It is the most common and best-known chromosomal disorder in humans. Its incidence in Saudi Arabia is reported to be 1 in 554 live births. and the scientific evidence on the experience of dental caries (Dental Caries) in DS population is non-conclusive. The aim of this systematic review was to report on the Dental Caries experience among DS population in Saudi Arabia. The electronic databases were searched for scientific research articles published from January 2000 to July 2020. The data search was performed in the electronic search engines like PubMed, Google scholar, Scopus, Web of science, Medline, Embase, Cochrane, and Saudi Digital Library. Eight studies which met the eligibility criteria were further analyzed. The qualitative and quantative data were included in the analysis. The sample size of the study population in the included studies varied from 36 to 224 participants and their age ranged from 3 years to 40 years. In this systematic review we found that five studies have reported a higher prevalence of Dental Caries among the DS population. Three studies reported that there was no difference in the Dental Caries prevalence among the DS population when compared to those without DS. The findings of these studies emphasizes the need to prioritize preventive and curative programs for this special care group. Oral health education programs should focus on targeting the DS population as well as their caretakers in order to help them in achieving better quality of life.

Background: Visual morbidities increase the burden of care and negatively impact the quality of life of older people. Few empirical reports exist on the visual status of older Nigerians. Aim: This study describes the visual morbidities and determinants of visual impairment among persons aged 60 years and above who presented at a geriatric center in southwestern Nigeria and discusses the merits of focused geriatric care at a single location. Materials and Methods: Data were obtained from electronic health records and case files of 628 older patients (≥60 years) who attended the facility between January 1, 2014 and December 31, 2018. Data extracted included, age, sex, married status, occupational status, visual acuity, eye diagnoses, eye medications, previous surgeries, and anthropometric measurements. Results: Mean age of patients was 70.1 ± 7.4 years and 378 (60.2%) were females. Two out of every three patients had more than one visual diagnosis. Significantly, glaucoma (P < 0.001) and cataract (P = 0.01) were common among men, whereas dry eye syndrome (P < 0.001) and allergic conjunctivitis (P = 0.01) were common in women. Antiglaucoma medications (55.8%) were the commonest medications used and 21.0% had previous eye surgery. Assessment of presenting visual acuity demonstrated that 28.7% of patients had moderate-severe visual impairment (MSVI) in both eyes at presentation while 10.3% were bilaterally blind. Increasing age (P < 0.001) and male sex (P = 0.01) were the factors significantly associated with blindness. Conclusion: MSVI and blindness were common in our setting with glaucoma and cataract being the most prevalent associated diagnosis. Information obtained should stimulate advocacy for the prompt management of preventable causes of poor vision in older Nigerians.

Aim: The focus of this study is to propose a new implant design that will resemble the tooth anatomy as with three roots thus increase the primary stability in bone and open new indications to dental implant applications. Methods: Developed implant design and control implants were fabricated from Grade 4 type medical titanium. Three different media are selected as similar structural mechanical properties of alveolar cancellous bone quality; bovine iliac bone, bovine spinal bone, and polymer block. Implant sites were prepared with a 2-mm final drill. Then implants were inserted and all insertion torques were recorded. Starting from 5 Ncm implants were applied removal torques to test the initial stability. The sample that withstands the removal torque is marked with “+” until the torque value where the implant started to move out from the bone socket. Results: Different bone structures and polymer material, designed implant with apical arms have shown relatively average gains of % 38.6 in bovine spinal bone samples, % 38.2 in bovine iliac bone samples and % 46.4 gain in polymer block in retention to removal torques. In the Bovine spinal bone environment, the percentage of gain of the Implant Group developed was significantly higher than the Control Implant Group (p: 0.000; P < 0.05). In the Bovine iliac bone medium, the percentage of gain of the Implant Group developed was significantly higher than the Control Implant Group (p: 0.002; P < 0.05). In the Polymer block environment, the gain percentage of the Implant Group developed was significantly higher than the Control Implant Group (p: 0.008; P < 0.05). Conclusions: The results of this study indicate promising positive future directions to make further researches on the material production and testings of such a new dental implant design including in vivo clinical controlled studies will be beneficial for better understanding the behavior of the developed implant design under different conditions.

