Aim: To compare dental anxiety and fear during procedures performed under local anesthesia either in the operating room or in the clinic as well as to investigate the potential factors that might influence this psychological condition. Subjects and Methods: Patients who were admitted to the Department of Oral and Maxillofacial Surgery of the universities in two cities, which have a different sociocultural patient profile, were enrolled. In addition to the State-Trait Anxiety Inventory (STAI), Dental Anxiety Scale (DAS), and Dental Fear Scale (DFS), the patients were asked to answer the questions concerning previous dental experience, education level, and previous psychiatric therapy. Statistical Analysis Used: The results of STAI were analyzed by Mann–Whitney U-test and results of DAS and DFS were analyzed by one-way analysis of variance test. Results: Two hundred patients, of whom 76 were enrolled in the first center and 124 were enrolled in the second center. A statistically significant difference was observed in state anxiety levels of the patients between the two centers, whereas the difference in trait anxiety levels was not significant. The results of DAS, DFS, and STAI-trait (STAI-T) displayed a significant difference between genders; the levels of anxiety and fear were higher in females than in males (DAS P = 0.025, DFS P = 0.017, STAI-T P = 0.045). Comparison between the patients with and without previous dental experience revealed a statistically significant difference regarding the results of STAI. Conclusions: The study found that sociocultural structure and gender are the significantly effective factors on dental anxiety and fear.

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Background: Patient discomfort secondary to an indwelling urethral catheter in the post operative period can be very distressing. These symptoms resemble the overactive bladder (OAB) syndrome. Muscarinic receptor blockers have been successful in the management of OAB. However, information on the use of these drugs in the management of the postoperative catheter-related bladder discomfort (CRBD) in sub-Saharan Africa is still relatively sparse. Objective: To assess the efficacy of preoperative oral tolterodine in the management of CRBD in surgical patients in the immediate postoperative period. Methods: This was a double-blind placebo-controlled study consisting of 56 patients in each arm who underwent general anesthesia. Each patient was given oral tolterodine or placebo 1 hour before the induction of anesthesia. The patient was later assessed at the recovery room at intervals after recovery from anesthesia. The presence of CRBD was noted and graded. Results: The overall incidence of CRBD in both the tolterodine group and the control were 85.7% and 91.1%, respectively. Overall, tolterodine prophylaxis (TP) was associated with an absolute risk reduction (ARR) of 5.4%, relative risk reduction (RRR) of 5.8%, and a number needed to treat (NNT) of 19. The incidence of moderate-to-severe CRBD in the tolterodine and control groups were 10.7% and 78%, respectively, with an ARR of 74.5% with TP. Conclusion: TP does not significantly reduce the incidence of CRBD in the immediate postoperative period but appears to be efficient in the reduction of the severity of postoperative CRBD.

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Background: Aim of this randomized controlled parallel-designed study was to evaluate the effects of diode laser as an adjunct to mechanical periodontal treatment on clinical parameters and gingival crevicular fluid (GCF) volume of the residual pockets diagnosed following initial periodontal treatment in chronic periodontitis (CP) patients. Materials and Methods: A total of 84 residual pockets on single-rooted teeth in 11 CP patients were included and randomly assigned into three groups. Residual pockets were treated either only by mechanical treatment (Group M) (n = 28) or only by diode laser disinfection (Group L) (n = 28) or by a combination of these techniques (Group M + L) (n = 28). Plaque index, gingival index (GI), bleeding on probing (BoP), probing depth (PD), clinical attachment level and gingival recession were assessed at baseline and 8 weeks after treatment of residual pockets. GCF samples were collected at baseline, 1 and 8 weeks after treatment. Results: All treatment modalities resulted in significant reductions in PD and attachment gain. GI and BoP showed a greater reduction in both Group M and Group M + L than Group L (P < 0.001), but there was no difference between the Groups M and M + L (P > 0.05). No difference was also found among groups for other clinical parameters. GCF volume decreased significantly in the Groups M and M + L (P < 0.05) but there was no difference among the groups (P > 0.05). Conclusion: Results demonstrated clinical improvements on residual pockets in CP patients treated with all three modalities. Moreover, our findings suggest that application of diode laser as an adjunct to mechanical periodontal treatment doesn't demonstrate any additional clinical effect on the residual pockets.

