Medical and Dental Consultantsí Association of Nigeria
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   2020| Dec  | Volume 23 | Issue 12  
    Online since December 23, 2020

 
 
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ORIGINAL ARTICLES
Correlation of Cervical Spinal Degeneration with Rise in Smartphone Usage Time in Young Adults
S Cevik, A Kaplan, S Katar
Dec 2020, 23(12):1748-1752
DOI:10.4103/njcp.njcp_605_19  PMID:33355830
Aims: The study aimed to define the association between spinal degeneration parameters and the rise in smartphone usage time. This was a cross-sectional study. Subjects and Methods: Young adults aged 20–35 years, who presented to our outpatient clinic due to neck pain between 2016 and 2018, were examined. Cervical disc degeneration, disc placement, Modic changes, and sagittal balance were retrospectively measured using magnetic resonance imaging (MRI) in 107 relatively patients. Data about daily phone usage times of the participants were obtained by a questionnaire filled in at the time of admission. Results: The total number of disc distances analyzed was 535 (Group 1; n = 200, Group 2; 335). In Group 1, the disc displacement was present in 30%, and in Group 2, the disc displacement was present in 35%. In terms of DD severity, the total DD score was >10 in 18 (18/40; 45%) patients in Group 1, and in 39 patients (39/67; 58%) in Group 2. The mean Cobb angle of Group 1 was 10.3° ± 6.57° (range, 2° to 34°), and that of Group 2 was 7.6° ± 5.14° (range, 1° to 26°) (Pcobb = 0.048). Modic changes were detected in 17 of the 107 patients (15.8%). Of the 17 patients, 3 (3/40, %7.5) were Group 1 and 14 (14/67, %20.9) were Group 2. MC was detected in 4 vertebrae in Group 1, and 24 vertebrae in Group 2 (P = 0.001) Conclusions: The analysis of cervical spine MRI data of young adult patients with neck pain shows that the smartphone usage time is effective in cervical sagittal balance disruption, disc degeneration, and development of Modic changes.
  4,610 335 -
Effect of Post-Isometric Relaxation and Laser on Upper Trapezius Trigger Point Pain in Patients with Mechanical Neck Pain
H Ahmed, MA Jarrar, R Ahmed, R Alqhtani, A Alshahrani
Dec 2020, 23(12):1660-1666
DOI:10.4103/njcp.njcp_6_20  PMID:33355818
Objective: The current study aimed to determine the effectiveness of post-isometric relaxation and LASER treatment in minimizing pain and increasing neck range of motion and function in people with upper Trapezius trigger point pain. Methods: A total of 45 participants with upper Trapezius trigger point pain were studied. All the participants were randomly assigned into three equal groups (post-isometric relaxation, LASER, and Control) to receive the respective treatments for 1 week. The pressure threshold meter was used to assess the pain-pressure sensitivity of myofascial trigger point pain. Pain intensity and cervical range of motion were measured using the visual analogue scale and cervical goniometry, respectively. The neck disability index was used to assess neck function. Results: The results of within group analysis indicate significant changes in all the outcomes in three groups (All groups, P = 0.001) except an insignificant improvement of pain pressure threshold in the control group (P = 0.069). Additionally, there were significant differences noted among three groups on pain-pressure threshold and visual analogue scale scores at posttest day 1, day 5, and day 12 (all P = 0.001). However, there was non-significant improvements of neck disability index and side flexion on both sides noted at all timelines except (all P > 0.05), a significant improvement at posttest day 5 (P = 0.015) among three groups. Conclusions: Both PIR and LASER treatment have been effective in reducing pain-pressure threshold and pain intensity in the management of muscle trigger point pain. Long-term studies are warranted to further validate the effectiveness of these modalities in the management of upper Trapezius trigger point pain.
  4,222 611 -
REVIEW ARTICLE
Factors Affecting Clinical Decision-Making and Treatment Planning Strategies for Tooth Retention or Extraction: An Exploratory Review
ME Sayed, CA Jurado, A Tsujimoto
Dec 2020, 23(12):1629-1638
DOI:10.4103/njcp.njcp_649_19  PMID:33355813
Dentists are often confronted with challenges concerning the determination of the treatment type for questionable teeth (retention or extraction) in their routine dental practice. The objective of this review was to explore the available literature pertaining to the factors influencing clinical decision-making and treatment strategies of dentists regarding tooth retention or extraction. Explorative analysis of the literature was conducted based on its relevance to the subjected study area and scope. Primarily, the papers were extracted from sources such as ERIC, PubMed, Scopus, and Medline. The keywords used for searching articles include Clinical Decision-Making, Treatment Strategies, Tooth Extraction, and Tooth Retention. Papers published up to 2018 were extracted and evaluated. The analyzed studies highlighted that a successful treatment plan is based on the practitioner's knowledge, abilities, and skills as well as patients' preference, which is also a determinant of treatment success in restorative dentistry. Multidisciplinary dental treatment is generally adopted for decision making in dental clinics. Overall, the treatment plan should be based on the extensive learning and keen observation of the disease and the associated factors which enable long-term success of the treatment.
