Objective: The aim of this study was to determine the frequency of anatomic variations of the paranasal sinuses and their roles in the development of sinusitis. Materials and Methods: Computed tomography of paranasal sinuses of 350 patients was assessed in terms of anatomic variations and inflammatory sinus pathology. The coexistence of anatomic variations with sinusitis was statistically investigated. Results: At least one anatomical variation of paranasal sinuses was detected in 325 patients (92.9%). In 297 (91.4%) of these patients, sinusitis was observed at rates varying depending on the types of anatomic variations. A statistically significant relationship was found between agger nasi cells, Onodi cells, hypertrophy of middle concha, concha bullosa, uncinate bulla, and the medial and lateral deviations of uncinate process and sinusitis. On the other hand, there was no statistically significant relationship between septal deviation, paradoxical middle concha, secondary middle concha, great ethmoidal bulla, and sinusitis. Conclusion: Certain types of paranasal sinus variations create a susceptibility to sinusitis.

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Purpose: The purpose was to examine the prevalence, gender, age and site(s) of odontogenic and nonodontogenic benign tumors, and tumor-like lesions occurring in the oral cavity and jaws in a Turkish population, particularly, in the Eastern Turkey, and to compare findings of this study with other reports. Materials and Methods: The data were collected from the files of the Department of Oral and Maxillofacial Surgery and the Department of Oral Pathology, Ataturk University, Turkey, during a 10-year period from January 2005 to January 2015. They were analyzed descriptively regarding prevalence, age, sex, lesion type, and site. Results: A total of 709 benign tumor and tumor-like lesions of the oral cavity, and jaws were selected during a period of 10 years. One hundred and twenty-one of these lesions (17%) were odontogenic benign tumors while 588 (83%) were nonodontogenic benign tumor and tumor-like lesions. Conclusions: This study revealed that the distribution and characteristics of benign tumors and tumor-like lesions of oral cavity and jaws in the Turkish population, particularly including the Eastern region of Turkey have some differences as well as similarities with the findings of studies in different populations.

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Background: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region. Methodology: We performed a cross-sectional study on adult patients who presented with acute spinal cord compression of traumatic etiology within a 2-year period. The primary outcome was change in Frankel's grading 6 months after surgery. Secondary outcomes were complication rates and mortality. Results: A total of 35 patients made up of 24 (68.6%) males and 11 (31.4%) females were recruited into the study. The spectrum of injuries included cervical 27 (77.1%), thoracic 7 (20.0%), and lumbar vertebrae 1 (2.9%). The outcome as measured by Frankel's grade at 6 months after surgery showed improvement in 9 (25.7%) patients following intervention. All patients who presented with Frankel's Grade C and D improved to Grade E while none of those who presented with Frankel's Grade E deteriorated. The common complications of spine decompression and fixation in this series were surgical site infections (11.4%) and chest infections (11.4%), especially in high cervical injury. Conclusion: Spinal cord decompression with spinal stabilization enhances the rehabilitation of patients with unstable spine and completes spinal cord injuries. Our experience shows improvement in neurological function in patients with spinal cord decompression despite the challenges of instrumentation in Sub-Saharan Africa.

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Background: Specialty choices of medical undergraduates are important in planning educational programs and human resources for health-care delivery. The aim of this study was to investigate the specialty preferences of medical undergraduates and determine the factors that influenced their specialty choices. Methods: This was a cross-sectional questionnaire-based survey carried out among final year medical undergraduates of University of Nigeria Enugu Campus, Enugu Nigeria. A self-administered questionnaire was used for data collection from the participants. Sociodemographic characteristics, decision to specialize, the timing of the decision, specialty choices and factors influencing these choices were evaluated. Chi-squared test and unpaired t-test were used to analyze the observations. Results: Surgery and surgical specialties 79 (52%) were the most preferred specialties among the students. This was followed by obstetrics and gynecology 22 (14.5%) and public health 16 (10.5%). Personal interest in a specialty, personal abilities/competence, and career prospects were the most influential determinants of specialty choices. The career choices of male students were preferentially influenced by family/societal expectations (P = 0.03) and diversity of patients (P = 0.01). Low work hours significantly (P = 0.04) influenced the career choices of female students. Conclusion: Surgical specialties, obstetrics and gynecology, and public health were the most preferred specialties among our participants. The most important determinants of specialty choices were personal interest, personal abilities, and career prospects.

