Background: Allergic rhinosinusitis is clinically defined as a symptomatic disorder of the nose induced by an IgE-mediated inflammation following allergen exposure to the membrane lining of the nose. It constitutes a global health problem. Both allergic rhinosinusitis and bronchial asthma are systemic inflammatory conditions that often coexist. Objective: The objectives of the study are to assess the pattern of allergic rhinosinusitis and to correlate nasal symptom score with lung volumes of patients with allergic rhinosinusitis. Methods: This is a prospective study of all the adult patients with clinically diagnosed allergic rhinosinusitis at the study center. Patients' biodata, symptoms, and signs were obtained using a specially designed form. The symptoms were scored using nasal symptom scoring protocol and the lung volumes determined using spirometry. The data were collated and analyzed using SPSS Version 15 statistical software. Results: There were 300 patients and another 300 nonallergic individuals as control. The most common presenting symptom was nasal congestion (98%), whereas the most common sign was engorged turbinates (91%). The most common trigger of allergic symptoms was dust (72.3%). Spirometric test results were below 90% on average in both sexes and significantly (P < 0.05) below those of the participants in the control group. A large number of patients with abnormal spirometry results have total nasal symptom scores of above 5 (n = 119), whereas few (n = 7) had symptom scores of 5 and below. There was a statistically significant correlation between high total nasal symptom score and abnormal spirometry (χ² = 72, P = 0.0001). Conclusion: There is a significant correlation between nasal symptom score and reduced lung volumes in patients with allergic rhinosinusitis even in the absence of asthma.

Introduction: Intracytoplasmic sperm injection (ICSI) currently helps many couples with male infertility. However, ICSI procedure may cause asynchronous sperm decondensation. This could introduce a risk for aneuploidy. The ICSI technique also could cause damage to the second meiotic spindle during injection and cause significantly abnormal pairing of chromosomes when compared with In vitro fertilization (IVF). In this study, we have examined whether ICSI has a higher incidence of aneuploidy when compared with IVF. Material and Methods: A retrospective study was conducted on 36 individuals. Common numbers of chromosome abnormalities were detected using fluorescent in-situ hybridization (FISH). Seven probes were used to detect chromosome X, Y, 13, 16, 18, 21, and 22. Chi-square test was used for statistical analysis and presented as odd ratios with confidence intervals. Results: The age range was 26 through 44 (mean age 35.5) for IVF and 25 through 46 (mean age 35.8) for ICSI. From the 36 egg retrievals, 57 embryos were obtained from nine individuals using IVF and 183 embryos were obtained from 27 individuals using ICSI. For the IVF group, 37 of the 57 examined embryos were abnormal (65%), whereas 128 of 183 examined embryos were abnormal for the ICSI group (69.9%). Among the 57 embryos from the IVF cases, the number of absolute abnormal chromosomes were as follows: X&Y chromosomes: 4 (12.9%), chromosome 13: 9 (29%), chromosome 16: 7 (22.5%), chromosome 18: 6 (19.3%), chromosome 21: 8 (25.8%), chromosome 22: 10 (32.2%). For the ICSI embryos: X and Y chromosomes: 18 (14%), chromosome 13: 34 (26.5%), chromosome 16: 23 (18%), chromosome 18: 23 (18%), chromosome 21: 26 (20.3%), chromosome 22: 31 (24.2%). The odds ratios for the difference between IVF and ICSI for each chromosome were as follows: X&Y chromosomes: 1.53 (0.598-3.916), chromosome 13: 0.969 (0.443-2.122), chromosome 16: 0.709 (0.307-1.639), chromosome 18: 1.650 (0.650-4.188), chromosome 21: 0.777 (0.350-1.724), chromosome 22: 0.647 (0.311-1.348). Overall no significant difference between two insemination procedures was seen 0.948 (0.678-1.324). Conclusions: As a result; ICSI does not create a significantly higher aneuploidy number when compared with IVF as examined by FISH analysis of seven chromosome pairs.

