Background: In recent literatures, much attention has been given to natural products for their health benefits. Aims: In this study, the objective was to measure the efficacy of the ginger-honey-chocolate mixture as the remineralization effect has been shown in the literature previously and to evaluate the individual contributions of this mixture; ginger, natural honey, bitter chocolate separately on remineralization of initial enamel caries lesion. Materials and Methods: All specimens were divided into eight groups as: Ginger (Arifoglu®, Turkey) in powder form, (n = 8); Ginger-Honey-Chocolate (n = 8); Natural honey (Balparmak Plateau Blossom Honey®, Turkey) (n = 9); Bitter chocolate (Nestlé®, Switzerland) (n = 8); MI Paste (GC, Japan) (n = 8); Paradontax (Sensodyne, Glaxosmithklein, USA) (n = 9); Pronamel (Sensodyne, Glaxosmithklein, USA) (n = 9); Control (n = 9) groups. Samples were carried out five pH cycles along 7 days at 37°C for each group. During pH cycling, blocks were put in a demineralization (6 h) and a remineralization solution (18 h). The treatment consisted of 1 min. interaction of enamel surfaces with agent/deionized slurries (1:3 w/w) on a daily basis. The surface microhardness (SMH) was determined before and after pH cycling with a Digital Micro-Vickers Hardness Tester (Wilson Wolpert; Europe BV, 401 MVD, Netherlands). Mineral changes were determined by using FluoreCam® and recovery values were calculated as SMHR% and FΔ%, respectively. Results: All groups showed an enhanced remineralization. There was no significant difference in terms of FΔ% (F = 1.223, P = 0.304) and SMHR% (F = 0.709, P = 0.664) between all groups. Conclusion: The herbals (ginger, honey, and bitter chocolate) examined in this study gave promising results with a high remineralization potential.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Coronavirus disease 2019 (COVID-19) caused by the new [novel] coronavirus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic with exceeding 72 million cases and 1.2 million deaths by the end of November 2020. We aimed to evaluate clinical, laboratory, and radiology findings of COVID-19 in children as reported worldwide and thereby to increase the clinical knowledge about the disease. Bibliographic searches were conducted in December 2020 using PubMed and Google Scholar. The search was limited to children [below 18 years of age]. The search strategy yielded a total of 336 potential articles but finally a total of 25 valid studies covering a total of 2446 (China: 1109, Europe: 663, North America: 674) pediatric patients. In the studies covered by this review, it was observed that the median age was calculated at various values between the ages of 1 and 7 years. In the studies, overall rate of the asymptomatic patients was 24.8% (ranging between 10.7 and 56.6). Acute upper respiratory tract infection (URTI) [mild disease] was observed in 40.7 (ranging between 22 and 50.6%), mild pneumonia in 27% (ranging between 9.5 and 40.6%), and severe pneumonia in 5.3% (ranging between 1.9 and 10.6%). A total of 3% (ranging between 0.7 and 5.1%) of the patients had critical severity. Among the most common clinical symptoms and findings; 61.7% (ranging between 57.4 and 64.3%) of the patients had fever, 53.2% (ranging between 30.6 and 75.1%) had cough, 16.8% (ranging between 4.6 and 27.2%) had diarrhea or nausea, and 15% had lymphopenia. Abnormal radiological findings were detected in 47.2 of the children with COVID-19 and ground glass opacity was in 22.2%. COVID-19 manifests milder and the clinical signs and symptoms vary widely in children. Laboratory and radiological findings of COVID-19 in pediatric patients are not mostly disease-specific, except lymphopenia may have a limited value, and ground glass opacity may have a significant diagnostic value.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Aims: The aim of this study was to explore adolescents' (11–20 years) usage of, beliefs in, attitudes toward, and barriers to contact lens use in Riyadh, Saudi Arabia. Method: The study recruited 1252 healthy participants from 20 highly populated schools. The schools were selected at random from middle and high schools in Riyadh. A self-administered contact lens questionnaire was used directed towards glasses usage and contact lens knowledge, usage, attitudes, and barriers. Result: A total of 726 of the 1252 participants had refractive errors, and 47% of those wore glasses. The proportion of non-compliance was 24%. One of the main reasons of non-compliance was cosmetic appearance (26%). Fewer than 10% were offered contact lenses for refractive error correction. One hundred and fifty-nine participants used contact lenses, and most obtained them without proper professional consultation. About 90% of contact lens-wearing participants did not sleep with the lenses and about 50% had no complications wearing them. Conclusion: The percentage of contact lens users was relatively low. A substantial number of older adolescents and females were found to wear contact lenses, although without proper professional consultation. Knowledge of and attitudes toward contact lenses among adolescents were in acceptable levels. These results gave indications that contact lens usage in adolescents can be achievable and valuable for refractive error correction, especially for those who are non-compliant with glasses.