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Introduction: HIV is the leading cause of maternal deaths in resource-poor countries. The use of highly active antiretroviral treatment (HAART) has been shown to almost eliminate vertical transmission and improve maternal health outcomes. Its effect on direct obstetric conditions has not been well documented. Methods: We conducted a retrospective study of women who delivered at a regional hospital from April 1, 2011, to April 30, 2014. We employed a stratified random selection, where the first 50 files recorded in the birth register during each calendar month were chosen, at a ratio of one HIV uninfected for every 4 infected women. Results: We analyzed files belonging to 302 HIV-uninfected women and 1159 HIV-infected women. The latter were further subdivided into those who used zidovudine, n = 424; those who initiated HAART prepregnancy, n = 312; and those who initiated in-pregnancy HAART, n = 423. We found that despite the use of HAART, HIV-infected women were at increased risk of both respiratory and lower genital tract infections (P = 0.009 and 0.001 respectively), compared to HIV-uninfected women. The women receiving HAART before pregnancy had an increased risk of preterm births (P = 0.004), and poor perinatal outcomes (P = 0.002); however, postpartum complications were reduced (P = 0.023). There was a trend toward an increased risk of preeclampsia (P = 0.064). Conclusion: The initiation of HAART before pregnancy reduces the frequency of postpartum complications. However, compared to HIV-negative women, women receiving HAART prepregnancy remained at risk of infectious morbidity, had poor perinatal outcomes, and may also be at an increased risk of preeclampsia.

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Background: There are only limited studies that have determined the antibacterial effects of various remineralizing agents that can be beneficial to children. Aim: The aim of this study is to compare the efficacy of tricalcium phosphate (TCP), calcium sodium phosphosilicate (CSP), and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) enhanced with fluoride in reducing the Streptococcus mutans (SM) levels in saliva of children. Materials and Methods: Out of 245 children, 120 of them with SM colony forming units (CFU)/ml in the range of 10⁴–10⁶/ml of saliva were assigned to four groups: (I) TCP; (II) CSP; (III) CPP-ACP enhanced with fluoride; and (IV) control. Salivary samples were collected at intervals of 1 week, 2 weeks, and 4 weeks and the number of CFU/ml of SM in saliva were counted post 48 hour incubation. Results: After 1 week, 2 weeks, and 4 weeks, there was a significant reduction in the mean score of SM (P < 0.05). The maximum reduction in the CFU/ml in the saliva was seen in the 1^st week after the commencement of the brushing in all the three test groups. Group III children demonstrated the maximum reduction of 15 × 10⁵ CFU/ml, followed by Group II children with 10 × 10⁵ CFU/ml. Conclusions: Twice daily use of CPP-ACP with fluoride, CSP, and TCP caused a significant reduction in the levels of SM in saliva.

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Objective: Headache is a common chronic neurologic disorder with huge economic and psychosocial impact. In comparison with other neurological disorders, there is limited data on primary headache, especially from sub-Saharan Africa. This study was done to fill in the gap and provide recent information on headache among Nigerian undergraduate students. Methodology: Quota sampling was used to select students from three tertiary educational institutions within Ilorin, the capital of Kwara state. Two-stage self-administered questionnaires developed from the guideline of the International Society of Headache were used to harvest information. Results: A total of 1500 students participated in the study. The mean age of the students was 20.9 ± 3.1 years, with male:female ratio of 1.6:1. A total of 356 students have frequent headache within previous 1 year, given the headache frequency of 23.7%. Fifty-three students (3.5%) had headaches on almost daily basis, 84 (5.6%) had ≥4 attacks/week, 145 (9.7%) had ≤2–3 attacks/month, and 123 (8.2%) had 1–3 attacks every 3 months. Close to 75% indicated that it limits their daily activity frequently. One hundred and eighty-seven (12.5%) students fulfilled the criteria for tension-type headache, 36 (2.4%) for migraine headache, and 133 (8.9%) had nonclassified headaches. The most frequent headache-associated symptoms are photophia – 100 students (6.7%), phonophobia – 159 students (10.6%), while 62 students (4.1%) had nausea and vomiting. None of the students had seen a physician for proper headache diagnosis. Majority (90.2%) used none prescription over-the-counter analgesia (acetaminophen) for symptomatic treatment of their aches. Conclusion: Headache is a common complaint among Nigerian undergraduate students and it limits the daily activity of majority of the sufferers. Students need proper education regarding treatment to alleviate their suffering and forestall complication, especially those associated with analgesic overuse.