Background: “Kissing” or “rosetting” of molars are extremely rare phenomenon with limited cases in the dental literature. It was first described in 1973, refers to contacting occlusal surfaces of the impacted mandibular second and third molars. The aim of the present study was to report the incidence of kissing molars (KMs), classification, incorporated pathologies, and its management in a group of Turkish population. Materials and Methods: The panoramic radiographs of the patients who referred to Gaziantep University Faculty of Dentistry between January 2012 and November 2014 for surgical treatment retrospectively were evaluated. The cases of KM were determined and evaluated with respect to its type, combined pathology, and treatment. Results: Of the 6570 radiographs included in the study, 4 were seen to present as KM illustrating 0.060% of the sample. Three cases were Class II (0.045%), and only one case was encountered as Class III (0.015%). The mean age at the time that the KM teeth were identified was 34 years with a range from 29 to 40 years. Three of the patients were male, one of the patients was female, and all cases were seen unilaterally. One of the KMs was associated with dentigerous cyst formation. Conclusion: KM is a very rare clinical condition and few treatment options described. Early detection is essential to preclude complications and to provide more successful treatment. In this study, we evaluated the cases of KM and review of the literature also presented.

Background: Substance abuse has been associated with psychosocial dysfunction from previous reports; however, the prevalence and pattern of such morbidity is unknown in our environment. Aims: The aim of the study was to determine the prevalence and pattern of psychosocial dysfunction among adolescents who abuse substance. Methods: A case-control study was carried out among adolescents selected from five secondary schools in Abakaliki. A multistage sampling procedure was used to select the students and the World Health Organization student drug use questionnaire was used to screen respondents for substance abuse. Substance abusers and matched controls (non substance abusers) were assessed for psychosocial dysfunction using the 35-item Pediatric Symptom Checklist (PSC). Socioeconomic classification was done using the parental educational attainment and occupation. Results: Two hundred and four students were abusers of one or more substances. The mean PSC score for substance abusers was 21.96 ± 10.77 whereas that for controls was 16.07 ± 8.69 (t = –6.74, P = 0.000). Eighty-nine individuals (43.7%) and 28 controls (13.9%) had PSC scores in the morbidity range of ≥ 28 for psychosocial dysfunction. This was statistically significant (χ² = 13.57, P = 0.001). Prevalence of dysfunction was significantly associated with age group, gender, and socioeconomic class in both participants and controls. The prevalence of dysfunction was significantly higher in multiple abusers than the single abusers. Conclusion: The prevalence of psychosocial dysfunction is higher in adolescents abusing substance than in controls. Psychosocial dysfunction was however not related to age, gender, or social classes in the study population but was related to the abuse of multiple substances.

Background: The incidence of metabolic syndrome (MetS), is rapidly increasing in developing countries. However, the epidemiology of MetS is not well reported in the pediatric and young adult population. We determined the prevalence of MetS and its components among overweight and obese Nigerian adolescents and young adults presenting for university admission. Materials and Methods: A cross-sectional study of overweight and obese adolescents and young adults was performed. Blood pressure readings were taken while participants were seated. Anthropometric measures of waist circumference, weight and height were also taken using standard protocols and the body mass index was computed thereafter. Venous blood for fasting plasma glucose, triglycerides and high density lipoprotein cholesterol was collected and assayed using standard laboratory methods. Metabolic syndrome was defined by the International Diabetes Federation criteria. Statistical significance was set at 0.05. Results: 91 individuals (18 males) aged 18.1 ± 4.85 years were studied. 13 (14.3%) of them had MetS and 11 (84.6%) of these were adolescents. Abdominal obesity was prevalent in 89 (97.8%) participants, hypertension was prevalent in 39 (42.9%) participants and hyperglycaemia was prevalent in 5 (5.5%) participants. Hypertriglyceridaemia was least prevalent in one (1.1%) participant who did not have MetS. All the participants who had hyperglycaemia (5.5%) had MetS. Conclusions: There is a high prevalence of MetS in obese and overweight Nigerian adolescents and young adults with the clustering of two components in half of the population. These findings have profound implications hence there is an urgent need to institute primary and secondary interventions in this population.

