Non-alcoholic fatty liver disease (NAFLD) which is defined as the accumulation of fat >5% of liver weight is increasingly becoming an important cause of chronic liver disease. This article tries to chronicle advances that have occurred in the understanding of the pathogenesis, pathology as well as the management of this disease. We have done a Medline search on published work on the subject and reviewed major conference proceedings in the preceding years. The Pathogenesis involves a multi-hit process in which increased accumulation of triglycerides in face of insulin resistance results in increased susceptibility to inflammatory damage mediated by increased expression of inflammatory cytokines and adipokines, oxidative stress and mitochondrial dysfunction, endoplasmic reticulum stress and gut derived endotoxemia. An interplay of multiple metabolic genetic expression and environmental factors however determine which patient with NAFLD will progress from simple steatosis to non-alcoholic steatohepatitis (NASH) and liver cirrhosis. The minimum criteria for diagnosis of NASH are steatosis, ballooning and lobular inflammation; fibrosis is not required. The NASH Clinical Research Network (CRN), histological scoring system is used to grade and stage the disease for standardization. The management of NAFLD consists of treating liver disease as well as associated metabolic co-morbidities such as obesity, hyperlipidaemia, insulin resistance and type 2 diabetes mellitus (T2DM). Patient education is important as their insight and commitment is pivotal, and lifestyle modification is thefirst line of treatment. Improvement in liver histology in non-diabetic NASH patients has been reported with use of Vitamin E. Other liver-related therapies under investigations include pentoxyfiylins, Caspar inhibitors, Resveratrol as well as probiotics. The prognosis (both overall and liver-related mortality) for simple steatosis is not different from that of the general population however.

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Objective: The purpose of this study was to analyze clinic and radiologic features of the 69 odontoma cases and present a rare case of erupted compound odontoma in the oral cavity. Material and Methods: The 69 cases were analyzed with regard to the following parameters: age, gender, location, associated unerupted teeth, missing teeth, radiological and histopathological features and treatment protocols. Results: Of the 69 cases, 49 were compound odontoma and 20 were complex odontoma. There was a female predilection for both compound and complex odontomas. Compound odontoma occurred more often in the anterior region of the jaws; complex lesions occurred more often at the posterior mandible. The most common clinical manifestations were the retention of permanent teeth. Conclusion: Compound odontomas rarely erupt into the mouth. The presented case is the 13 ^th case of erupted compound odontoma reported in the literature. The treatment of choice is surgical removal of the odontoma. In the case of odontomas associated to impacted teeth, the teeth should be preserved in wait of spontaneous eruption, or alternatively fenestration followed by orthodontic traction is indicated. Regular follow-up period is crucial to evaluate the prognosis of these teeth.

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Purpose: The aim of this study was to analyze the clinical and radiological features of supernumerary teeth (ST), record the related complications, and discuss different forms of treatment. Materials and Methods: A total of 111,293 patients were examined over a 3-year period. The patients' ages and genders, in addition to the number, morphology, location, position, shape, developmental stage, and eruption status of ST and associated complications, were recorded. Results: Among the 111,293 patients, there were 851 (0.76%) patients with 1100 ST. Of these patients, 478 (56.2%) were males, and 373 (43.8%) were females, with a mean age of 22.71. Most of the 1100 ST were located in the maxilla, 437 (39.72%) were a conical shape, with 82.81% of these including a fully developed tooth. A mesiodens was the most common type of supernumerary tooth (n = 284, 33.37%), followed by distomolars (n = 204, 23.97%) and parapremolars (n = 146, 17.16%). Among the 1100 ST, 422 (38.36%) were associated with complications. Conclusions: No previous studies in the literature have examined in detail so many cases with ST. The demographic profile of the patients with ST presented herein provides useful additional epidemiological information.