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Objective: The objective of this study was to compare the masticatory efficiency in subjects with shortened dental arch (SDA) before and after restoration with removable partial denture (RPD). Materials and Methods: This was a prospective study carried out on 36 consecutive patients. The subjects were asked to chew 5 g of a measured portion of fresh raw carrot for 20 specified numbers of strokes. The raw carrot was recovered into a cup and strained through a standard mesh sieve of 5 mm by 1 mm, it was air dried for 30 min and weighed with FEM digital series weighing scale. The masticatory performance ratio was then determined. Result: The age range of the subjects was 34–64 years with the mean age being 52.2 ± 8.2 years. The difference between the total masticatory performance score at the post- and pre-treatment phases was statistically significant (P = 0.001). The improvement in masticatory performance was marked among the younger age groups (P = 0.001), unilateral free end saddle subjects (P = 0.001), and among the male gender (P < 0.05). Conclusion: Masticatory performance improved with the provision of RPD. However, the improvement was marked among the younger age groups, unilateral free end saddle subjects, and the male gender; thereby supporting the need for RPDs in patients with SDA.

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Tracheobroncopathia osteochondroplastica (TO) is a benign disease of the large airways seen very rarely. It is characterized by 1-3 mm sized ossified nodular lesions in submucosa. Its etiology is unclear, but it is stated that malignancy, chronic inflammation, amyloidosis, and genetic factors might have an effect on it. It was first described by Wilks in a 38-year-old man diagnosed with tuberculosis in 1857. Generally, patients are asymptomatic and TO is diagnosed incidentally. But symptoms become significant with infections and obstruction in tracheabronchial tree. Generally chest radiography is normal, so thorax computed tomography can be remarkable in diagnosis of TO. Besides, final diagnosis can be established by viewing ossified nodules in trachea and bronchus through the fiberoptic bronchoscopy. Amyloidosis, tuberculosis, sarcoidosis, bronchial carcinoma, and tracheobronchial calcinosis must be remembered in differential diagnosis. Also ossifications in submucosa and proof of bone marrow in histopathological examinations are important in diagnosis of TO. Mostly palliative treatment is performed to the symptoms . We want the clinicians to keep in mind for this very rarely seen tracheal disease with three case reports.

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The purpose of this report is to evaluate the effectiveness of a high Le Fort I osteotomy design, including the malar bones, which allows segment sliding over the zygoma and forces the osteotomized segment to move forward with distraction. Two patients (male, 23-and 30-year-old) with malar deficiency underwent high Le Fort I osteotomy and surgically assisted rapid maxillary expansion procedure was followed. Records were taken before and 6 months after surgery for comparison, including intra and extra oral photographs and three-dimensional cone-beam computed tomography (CBCT) images. The bone malar width and bone malar depth changings in malar region were evaluated. Preoperative and postoperative CBCT images and clinical views of the patients showed forward movement of the malar region.

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A 19-year-old male patient was observed due to having central diabetes insipidus (DI) for five years. He had a history of smoking 5–10 cigarettes a day for two years, but stopped smoking from the last month. The computerized tomography revealed thin-walled cystic lesions in different sizes more dominantly in the upper lobes and consolidated areas in the left upper and lower lobes. The wedge resection from the right lower lobe revealed pulmonary langerhans cell histiocytosis. Follow-up acid-fast bacteria (AFB) examinations revealed (+++) and antituberculous treatment was started. On the 40th day of the anti-tuberculosis treatment, the patient applied once again due to fever and chest pain. Although infiltrations persisted in the left upper and middle zones in the postero-anterior lung rontgenogram, right-sided pneumothorax was detected. The case is considered tuberculosis and the patient continued to receive anti-TB treatment under the close supervision.