Background: Postoperative throat pain is an established complication of general anaesthesia with endotracheal intubation. We thus sought to determine the incidence of postoperative throat pain and the efficacy of lidocaine jelly and ketamine gargle in the prevention of postoperative throat pain. Materials and Method: One hundred and fifty ASA I or II, male: female ratio of 1:2 patients, aged18 -64 year, scheduled for elective general surgery requiring general anaesthesia with endotracheal intubation were randomly recruited into two groups, ketamine (K group) and lidocaine (L group). Group K received ketamine gargle (40 mg in 30 ml normal saline) for 30 sec, five minutes before induction of anaesthesia, while Group L received 2% lidocaine jelly applied to the ETT cuff and 30 ml normal saline was gargled for 30 sec, five minutes before induction of anaesthesia. Results: Postoperative throat pain was defined as pain present with swallowing and it was assessed using verbal rating scale. Time from extubation to onset of postoperative throat pain was significantly longer for patients in K group compared to the lidocaine group, P<0.01. Group L patients recorded a higher occurrence of moderate to severe pain (44.1% vs. 23.5%) as against group K with 58.3% no pain and 36.5% mild pain, P< 0.01. The overall incidence of postoperative throat pain for the study was 55.4%. Conclusion: The study demonstrated that ketamine gargle has more protection against moderate to severe postoperative pain as compared to topical lidocaine jelly. Patients undergoing surgery under general anaesthesia with endotracheal intubation will benefit from ketamine gargle five minutes before induction of anaesthesia as prophylaxis against postoperative throat pain.

Objectives: The aim of this in vivo study was to quantitatively evaluate the remineralization of the enamel caries on smooth and occlusal surfaces using DIAGNOdent, after daily application of casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP). Materials and Methods: Thirty volunteers, aged 18–30 years, with white spot lesions on the smooth and occlusal surfaces of the teeth were included in the study. These white spot lesions were visually examined and the degree of demineralization was quantitatively evaluated using DIAGNOdent. Volunteers with lesions scored as enamel caries on smooth surfaces (n = 109) and on occlusal surfaces (n = 176) were randomly divided into control and study groups. Both groups were instructed regarding oral hygiene and were asked to brush their teeth with the same tooth paste and tooth brush. In the study group, CPP-ACFP was applied daily for 4 min on the existing enamel caries lesions. After 4 weeks, the mineralization changes in enamel caries on the smooth and occlusal surfaces were assessed by DIAGNOdent. Recorded data were statistically analyzed by Wilcoxon signed-rank test and Mann–Whitney U-test. Results: Comparison of DIAGNOdent values evaluated before and after the application of CPP-ACFP showed that the remineralization of enamel caries lesions on smooth and occlusal surfaces occurred in the study group (both, P < 0.001). The control group showed no quantitative changes at the end of 4 weeks (P > 0.05). At the end of the study period, the DIAGNOdent values differed significantly between the control and study groups (P < 0.001). Conclusions: Daily local application of CPP-ACFP for 4 min for 4 weeks results in significant remineralization of the initial caries lesions. Clinical Relevance: CPP-ACFP can be used in the treatment of white spot lesions.