Aims: To investigate alteration of intestinal microflora in uremia patients with or without blood purification treatments. Methods: The present study included a total of 109 adult patients who were administered in our hospital during 2014 August to 2015 December, 85 cases had already received hemodialysis treatment and 24 cases had not received any renal transplantation treatments. Serum levels of hemoglobin, albumin, creatinine, hypersensitive C reactive protein, and cystatin C, as well as blood urea nitrogen and estimated glomerular filtration rate were determined. 16S rRNA sequencing was conducted to determine the levels of Bifidobacterium, Lactobacillus acidophilus, Escherichia coli, and Enterococcus faecalis. Results: The hemoglobin level in the hemodialysis group was significantly higher than that of the non-hemodialysis patients. The levels of Bifidobacterium and Lactobacillus acidophilus were significantly lower while the levels of Escherichia coli and Enterococcus faecalis were significantly higher in both of the patient groups compared with the healthy control. In all treatment groups, levels of Bifidobacterium and Lactobacillus acidophilus were significantly higher and levels of Escherichia coli and Enterococcus faecalis were significantly lower compared with the non-blood purification treatment group. Conclusions: The intestinal microflora might be influenced by uremia and might also be affected by blood purification treatments.

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease during pregnancy. Studies of risk factors are of great significance to maternal and fetal outcomes in patients with TOF. Aims: To identify predictive risk factors for maternal and perinatal complications in women with TOF. Subjects and Methods: 78 patients with TOF who delivered at Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and December 2017 were retrospective reviewed. A logistic regression model was used to identify risk factors for maternal and perinatal complications. Results: There was no maternal death, five patients developed cardiac failure, sustained arrhythmias requiring treatments were recorded among 2 patients. Factors identified for maternal complications included previous cardiac events and oxygen saturation <90%. Oxygen saturation <90% was found to be independent predictor of maternal cardiac complications (RR = 21.455, 95%CI 2.186–210.572, P = 0.009). The perinatal survival rate was 87.18%, there were 52 term deliveries (66.67%). Perinatal poor outcomes include 9 therapeutic abortions (11.54%), 1 neonatal death (1.28%), 16 premature births (20.51%), 18 small for gestational age children (23.08%), 3 neonatal asphyxia (3.85%), and 3 neonatal cardiac malformations (3.85%). Factors identified for perinatal complications included without cardiac surgery, higher hemoglobin values, higher hematocrit values, oxygen saturation <90%, right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and pulmonary hypertension. Oxygen saturation <90% was found to be independent predictor of perinatal complications (RR = 8.270, 95%CI 1.374–49.790, P = 0.021). Conclusions: Oxygen saturation <90% is associated with maternal and perinatal risks. Women with TOF whose oxygen saturation <90% are not recommended for pregnancy because of high maternal and perinatal complications.

Background: Infertility is a common gynecological problem in sub-Saharan Africa, including Nigeria. It tends to affect the sexual life of couples and may affect their quality of life. Objective: The study was aimed to assess the impact of infertility on the sexual life of women with infertility seeking care in Enugu, South-East Nigeria. Methods: A questionnaire-based, multicenter cross-sectional study of women with infertility managed at the Gynecology units of the two government-owned tertiary hospitals in Enugu over a 2 months period. The relevant data were obtained and analyzed using SPSS version 20.0. Results: Three hundred and sixty female respondents participated in the study. Their mean age was 35.23 ± 5.7 years. The majority of them were married (98.3%) and attained a tertiary level of education (69%). The number of respondents that reported adequate sexual intercourse dropped from 33.9% before the diagnosis of infertility to 12.2% after the diagnosis. Almost two-thirds of the respondents (65%) reported that they no longer enjoy sex with their husband/partner, whereas 38.9% of them feel they were no longer attracted to their partners. Conclusion: Infertility seems to have a negative effect on the sexual life of women. Addressing this identified negative effect may improve the outcome of infertility management and also may improve the quality of life of women with infertility in the region.