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Purpose: Pancreatic carcinoma is the most lethal cancer, with a 5-year survival rate of <5%. Hyperglycemia is one of the severe adverse drug reactions (ADRs) in cancer treatment. The aim was to analyze the blood glucose-related ADR of antineoplastics in treating pancreatic cancer. Materials and Methods: Antineoplastic drugs were selected from Martindale-The Complete Drug Reference (36^th edition). ADR data were extracted from VigiBase, the WHO Uppsala Monitoring Centre, and the WHO's specialist center for drug safety. Results: Nineteen antineoplastic drugs were selected; VigiBase provided their ADR records including total 235,625 records and 27 heading ADR items, 1348 records of glucose metabolism disorders (GMDs), and 807 records of hyperglycemia. Based on the emphasized nine antineoplastic drugs with high hyperglycemic ADR incidence, we found: fluorouracil, sorafenib and pemetrexed with high ADR record of metabolism and nutrition disorders; fludarabine and flutamide with high ADR of GMD ratio. All the hyperglycemia ratios of the 9 antineoplastics were more than 50.0%, except pemetrexed and sorafenib. Thoroughly, doxorubicin carried high absolute records and ratios in hyperglycemic conditions. Conclusions: Pancreatic carcinoma is an aggressive malignancy typically associated with severe hyperglycemia. Furthermore, hyperglycemia is one of the severe ADRs from antineoplastics, which must be paid special attention to when treating in pancreatic carcinoma, especially doxorubicin, fluorouracil, and gemcitabine. Such real-time monitoring or pretreatment gene test can be suggested.

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Psoriasis is a chronic, papulosquamous, and an inflammatory skin disease. It has been found that between 5% and 24% of patients develop psoriatic arthritis (PA) at the same time after or even prior to skin findings. The involvement of temporomandibular joint (TMJ) is a rare condition. In this report, a-46-year-old male patient was referred to our clinic with the complaint of pain in the bilateral TMJs, and a limited jaw movement. Medical anamnesis revealed he had psoriasis for the last 21 years, and developed a seronegative polyarthritis with destructive changes for 8 years. On extra-oral examination, crepitation at TMJs and limitation of jaw movements was detected. The radiographic examination with cone-beam CT revealed the bilaterally decreased joint spaces, erosion, and the loss of cortical edge of the joint on the condylar heads. The definitive diagnosis of PA was made with the help of patient's history and radiological findings. The uses of non-steroidal anti-inflammatory drugs and occlusal splint have been suggested for conservative treatment.

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Simultaneous existence of parathyroid adenoma and thyroid nonmedullary carcinoma is rarely observed. A 52-year-old female was diagnosed approximately 4 years ago with primary hyperparathyroidism (PHPT) on the basis of hypercalcemia and elevated serum parathyroid hormone (PTH) level. Clinically, PHPT diagnosed patient was examined with Tc-99m MIBI scintigraphy to investigate parathyroid adenoma. Early Tc-99m MIBI images showed focal focused enhanced activity retention on both thyroid left lobe upper pole and thyroid lower pole inferior neighborhood. However, late images indicated thyroid activity washout and persistence of activity on left lobe lower pole. The observed lesion on left lobe lower pole neighborhood was identified as parathyroid adenoma. One-day thyroid scintigraphy was also conducted to correlate enhanced activity retention on the left lobe upper pole. Results on thyroid scintigraphy showed hypoactivity, and thyroid fine-needle aspiration cytology process was suggested from the nodule. Simultaneous existence of parathyroid adenoma and thyroid nonmedullary carcinoma is rarely observed. Diagnosis and treatment of hyperparathyroidism is crucial during preoperative period. Even observed rarely, parathyrotoxicosis diagnosed patients can develop thyroid cancer along with parathyroid adenoma.