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Background: Many women with breast cancer present at the health institutions with advanced multiple nodal involvements have poor prognostic outcome. Knowledge and awareness of breast cancer may promote health-seeking behavior, thus early diagnosis and increased survival rate of breast cancer cases. The objective of this study was to assess the level of knowledge and awareness of women on breast self-examination (BSE) in Umuowa, which would guide future intervention program on breast cancer prevention and control in the community. Method: Descriptive survey design with the aid of a questionnaire served as an interview schedule for the study on 349 Women in Umuoawa, Orlu Local Government Area (LGA) of Imo State. Descriptive and inferential analysis was done using Statistical Package for Social Sciences. Results: The main outcome measure was the level of awareness on breast cancer. With a Pearson's correlation coefficient (R) of 0.569 and a Spearman's rank correlation coefficient (r) of 0.600 and a P value of 0.000 < 0.05, a correlation between educational attainment and BSE awareness was established. The correlation coefficient being positive, the result showed that with increase in educational attainment, the awareness of BSE increased and vice versa. Thus, there was a positive relationship between educational attainment and the awareness of BSE. One hundred and four (29.8%) respondents showed that breast cancer is an illness caused by ancestral forces. Their knowledge of the risks factors for breast cancer was also low. Their major source of information on breast cancer was through health care providers followed by friends/relatives. Conclusion: There is a need to scale up health education programs to remove myths regarding breast cancer and improve health-seeking behavior among the rural women.

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Introduction: Hepatitis B virus (HBV) is a public health problem in Nigeria, with 13% of its general population having evidence of a previous or current infection. Lack of awareness of HBV, its risk factors, and its consequences are recognized as major deterrents to adopting positive preventive behavior including immunization among HBV high-risk groups. Objective: The objective of this study is to evaluate the knowledge, attitude, and practice (KAP) of HBV infection among traders. Materials and Methods: A structured KAP questionnaire on HBV infection was administered to traders as part of the activities to mark the World Hepatitis Day in 2014. A score was created for the correct answer to 20 questions. Results: A total of 335 traders were interviewed for this study. The mean age was 33.08 ± 13.8 years and the median age was 29 years. There were 165 males and 170 females. Majority of the traders had secondary education (57.1%) and were of the Ibibio and Igbo tribes. Only 10.4% had HBV vaccination. Only 44.2% of the traders reported having any knowledge of HBV. The most common source for the knowledge was television/radio (25%) and hospitals (22%). The median (interquartile range) of the overall KAP score was low (11, 5–16). The score was least in persons aged 35 years and above, but the difference was not statistically significant (P = 0.33). Conclusion: The knowledge of HBV is low among traders in Calabar metropolis. There is need to intensify educational campaigns for the general public.

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Aim: To construct normal values for the tests of the psychometric hepatic encephalopathy score (PHES) and evaluate the prevalence of minimal hepatic encephalopathy (MHE) among Turkish patients with liver cirrhosis. Materials and Methods: One hundred and eighty-five healthy subjects and sixty patients with liver cirrhosis without overt hepatic encephalopathy were included in the study. All subjects underwent psychometric tests, which include number connection test-A and B (NCT-A/B), serial dotting test (DST), line drawing test (LDT), and digit symbol test (DST) in the same day. The variables that affected the results of the test were included in the multiple linear regression models and formulas were constructed to predict the expected results for each tests. Results: The results of all PHES tests, except the LDT in the cirrhotic group were significantly different than center of gravity (CG) (P < 0,001). The score of PHES in the cirrhotic group was -2,18 ± 3,3 (median -2; range: 11 to +4), significantly lower than CG (-0.31 ± 2.18 [median, 0; range, -8 to +5]) (P < 0.001). the cutoff of PHES was set -4 point. Therefore, 19 of the 60 cirrhotic patients were diagnosed with MHE (31.6%). Among the patients with MHE, 11 (11/45, 24,4%) had Child-Pugh classification (CTP) A and 8 (8/15, 53.3%) had CTP B. No differences in age and education years were found between the MHE and non-MHE groups (P > 0.05). Conclusion: Turkish PHES normograms have been developed for detecting patients with MHE. Future multicenter national studies are needed to validate widely applicable norms.