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Background: Hibiscus sabdariffa (HS) is widely consumed in Nigeria as a refreshing beverage and also as an antihypertensive agent. Since three decades ago when its antihypertensive activities were reported in several animal experiments, its consumption has greatly increased. Aim: The aim of this study is to investigate the effect of HS consumption on blood pressure (BP) and electrolytes of mild to moderate hypertensive Nigerians and compare it with that of hydrochlorothiazide (HCTZ), a diuretic widely used asfirst-line antihypertensive drug. Subjects and Methods: Eighty newly diagnosed, but untreated mild to moderate hypertensive subjects attending Medical Out-Patients clinic of Enugu State University Teaching Hospital, Enugu, were recruited for the study. They were randomly divided into three groups: A, B and C. Those in Groups A were given placebo; those in Group B took HCTZ while those in Group C were given HS. Treatment lasted for 4 weeks. BP, serum, and urine electrolytes were measured at baseline, weekly during treatment and 1 week after withdrawal of treatment. Results: At the end of treatment, both HCTZ and HS significantly (P < 0.001) reduced systolic BP, diastolic BP, mean arterial pressure and serum Na+ compared to placebo. When compared to each other, HCTZ significantly (P < 0.001) reduced serum Na+ and Cl− compared to HS and significantly (P < 0.001) increased K+ and Cl− output in urine. After withdrawal of treatment, the fall in BP and serum Na+ in HS group were significant compared to HCTZ where they returned to baseline values. No side effect was reported during the study. Conclusion: HS was a more effective antihypertensive agent than HCTZ in mild to moderate hypertensive Nigerians and did not cause electrolyte imbalance. HS showed longer duration of action compared to HCTZ and reduction in serum Na+ may be another antihypertensive mechanism of action of HS.

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Context: Risk factors for and survival of singleton preterm births may vary according to geographical locations because of socioeconomic differences and lifestyle. Aims: The aim was to describe maternal risk factors and survival-to-discharge rate for singleton preterm births at the University of Nigeria Teaching Hospital and determine the relationship between maternal risk factors and the survival of singleton preterm babies. Subjects and Methods: A comparative retrospective review of singleton preterm and term births from January 2009 to December 2013 was carried out. Statistical analysis involved descriptive and inferential statistics at 95% level of confidence using the Statistical Package for Social Sciences (SPSS) version 15 for Windows. P ≤ 0.05 was considered significant. Results: A total of 784 births including 392 singleton preterm births (aged 26 − 36 + 6) and 392 singleton term births were studied. The mean age of mothers who delivered singleton preterm babies did not differ significantly from that of mothers who delivered singleton term babies (30.2 ± 4.9 years vs. 30.8 ± 4.7; P = 0.06). Lack of antenatal care (adjusted odds ratio [aOR] = 2.63; 95% confidence interval [CI] 1.92, 6.07), Previous preterm birth (aOR = 5.06; 95% CI: 2.66, 9.12), having pregnancy complications including antepartum hemorrhage, preeclampsia/eclampsia or premature rupture of membranes (aOR = 5.12; 95% CI: 2.4, 11.8), being unmarried (aOR = 2.41; 1.56, 3.71) and nulliparity (aOR = 2.08, 95% CI: 1.22, 4.91) were independent risk factors for singleton preterm births. The average survival-to-discharge rate for preterm babies during the period was 38.4%. The mean duration of admission for singleton preterm babies was 16 ± 5.8 days (range: 2−75 days). Whereas survival was dependent on, gestational age at birth ( P < 0.001) and mode of delivery ( P = 0.01), it was not dependent on maternal risk factors of parity, marital status, complications of pregnancy, and antenatal care. Conclusions: There was a low rate of survival of singleton preterm babies at the study center and survival was dependent on gestational age at birth and mode of delivery, but not on maternal sociodemographic risk factors for singleton preterm births. Active collaboration between the obstetrician and the neonatologist in deciding when and how to deliver these babies may provide improved chances of survival.