Background: The association between conventional folic acid supplement (FAS) in pregnancy and the occurrence of adverse pregnancy outcomes, newborn defects has been proven. However, recent researches have reported a weakened association. Based on the different maternal metabolism capability of folic acid, it's beneficial for clinicians to provide pregnant women with different doses of FAS, that's individualized FAS. Subjects and Methods: A total of 2,677 pregnant women in Dazu, Chongqing, China were recruited in this cohort study. 1,539 women volunteered to receive individualized FAS, in which FAS dose increased with the risk level of maternal genotype? specify MTHFR and MTRR (write in full then abbreviate bracket open and close) while 1,138 women received conventional FAS with unified FAS dose. Additionally, 1,964 pregnant women without FAS were retrospectively analyzed as the control. Finally, the incidence of adverse pregnancy outcomes and newborn defects were recorded. Results: Based on the genotype of MTHFR and MTRR, women were identified as five risk levels of folic acid metabolism. The distributions of genotype and risk levels were not significantly different between FAS-individualized supplement group and FAS-unified supplement group. However, compared with control or FAS-unified supplement group, the incidence of spontaneous abortion, prolonged pregnancy, premature labor, fetal macrosomia and congenital heart disease were significantly decreased in FAS-individualized supplement group. In subgroup analysis, individualized FAS significantly improved pregnancy outcomes for women between 20-40 years old and inhibited the occurrence of newborn defects in both women of the first gestation and women of ≥2 gestations. Conclusions: The application of individualized FAS based on gene polymorphisms was more effective in preventing adverse outcomes in the mother and child.

Objective: Our aim was to compare the efficacy of two triggering method one with dual triggering with gonadotropin-realising hormon (GnRH) agonist plus standard dosage human chorionic gonadotropin (hCG) and the other with hCG only for final oocyte maturation on oocyte/follicle ratio and pregnancy rates in normoresponders in GnRH antagonist cycles in invitro fertilization-intrastoplasmic sperm injection (IVF-ICSI). Material Methods: In this retrospective study, all patients underwent GnRH antagonist protocol. When at least ≥3 follicles reached ≥17 mm diameter, 116 patients received dual trigger with GnRH agonist plus hCG (1mg Leuprolide acetate plus 10.000 IU uhCG) and 178 patients received uhCG (10.000 IU u hCG) for final oocyte maturation. All follicles ≥10 mm diameter were aspirated. Number of oocytes and metaphase II oocytes retrieved per aspirated follicles, implantation rate, and clinical pregnancy rate per cycle was recorded. Results: There was no statistically significant difference in terms of metaphase II oocyte ratio per aspirated follicle, implantation rate and clinical pregnancy rate between the dual trigger group and hCG only group (45.7% vs. 51%; 35.4% vs.30.3% and 45%vs. 40% respectively). Oocyte/ follicle ratio was significantly higher in dual trigger group (68.2%vs 63.8% p=0,028). Conclusions: Dual triggering in normal responders with a GnRH-agonist and a standard dosage of hCG is superior to hCG only protocol in terms of oocyte/follicle ratio but does not improve metaphase II oocyte, implantation and clinical pregnancy rates in GnRH-antagonist cycles. Dual triggering method may be beneficial in patients with immature oocytes and emty follicle syndrome.

Background: Hepatitis B infection is endemic in Nigeria where greater than six percent of the general population are chronic carriers. Transmission predominantly occurs in infants and children when compared with adults. Viral hepatitis deaths are mostly due to chronic liver disease. Routine immunization against hepatitis B virus infection in Nigeria is still low. Aims: We planned to describe the burden and trend of hepatitis B viral infection at Federal Teaching Hospital, Gombe. Methodology: This study was a retrospective cross-sectional descriptive study. The results of all hepatitis B surface antigen (HBsAg) tests using rapid chromatographic immunoassay performed at the Federal Teaching Hospital, Gombe (FTHG), Nigeria from January 2000 to December 2014 were retrieved and analyzed. Results: Between 2000 and 2014, 23,611 individuals ranging from 2 months to 98 years of age were tested for HBsAg. A total of 13,136 (55.6%) were males and 10,475 (44.4%) were females. Among individuals tested for hepatitis B surface antigen, 18.9% (4,456) were positive. A total of 70.6% (3,147) were males and 29.4% (11,239) were females. Male sex was significantly associated with HBsAg positivity (P < 0.001). The mean HBsAg prevalence over the 15-year periods among males and females were 22% and 12%, respectively (P < 0.001). The mean yearly HBV prevalence was 17.5%, 17.2%, 19.6%, 15.5%, and 4.4% among age-groups 0–18 years, 19–25 years, 26–45 years, 56–65 years, and >65 years, respectively (P = 0.132). The proportion of HBsAg-positive individuals was highest in the year 2012 (28.7%) and lowest in 2014 (1.8%). Conclusion: There was an increasing trend in HBV testing and diagnosis in children and adults in our facility over the last 15 years. Health facility capacity for HBV treatment and care requires strengthening

