. Our study showed eight patients, five males and three females with mean age of 49.25 years (range 20-71 years). Clinical presentations were a rapidly progressing painful neck swelling, fever, dysphagia and trismus. The aetiology varied from idiopathic, pharyngeal/tonsillar infection, trauma and nasal malignancy. There were associated variable comorbidities (diabetes mellitus, HIV infection, hypertension and congestive cardiac failure). All the patients received early and aggressive medical treatment. The earliest time of surgery was 12 h after admission because of the poor financial status of patients. Three cases came in with complications of the disease and were not fit for extensive debridement under general anaesthesia. For them limited and reasonable bed side debridement was done. Mortality was 50 % from multiple organ failure, HIV encephalopathy, aspiration pneumonitis and septicemia. The duration of hospital stay for the patients that died ranged from 1 to 16 days and 4 to 34 days for the survivor. Our study heightens awareness and outlines the management challenges of necrotizing fasciitis of the head and neck in a poor resource setting.

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This paper studies changes observed in pregnant women at the 3 stages of pregnancy in Calabar. Eighty pregnant women and eighty non-pregnant women were used. Most signs and symptoms occurred more in the first trimester while others occurred more in the third trimester. Vomiting, loss of appetite, excess salivation, Nausea gastroesophageal reflux, fever, headaches otomycosis were predominant in our study.

Noise above a certain acceptable level or sustained noise may cause damage to the ears. The aim of this study is to determine the prevalence and level of awareness of noise induced hearing loss in Calabar. Seventy-five workers from two noise producing companies, in Calabar-Flour mill and Wartsilla were chosen for this study. An author administered questionnaire was used to record sociodermographic data, occupation, access to ear protection, number of working years, etc; Rhine's test, Webers test, otoscopy and pure tone audiometry were done for each of the participants. Workers in the generator house, loading bay and production plant were regarded as noise exposed workers while others were non-noise exposed. Forty-one of the noise exposed workers in flour mill (66.83%) had mild hearing loss and ten (16.66%) had moderate loss. In Wartsilla, twenty six workers (50.98%) of the noise exposed workers had mild hearing loss and six(11.76%) had moderate loss. Three non-noise exposed workers in each of the companies also had mild hearing loss. 40% of the participants never heard about ear protection devices; 60%, knew about them. 50% had seen them and 30% felt better using them.

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