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Context: Sickle Cell Anaemia (SCA) is a genetic disorder with a life-long disability, which is of public health importance. The diversity in its clinico-pathologic and laboratory presentations may be due to the interplay between additional genetic differences and environmental factors. The genetic factors may be within the β-globin gene itself, the β-globin gene cluster or elsewhere in the genome. Aim: To characterize the β-globin gene for variations associated with the Sickle Cell mutation. Settings and Design: A cross-sectional descriptive study involving 51 adult SCA patients attending Sickle Cell Clinic of Haematology Department Ahmadu Bello University (ABUTH) Zaria, Kaduna State, Nigeria. Methods and Material: The buccal swab specimens were collected and β-globin gene DNA sequencing was done. The sequences obtained were compared with a Genbank Reference β-globin gene (NC_000011.9) using Basic Local Alignment Search Tool (BLAST), and variations noted. Data generated were analyzed using SPSS Version 20.0. Statistical analysis used: Data generated was summarized by using charts, means±2SD, and 95% confidence intervals. Results: There were 40 (78.43%) females and 11 (21.57%) males. The mean age of the participants was 25.35 ± 7.67 years, 95% CI (23.20, 27.51). The classic sickle cell mutation A T was present in all participants. The mean number of β-Globin gene variations was 8.61±11.30, 95% CI (5.43, 11.78). The number of Substitutions were 122 (27.79%), insertions 184 (41.91%), and deletions 133 (30.30%). These occurred in various combinations. The mean number of substitutions, insertions, and deletions were 2.39±3.23, 3.61±7.66, and 2.60±2.46 with 95% CIs of (1.48, 3.30), (1.45, 5.76), and (1.92, 3.30) respectively. Conclusions: There are β-globin gene variations in SCA patients in Zaria, and locally relevant genetic database of the SCA population will be the cornerstone in understanding genotype-phenotype interactions in this disorder.

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Background: Chlorhexidine mouth rinses have a proven efficacy for the prevention of alveolar osteitis after third molar surgery. This study compares the efficacy of warm saline rinse, a component of postextraction instructions, with that of chlorhexidine in our institution over a period of 2 years. Patients and Methods: Apparently healthy patients who were referred to the Oral Surgery Clinic of our institution, with an indication for surgical extraction of lower third molar were prospectively, consecutively, and uniformly randomized into warm saline and chlorhexidine groups. The experimental group (n = 50/100) were instructed to gargle twice daily with warm saline, whereas the chlorhexidine group (n = 50/100) were instructed to gargle with 0.12% chlorhexidine. Information on demographic, types and level of impaction, indications for extraction, and development of alveolar osteitis were obtained and analyzed. Comparative statistics were done using Pearson's Chi-square, Fisher's exact, or Mann–Whitney U-tests as appropriate. P <0.05 was considered statistically significant. Results: The demographic, types and level of impaction as well as indications for extractions were comparable between the study groups (P > 0.05). The overall prevalence of alveolar osteitis was 5%. There was no statistically significant difference between application of warm saline and 0.12% chlorhexidine rinse with respect to the development of alveolar osteitis (P = 0.648). Conclusion: Warm saline mouth rinse is equally as effective as chlorhexidine mouth rinse, as prophylaxis against prevention of alveolar osteitis after third molar surgery.

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Background and Objectives: Psoriasis is a common, chronic, inflammatory, and hyperproliperative skin disease. It has been known that the infectious agents play a role in triggering and exacerbation of the disease. Periodontal diseases are chronic inflammatory gum diseases initiated by microorganisms in dental plaques. This study intended to determine the role of periodontal diseases, as chronic infective foci in psoriasis. Materials and Methods: A total of 76 patients, who applied to Faculty of Medicine, Department of Dermatology, İnönü University, diagnosed as psoriasis and a control group consisting of 76 dermatologic patients without any systemic disease at similar age and gender were included the study. The dental examinations of the subjects were done by the Community Periodontal Index of Treatment Needs index system, using a periodontal probe. Results: Significant difference was identified between the patients with psoriasis and control group, in terms of CPI (Community Periodontal Index), oral hygiene habits, frequency of tooth brushing and flossing (P = 0.01, P = 0.001, P = 0.01, P = 0.05, respectively). A positive correlation between the severities of psoriasis and dental disease was determined, but this difference was not statistically significant (P = 0.204). Conclusion: The periodontal disease may affect psoriasis as a chronic infectious focus and probably through proinflammatory cytokines. In order to clarify the exact role of periodontal disease in psoriasis, the issue should be studied in larger series with serum cytokine levels.