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Introduction:Physical activity (PA) is a key requirement for maintaining good health. There is growing evidence of declining PA worldwide. Physical inactivity is linked with the global obesity pandemic and increasing burden of noncommunicable diseases (NCDs) in developing countries. A barrier to PA counseling by health care providers (HCPs) is personal PA habits. Information regarding PA among HCPs in Nigeria is limited. We aimed to determine the adequacy and predictors of PA among HCPs of a tertiary health care facility in Lagos, Nigeria. Methods: A cross-sectional study was carried out with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Using the World Health Organization (WHO) guideline, PA was categorized as adequate or inadequate. Predictors of PA were explored with multivariate logistic regression. Results: A total of 300 HCPs were recruited, comprising 47.7% doctors and dentists, 43.3% nurses and 9.0% other HCPs. Mean age was 39.9 (9.0 years), 79.2%, 9.7% and 11.1% of the HCPs had low, moderate or high PA levels respectively. Thus, only 20.8% had adequate PA. 71.3% had body mass index (BMI) above the recommended value. BMI of ≥25 kg/m² was associated with inadequate PA (Adjusted Odds Ratio-2.1,P= 0.018). Conclusion:Majority of the HCPs had inadequate PA levels according to WHO guidelines. BMI ≥25 kg/m² was associated with inadequate physical inactivity. The low level of PA implies that these HCPs are at risk for NCDs. This will have a negative impact on availability of human resource for health. There is an urgent need to establish programs to increase PA among HCPs.

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Objectives: The objectives were to determine the seroprevalence of hepatitis B virus (HBV) infection and assess the major risk factors among Nigerian pregnant women. Subjects and Methods: This was a cross-sectional descriptive study carried out among pregnant women at the antenatal clinic of a Tertiary Hospital in Lagos, Nigeria. A total number of 150 consenting pregnant women were selected for the study. A structured pretested interviewer-administered questionnaire was used for the data collection. Sera were collected and tested for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Results: Of the150 women screened during the study, 11 (7.3%) were seropositive for HBsAg. Of these 11 women, 4 (36.4%) were also positive for HBeAg. There was no statistically significant difference in the mean ages of participants who were seropositive for HBsAg and those who were negative for the virus (P = 0.888). There were statistically significant differences in the seroprevalence of HBsAg recorded among respondents with previous surgery (odd ratio [OR] - 2.97; 95% confidence interval [CI] - 1.08-16.67; P = 0.046), previously affected sibling or spouse (OR - 5.03; 95% CI - 1.11–25.27; P = 0.001) and those with two or more lifetime sexual partners (OR - 4.11; 95% CI - 2.85–9.22; P = 0.024). Conclusion: The sero-prevalence rate of HBV infection and also its infectivity is high in Lagos, Nigeria. These findings thus support the need for a nationwide policy of routine and widespread HBV screening among pregnant women.

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Priapism is a painful medical condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within 4 h. Priapism is considered a medical emergency, which should receive proper treatment by a qualified medical practitioner. Treatment initially involves conservative measures, such as corporeal aspiration and irrigation with saline or dilute phenylephrine. If this fails, embolization or surgical shunting may be required. Priapism is more commonly associated with sickle cell hemoglobinopathy. However, hyperviscosity resulting from leukemia is a rare cause of priapism. We report a case of a 19-year-old man with an 18-h history of priapism secondary to undiagnosed chronic myeloid leukemia. We discuss the method of leukapheresis (mechanical white cell depletion) to reduce viscosity.

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Aims: The aim of this study was to evaluate the shaping effects of two M-wire and two traditional nickel-titanium (NiTi) rotary systems in simulated S-shaped resin canals. Subjects and Methods: Forty simulated S-shaped canals in resin blocks were instrumented with two traditional (ProTaper, Sendoline S5) and two M-wire (WaveOne, GT series X) NiTi systems according to the manufacturers' instructions. Ten resin blocks were used for each system. Pre- and post-instrumentation images were captured using a stereomicroscope and superimposed with an image program. Canal transportation, material removal, and aberrations were evaluated and recorded as numeric parameters. Statistical Analysis Used: Data were analyzed using one-way ANOVA and post-hocTukey tests with a 95% confidence interval. Results:There were significant differences between systems in terms of transportation and material removal (P < 0.05). Coronal danger zone was the most common aberration. Conclusions: Within the limits of thisex vivostudy, it was found that the manufacturing methods (M-wire or traditional NiTi) and kinematics (rotary or reciprocating motion) did not affect the shaping abilities of the systems. The extended file designs of highly tapered NiTi systems (ProTaper, WaveOne) resulted in greater deviations from the original root canal trace and more material removal when compared to less tapered systems (Sendoline S5, GT series X).