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Objectives: The purpose of this study was to investigate the fracture resistance, biocompatibility, hardness, and transverse strength of non-precious metal alloy (chromium-cobalt; Cr-Co), titanium (Ti), zirconia (Zr), polymethylmethacrylate (PMMA), and polyetheretherketone (PEEK) when employed as substructure materials according to the implant supported full arch fixed prosthesis treatment concept. Materials and Methods: In total, 150 Cr-Co, Ti, Zr, PMMA, and PEEK samples (n = 30 per material) measuring 25 × 2 × 2 mm in size were produced. Of the samples, 50 (n = 10 for each material, all having dimensions of 6 × 3 mm) were subjected to biocompatibility tests. The Vickers hardness test and three-point bending test were performed; fracture resistance measurements were taken and the biocompatibility of the samples was evaluated by the XTT assay. Results: Vickers hardness was highest for Zr (p < 0.05). PEEK and PMMA had the lowest (and similar) fracture resistance values (p < 0.05). Cell proliferation on the surfaces of the materials was similar between PEEK and Zr (p > 0.05), which were the most biocompatible materials. Conclusions: Within the limitations of this study, the most favorable materials in terms of biocompatibility were found as PEEK and Zr. When biomechanical properties are evaluated, the most durable materials can be specified as Cr-Co and Zr. Also, further studies are needed to improve material stability.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Fournier's Gangrene (FG) is the necrotizing fasciitis of the perineal region. Aims: To compare the effectiveness of debridement alone and debridement with vacuum-assisted closure in the treatment of Fournier's gangrene. Methods: Twenty-two patients operated for FG were analyzed retrospectively. Debridement-only and debridement + VAC treatment groups were compared in terms of age, gender, predisposing factors, comorbid diseases, intensive care unit and hospital stay durations, laboratory results, septic shock, treatment methods, Fournier' gangrene severity index (FGSI) and mortality. Results: The M/F ratio was 13/9. There were 10 and 12 patients in debridement-only and debridement + VAC groups, respectively. Ten patients (45.5%) were admitted to intensive care unit, 8 (36.4%) needed colostomy and 7 (31.9%) developed septic shock, respectively. The mortality rate was 27.3%. There was no significant difference in terms of age, gender, laboratory parameters, number of debridement, length of stay in intensive care unit and hospital, shock duration, and mortality (P > 0.05). The FGSI scores also did not show any difference between the groups which showed that the severity of the disease in both groups are similar. Conclusion: The VAC treatment was found not to provide a statistically significant benefit on mortality. Early and adequate debridement and antibiotic are still the most important factors in the treatment of FG and to reduce mortality.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Objective: This study aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of the thoracolumbar vertebral compression fracture (VCF) without neurologic deficits. Materials and Methods: This was a prospective observational study. Between January 2015 and December 2018, 62 patients who had suffered from traumatic thoracolumbar (VCF) burst fractures without neurologic deficits were included in this study. The patients were divided into two groups as follows: patients who underwent PPSF combined with PVP (PPSF-PVP Group; n = 24) and patients who underwent only PPSF (PPSF Group; n = 38). The patients were (PPSF and PPSF-PVP Group) followed up for more than 9 months. The kyphotic angle, compression ratio, and visual analog scale (VAS) score for back pain were analyzed and compared between the two groups. Results: The patients were followed up for an average of 9.1 months. Hospital stay significantly decreased in PPSF-PVP Group (P < 0.001). The median VAS score significantly decreased after the surgery in both the groups (P < 0.005), and mean VAS scores in PPSF-PVP Group were significantly lower than those in PPSF Group. No significant (P > 0.005) changes in local kyphosis and the vertebral body height gains obtained at the end of the follow-up period in PPSF-PVP Group. However, local kyphosis increased significantly (P < 0.005) and the central and anterior vertebral body height decreased significantly (P < 0.005) when compared with the PPSF-PVP Group. Conclusion: PPSF combined with PVP procedure is a good choice for the treatment of traumatic thoracolumbar VCF; however, due to the lack of long-term follow-up data, concern still exists regarding the effects of pedicle screw procedure after PVP.