Objective: In this study, we report the results of patients who underwent ulnar nerve submuscular anterior transposition surgery due to cubital tunnel syndrome. Methods: Data of 46 patients who underwent anterior submuscular transposition surgery due to cubital tunnel syndrome between January 2010 and December 2014 were retrospectively reviewed. Twenty-seven patients with preoperative and postoperative complete medical records available and who had completed at least 24 months follow-up were included in the study. Results: According to preoperative McGovan staging system, 1 patient was classified as stage 1, 8 were stage 2A, 3 were stage 2B, and 15 were stage 3. The mean follow-up time was 61.4 (35–88) months. The mean DASH score of the patients was calculated as 19 (0–81.81). Mayo elbow performance score was excellent in 13 patients, good in 7, fair in 6, and poor in 1. Conclusion: Anterior submuscular transposition of ulnar nerve had resolved symptoms 89% of our patients. The technique is a successful method with a low recurrence and complication rate.

Background: Secondary repair of flexor tendon injuries remains a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by a staged approach. Two-stage surgical reconstruction of the flexor tendons by the Hunter technique is the salvage option in case of a severely damaged fibro-osseous canal or neglected flexor tendon injury. Aims: We report the results of staged flexor tendon reconstruction in 10 patients (10 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Materials and Methods: Between 2012-2016, patients who underwent two-stage tendon reconstruction due to flexor digitorum profundus (FDP) sectioning or tearing in zone II with destruction of flexor pulleys and extensive scarring in the flexor tendon bed were included in the study. Results: Ten patients included to study with a mean follow-up of 34 months (range 12–70 months) and the results were assessed by clinical examination and questionnaire. According to the Strickland score, one (20%) of the results were excellent, five (50%) were good, two (20%) were fair and two (20%) were poor. After the second stage, good to excellent results were achieved in 60% of patients, one patient needed graft tenolysis. These results were similar to the subjective scores given by the patients, four of whom complained of functional problems in daily life at follow-up. There was no complication after the first stage. But after the second stage, there was one bowstringing and one adhesion that require tenolysis. Conclusions: Hunter technique is still the reference procedure for the reconstruction of flexor tendons. The results of our study showed that two-stage tendon reconstruction which is applied in patients with tendon sheath disruption as a result of acute or delayed tendon injuries which are not possible for primary repair is reliable and satisfactory.

Objective: The aim of this study was to investigate the expression level and clinical significance of inflammatory factors and biochemical markers in gingival crevicular fluid during different crown-binding styles in dental implant patients. Methods: A total of 38 patients with posterior tooth loss and implant repair were recruited and divided into two groups according to the different ways of crown bonding, including 19 prostheses (19 patients) in the adhesive retainer group and 19 prostheses (19 patients) in the modified adhesive retainer group. Moreover, the peri-implant gingival sulcus fluids of each group of patients were collected at 7, 15, 30, 60, and 90 d of post-treatment, and the expression level of each cytokine as well as biochemical marker were analyzed by enzyme-linked adsorption method, respectively. Results: Compared with the control group, the peri-implant plaque index and gingival bleeding index were decreased in the observation group. In addition, the secretion of peri-implant gingival crevicular fluid in the observation group was significantly higher than that of the control group. The level of IL-6, TNF-α expressions in peri-implant gingival crevicular fluid were gradually decreased with follow-up time, and the rate of decline gets slow at 15 h after operation. The TGFα in peri-implant gingival crevicular fluid in the two groups began to increase at 7 d, reached a peak at about 15 d, then slowly decreased and stabilized after 60 d. While the OCN was gradually increased during the whole detection process, slowly released before 30 d, then increasingly released and maintained at a peak state after 60 d. All the above differences were statistically significant (P < 0.05). Conclusion: Different crown-binding patterns of implant teeth have a significant effect on the secretion amount of peri-implant gingival crevicular fluid and the expression level of inflammatory cytokines as well as biochemical markers.