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Background: Acquired heart diseases (AHDs) are serious but largely preventable diseases. They are highly prevalent in developing countries where poverty, illiteracy, and poor socioeconomic conditions still pose a significant challenge. The prevalence and pattern of AHD among children have not been previously documented within the study area. Objectives: To determine the pattern and outcome of AHDs among children in Sokoto, North-Western Nigeria. Subjects and Methods:A prospective study conducted at the Pediatric Department of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria from 1^st July 2009 to 30^th June 2014. Data from all the subjects with AHD were analyzed using Statistical Package for Social Sciences. Results: Of the 3810 children, 110 (2.9%) children were diagnosed with AHD over the study period. The mean age of the subjects was 10.4 ± 3.4 years with M: Fratio of 1.2:1. Rheumatic heart disease (RHD) was the most common AHD seen in 47 (42.7%) patients, followed by dilated cardiomyopathy/myocarditis in 36 (32.7%) and pericardial effusion in 12 (10.9%) patients. Endomyocardial fibrosis was seen in 7 (6.4%) patients while infective endocarditis and Kawasaki disease occurred in 6 (5.5%) and 2 (1.8%) patients respectively. Mortality rate was 17.3%. Commonly observed co-morbidities included heart failure, bronchopneumonia, and pulmonary hypertension. Conclusion: The pattern of AHD is similar to other studies in developing countries, with RHD being the most prevalent. There is a need for increased emphasis on primary prevention to reduce the burden of these diseases in the study area.

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Background: Malnutrition is a clinical state resulting in prolonged hospital stay, increase in severity of infections and poor wound healing. Aims: Our aim was to investigate the prevalence and etiologic factors of malnutrition in medical inpatients. Study Design: A total of 290 consecutively admitted internal medicine patients from February to May 2012 were included. On admission, demographic data, anthropometric measurements, laboratory parameters and nutritional screening test results were recorded. Methods: Nutritional risk score-2002 for patients under 65 years old, mini nutritional assessment for older patients and subjective global assessment (SGA) tests performed. Relation of demographic characteristics, laboratory parameters, weight and body mass index (BMI) with nutritional status were evaluated. Results: Mean age was 61 ± 17 years; 145 patients were male. Among 160 patients < 65 years old, 34 were in malnutrition (21%), 41 (26%) were under risk of malnutrition and 85 (53%) were normal. When they were divided into three groups according to SGA, we found significant difference in hemoglobin, low density lipoprotein (LDL), high density lipoprotein, cholesterol, triglyceride, albumin and protein, weight and BMI. Among 130 patients over 65 years old, 47 patients (37%) were in malnutrition, 41 (31%) were under risk of malnutrition and 42 (32%) were normal. There was significant difference in LDL, cholesterol, albumin, protein, weight and BMI between three groups; each 1 g/dl decrease in serum albumin and age older than 65 years old increased malnutrition risk 5.21 and 1.97 times, respectively. Conclusion: Malnutrition risk is high among internal medicine inpatients and risk seems to be higher among older patients. Nutritional screening of geriatric patients, close follow-up and providing earlier health care would contribute rehabilitation of chronic diseases and decrease re-admissions.

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Objective: The objective was to determine the pattern of admission and outcome of patients in the Intensive Care Unit (ICU) of University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Materials and Methods: A retrospective review of all patients admitted into the general ICU at UNTH from 2008 to 2012. Data were collected from the ICU admission and discharge registers, and data analysis was done using Microsoft Excel 2007. Results: A total of 766 patients were admitted during the period, consisting of 501 (65.4%) males and 265 (34.6%) females. Ages ranged from 1-day to 89 years with a mean age of 38.2 ± 18.2 years. The most common cases admitted were neurosurgical patients of which there were 316 (41.2%). Patients admitted as a result of critical incidents in anesthesia formed the lowest number of cases admitted 10 (1.3%). Of the 316 neurosurgical cases, 224 (70.9%) were due to severe traumatic brain injury (TBI). An overall admission of 92.4% (207) was for severe TBI due to motor-vehicular accident (MVA). The average length of stay was < 24 h to 72 days with a mean of 4.9 ± 3.2 days. A total of 16.7% (128) patients received invasive mechanical ventilation during their stay in ICU. Only 15% (34 patients) of all the cases of severe TBI patients received invasive mechanical ventilation. Mortality rate was 34.6% in this study. Conclusion: The highest number of admissions into the ICU was for severe TBI following MVA. Developing a viable trauma team and separately equipped neurosurgical ICU with adequately trained and motivated staff will help improve the outcome of patients.