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Tuberculosis (TB) is a communicable disease as well as an airborne disease. Mycobacterium tuberculosis (MTB) could survive on dental materials shipped to dental laboratories. Aims: The aim of this study was to determine the number of bacilli held on the prosthetic material and the effect of chemical disinfection agents on various prosthetic materials that were shipped to dental laboratory of TB patient. Materials and Methods: The study consisted of three study groups, and a control group. 10 mm x 2 mm disc-shaped (n = 18 for each group, n = 72 in total) nickel-chromium alloy (Ni-Cr), polymethylmethacrylate (PMMA), and dental ceramic (DC) samples were prepared. After exposure to MTB 24 hours in a 37°C incubator, six samples for each group (PMMA), Ni-Cr alloy and a control group DC samples) were exposed to three disinfectants; 10 minutes into 2% glutaraldehyde, 10 minutes into 5% sodium hypochlorite, and 1 minute into alcohol-based disinfectant after vortexed in distilled water. Colony forming units (CFU/ml) were calculated per milliliters. Two-way ANOVA statistical analysis method was used, and a P value less than 0.05 was considered as significant. Results: The bacteria count for six Ni-Cr alloy disc-shaped specimens were recorded as 40, 10, 8, 6, 5, and 4 CFU/ml, respectively. Intensity of the colonies were found to be lower in other groups. 5 CFU/ml were detected on a single PMMA sample in the control group, and 40 CFU/ml were detected on one of the dental ceramic sample. No MTB uptake was observed on any sample in the 2% glutaraldehyde and 5% NaOCl disinfectant study groups. In alcohol-based disinfectant group, 1 CFU/ml was observed on Ni-Cr alloy sample. The effect of prosthetic materials used in this experimental study were not statistically significant on the CFU (p = 0.293). However, the disinfectants use was statistically significant on the number of colonies (p = 0.004). Conclusion: NaOCl and glutaraldehyde appeared to be more effective than alcohol-based disinfectant in removing MTB from Ni-Cr alloy, PMMA and dental ceramic surfaces.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Epidemiologic studies have reported increasing prevalence of childhood asthma in Nigeria and other developing countries where there are parallel increases in school enrolments. Children with asthma face lots of challenges in school which can affect their academic performance and quality of life. This narrative review highlights the challenges and the risks of schooling encountered by Nigerian children with asthma and the prospects of utilizing the School Health Programme (SHP) to overcome these challenges. An electronic search of relevant published articles from 2000 to 2020 was carried out using appropriate search engines for the following words: “schooling”, “childhood asthma”, “school health programme”, “school environment,” “health instructions”, “school health services” and “asthma care in schools”. The challenges and risks the school age asthmatics encounter in school include discrimination and victimization, exposure to triggers on the road and in the school environment, poor and non-existence asthma care services in schools, suboptimal knowledge of teachers and caregivers about childhood asthma hence poor asthma-related instructions and increased school absenteeism. The prospects of SHP as a tool to overcome these challenges are highlighted. These include the roles expected to be played by all stakeholders – the government and education authorities need to revise and more effectively implement the school health policy. The roles of asthma care professionals include the need to “adopt” schools to ensure optimal asthma care for the school population and the all-important enlightenment of teachers, school health workers, parents/caregivers and school children for overall improved asthma care delivery in Nigerian schools.