Background: Helicobacter pylori (H. pylori) is a gram-negative ubiquitous bacterium affecting over half of the world's population. Most infections are acquired in early childhood with highest prevalence in Africa and Asia. Infected individuals develop antibodies against H. pylori which persist up to 6 months after eradication. Low socioeconomic status, poor sanitation, poor personal hygiene, and absence of potable household water supply are prevalent in our environment and also linked with increased frequency of the disease with attendant health consequences. Aims: The aim of the study was to determine the seroprevalence of H. pylori infection and potential sociodemographic factors among children in Owerri. Methods: One hundred and twenty children aged 6 months to 15 years were studied from March to June 2016. Sociodemographic data was documented in a pretested structured questionnaire while rapid test kit that detects antibody to H. pylori by chromatographic flow was used to identify subjects with infection. Data were analyzed using SPSS version 20.0 with level of statistical significance at P < 0.05. Results: H. pylori infection prevalence was 20.0%, increased with age and highest in the 10–15 years age group (P = 0.001). Increasing age and low socioeconomic class (SEC) were found to be significant risk factors of H. pylori seropositivity among study subjects. Conclusion: Prevalence of H. pylori infection was high, increased with age and lower SEC as well as highest among children aged 10 years and older. Efforts should be made to exclude H. pylori infection in children with suspected symptoms considering the high burden of the disease in our setting.

Background: Assessment of nutritional status is gaining more importance in cancer patients because nutritional status is associated with response to chemotherapy, side effects of cancer treatment and disease progression. Several studies that were performed on patients with solid malignancies have shown the clinical significance of CONUT score (Controlling nutritional status). Aims: Therefore we tried to show the utility of CONUT score in newly diagnosed Diffuse Large B Cell Lymphoma (DLBCL) patients which is the most frequently seen B Cell Lymphoma type. Methods: Data of the 81 patients diagnosed with DLBCL were retrospectively evaluated. The primary endpoint of our study was to evaluate and classify newly diagnosed DLBCL patients according to the CONUT score and secondary endpoint was to show any relationship with CONUT score and overall survival. Patients' demographics, treatment details, stages, extranodal involvements, the presence of bulky disease, response to treatment options and overall survivals were evaluated from medical recordings. Results: Univariate cox regression analysis CONUT score was associated with overall survival (HR: 2.34–95% CI: 1.55–3.24 P = 0.040). On multivariate Cox regression analysis model CONUT score ≥5 was found to be an independent prognostic factor for overall survival (HR: 4.96–95% CI: 1.77–13.97- P = 0.002). Conclusion: The value of obtaining nutritional status in cancer patients is underestimated and CONUT score is simple, easily applicable and in our opinion is going to fill the gap especially in DLBCL patients.

Objective: The aim of this study was to investigate the potential relationship between the volumetric area of the upper airway and rheumatoid arthritis (RA) by comparing upper airway measurements between patients with and without RA. Methods: This case-control study compared upper airway measurements between patients with and without RA using lateral cephalometric radiographs. Two distinct measurements were made: the area of the upper airway, which is defined as “the area extending from the point of the retro-palatal region to the base of the epiglottis,” and the distance of the upper airway, which is defined as “the distance between the anterior border of the third cervical vertebra (C3) and the anterior border of the soft tissue of the neck“. A single examiner performed all measurements, and the intra-examiner reliability was assessed. Results: Sixty-one RA patients and 95 non-RA patients were included in the case and control groups, respectively. RA patients were significantly older in age and with higher BMI values. Patients with or without RA had Angle Class II as the most prevalent orthodontic classification. The upper airway was slightly narrower in RA patients, resulting in a smaller area, and the length of the upper airway was significantly longer in RA patients. Conclusion: Patients with RA have narrower upper airways as measured on lateral cephalometric radiographs. This may partially explain the high prevalence of obstructive sleep apnea among patients with RA. Focusing on airways measurements when cephalometric radiographs are taken for patients with RA could give some idea about which patient is likely to have OSA.