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Objective: The objective of this study was to evaluate the tissue inflammation caused by three endodontic repair materials. Materials and Methods: The materials included micro mega-mineral trioxide aggregate (MM-MTA), bioaggregate (BA), and biodentine (BD), which were implanted into the subcutaneous tissue of rats. The tissue samples for histological examination were prepared. The infiltration of lymphocytes and macrophages into the tissue was examined to assess the inflammatory response. Results: Lymphocyte infiltration: A significant increase was detected in the MM-MTA and BA groups on the 7 ^th and 14 ^th days as compared with the control (7 ^th day P = 0.0001, 14 ^th day P = 0.0176). There was no difference between the groups on the 45 ^th day (P = 0.1730). Lymphocyte infiltration had decreased over time in all groups. Macrophage infiltration: There was a significant increase by the 7 ^th day in the test groups as compared to the control group (P = 0.007). However, there was no difference between the experimental groups on the 14 ^th (P = 0.2708) and 45 ^th (P = 0.1291) days. Conclusion: While MM-MTA and BA showed a similar biocompatibility, BD was more biocompatible than MM-MTA and BA in the 1 ^st week of the experiment. However, there was no difference between the materials at the end of the 45 ^th day. MM-MTA, BA, and BD can be considered suitable endodontic repair materials.

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Objective: To evaluate the amount of apically extruded debris during retreatment (with or without solvent) of root canals filled by two obturation techniques. Materials and Methods: Forty-eight root canals were prepared using ProTaper Universal F3 and filled with Gutta-percha and AH 26 sealer using single cone or lateral condensation techniques. The root canal fillings were removed using ProTaper Universal Retreatment system with or without solvent, and the canals were further prepared with ProTaper F4. The operating time was measured. The debris extruded was collected into preweighed Eppendorf tubes. The dry weight of the extruded debris was calculated by subtracting the weight of the empty tube from that of the tube containing debris. Statistical analysis was performed with two-way analysis of variance test, with Bonferroni correction at a 95% confidence level. Results: There was no statistically significant difference in the amount of extruded debris between the two obturation techniques ( P = 0.332). The mean amount of debris was higher in the nonsolvent groups than the solvent groups, particularly with the single cone technique ( P = 0.013). There was a significant difference between groups with regard to the retreatment time ( P &60; 0.001). Gutta-percha removal took less time in the single cone group than in the lateral condensation group ( P &60; 0.001). Gutta-percha removal in the nonsolvent groups took significantly less time than that in the solvent groups ( P &60; 0.001). Conclusions: The amounts of apically extruded debris were similar in both obturation techniques. A greater amount of apically extruded debris was observed in the nonsolvent groups than the solvent groups.

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Objectives: The purpose of this study was to compare the antibacterial effects of gaseous ozone (O₃) and photo-activated disinfection (PAD) methods against Enterococcus faecalis (E. faecalis) biofilms. Materials and Methods: Sixty-five human mandibular premolars with straight root canals were selected. After root canal preparation, the samples were sterilized and placed into eppendorf tubes with 1 mL brain heart infusion broth containing 1.5 × 10⁸ colony-forming units (CFUs)/mL of E. faecalis. The contaminated samples were then divided into four groups (n = 15) according to the disinfection method used: Group 1, Saline (positive control); Group 2, NaOCl (negative control); Group 3, Gaseous O₃; and Group 4, PAD. Three non-contaminated teeth were used to control the infection and sterilization process. The CFUs were counted and the data were analyzed statistically. Results: There was a statistically significant difference between the experimental and control groups (P ' 0.05). The saline group had the highest number of remaining microorganisms. Complete sterilization was achieved in the 2.5% NaOCl group. There were no statistically differences between PAD and gaseous O₃ (P > 0.05). Conclusion: Both PAD and gaseous O₃ have a significant antibacterial effect on infected root canals. However, 2.5% NaOCl was superior in terms of its antimicrobial abilities compared with the other disinfection procedures.