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Rehabilitation of completely edentulous patients with implant-supported prosthesis (ISP) is the need of the day, but in many patients, the routine ISP is not possible due to the severe atrophic residual ridges. The present case series describes three cases with atrophic ridges rehabilitated using zygomatic implants and/or All-on-4 treatment concepts. In case 1 and case 3, in maxillary arch, there was not enough bone in Zone 3 to rehabilitate the patient with routine protocol followed for the All-on-4 treatment concept, so in these two cases, zygomatic implants were placed. Case 1 and case 2 were rehabilitated with Malo Bridge and case 3 with acrylic teeth-hybrid prosthesis using a computerized milling procedure to obtain improved fit, function, esthetics, and ease of retrievability whenever required.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Objectives: The study aimed to identify the prevalence and associated factors of dental caries in primary school children. Materials and Methods: This was a cross-sectional study of 657 primary school children from South East, Nigeria. Data on age, sex, birth rank, dental visits, oral hygiene status, and enamel defects were collected. The presence of dental caries was recorded by using the World Health Organization criteria. Mean DMFT/dmft scores were determined and SPSS version 21 was used for analysis. Chi-square test and multivariate logistic regression were conducted and P ≤ 0.05 was considered significant. Results: The study participants were 316 (48.1%) males and 341 (51.9%) females, and their mean age was 8.41 ± 2.18 years. The prevalence of caries was 22.7% while the mean DMFT and dmft scores were 0.10 and 0.45, respectively. Bivariate analysis showed a significant association between birth rank (P = 0.04), oral hygiene status (P = 0.05), enamel defects (P < 0.001), and dental caries. Multivariate regression analysis showed that good oral hygiene (OR = 0.180, CI: 0.036-1.003, P = 0.04), fair oral hygiene (OR = 0.576, CI: 0.345-0.993, P = 0.04) and enamel defects (OR = 4.939, CI = 2.406-10.137, P < 0.001) were significant predictors of caries in this study. Conclusion: The prevalence of dental caries in this study was high. Oral hygiene and enamel defects were predictors of dental caries in the study population.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Objective: We aimed to investigate the effectiveness of the liquid PRF-DBBM mixture on new bone formation in maxillary sinus augmentation. Material and Methods: Seven patients requiring two-stage bilateral maxillary sinus augmentation were included in the study. The patients were selected according to the criteria of having an alveolar bone height of at least 2 mm in the atrophic region. The elevated sinus cavities were randomly grafted with DBBM + liquid PRF (test) or DBBM alone (control) in a split-mouth design. Bone samples were collected during implant surgery with a trephine bur for histomorphometric evaluation after 4 months. Results: In the control group, the newly formed bone was 39.49%, the mature bone was 15.66%, the residual graft was 15.62%, and the fibrous tissue ratio 28.59%, while in the test group, the newly formed bone (NFB) was 45.95%, the mature bone was 14.40%, the residual graft was 10.32%, and the fibrous tissue was 29.31%. No statistically significant difference was found between the groups in terms of the parameters studied (p > 0.05). The mean osteocalcin score in the control group was 2.70 ± 0.39, while it was 2.81 ± 0.36 in the test group. There was no statistically significant difference between the averages of osteocalcin scores of the groups (p > 0.05). Conclusion: The results of our study showed that DBBM is a reliable graft material for maxillary sinus augmentation even in the early period. Combining of DBBM with liquid-PRF contributed to new bone formation over a four-month period, but this contribution was not statistically significant.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Aim: The aim of this study was to investigate prevalence and pattern of self-medication with alternative medicine (ALM) among oral submucous fibrosis (OSF) patients with emphasis on treatment-switch analysis. Methods: A total of 115 OSF patients were recruited and subjected to scientifically validated questionnaire. Two groups were identified: S-ALM: patients who have previously received modern medicinal treatment but switched to ALM; and DN-ALM: patients who started ALM from De Novo. Results: A total of 37 (32.18%) patients reported use of the ALM at some point of time. Twenty-five (67.56%) switched to ALM, whereas 12 (32.43%) patients used ALM from De Novo. The pattern of switching to ALM in short period was significantly prevalent in patients with advanced stages (stage III and IV) as compared to early stages (stage I and II) of OSF. Clarified butter, glycerin, and honey were the most commonly used ALM in both the groups. The most common reasons for switching to ALM were the cost of treatment (32.00%), longer duration of medicinal treatment (24.00%) and ineffectiveness of the medications (24.00%). Conclusions: ALM usage is common in OSMF patients with significant percentage of patient switched from modern medicine to ALM. Therapeutic efficacy of ALM in OSF needs exploration in future.