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Background: Clefts of the lip and/or palate are the most common congenital craniofacial defects and second only to club foot among all congenital anomalies. The management of this condition is resource intensive due to the multidimensional needs. This survey was carried out to ascertain the current state of cleft management in Nigeria with emphasis on training, scope of management, and assessment of treatment outcome. Materials and Methods: Structured questionnaires were administered to cleft surgeons based on professional and practitioners' register and the result of literature search for cleft surgeons whose names may not appear in the registers. Results: A total of 69 returned questionnaires were analyzed. The highest number of surgeons was from southwest geopolitical region while the northeast had the least. Fifty-eight (84.1%) were specialists with the fellowships. Forty-seven had been cleft surgeons for <10 years. Majority undertook lip repair between 3 and 4 months while 50% did cleft palate at or more than 9 months. Millard rotation and advancement was used for lip repair by 91.2% and 44 employed the von Langenbeck technique for palatal repair. Forty-six respondents carried out nasal repair at the time of lip surgery with 44 doing this as closed rhinoplasty. Adhesive tapes were usually employed by 44 (63.7%) for managing the protruding premaxilla. Orthodontic evaluation was not usually part of the treatment plan of 34 respondents. Otology assessment and assessment of velopharyngeal competence were rarely done. Revision surgeries, alveolar bone grafting, rhinoplasties, and maxillary osteotomies were uncommon. Interdisciplinary team care approach was practiced by 54 (78.2%) respondents. Conclusion: Findings suggest an increase in the number of surgeons, but the training, scope, and standard of care remain relatively limited. Audit and assessment of the practice should also become points of emphasis.

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Background: Sickle cell anaemia is one of the most common inherited disorders globally. Some affected children have retardation of physical growth which is also seen in those with zinc deficiency. Objective: To assess the relationship between zinc levels and anthropometric indices of SCA children. Methods: A cross- sectional, case-control study on young females aged 6-18 years at the UNTH, Enugu. Relevant clinical data as well as 24 hour dietary recall were collected. Weights and heights were measured using standard protocols and BMI calculated. Serum zinc was determined using Atomic Absorption Spectrophotometer. Data was analyzed using SPSS version 15.0 while the level of statistical significance was set at P < 0.05. Results: Eighty-one subjects with HbSS and 81 matched controls with HbAA were studied. Mean weights of 34.58 ± 12.76kg found in patients were significantly lower than 40.19 ± 13.37kg in controls. Also mean BMI of 16.27 ± 2.76kg/m2 in patients were significantly lower than 18.40 ± 2.96kg/m2 in controls (P = 0.01). Mean heights of patients were lower than that of the controls though not significantly so (P > 0.05). Mean serum zinc levels of 58.01 ± 10.58μg/d1 in patients were significantly lower than 68.37 ± 8.6μg/dl in controls (P = 0.01). Positive correlation was found between serum zinc and BMI of the studied children. Serum zinc has a significant relationship with weight, height and BMI. Conclusion: Reduced serum zinc in SCA children was associated with low anthropometric indices. Estimation of serum zinc is also recommended in SCA children with low anthropometric indices.

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Objectives: To determine the effect of different gutta-percha solvents (chloroform, Endosolv E, orange oil, and eucalyptol) on the push-out bond strength of calcium silicate cements (CSCs; white mineral trioxide aggregate [WMTA]; capsule-form mineral trioxide aggregate [CMTA], and Biodentine). Materials and Methods: One hundred and fifty extracted single-rooted human mandibular premolars were sectioned into 3-mm-thick slices. The canal lumens were enlarged for 1.35-mm-diameter standardized cavities. The samples were randomly divided into five groups (n = 30) according to the solvent type: G1, chloroform; G2, Endosolv E; G3, eucalyptol; G4, orange oil; G5, no solvent (control). After application of the solvents for 5 min, the specimens were divided into three subgroups (n = 10): (i) WMTA, (ii) CMTA, and (iii) Biodentine. The push-out bond strength was measured. Two-way ANOVA analysis of variance and post hoc Tukey tests were used for analyses (P = 0.05). Results: The highest push-out bond strength was observed in the Biodentine (P < 0.05), and the values of WMTA and CMTA were not significantly different in all solvent groups (P > 0.05). There were no statistically significant differences among the gutta-percha solvents and control group in WMTA (P > 0.05). Conclusions: Gutta-percha solvents used during retreatment decreased the bond strength of Biodentine and CMTA to root dentin. The bond strength of WMTA was not affected by the use of gutta-percha solvents.