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Introduction: Stroke is a major cause of death and disability in population across the world. Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. Materials and Methods: We screened 224 volunteers from Ile-Ife during the 2011 and 2012 world stroke day commemorative activities. Blood pressures (BP) were measured and body mass index (BMI) was determined from weight and height measurements. The data from 40 (18%) were incomplete and were excluded from further analysis. Results: The 184 subjects eligible for analysis comprised 85 males (46.2%) and 99 females (53.8%), with a male to female ratio of 0.85:1. Their ages ranged from 16 to 95 years (mean, 53 ± 16 years). 25% of the study population had stage 1 or 2 hypertension (mean systolic blood pressure: 127 ± 27 mmHg, mean diastolic blood pressure: 78 ± 16 mmHg), while 34.8% and 14.7% were overweight and obese, respectively (mean BMI: 25.8 ± 5.0 kg/m²). Conclusion: Stroke risk factors such as hypertension and obesity were common among the participants of the world stroke day awareness program in an urban area of Nigeria. Community screening and modification of these risk factors should be intensified in order to reduce stroke morbidity and mortality.

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Background: An important goal in the treatment of chronic hepatitis B virus (HBV) infection is to prevent hepatocellular carcinoma and liver cirrhosis by suppressing HBV replication. Tenofovir and entecavir are effective viral suppression compounds. However, comparative data is scant, especially in Korea. This study compared tenofovir and entecavir concerning efficiencies and side effects. Materials and Methods: We retrospectively reviewed data of nucleos (t) ide-naïve patients with chronic HBV infection. Independent variables reflecting virological response were evaluated, and the decline in serum HBV DNA levels, and side effects between tenofovir-and entecavir-treated patients were compared at treatment week 12, 24, and 48. Results: At the end of 48 weeks, there was no statistical difference in the induction of undetectable levels of HBV DNA between the entecavir (82.5%) and tenofovir (69.2%) groups. Entecavir was more effective in reducing serum HBV DNA levels at 24 weeks of treatment (serum HBV DNA decline of 5.53 and 4.95 log10 units for entecavir and tenofovir, respectively; P = 0.044), but the rate of decline was similar at other weeks. There was no difference between the two groups in terms of side effects and discontinuance of treatment due to side effects. Conclusions: Tenofovir is not significantly different from entecavir in virologic response and tolerability in the treatment of chronic HBV.

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Introduction: The early detection of critically ill patients together with the rapid initiation of effective treatment in emergency departments(ED) increase the survival rates. Aim: This study investigated whether a correlation exists between haemodynamic parameters of critically ill patients and the diameter of the inferior vena cava (IVC). Materials and Methods: A cross-sectional study was performed included patients aged ≥18 years with an unstable haemodynamic and/or respiratory status who were referred to the ED for non-traumatic issues. IVC diameters were measured by ultrasound (US) and then central venous pressures (CVP) were measured. Anteroposterior (AP) and mediolateral (ML) diameters of the IVC, both in the inspirium (IAP, IML) and expirium (EAP, EML), were measured by US. Results: 102 patients were evaluated with a median age of 59. The relationship between the diameters of IVC and CVP was evaluated and significant correlation was found in IAP, EAP according to CVP values (p' 0.001). ROC analyses were performed and significant relationship was found between the EAP diameter with haemoglobin (Hmg), haemotocrit (Hct), and central venous oxygen saturation (ScvO2) and also significant correlation was detected between the IAP diameter and white blood cell (WBC). Discussion: We detected significant correlation between the CVP and the IVC diameter in our study compatible with recent studies besides, significant correlation was found between the diameter of the IVC and CVP values as well as between the EAP diameter and Hmg, Hct, ScvO2 levels. Conclusion: Measurement of IVC diameters, especially EAP may be useful at the monitoring of critically ill patients in ED.