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Colorectal carcinoma (CRC) is a major cause of morbidity and mortality worldwide. Microsatellite instability pathway is important in the pathogenesis of CRC. Immunohistochemistry expression of mismatch repair (MMR) proteins serves as surrogate marker for MMR gene mutation. Aims: This study aimed to determine MSI status of a cohort of CRC cases using immunohistochemistry. Materials and Method: Surgical pathology blocks of resected colonic carcinoma (CC) between 2011 and 2015 were extracted from our departmental archives and The Specialist Laboratories in Lagos. Immunohistochemical expression profile of 4 MMR proteins was assessed in the representative blocks and this was correlated with the demographic and pathological characteristics. Results: There were 19 males and 16 females with CC, mean age of 51.6 years, and 40% of them were below 50 years of age. Twenty (57.1%) out of the 35 CC cases seen were mismatch repair proficient (pMMR) while the remaining 15 (42.9%) were mismatch repair deficient (dMMR). Seven dMMR cases were seen equally on the right and left colonic tumors respectively. Five (71.4%) out of the 7 mucinous tumors in this study were dMMR, right sided with 3 of them in patients who were below 50 years of age. Conclusion: The frequency of mismatch repair deficiency in CC among Nigerians is high, and presence of right-sided mucinous colon cancer in patients below 50 years is highly suggestive of dMMR status. Mutation studies of larger patient samples to determine the percentage with germline mutation will further our knowledge, and influence therapeutic options for CC.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Aims: The aim of this study was to evaluate the effect of passive ultrasonic activation on calcium hydroxide removal from simulated internal root resorption (IRR) cavities at different root levels. Methods and Material: Sixty mandibular canines were prepared and divided into 3 groups to create IRR cavities at apical, middle, coronal root levels. The cavities filled with calcium hydroxide (CH). Specimens were divided into two subgroups according to the technique used for CH removal: Passive ultrasonic activation (PUA), Classic syringe irrigation (CSI). The cavities were photographed with a stereomicroscope, and percentage of remaining CH was measured using digital image analysis software (Image J). Statistical analysis was performed with two-way ANOVA and post-hoc Duncan tests. Results: PUA removed significantly more CH at apical and middle levels. (p < 0.05) There was no significant difference between PUA and CSI at coronal level. (p > 0.05) In PUA group, the amount of residual CH was the highest at coronal level. (p < 0.05) In CSI group, the amount of residual CH was the highest at apical level. (p < 0.05) Conclusions: None of the tested technique was able to completely remove CH from the simulated IRR cavities. CH was removed better with PUA than CSI at middle and apical root levels. For both techniques, the best results were obtained at middle root level.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Hemodialysis patients develop many physical and psychosocial symptoms associated with chronic kidney disease and its treatment. The presence of these symptoms also adversely affects an individual's activities of daily living. Aim: The aim of this study was to evaluate the symptoms seen in hemodilaysis patients and to examine the effect on daily living activities. Materials and Methods: This was a cross-sectional descriptive study carried out on 126 patients in two dialysis centers in Turkey. Patient Information Form, Dialysis Symptom Index (DSI) and Katz Activities of Daily Living Scale (KADL) were used as data collection tools. Results: The most frequent symptoms described by the patients undergoing hemodialysis were tiredness, sadness, and muscle-joint pain. The mean of the DSI was 30.03 (SD: 14.7). There was a statistically significant relationship between dialysis symptom index and disease duration and hemodialysis vintage (P < 0.05). In addition, the mean score of the Patients' KADL was 14.48 (SD: 2.55). Eighty-two (65.1%) patients maintain their daily living activities independently. On the other hand, 26.2% of the dialysis patients maintained their daily living activities as semi-dependent, while 8.7% were totally dependent on others. A statistically significant relationship was found between KADL, marital status, year of dialysis and presence of another chronic disease (P < 0.05). There was statistically significant relationship between DSI and KADL. In hemodilaysis patients, as the DSI score increased, the dependence on daily living activities increased. Conclusion: The symptoms seen in patients have a negative effect on maintaining their daily living activities. Health workers should perform symptom evaluation in patients undergoing dialysis. Thus, each patient-specific individualized care plan should be designed for effective management of these symptoms in patients. Effective symptom management will be effective in maintaining patients' daily living activities.