Background: Obesity and overweight are emerging major health problems in developing countries in the background of undernutrition. These have been linked to a substantial increase in mortality and morbidity. Objectives: This cross-sectional survey was aimed at determining the prevalence of underweight, overweight, and obesity using body mass index (BMI) in primary school pupils in Abakaliki metropolis of Ebonyi State, south-east Nigeria. Method: Eight hundred and four participants aged 6–12 years, from four public and four private primary schools had their weights and heights measured using standard methods. BMI value was calculated for each subject and compared with BMI for age and sex from World Health Organisation (WHO 2007) reference standard. Socioeconomic status was determined using method proposed by Oyedeji. Results: Out of 804 subjects, 426 (53.0%) were from public schools, whereas 378 (47%) were from private schools (P ≤ 0.01). Four hundred and fifteen (51.6%) were males and 389 (48.4%) were female (P = 0.88). The prevalence of underweight, overweight, and obesity using BMI were 4.5% and 1.2%, 0% in public schools and 1.1%, 5.0%, and 3.0% in private schools, (P < 0.001). The socioeconomic class significantly affected the prevalence of underweight, overweight, and obesity as more subjects with overweight and obesity belonged to upper social class, whereas more underweight subjects belonged to lower social class. Conclusion: Overweight and obesity are emerging in a background of undernutrition, showing ''double burden'' of nutritional disorder.

Aim: To compare the bleaching efficacy of sodium perborate with different activation methods on crowns discolored by two different antibiotic pastes. Materials and Methods: Eighty-five extracted human incisors were prepared to size #30 using ProTaper rotary instruments. After chemomechanical preparation and irrigation procedures, the specimens received triple antibiotic paste (TAP, n = 40), minocycline paste (MP, n = 40), or calcium hydroxide (n = 5, control group) and coronally sealed with temporary filling material. Spectrophotometric readings were obtained on day 0–week 4. Data were analyzed with the Mann–Whitney U-test and Wilcoxon sign test (P < 0.05). Sodium perborate was then inserted into the pulp chambers of discolored teeth (four subgroups, n = 10) and activated by heat or ultrasonically using two different frequencies and times. Spectrophotometric readings were obtained on days 3–7. Data were analyzed by the Mann–Whitney U-test and Kruskal–Wallis test (P > 0.05). Results: Both groups showed statistically significant coronal discoloration at each time interval (P < 0.01), but their final shades did not significantly differ between the groups (P > 0.05). Although the MP subgroups exhibited more bleaching than the TAP subgroups on days 3 and 7, the difference was not significant (P > 0.05). The bleaching results for the sodium perborate activation techniques did not significantly differ among groups (P > 0.05). Conclusions: Both antibiotic pastes induced crown discoloration that was reversible using all sodium perborate bleaching techniques.

Background: Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria's contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria. Materials and Methods: This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a hall and a semi-structured questionnaire was administered to every consenting woman until the sample size was attained. Data obtained from the study were analyzed using the Statistical Package for the Social Sciences version 20 and presented in tables as frequencies and percentages as well as figures. Association between categorical variables was explored using chi-square test. Binary logistic regression was also performed to determine predictors of use of at least one family planning method at some point in time. Results: Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included “Family planning is against my religious beliefs” (56%); “it is against our culture” (43.8%); “I need more children” (64.9%); “my partner would not agree” (35.3%); “family planning does not work” (42.9%); “it reduces sexual enjoyment” (76%); and “it promotes unfaithfulness/infidelity” (59%). Binary logistic regression conducted to predict the use of at least one family planning method at some point in time using some independent variables showed that who makes the decision regarding family planning use was the strongest predictor of family planning use (OR = 0.567; 95% CI = 0.391–0.821). This suggests that family planning uptake is more likely when couples make a joint decision. Conclusion: The proportion of respondents who were currently using at least one family planning method was low. The findings of this study suggest that family planning uptake would increase if couples make joint decisions in this regard.