Objective: To determine the pattern and risk factors of pterygium in adults at the Guinness Eye Centre Onitsha, Nigeria. Materials and Methods: Consecutive adults aged ≥30 years with pterygium were studied. Each patient had comprehensive ocular examination including visual acuity, anterior segment, and adnexal assessment and fundoscopy. The pterygium was graded in terms of severity and type. Results: A total of 156 patients with pterygium participated; 92 (59%) females versus 64 (41%) males (F:M =3:2). The age range was 30–65 years; mean: 43.9 ± 8.4 years. The majority of the study population (36.5%) was of the age group 40–49 years. The subjects were predominately traders 78 (50%) and 93 (59.6%) of the pterygium patients were outdoor workers. Bivariate analysis indicated that those involved in outdoor work were six times at greater risk of developing pterygium than indoor workers (P = 0.001; OR = 6.2). Out of the 156 pterygium patients seen, 107 (68.6%) of them complained of associated symptoms. Redness of the eye was the commonest symptom reported by 79 (50.9%) cases while 8 (5.1%) cases complained of burning sensation. There was a preponderance of nasal pterygia with temporal pterygia being the least. Blinding pterygium was seen in three eyes (1.3%). Conclusion: Pterygium is a common disorder presenting at eye clinics. Outdoor workers are at a greater risk of developing pterygium. Thus, health education is of great importance.

Background: Acute gastrointestinal (GI) bleeding is a common cause of hospitalization. There are conflicting results regarding the effectiveness of early endoscopy in patients with upper GI bleeding. Objective: The study aimed to determine the benefit of early endoscopy and the epidemiological characteristics of patients presenting to the emergency department with non-variceal acute upper GI bleeding. Methods: Patients over 18 years of age who presented to the emergency department with upper GI between 2015 and 2016 and underwent endoscopy were included in the study. The patients were divided into two groups: early endoscopy group (endoscopy within the 24 h) and late endoscopy group (endoscopy after 24 h). Results: Of 104 patients, 57.7% were man, and the mean age was 66.27 ± 17.64 years. Of the patients who underwent endoscopy, 80 (76.9%) were in the early endoscopy group. There was no difference in blood transfusion needs (P = 0.388), re-bleeding (P = 0.137), the need for surgery, and mortality rates with regard to the timing of endoscopy. The results of the receiver-operating characteristics curve analysis revealed patients with a GBS ≥ 9 were taken as high-risk, and a prognosis analysis was performed accordingly. However, in patients undergoing early endoscopy, a difference was detected with respect to the length of hospital stay (P = 0.011) and treatment costs (P = 0.030). In the comparison with the admission time (working/non-working h) and variables, there were no significant differences in the length of hospital stay (P = 0.230), transfusion needs (P = 0.348), re-bleeding frequency (P = 0.905), and treatment costs (P = 0.094). Conclusion: Endoscopy within 24 h in the setting of acute upper non-variceal GI bleeding is associated with an increase in the length of hospital stay and treatment costs, but is not associated with re-bleeding, transfusion needs, need for surgery, and mortality.

Background: Increasing use of ¹⁸F-FDG PET/CT in cancer patients, has led to more common detection of ¹⁸F- FDG uptake in the gastrointestinal tract (GIT). Aims: The objective of this study was to assess ¹⁸F-FDG uptake in incidental and known GIT malignancy. Methods: A total of 6500 patients followed-up in a single and tertiary center between January 2010 and September 2016 were retrospectively reviewed. Of 2850 patients assessed with ¹⁸FDG-PET/CT, known GIT malignancy and ¹⁸F-FDG uptake cases during follow-up were included in the study. Results: Of 658 patients with ¹⁸F-FDG uptake, 150 patients who underwent endoscopy were included in the study. Seventy-seven of these patients had known GIT malignancy and 73 had incidental ¹⁸F-FDG uptake. Among these 73 patients; 7 (9.6%) had malignancy, 20 (27,2%) adenoma and 24 (32.9%) inflammation that were confirmed. Endoscopy was normal in 22 (30.2%) patients. One hundred forty-three (95.3%) patients had focal and 7 (4.7%) had diffuse uptake. While no malignancy was detected in patients with diffuse uptake, 58.7% (84/143) of the patients with focal uptake presented malignancy. Mean the standardized uptake value (SUV) max values were found as 15.0 ± 10.6 (range, 3.8–56.5) in malignant disease, 10.2 ± 4.3 (range, 2.4-19.7) in adenoma, 7.3 ± 3.6 (range, 3.6–18.7) in inflammation, and 9.8 ± 4.2 (range, 3.8–19.9) in normal endoscopy groups (p < 0.001, rho = 0.378). Conclusion: Although this study demonstrated high probability of malignant disease with increased ¹⁸F-FDG uptake in the GIT, it would be a more appropriate approach to confirm all patients with ¹⁸F-FDG uptake through endoscopy as SUVmax values vary in a wide range.