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: As SARS-CoV-2 is detected in the infected patients' saliva, dental employees performing aerosol-generating procedures are at high risk of being infected/spreading the infection. Aims: This study aimed to assess the impact of restarting the high-risk procedures for COVID-19 infection in dental practice during the pandemic on the anxiety levels of dental employees. Methods: All dental employees (dentists, nurses, data entry/cleaning staff) working in a university dental clinic were invited to the study and eighty-one employees (response rate: 97.5%) participated in the study. The volunteers' anxiety was measured consecutively twice with the State-Trait Anxiety Scale: First, on the day prior to restarting the high-risk procedures and the second, on the day these procedures began. Data were analyzed using t tests and the repeated measures ANOVA. Results: The state anxiety level of the dental employees increased significantly on the day that the high risk procedures were restarted (mean 42.6 vs. 49.0, d = 0.6, P < 0.001). Concerning the subgroups, the increase in state anxiety levels was significant for females (t = 3,7; d = 0,8; P < 0.001), dentists working in departments of endodontics and restorative dental care (t = 3,5; d = 0,9; P < 0.001) and nurses (t = 2,8; d = 0,9; P < 0.001). The analysis showed no significant difference in trait anxiety levels between the assessment days (mean 44.0 vs. 44.2, P = 0.9). Conclusions: Restarting the high-risk procedures for COVID-19 infection in dental practice during the pandemic seems to be an extra stressor for dental employees' who already have high anxiety levels during the pandemic.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Aims: We aimed to investigate of intrapleural use of ecballium elaterium (EE) in a rabbit model empyema. Methods: An empyema was induced in 21 rabbits after inoculation of Staphylococcus aureus. Glucose levels, pH, lactate dehydrogenase levels, and amounts of pleural drainage were evaluated in addition to pleural and empyema scores. The rabbits were divided into three groups, each 7, the isotonic solution, the streptokinase, and the ecballium group. Results: At autopsy, there was no difference in pH, glucose, and LDH levels in three groups. The mean pleural drainage was greater in the ecballium group. A significant difference was detected between groups in terms of drainage amounts and pleural and empyema scores (P < 0.05). A significant difference in pleural and empyema scores was detected in the ecballium and streptokinase groups (P < 0.05). EE group had significant differences in drainage amounts and plural and empyema scores regard to the control group (P < 0.05). No significance was found between streptokinase and EE groups. Conclusion: We conclude that intrapleural use of EE is at least as effective as streptokinase for the treatment of empyema.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Coronavirus disease-2019 (COVID-19) is a communicable disease and a global pandemic affecting different parts of the world including Nigeria. Measures to curb the spread of the causative virus included a nationwide lockdown. Aim: The aim of this study was to assess the impact of COVID-19 on ophthalmic outpatient services in an eye care center in Nigeria. Method: The medical statistics for all persons attending the Ophthalmic Outpatient Clinic from January to August 2020 and January to August 2019 was obtained. The statistics for January to August 2020 was compared with that of the corresponding months in 2019 for outpatient clinic attendance, gender, and number of children and adults. Results: In the 2019 study period, the total number of patients attending the Ophthalmic Outpatient Clinic was 16,189. There were 6788 males, 9401 females, 2963 children, and 13,226 adults. In similar months in 2020, the total number of patients was 8,735, of which 3,934 were males, 4801 females, 1651 children, and 7084 adults. There was an overall decline of 46% in the number of outpatient attendance in 2020. The decline was 76.3% in April 2020 (peak of the lockdown). There was a rebound in outpatient visits in July 2020 (when the interstate travel ban was lifted) to 4.9 times that of April 2020; however, this was 56.9% that of July of the preceding year. Conclusion: COVID-19 pandemic impacted negatively on outpatient visits. A rebound in the number of visits was observed when the interstate travel ban was lifted, although far below the preceding year's value.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