Introduction: The human immunodeficiency virus (HIV) infection remains one of the most daunting public health challenges today. Cardiac involvement in HIV/acquired immune deficiency syndrome (AIDS) is frequent and has been recognized on autopsy since the emergence of the pandemic. The objective of the study was to assess the pattern of structural echocardiographic (echo) findings in HIV/AIDS patients and compare this to the echo findings in apparently healthy HIV-negative controls. Materials and Methods: One hundred and fifty HIV-positive patients were recruited consecutively from the HIV patients attending the University of Ilorin Teaching Hospital, Ilorin, North Central, Nigeria. One hundred and fifty age- and sex-matched controls were also recruited from the surrounding community. All the individuals had clinical examination, electrocardiography (ECG) and echocardiography (echo) done. Results: ECG abnormalities were seen in 55.3% of the HIV-positive patients compared with 2.7% of controls (P < 0.001). The overall prevalence of echo abnormalities among the patients was 54%, against 15.3% (P < 0.001) of the controls. All the structural dimensions of the cardiac chambers were significantly greater than the cardiac chamber dimensions in the controls except for left atrial dimension (LAD). When the patients were considered in two groups of those with CD4 count less than 200 cells/mm³ than those with CD4 count more than 200 cells/mm³, the structural chamber dimensions were similar between both groups. Conclusions: Echo is an important tool for detecting cardiac abnormalities in HIV/AIDS patients. There is a high prevalence of echo abnormalities among HIV patients seen in our centre. The HIV infection was associated with increased structural dimensions of cardiac chambers compared with HIV-negative controls. This however did not seem to be related to disease severity as the chamber dimensions were similar between those with CD4 count below and above 200 cells/mm³.

Aims: The aim of this study was to evaluate the frequency and characteristics of hypercementosis in the Turkish population using cone-beam computed tomography (CBCT). Settings and Design: A retrospective study was performed using CBCT (I-CAT Vision TM Imaging Science International) in 1263 patients admitted to the Faculty of Dentistry at the University of Dicle (Diyarbakir, Turkey) between January 2013 and January 2015. Subjects and Methods: A total of 1152 patient and 29,606 teeth were evaluated with CBCT. The age, gender, location (left vs. right side, maxillary vs. mandibular teeth, incisors, premolars, and molars), and missing teeth were recorded for all patients. Statistical Analysis Used: The Pearson Chi-squared test was used to determine the potential differences. Results: Hypercementosis was observed with a frequency of 2.4%. Of these, 18 of 28 (64.3%) had only 1 tooth with hypercementosis and 10 (35.7%) had more than 1 tooth. It was identified in 42 of the 29,606 teeth examined (0.14%). The lesion was found in 2.47% (n = 14) of females and 2.38% (n = 14) of males. The lesion was detected in 28 molars and 14 premolars, but hypercementosis was not detected in incisors. Of the 42 teeth, 12 (28.6%) maxillary and 30 (71.4%) mandibular teeth were associated with hypercementosis. Of the 28 cases, 20 (59.0%) were unilateral and 8 (41.0%) were bilateral. Of the 20 unilateral cases, 12 (69.6%) were on the right and 8 (30.4%) were on the left side. Conclusions: In our study, the prevalence of hypercementosis has been found 2.4% in the Turkish population. Besides, the lesion has been found more in the mandible than the maxilla, in the molars than the premolars and in the unilateral distribution than the bilateral distribution.

Background: Penile erection is a complex phenomenon that involves coordinated interaction of the psychologic, hormonal, nervous, arterial, venous, and sinusoidal systems. Erectile dysfunction (ED) is the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. This study aims to determine the real-time morphologic vascular abnormalities in men with ED using penile Doppler sonography in Kano, Nigeria. Materials and Methods: Twenty-one patients who were referred from urology clinics on account of suspected vasculogenic ED were reviewed. The cavernorsal arteries were examined with 7.5 MHz linear transducer in gray scale and duplex Doppler modes before and after intracavernosal injection of 60 mg papevarine. Serial peak systolic velocity (PSV), end diastolic velocity (EDV), and diameter measurements were performed at 5-min intervals for 30 min. Results: The mean age of the patients was 43.14 ± 9.84 years. Out of the 21 patients examined, 5 showed normal findings while 10 had evidence of venous leakage. Five patients had arterial insufficiency; out of which 3 patients showed calcifications of the tunica albuginea, suggesting Peyronie's disease. Interestingly, 1 patient showed combining features of arterial insufficiency and of venous leakage. Those with arterial insufficiency were relatively older than other patients. They also had compounding medical conditions of diabetes and hypertension. Conclusion: Vascular etiologies are important contributors of ED in our setting. Papavarine-induced Doppler sonography and cavernosography shows promise in accurate assessment and overall care of these patients.