Background: Antimicrobial resistance (AMR) is a rising global public health threat. Knowledge of the circulating pathogens in a particular area and their antibiotic resistance profile is essential to direct clinicians on rational antibiotic prescribing. Aim: The study was conducted to determine the microbial isolates and antibiotic susceptibility profiles of pathogens from a range of clinical samples in a tertiary hospital in Edo Central Senatorial District in Edo State, Nigeria. Settings and Design: The study was a retrospective analysis of microbiological isolates from clinical specimens collected between January 2016 and December 2019, using standard techniques from outpatient clinic attendees. Chi-square test was used to compare the association of the type of bacterial isolates with patients' sex and level of significance P set as < 0.05. Prevalence rates of bacterial isolates and resistance rates were calculated for each antibiotic used in the microbiological culture. Results: Of the 3,247 clinical specimens processed, 994 (30.6%) showed microbial growth with 436 (43.9%) as gram-positive and 558 (56.1%) as gram-negative bacterial isolates. Escherichia coli (E. coli) made up 286 (28.8%) of all the isolates. Resistance to cotrimoxazole, tetracycline and cloxacilin for gram-poisitive pathogens was 93.1%, 86.4% and 72.5% respectively. For gram-negative pathogens, resistance to amoxycilin, cloxacilin and erythromycin was 100%, 96.9% and 95.6% respectively. Sensitivity to carbapenems, nitrofurantoin, and cefixime was high for gram-negative bacteria (100.0 %,76.8 % and 82.5 % respectively). Gram-positive bacteria exhibited high sensitivity to carbapenems ceftriaxone and cefixime. Conclusion: High rates of resistance to common antibiotics were observed for gram-positive and gram-negative isolates. Hospital pharmacies and treatment guidelines should be made to reflect the current patterns of resistance to available antibiotics.

Aims: The aim of this study is to evaluate the multidisciplinary treatment relationship between the two specialties of Dentistry, Departments of Periodontology and Orthodontics, by examining consultation request notes between the two departments. Materials and Methods: The consultation request notes of 1685 patients who were treated at Erciyes University Faculty of Dentistry were included in the study. All notes were analyzed retrospectively and divided into categories. While the consultation request notes of 446 patients from the Department of Periodontology (DP) to the Department of Orthodontics (DO) were evaluated, the consultation request notes of 1239 patients from DO to DP were evaluated. Pearson's Chi-Squared test was used in the cloud-based TURCOSA statistical software for the statistical analysis of the obtained data. Results: The highest number of requests for consultation from DP to DO was due to “Evaluation of the patient for orthodontic treatment (n = 203; 45.5%),” and the highest number of requests from DO to DP was “Gingival/Periodontal Treatment and Providing Motivation of Oral Hygiene (n = 558; 45.0%)“. It was observed that most patients for whom consultation was requested were women (P < 0.05). Conclusions: This study determined the most common reasons for consultation requests between DP and DO and the sex which was the most prevalent. It was concluded that requests were made for the expertise of the other department for problems that could not be solved by the first department.