The purpose of this study is to describe the details of initial care, reconstruction and rehabilitation of blast injury to the hand of an adult scavenger staff of a recycling plant from an IED and determine the functional outcome of the treatment in terms of restoration of prehension of the hand. A detailed chronology of the clinical evaluation of a Nigerian adult admitted on the 14^th of August, 2018 with blast injury to his left hand, the initial and subsequent care he received (while both on admission and after discharge) and the outcome of the treatment: return of prehension and time taken by patient to return to work. This patient was resuscitated and had initial care which comprised of serial debridement and fixation of fractures. Subsequent care he had included: wound resurfacing with thoraco-abdominal flap and glabrous skin grafting, digit stump refashioning of injured hand. Rehabilitation was achieved by meticulous physiotherapy and patient regained adequate prehensile function and returned to work within three months of discharge. Follow up at 16months showed tremendous improvement of function of the hand. A carefully executed care plan is rewarded with a good functional outcome (restoration of prehension of the injured hand and return to work) especially when treating a patient with a complex injury like blast injury to the hand.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: In recent times, Nigerian media have carried multiple reports of violent and traumatic social vices. These are well-known trigger factors for fear, worries, and anxiety for corp members and their families. Core member's presentations at the NYSC primary care clinic are commonly triggered by change in environmental, biological, and psychosocial factors which invariably affect their social and occupational functioning. Aims: The objective of the study was to screen for depression symptoms among young recent Nigerian graduates with the view of further evaluating those positive on screening test with subsequent diagnostic tests. Methods: The survey was conducted on 327 participants of the April 2017 batch of graduates during the Delta State National Youth Service Corps (NYSC) Orientation Camp period in Issele-Uku, Delta State, Nigeria. They were requested to complete a self-administered questionnaire comprising of 2 sections (i) Socio-demographic profile and (ii) Patient-Health Questionnaire -9 (PHQ-9) - a Depression screening tool. Results: The prevalence of depression symptoms in the study was found to be 57.2%. Family size (P < 0.001) and sibling rank (P < 0.001) were the socio-demographic factors found to be related to depression. Independent predictors of depression were family size and sibling ranking. Conclusion: The study found the prevalence of depression symptoms among young adults to be 57.2% which is quite high. Family size and sibling rank were found to be independent risk factors.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Objective: To investigate the prevalence and presentation of polypoidal choroidal vasculopathy (PCV) in Nigerians. Methods: A cross-sectional, multicenter, hospital-based, descriptive study. Data were collected prospectively between January and December 2018, from consecutive patients diagnosed to have a retina disease at the general outpatient and retinal clinics of four eye departments in Nigeria. All participants had visual acuity, refraction, intraocular pressure, anterior segment examination, and dilated fundus examination. Some patients had fundus fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA). Systemic comorbidity was determined by medical history and systemic evaluation. Diagnosis of PCV was based on clinical findings, and in some patients using OCT. Results: A total of 8,614 patients were seen and 15 patients (18 eyes) were diagnosed to have PCV giving a yearly hospital-based prevalence of 0.17%. The mean age at presentation was 63.27 ± 11.5 years (range 44–84 years). There were nine females (60%). The male: female ratio was 1.5:1. Twelve (66.7%) of the 18 eyes were blind, 16.7% had severe visual impairment while 11.1% had mild visual impairment. Seven eyes (38.9%) had vitreous hemorrhage. Of the 12 blind eyes, 50% had vitreous hemorrhage (P = 0.463). Nine patients (60%) had systemic hypertensive as comorbidity (P = 0.016). Conclusion: PCV is a cause of vision loss among Nigerians. Majority of the eyes were blind and 50% of blind eyes had vitreous hemorrhage. Since Indocyanine Green Angiography is the most appropriate imaging technology and is mostly unavailable in Nigeria, efforts should be made to address this need and improve the diagnostic accuracy.