Purpose: To assess the effect of the erbium:yttrium aluminum garnet (Er:YAG) laser on bond strength of a total-etch adhesive system to the caries-affected dentin on the gingival wall. Materials and Methods: Ten human molars with proximal carious lesions were randomly divided into two groups. In the first group, the carious dentin was removed with a bur, whereas in the second group it was removed with the Er:YAG laser. Carious lesions were excavated with one of these two techniques until laser fluorescence values decreased to 15 in the center of the lesions. The teeth were then restored with a total-etch adhesive system (Adper Single Bond 2) and composite resin (Filtek Z250). Five teeth from each group were sectioned to obtain 1 mm² stick-shaped microtensile specimens from each tooth. Twenty-five specimens were obtained for each group with using this technique. The data were analyzed in independent-samples t-test (α = 0.05). For each removal technique, one sample was analyzed using scanning electron microscopy. Results: No statistically significant differences were found between the bond strength of the Er:YAG laser and the bur-treated groups (P > 0.05). Conclusion: The Er:YAG laser treatment did not negatively affect the bonding performance of the total-etch adhesive system to caries-affected dentin on the gingival wall.

Background: Early detection of preeclampsia will help reduce the morbidities and mortalities associated with the disorder. Late-onset preeclampsia was the predominant presentation in this cohort. The search for biomarkers for predicting preeclampsia is still ongoing. Mean arterial blood pressure (MABP), which has the advantage of presenting a single cutoff value compared with the use of systolic and diastolic blood pressure measurements, merits evaluation. Aim: The study aims to evaluate the clinical utility of second trimester MABP in the prediction of preeclampsia. Methods: This was a prospective cohort study of 155 normotensive, nonproteinuric pregnant women without prior history of gestational hypertension. The women were booked patients attending the antenatal clinic at the Lagos University Teaching Hospital and were all in their second trimesters of pregnancy. The outcome measures were systolic blood pressure, diastolic blood pressure, and MABP. The end point of the study was the development of preeclampsia. The diagnosis of preeclampsia was made by the attending obstetrician. The data were analyzed using the IBM SPSS statistical software. Statistical significance was set at P < 0.05. Results: One hundred and fifty-five pregnant women participated in the study. Eleven (7.1%) of the women developed preeclampsia after 34 weeks gestation and 144 (92.9%) had normal pregnancy. The mean gestational age at the time of assessment was 18.88 ± 3.15 weeks with a range of 14 weeks to 27 completed weeks. There was a statistically significant increase in the systolic blood pressure, diastolic blood pressure, and MABP values in the group of women who later developed preeclampsia, P = 0.005, 0.001, and <0.001, respectively. At a false-positive rate of 10%, MABP value of 88.33 mmHg predicted preeclampsia with a specificity of 90% and a sensitivity of 45.5%, P <0.05. The area under the receiver-operative characteristics curve (AUC) was 0.732 (95% confidence interval, 0.544-0.919, P = 0.011). The negative predictive value (NPV) was 88.88% and the positive predictive value (PPV) was 45.45%, P < 0.05. At an MABP cutoff of 88.33 mmHg, preeclampsia was predicted with a relative risk of 4.44 and a positive likelihood ratio of 6.46, P < 0.05. Conclusions: With an AUC of 0.732, MABP performed moderately (considering that excellent performance has an AUC of 1.0) in the prediction of late-onset preeclampsia in Nigerian women. Its high NPV suggests a strong ability to rule out preeclampsia and help to appropriate management.