Background: The serum adiponectin level (AD), adiponectin resistance (AD-R) may reflect the degree of metabolic syndrome (MetS). The role parameter AD-R, The Homeostasis Model Assessment-Adiponectin (HOMA-AD) index on the coronary artery disease (CAD) severity is not still understood. Objective: To determine adiponectin concentration and HOMA-AD index in patients with CAD with/without MetS and to evaluate their prognostic importance on severity of CAD. Methods: This cross-sectional study involved selected 130 examinees which were divided into three groups: CAD+MetS, CAD-MetS, control group (no CAD/MetS). In all examinees values of biochemical and anthropometric parameters were determined. We analyzed the severity of coronary artery lesions from coronary angiography. Total serum adiponectin concentration was measured by ELISA. We calculated atherogenic Gensini scoring system, Duke prognostic index, and HOMA-AD-index. Results: Serum adiponectin level was significantly lower in the group with CAD+MetS (p < 0.001) and in CAD-MetS group (p < 0.01), compared to the control group. The HOMA-AD index showed statistically significant positive correlation with the key parameters of MetS, as well as with the parameters of CAD, number of CAD and modified Gensini score. After applying logistic regression analysis the best predictors for CAD were: adiponectin, blood pressure, HOMA-IR index, and HOMA-AD index. The cut-off values of adiponectin ≤1506.38 pg/mL, HOMA-IR index ≥3.91 and HOMA-AD index ≥0.67 were associated with a higher risk of CAD. Conclusion: Patients with CAD with or without MetS had low adiponectin levels and this hypoadiponectinemia indicates that AD and HOMA-AD index may be a useful marker for identifying patients at risk for CAD.

Background: Chest injury remains a major source of morbidity and mortality in trauma as approximately two-thirds of all severe traumas involve the chest. Objective: To determine the changes in the profile management and outcome of severe chest injury in Jos University Teaching Hospital, Jos, Nigeria. Materials and Methods: This is an analysis of the Trauma Registry of Jos University Teaching Hospital—a prospectively gathered database. Patients' entries with severe chest injuries for 7 years, from January 2012 to December 2018, were entered into a database and analyzed using the Epi Info Statistical Software, using simple statistics. Results: In all, 162 patients presented with severe chest injury over a 7-year period, of whom 78 (48.1%) had polytrauma, while 84 (51.9%) had isolated chest injury. There were 139 males and 23 females, giving male: female ratio of 6:1. Over 95 (58.6%) of them were between 20 and 39 years. Blunt injury was predominant, constituting 66.7%. Motor vehicular crash was the most common mechanism of injury constituting 87 (53.7%), while gunshot injuries were responsible for 34 (21%). In managing these severe chest injuries, 146 (90%) of the patients had closed-chest tube thoracostomy as the definitive treatment, while 16 (9.9%) had thoracotomy. The mean and median duration of hospital stay was 13.3 and 10 days, respectively. The commonest complication was wound infection in 8 (4.9%) patients and a mortality of 5.9%. Conclusion: Blunt chest injury remains the commonest mechanism of chest injury but with an increasing proportion of penetrating injuries affecting predominantly young males. Most severe chest injury patients survive with simple interventions of resuscitation, and closed-chest tube thoracostomy for definitive treatment.

Generalized eruptive syringomas are a very rare variant of syringoma which appear on the chest, neck, abdomen, upper and lower arms, thighs, legs and back. They often affect adolescent or post-adolescent females, although cases have been described in children and older adults. Generalized eruptive syringomas are mostly sporadic but familial cases, and those associated with eczematous skin conditions, solid organ transplants, renal cell carcinoma and some genodermatoses have also been reported. Although eruptive syringomas may resemble cutaneous mastocytosis, disseminated granuloma annulare, eruptive xanthomata, steatocystoma multiplex, eruptive velus hair syndrome, verruca plana and other skin conditions clinically, the histological appearance characterized by upper dermal epithelial cords with a tendency to ductule formation and tadpole extension of outer epithelial layer is diagnostic. We report the case of a 20-year-old Nigerian woman with generalized eruptive syringoma.

Solitary rectal ulcer (SRU) is a rare, benign disease that has a rate of 1–3.6/100000. Perineal pain, rectal bleeding, mucosal discharge accompanied by incomplete defecation, rectal prolapse, obstructive symptoms, such as constipation and obstipation, may occur as clinical findings in SRU. Different methods, ranging from medical treatment to surgery, can be applied according to the severity of the disease and clinical findings. A 36-year-old female patient, who did not have any chronic disease or previous surgical operation, was admitted to our outpatient clinic due to complaints of abdominal pain, anorexia, constipation, occasional rectal bleeding, and weight loss, which had been ongoing for about 2 months. An obstructive polypoid mass was detected in colonoscopy. Low anterior resection was performed. The pathology result was SRU. The patient was discharged on the 12th day after healing without any complication. SRU should always be considered in patients who present lower gastrointestinal system symptoms. Surgery may be preferred in patients who do not respond to medical treatment or have an obstructive lesion and suspected malignancy.