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Background: Mini-mental state exam (MMSE) was used several times but no study has examined cognition on the Montreal Cognitive Assessment (MoCA) in diabetes and diabetic retinopathy (DR). In this study, we compared MMSE with MoCA in patients with DR and searched for an association between the severity of DR and cognitive impairment (CI). Methods: This cross-sectional study comprised 120 consecutive patients with diabetes. Patients were divided into four groups as no DR, mild DR, severe nonproliferative DR (PDR) and PDR. Each group consisted 30 inviduals. CI was assessed using the MMSE and MoCA. Results: The number of subjects with a score &&#gt;21 were significantly lower on the MoCA than on the MMSE between groups (all P < 0.05). The mean MoCA score was significantly lower than the MMSE score (P < 0.001) There was a linear association between the grade of DR and a score &#lt; 21 on both tests, Conclusion: MoCA provides more insight into the cognitive function in DR.

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Context: The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. Aims: The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. Settings and Design: The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). Subjects and Methods: The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. Statistical Analysis Used: Chi-square test and z-test were used. Results: All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). Conclusions: The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.

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Advanced gynecological laparoscopic surgery is an evolving subspecialty that requires specialized skills, expertise and equipment. This is more challenging and daunting, especially in sub Saharan Africa. Laparoscopic supracervical hysterectomy (LSCH) is an advanced gynecological procedure that has hitherto been seen as difficult because of the big size uteri seen in Nigerian women. We present thefirst LSCH and uterine morcellation done in Nigeria in a 45-year-old multipara on account of symptomatic uterine fibroid of 16 weeks size, at the Asokoro District Hospital, Abuja. Nigeria. She fared well postoperatively and highly satisfied with the procedure at the gynecological clinic review. Our case report has demonstrated clearly that the uterine size is not a limitation to laparoscopic hysterectomy. With proper port placement and adequate skills, LSCH of big size uteri, which is typical in sub Saharan Africa, can be safely achieved. We, therefore, recommend capacity building of Gynaecologists and peri-operative nurses in the field of minimal access surgery and improvement in the equipment in our various facilities to the modern standard.

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Objective: We investigated the pattern of common risk factors present in women undergoing oral glucose tolerance test (OGTT) in our center and to determine their relationship with time of presentation for the test. Materials and Methods: The records of women referred to the metabolic clinic for OGTT over a 1-year period were reviewed. Data available for retrieval included age, gravidity and gestational age, weight, and risk factors for gestational diabetes mellitus (GDM). Results: Two hundred and fifty-three (253) pregnant women form the subject of this study. Thirty-five (13.8%) of the study population had GDM by WHO criteria. Approximately, 10% of the women were tested before 24 weeks and 87.6% of the women had at least one of the common risk factors as indication for testing. The most frequent indications were a history of previous macrosomic baby 77 (30.4%) and maternal obesity 61 (24.1%). Among the indications for OGTT, only a history of previous intrauterine fetal death was significantly associated with testing before 24 weeks of gestation. Conclusion: Early screening for GDM is not common in our environment. The presence of risk factors for GDM did not prompt early screening. Public enlightenment on the risk factors for GDM and the need for early screening should be vigorously pursued particularly for women at risk for GDM.

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Objective: The study assessed the knowledge and utilization of point of care testing (POCT) amongst doctors in two health facilities in Edo State, Nigeria. Methods: A descriptive cross-sectional study was carried out using a multistage sampling technique. Data were collected from 174 doctors in both centers using a 25 item structured questionnaire which was analyzed using SPSS version 20.0. Result: The mean age of respondents was 31.26 ± 2.14 years with 120 (69.0%) males and 54 (31.0%) females (male: female = 2.2:1). Knowledge of POCT and utilization of POCT devices was good in 50.6% and 32.2% of respondents respectively. Utilization of POCT correlated significantly with knowledge of POCT (r = 0.67, P < 0.001) and availability of POCT devices (r = 0.43, P ' 0.001). There was statistically significant association between utilization of POCT devices and Hospital (χ² = 9.95, P = 0.002); job designation (χ² = 10.03, P = 0.018) and availability of POCT devices (χ² = 6.80, P = 0.001). However, no statistically significant relationship was found between utilization of POCT devices and sex (χ² = 0.23, P = 0.629). Conclusion: Promotion of POCT's utilization with regulation, training of doctors and establishment of regulatory framework/assessment teams will help improve healthcare services and achieve more beneficial outcomes. That way, POCT that is faster could be better.

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