Background: Acute kidney injury (AKI) has been shown to be common in critically ill patients with associated very poor outcome. There is paucity of data regarding its epidemiology, particularly in developing countries. This study aims to assess the presence of AKI among critically ill children to determine its prevalence, outcome, and outcome determinants in children suffering from AKI. Patients and Methods: This is a cross-sectional observational study of critically ill children admitted to the children emergency unit of University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu. Critically ill children suffering from AKI were identified and classified using the pediatric RIFLE criteria. Result: A total of 300 children were studied. One hundred and eighty (60%) were males. The prevalence of AKI in the study population was 56%. Factors associated with AKI included age <5 years (OR = 3.618; 95% CI = 2.100–6.235; P < 0.001), inability to drink (OR = 2.866; 95% CI = 1.723-4.766; P < 0.001), tachycardia (OR = 2.111; 95% CI = 1.071-4.163; P = 0.031), unconsciousness (OR = 3.128, 95% CI = 1.303-7.511; P = 0.011), and hypotension (OR = 2.619; 95% CI = 1.008–6.804; P = 0.048). The odds of death increased with increasing severity of AKI among those who had pRIFLE-F, who were 24 times more likely to die than those with no AKI (OR = 24.38; 95% CI = 5.702-104.194; P = 0.001). Conclusion: The prevalence of AKI in the study population was unacceptably high. The risk factors to its occurrence can be determined from epidemiologic and clinical data, and therefore, clinicians attending to critically ill patients should identify those with AKI for early intervention to reduce the expected poor outcomes associated with its occurrence.

Background: Despite the increasing global importance of gestational weight gain (GWG) and its impact on birthweight, little is known about the patterns of GWG in African populations. Objectives: To determine the pattern of GWG and its association with birthweight in Nigeria. Methods: It was a longitudinal study of 200 pregnant women receiving antenatal care at two tertiary hospitals in Enugu, south eastern Nigeria. The women were consecutively recruited at <14 weeks gestation and their body mass indexes recorded upon recruitment. Thereafter, weight measurements were taken at each visit until 38–39 weeks. Results: Mean total GWG was 10.7 ± 3.4 kg, while mean birthweight was 3.3 ± 0.6 kg. GWG in second trimester had positive correlation with birthweight (r = 0.164, P = 0.02). Obese women gained above the recommended limits by the “institute of medicine” while underweight women gained below the limits. Excessive total GWG was associated with higher risk of macrosomia [8/21 (38.1%) vs. 7/179; RR: 9.74; 95% CI: 3.9–24.2; P < 0.001] while inadequate total GWG was associated with higher risk of low birth weight [7/72 (9.7%) vs. 3/128 (2.3%; RR: 4.15; 95% CI: 1.1–15.4; P = 0.03]. Maternal age of <35 years, high social class, nulliparity, and regular antenatal care were associated with normal GWG while maternal age <35 years and regular antenatal care were associated with normal birthweight (P < 0.05). Conclusions: Women should be counseled on the factors that influence GWG and birthweight. Interventions to assist women achieve appropriate GWG may need to include components related to improved dietary intake for the underweight and increased physical activity for the obese.