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Background: The relevance of sleep in the life of a human being cannot be overemphasized in terms of physical and mental well-being. Among several factors that can affect the sleep health of an individual occupation have been found to play a prominent role. The literature is still scanty with regard to sleep studies in our environment. Aim: This study aims to assess the sleep health of tertiary healthcare workers in Kano Nigeria and find, if any, its determining or related factors. Material and Methods: This study was cross-sectional questionnaire-based survey and involved all consenting staff members of Aminu Kano Teaching Hospital, Kano, Nigeria. The Pittsburgh Sleep Quality Index Questionnaire was used to assess the sleep health of the participants. Results: The participants' ages ranged from 18 to 65 years and have a mean age of 38.94 ± 8.07 years. There were 119 (74.4%) males and 41 (25.4%) females with a M:F ratio of 3:1 (χ² = 19.415; P = 0.000). Among the 155 participants who completed all the aspects of the Pittsburgh Sleep Quality Index questionnaires, the overall sleep quality of the study population was found to be significantly poor [good sleepers = 71 (45.8%), poor sleepers = 84 (54.2%), χ² = 116.4; P = 0.000]. Considering the various occupational groups working in the hospital, poor sleep was commonest among the nurses 35 (42.7%). Furthermore, among the nurses, poor sleep was significantly commoner in those on shift work 27 (77.1%) than those not on shift work 8 (22.9%); χ² = 36.2; P = 0.000. Multivariate logistic regression analysis showed that age, sex, and duration in service were not significant predictors of poor sleep quality among the participants [odds ratio (OR) = 1.013, 95% confidence interest (CI) = 0.948–1.084, P = 0.698; OR = 0.691, 95% CI = 0.293–1.631, P = 0.399; and OR = 0.993, 95% CI = 0.932–1.058 P = 0.840, respectively). Conclusions: Our study found that a significant proportion of healthcare workers and particularly nurses had poor sleep quality. Also, age, sex, and duration in service were not significant predictors of poor sleep quality among the participants.

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Objective: It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. Materials and Methods: In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included. Exclusion criteria were as follows: symptom onset exceeding 24 hours, trauma, pregnancy, acute myocardial infarction, acute pulmonary embolism, chronic renal insufficiency and steroid therapy. Results: A total of 90 participants, forty patients with ischemic infarction who were diagnosed by CCT and clinical findings (Normal CCT in 17 patients and CCT with an area of infarction in 23 patients) and fifty healthy controls, were included in this study. Compared with the control group, levels of Galectin-3 and GFAP were found to be significantly increased in patients with ischemic infarction (P <0.001 and P = 0.01, respectively). It was found that levels of Galectin-3 and GFAP were significantly increased in ischemic stroke patients with normal CCT compared to the control group (P = 0.04 and P = 0.025, respectively). In ROC curve analysis, we detected %70.59 sensitivity and 70% specificity (AUC = 0.684, P = 0.0213, 95% CI: 0,558-0.792) with a cutoff value of 33.24 ng/ml for GFAP and 76.47% sensitivity and 68% specificity (AUC = 0.734, P = 0.0048, 95% CI: 0.611-0.834) with a cutoff value of 0.84 ng/ml for Galectin-3. No correlation was found between National Institutes of Health Stroke Scale (NIHSS) scores and Galectin-3 and GFAP (r = 0.251, P = 0.118 and r = 0.164, P = 0.311, respectively). Conclusion: The levels of Galectin-3 and GFAP were increased in acute ischemic stroke patients.