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Objective: Triethylene glycol dimethacrylate (TEGDMA) is an important resin monomer commonly used in the structure of dental restorative materials. Recent studies have shown that unpolymerized resin monomers may be released into the oral environment and cause harmful biological effects. We investigated changes in the gene expression profiles of TEGDMA-treated human dental pulp cells (hDPCs) following short- (1-day) and long-term (7-days) exposure. Materials and Methods: HDPCs were exposed to a noncytotoxic concentration of TEGDMA, and gene expression profiles were evaluated by microarray analysis. The results were confirmed by quantitative reverse-transcriptase PCR (qRT PCR). Results: In total, 1282 and 1319 genes (up- or down-regulated) were differentially expressed compared with control group after the 1- and 7-day incubation periods, respectively. Biological ontology-based analyses revealed that metabolic, cellular, and developmental processes constituted the largest groups of biological functional processes. qRT-PCR analysis on bone morphogenetic protein-2 (BMP-2), BMP-4, secreted protein, acidic, cysteine-rich, collagen type I alpha 1, oxidative stress-induced growth inhibitor 1, MMP3, interleukin-6, and heme oxygenase-1 genes confirmed the changes in expression observed in the microarray analysis. Conclusions: Our results suggest that TEGDMA can change the many functions of hDPCs through large changes in gene expression levels and complex interactions with different signaling pathways.

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Background and Aim: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. Materials and Methods: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents. Two study groups (Group 1 consisted from patients with special needs <18 years, while Group 2 consisted from patients ≥18 years) were created. PONV incidence and other complications recorded. Results: There was no statistical difference between groups in terms of used anesthetic agent except midazolam (P < 0.017), while higher female/male ratio and longer duration of anesthesia was recorded in Group 2 (P = 0.043 and P = 0.046, respectively). We found significantly higher PONV rates in disabled patients under 18 years (P = 0.006). Hypoxia (peripheral oxygen saturation (SpO²) <90%) and bradycardia (heart rate <50/minute) were observed in only two patients. Conclusion: PONV is more common in disabled patients younger than 18 years and dental treatment procedures under deep sedation can be provided with acceptable complication rates in patients with special needs.

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We report two cases of bilateral asymmetric optic disc coloboma (ODC) in siblings. The index patient is a 9-year-old Nigerian girl with severe cognitive deficit who presented with a poor vision of 3 years' duration. She had a history of childhood febrile convulsions and delayed developmental milestones. Her visual acuity could not be assessed because she had a cognitive deficit and expressive aphasia. Ocular examination revealed a very large excavated right optic disc with only a strip of remnant neuro-retinal rim superiorly, and a smaller left optic disc with inferior disc excavation, superior wedge of the pink neuro-retinal rim as well as a temporal optic disc pit. No systemic features of syndromes associated with ODCs and intellectual disability were present in both patients. The younger sibling an 8-year-old girl later presented to the eye clinic with a 5-month history of poor vision in the left eye. Ocular examination revealed visual acuity of 6/6 in the right eye and counting fingers in the left eye. Dilated binocular indirect ophthalmoscopy revealed a right large excavated colobomatous disc and a left small disc with infero-temporal disc coloboma.