Objective: To compare the efficacy of manual and mechanical instrumentation techniques, including ProTaper Universal retreatment system, Mtwo retreatment system, Reciproc system, and Hedström files, regarding removal of overextended root canal filling material. Materials and Methods: Eighty extracted human mandibular premolar teeth were prepared at the apical foramen level using Revo-S rotary files and subsequently obturated. The root canal filling material was deliberately extruded from the apex. Samples were transferred to glass vials that simulated the periapical area. Eighty samples of overfilled teeth were randomly assigned to four equal groups (n = 20) for removal of the root filling material with ProTaper Universal retreatment files (Group 1), Mtwo retreatment files (Group 2), Reciproc system (Group 3), and hand files (Group 4). Removal of the root canal filling material and additional preparation were performed by individual instruments from each different system up to a #40 size. The external apical surface of the teeth and the surrounding glass vials were checked using a dental operation microscope with ×12.5 magnification. Samples were divided into two groups based on whether removal of the overextended root canal filling material was successful or not. The Fisher's exact test was used to detect any significant difference between the groups (α = 0.05). Results: The success rate for removal of overextended gutta-percha was greater for the Mtwo (30%) and hand files (30%) compared with the ProTaper (20%) and Reciproc (10%). However, no significant statistical differences existed among the experimental groups (P > 0.05). Conclusions: This study demonstrated that all tested systems had similar efficacy in removing overextended root canal filling material.

Background: There is at present the dearth of information on the possible contribution of insulin resistance to scores obtained from mortality risk estimation in patients with type 2 diabetes mellitus (T2DM). Aim: This study determined the mortality risk scores in patients with T2DM and its relationship with insulin resistance. Methods: Fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, serum and urinary creatinine, glycated hemoglobin (HbA1c), serum insulin, and urinary albumin were determined in 111 T2DM patients. Thereafter, low-density lipoprotein cholesterol (LDL), quantitative insulin sensitivity check index (QUICKI), urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) were calculated using the standard formula. Mortality risk was estimated using the validated Gargano mortality risk calculator with scores ≤0.67, 0.68–0.79, and ≥0.80 considered as low, intermediate, and high risks, respectively. Results: Of the total patients, 5 (4.5%), 28 (25.2%), and 78 (70.3%) patients had high, intermediate, and low mortality risk, respectively. There was no difference in the median QUICKI values when the three groups were compared. However, there was a significant elevation in the median eGFR in patients with high mortality risk compared with patients with low and intermediate mortality risks. Also, the median mortality risk score of patients with low insulin sensitivity (QUICKI ≤0.3) was similar to that obtained in patients with normal insulin sensitivity (QUICKI ≥0.31). No significant correlation was found between QUICKI and mortality risk scores. Conclusion: Insulin sensitivity status does not have a direct effect on scores obtained from the Gargano mortality risk prediction model.

Hamartomatous polyps of the tonsil are rare. They have been described using various terms such as a lymphangiomatous polyp, lymphangiectatic fibrous polyp, lipomatous polyp, or pedunculated tonsil; hence, the actual incidence is difficult to be quantified. Polyp of the palatine tonsils is an unusual benign lesion of the head and neck. It is a rare polypoidal mass that generally arises from a pedicle attached to the tonsil and projecting into the oropharynx. Polypoid lesions of the head and neck are likewise rare, and such tumors arising from the palatine tonsils are sparse. Tonsillar polyp is an uncommon hamartomatous lesion that generally arises from the tonsillar surface. It has rarely been reported in the medical literature. We present a case of hamartomatous polyp of the palatine tonsil in a 17-year-old male patient.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, clinically aggressive hematologic malignancy, that most commonly manifests as cutaneous lesions. A 19-year-old Malian female was admitted to the Unit of Medicine of Hopital du Mali with anemia, fever, weakness, and weight loss. On physical examination she was wasted, pale, febrile (37.4^°C), and had inguinal and axillary lymphadenopathies. The complete blood count found pancytopenia with Hemoglobin level of 4.8 g/dL, Leucocytes count of 1900/μL (neutrophil: 300/μL), and platelets count of 56 000/μL. The ultrasonographic examination found hepatomegaly and splenomegaly. The bone marrow biopsy and flow cytometer analysis were in keeping with a diagnosis of BPDCN. The patient, unfortunately, was lost four months later after her hospital admission due to late diagnosis by septicemia. The early diagnosis and availability of specific drugs for acute leukemia could improve the clinical outcome of patients with BPDCN in Mali.