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Background and Purpose: We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. Materials and Methods: A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. Results: There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. Conclusion: Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

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Context: Metabolic syndrome (MS) is a constellation of metabolic irregularities consisting of dyslipidemia, hypertension, hyperglycemia, chronic inflammatory, and hypercoagulable state predisposing to diabetes and cardiovascular events. Statins are first-line drugs to treat the associated atherogenic dyslipidemia. Aim: Effect of rosuvastatin on MS in Saudi patients was studied. Settings and Design: Prospective, open label, randomized clinical study. Materials and Methods: Patients of either sex ≥18 years (n = 153) having MS as per modified National Cholesterol Education Program Adult Treatment Panel III criteria were prescribed rosuvastatin 10 mg OD for 24 weeks. Serum lipids, biochemical, clinical, and anthropometric parameters were studied before and after treatment. Statistical Analysis Used: Statistical Package for Social Sciences version17 was used. Descriptive analysis was used for all variables and documented as mean ± SD. Normality checked by Shapiro–Wilk test, Kurtosis and Skewness Z-score, and visualization of histograms. Lipid levels and other parameters before and after treatment were evaluated by paired t-test for parametric data and Wilcoxon signed rank test for nonparametric data. Pre- and post-test values were correlated by Pearson's correlation coefficient. Multiple regression analysis was performed to see effect of other variables. Results: Highly significant reduction was observed in low density lipoprotein cholesterol, total cholesterol, triglycerides; very low density lipoprotein cholesterol, non-high density lipoprotein cholesterol and atherosclerotic index with an elevation in high density lipoprotein cholesterol. A total of 86% patients reached low density lipoprotein cholesterol goal of ≤ 100 mg/dL. Beneficial response was observed on other associated parameters. There was strong correlation between pre- and post values. No significant effect was observed for any of the variables on cholesterol reduction. No serious/severe adverse effect was observed. Conclusion: Rosuvastatin markedly improved atherogenic dyslipidemia of MS.

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Objective: To determine the correlation between severity of symptoms using the International Prostate Symptom Score (IPSS) and uroflowmetry in patients with lower urinary tract symptoms-benign prostatic hyperplasia (LUTS-BPH). Patients and Methods: We prospectively collected data from 51 consecutive men, who presented with LUTS-BPH at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from January 2012 through December, 2014. Symptom severity was assessed using the self-administered IPSS questionnaire. We also performed uroflowmetry using the Urodyn 1000 (Dantec, serial no. 5534). Results: The mean age of the patients was 67.2 ± 9.7 years (range 40-89 years). The most common presenting IPSS-LUTS was nocturia (100%) followed by urinary frequency (98%), straining (92.0%), weak stream (84.3%), urgency (41.2%), incomplete voiding (39.2%), and intermittency (35.3%) Most of the patients had moderate symptoms (58.8%) on IPSS with a mean value of 13.5 ± 3.0. The mean Qmax was 15.6 ± 18.7 mL/s and the mean voided volume was 193.0 ± 79.2 mL. About one-third of the patients (39.2%) had an unobstructed flow pattern based on Qmax. Correlation analysis showed a weak correlation between IPSS and voiding time (r = 0.220, P > 0.05), flow time (r = 0.128, P > 0.05), and time to maximum flow (r = 0.246, P > 0.05). These correlations were not significant (P > 0.05). IPSS showed a negative correlation with maximum flow rate (r = 0.368; P < 0.0075), average flow rate (-0.203, P > 0.05), and voided volume (r = -0.164, P > 0.05). This negative correlation was significant for maximum flow rate. Conclusion: Correlation between IPSS and Qmax was negative but statistically significant. This implies that an inverse relationship exists between IPSS and Qmax, and remains the only important parameter in uroflowmetry. There was no statistically significant correlation between IPSS and the other variables of uroflowmetry.

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Renal cell carcinoma (RCC) is a rare cancer in developing countries like Nigeria. However, with an increasing understanding of its epidemiology, the increasing availability of trained personnel, improvement in diagnostic facilities, and greater awareness in the populace, an increase in its incidence as was witnessed in developed nations in the last few decades could be safely predicted. This narrative review highlights the international best practices in the multidisciplinary approach to the management of RCC, its diagnosis and treatment, with emphasis on recent advances and radiation treatment. The National Comprehensive Cancer Network (NCCN) guideline (version 3.2015) served as a guide to select relevant articles through a PubMed and Google scholar query.

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