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Background and Objective: Multiorgan failure including liver dysfunction is a common finding in sickle cell anemia (SCA) patients, the cause of which is multifactorial with advancing age said to be a major determinant. There is a paucity of data on liver function among SCA patients in relation to age in northern Nigerian hospitals, including Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. This study was to assess the biochemical liver function tests (LFTs) as they relate to age among SCA patients in steady state, with a view to improving the overall monitoring of these patients. Subjects and Methods: This study was carried out in ABUTH, Zaria, Northern Nigeria. LFTs were carried out in 100 SCA and 100 apparently healthy participants (controls). The SCA group was made up of fifty adults and fifty children diagnosed of SCA, whereas the control group was made up of fifty adults and fifty children who were apparently healthy and had hemoglobin AA. Paired two-tailed Student's t-test for matched samples and Pearson's linear correlation statistical methods were employed for the data analysis using Microsoft Office Excel 2007. A P ≤ 0.05 was considered as statistically significant. Results: The serum concentrations of total bilirubin (TB), alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and AST/ALT ratio were significantly higher in SCA patients compared to the controls (P = 0.001, P = 0.001, P = 0.05, P = 0.05 and P = 0.001, respectively). Serum total protein (TP) and ALB were significantly lower (P = 0.01 and P < 0.05, respectively) in SCA patients compared with the controls. The levels of TB, ALT, AST, ALP, and AST/ALT were significantly lower in SCA adults compared to SCA children, whereas TP and ALB were higher in SCA adults compared to the SCA children. There were significant negative correlations between age and each of TB, ALT, AST, ALP, and AST/ALT, and significant positive correlations between age and each of TP and ALB in SCA patients. Conclusion: There are mild LFTs derangements in SCA patients even in steady state with the extent of the abnormalities decreasing with advancing age of the patients.

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Objectives: The aim of this study is to describe the experience and outcome of higher order multiple (HOM) births in a private tertiary health facility in Nigeria. Materials and Methods: This was a retrospective review of records of HOM over 3 years in a private tertiary health facility in Nigeria. Relevant data on HOM births were extracted from both the patients' case notes, admission registers and maternity ward and delivery records of the hospital using a predesigned pro forma. Data were analyzed using Statistical Package for Social Sciences Version 22.0. Results: The prevalence of HOM births was 0.72% of 1950 births over the 3 years study period; while for triplets, quadruplets, and quintuplets were 0.56%, 0.1% and 0.05%, respectively. The mean gestational age was 32 ± 3 weeks, and all except three sets of triplets were by Assisted Reproductive Technology (ART). Respiratory distress syndrome, neonatal jaundice, and neonatal sepsis accounted for more than 80% of the neonatal complications noted in HOM births. However, there was no significant difference between neonatal survival of HOM as compared to twin deliveries, P = 0.08. Conclusion: HOM is becoming increasingly common in Nigeria. The strongest risk factor is ART, and neonatal complications are common reinforcing the need to streamline ART protocols in Nigeria.

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Introduction: Anterior knee pain can be chronic sequelae of intramedullary nailing of the tibia. Several causes have been identified; no single reason can fully explain the occurrence. We, therefore, set out to find the rate of anterior knee pain in our practice and if any relationship exists between the anterior knee pain and extensor muscle strength. Methodology: A total of 72 knees in 36 patients with no prior history of knee pain, but had unilateral tibiofibular fracture, who had internal fixation with interlocking intramedullary nailing done and were followed up for at least 1 year were recruited into the study. The tension generated on extension of the knee against a resistance using tensiometer was measured in Newton. The ranges of motion of the knees were documented, as well as Lysholm score which measures activities and document the presence and limitation caused by anterior knee pain. Results: A total of 36 patients with 72 knees were studied. Anterior knee pain occurred in 7 (19.4%) patients in this study. There was no statistically significant relationship between the force of tension (N) generated in the extensor in patients with anterior knee pain compared with those without knee pain (158.43 ± 49.35, 189.54 ± 74.63, P = 0.304). There was, however, a significant statistical relationship between the mean Lysholm score of the operated and unoperated knee (P = 0.042). Conclusion: Anterior knee pain rate was 19.4% in our series and no statistical association exists between the extensor strength and occurrence of anterior knee pain.

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Intramural hematoma (IMH) of ascending aorta is a rare but potentially lethal form of acute aortic syndrome (AAS). It is characterized by a hematoma within the media layer of the aorta secondary to rupture of the vasa vasorum in the absence of an intimal tear. However, the theory of “micro-tear” which cannot be easily detected has been raised. It may stabilize, regress, or progress to rupture or dissection. Similar to Type A aortic dissection (AD), patients with IMH of ascending aorta, as well as patients with persistent pain, are treated urgent surgery. We report a case of an ascending aorta IMH in a patient admitted to hospital with epigastric and chest pain with ST-elevation myocardial infarction in inferior leads. Coronary angiography (CAG) was performed and contrast injection from the right coronary artery (RCA) ostium showed marked contrast enhancement of the aortic wall. The CAG was terminated with a suspicion of Type A AD. The diagnosis of IMH starting just above RCA ostium with a thickness of 18 mm was made with computed tomographic angiography. An emergent surgical repair of the aorta and one-vessel coronary artery bypass graft surgery was performed successfully in our patient.