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Ossifying fibroma (OF) is a benign tumor of the jaws, which belongs to the group of fibro-osseous lesions, and exhibits slowly progressive growth leading to jaw expansion with well-defined borders. Objective: To evaluate the clinical and radiological characteristics of OFs and their treatment. Materials and Methods: A 5-year retrospective study was done. The case notes of subjects were retrieved, analyzed, and evaluated. Relevant information about patients was categorized into bio-data, clinical, and radiological. The diagnosis of lesion was made histopathologically by the oral pathologist. Results: Forty- five patients' case notes were retrieved and analyzed and the patients' age ranged from 2 to 70 years (mean 29.4 ± 16.9). Majority of the patients (55.5%; P = 0.23) were 10–29 years. There were 16 (35.6%) males and 29 (64.4%) females giving a male: female ratio of 1:1.8 (P = 0.01). The cross-sectional dimension of the tumors measured vertically and horizontally ranges from 1 cm² to 420 cm² (mean = 54.7 cm² ± 82.9). There were 60% in the maxilla and 40% in the mandible (P = 0.014). Most of the lesions (68.9%; P = 0.01) showed patchy opacity and cotton wool appearances. Majority of the lesions were extirpated by enucleation alone (P = 0.01). Conclusion: The prevalence of OF among the fibro-osseous lesions was 51.0% while against other benign lesions, it was 16.0%. In conclusion, contrary to most other reports across the globe, this lesion in southeast Nigeria occurred more frequently in the maxilla than mandible.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Vascular events are a major cause of flap failure and identifying patients who are at risk is of paramount importance. In the past, many studies have been conducted to investigate the effect of blood count parameters for ischemic events such as peripheral vascular diseases. Aims: This study aimed to evaluate whether blood count parameters can have predictive value for vascular events in microvascular flap surgery. Methods: Elective cases with free flap microsurgery performed in a single center were reviewed from 2015 to 2019. Demographic data, comorbidities, flap types, perioperative complications, and preoperative blood count parameters from the hospital records were screened. Results: A total of 147 patients were included in the study, taken from the 163 patients undergoing free tissue transfer. The rate of thrombosis and partial necrosis was 8.8%, was 8.2%, respectively, and the total flap loss due to these complications was 5.4%. Only patient age, gender, and length of hospital stay were correlated with flap loss. According to the preoperative blood count results, there were significant differences between vascular events and leucocyte, and neutrophil counts. Conclusion: The findings of this preliminary study suggest that these parameters may be used in predicting vascular events in flap surgery.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]

Background: Nowadays, the practice of day case surgery (DCS) is an attractive and appealing one with widespread acceptability because of numerous benefits. Aim: This study aimed at presenting our experience with urologic DCS in a tertiary healthcare center. Patients and Methods: A 5-year review of all day-case urologic surgeries at our tertiary healthcare center was carried out. Data on patients' biodata including age and sex, diagnoses, indications and procedures performed, types of anesthesia, complications, admission and re-admission history were obtained from theatre records and patients' case notes. Data were analyzed using PASW Statistics version 18.0 and results presented in table and charts. Results: A total number of 1277 of the 1825 urologic surgeries which took place during the study period were performed as day cases giving a proportion of 67.8%. The age range was 11 days to 94 years. The most commonly performed DCS are prostate biopsy, cystoscopy and varicocelectomy in 368 (28.8%), 165 (12.9%) and 163 (12.8%) patients respectively. Local anesthesia with or without sedation was the most commonly used in 981 (76.8%) cases. Twenty-four (1.9%) patients required unplanned admission for complications, 18 (1.4%), delayed completion of surgery, 4 (0.3%) and delayed recovery from anesthesia, 2 (0.16%). Three (0.2%) of these patients were re-admitted for management of sepsis following prostate biopsy. Conclusion: This study like numerous others demonstrated the feasibility, effectiveness and safety of DCS. To meet up with the global trends in DCS in Nigeria, there is need for investment in infrastructure and adoption of minimally invasive techniques to allow incorporation of more complex cases in the range of procedures offered as DCS.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]