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Objectives: The purpose of this experimental study was to compare the biomechanical behaviors of two different types of osteosynthesis that are used in the treatment of mandibular angle fractures. Materials and Methods: Twenty synthetic polyurethane human mandible replicas, with medullar and cortical portions, were used in this study. These polyurethane hemimandibles were randomly divided into two groups (n = 10). The transbuccal group (Group A) was fixed with 7 mm long self-tapping 2.0 mm titanium screws at 85° to the reference line and the transoral group (Group B) was fixed with the same screws at 15° to the reference line. All testings were performed on a servo-hydraulic testing machine. The data were transmitted directly from the load cell to a computer, which showed the emergent results of the material characteristics under resisted forces as a graphic containing force and displacement. The peak point loading and displacement for each subject were measured. Results: The comparison between the groups was analyzed with an independent-samples t-test, and P < 0.05 was considered to be significant. The results show that there were no significant differences between the groups for the peak loads and displacement values at the peak loads. Conclusion: The results of this experimental study demonstrated that there were no significant differences between the transbuccal and transoral methods in terms of fixation stability. In other words, the screw position and angle seemed to no have influence on the fixation stability in single miniplate treatments of a mandibular angle fracture.

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Aim: To evaluate the success level of autogenous periosteum in sinus lifting as a barrier membrane which contributes positively to wound healing and is effective in bone formation without the risk of tissue rejection. Materials and Methods: In this study, 32 male New Zealand rabbits were used and were divided into four groups, in which eight rabbits were placed randomly. Sinus lifting with lateral window technique was applied bilaterally to all rabbits. In the first group, the upper face of the graft materials applied was left open. In the second group, the removed bone walls were placed back over the graft materials. In the third group, synthetic membranes were placed over the graft materials. In the fourth group, the autogenous periosteums obtained from tibias of the rabbits were placed over the graft materials. After 6 weeks, the rabbits in all groups were sacrificed, and the operated regions were examined histologically, and stereological assessments were conducted regarding new bone formation, connective tissue, and osteoblasts. Results: After a 6-week recovery period, synthetic membrane showed the highest success rate regarding new bone formation. Autogenous periosteum, which achieved the second highest success rate regarding new bone formation, was the first in the number of osteoblasts. Conclusion: Autogenous periosteum was considered to have the potential to be an alternative to synthetic membranes.

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Objective: The purpose of this study was to compare the effects of thymoquinone and icodextrin in rats within the framework of an experimental adhesion model. Materials and Methods: Rats were separated into three groups: (1) a control group consisting of rats that had 2 ml of isotonic solution administered intraperitoneally, (2) an ICO group administered with 2 ml of 4% icodextrin, and (3) a TQ group administered thymoquinone (10 mg/kg), all following cecal abrasion. The three groups underwent a reoperation on the 7^th postoperative day. Hydroxyproline levels were analyzed in the resected adhesive tissues, and histopathological investigations were conducted. Blood samples were collected for biochemical analyses. Results: Fewer postoperative adhesions were observed in the ICO and TQ groups compared with the control group. A comparison of the TQ and ICO groups revealed lowers levels of postoperative adhesions in the TQ group. Compared with the control group, malondialdehyde, 8-OH-deoxyguanosine/deoxyguanosine (8-OHdG/10dG), Coenzyme Q10 (CoQ10), and CoenzymeQ10/reduced CoenzymeQ10 (CoQ10/CoQ10H) values were found to be lower in the TQ and ICO groups. When the TQ and ICO groups were compared with respect to their biochemical parameters, the results for all of the four parameters were found to be statistically significantly lower in the TQ group (P < 0.000). The levels of hydroxyproline in the control, ICO, and TQ groups were found to be (mean ± standard deviation) 502.25 ± 90.39 μg/g, 342.13 ± 66.61 μg/g, and 287.88 ± 49.59 μg/g, respectively. Conclusions: A comparison of the antiadhesive effects of thymoquinone and icodextrin revealed thymoquinone to be more effective. These results indicate that thymoquinone is an efficient and strong antiadhesive molecule.

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