  3,366 524 1
ORIGINAL ARTICLES
The Efficacy of Botulinum Toxin Injection Site in Chronic Anal Fissure Healing
U Sekmen, M Paksoy
Dec 2020, 23(12):1639-1642
DOI:10.4103/njcp.njcp_14_20  PMID:33355814
Background: Chronic anal fissure is a common disease of the anoderm. Botulinum toxin injection has recently been recommended. However, the injection sites are still debatable. Aims: This study aimed to assess the site-dependent efficacy of Botulinum toxin injection for chronic anal fissure healing. Methods: Randomized clinical trial was performed, 80 patients were enrolled in two semi groups according to the site of botulinum toxin injection. Lateral sites of internal sphincter muscle were used in group 1, anterior and posterior regions were used in group 2 in lithotomy position. In this prospective study, the effect of injection site preference on the early complications (pain, infection, hematoma, incontinence) and late results (clinical fissure healing) of chronic anal fissure treatment were assessed. Results: There was no statistical significant difference between the number of patients who achieved complete healing at the end of the 12th week. Postoperative pain scores were significantly lower in group 2 at the end of 1st week and they stayed lower at the end of the 2nd week. Thrombosed haemorrhoids were encountered significantly lower in group 2. Conclusions: Even though there was no statistical difference in the long term healing rate between groups 1 and 2, choosing 6 and 12 o'clock alignments of internal sphincter muscle for botox injection is more advantageous than 3 and 9 o'clock alignments in terms of better postoperative pain and lower complication rate in the early period.
  2,760 415 1
Leadership Styles versus Health Workers' Job Satisfaction: Relationships, Correlates and Predictors in Tertiary Hospitals in Ekiti State, Southwest Nigeria
KA Durowade, IB Kadiri, SB Durowade, TA Sanni, MA Ojuolape, LO Omokanye
Dec 2020, 23(12):1702-1710
DOI:10.4103/njcp.njcp_525_18  PMID:33355824
Background: The healthcare delivery in Nigeria operates in a turbulent environment with professional rivalry leading to job dissatisfaction among players. This lack of cohesion, which has shown the need for appropriate leadership, has made healthcare professionals function in an environment of uncertainty, disorder, and ambiguity. Aims: This study assessed leadership styles and health workers' job satisfaction in tertiary hospitals in Ekiti State, Nigeria. Methods: This is a cross-sectional study. Multistage sampling technique was used to select respondents. Data were analyzed using IBM SPSS version 20.0 statistical software. Level of statistical significance was set at P < 0.05. Results: More than half, 205 (51.8%), of the employees were found to be within the third decade of life with a mean of 33.2 ± 7.2 years. Among the employees, only 6 (1.5%) had high job satisfaction; laissez faire style had negative relationship with job satisfaction (r = -0.084; P = 0.094). Age of the leader (r = -0.095), duration of tenure by the heads of units (r = -0.003) exhibited negative correlation with job satisfaction. Age of employees and contingent reward were found to be significantly predictive of job satisfaction (P < 0.05). Conclusion: Very few of the employees had high job satisfaction and leadership styles impacts health workers' job satisfaction differently. Transformational styles were more related to health workers' job satisfaction than the transactional styles. Laissez-faire exhibited a negative relationship with job satisfaction. There is need for leadership skills on the part of the healthcare leaders; age of leader and duration of tenure needs to be further benchmarked to improve job satisfaction among the healthcare workers.
  2,286 296 -
Prevalence of Rhesus C and D Alloantibodies among Rhesus-Negative Women of Child Bearing Age at a Tertiary Hospital in South-West Nigeria
L Otomewo, S John-Olabode, K Okunade, G Olorunfemi, I Ajie
Dec 2020, 23(12):1759-1766
DOI:10.4103/njcp.njcp_114_20  PMID:33355832
Background: A major cause of hemolytic disease of the fetus and newborn (HDFN) is an incompatibility of the Rhesus (Rh) blood group between the mother and fetus. Aim: To determine the prevalence of Rh c and D alloantibodies among Rh-negative women of childbearing age (18–49 years). We conducted a cross-sectional study among women who attended the antenatal, gynecology and blood donor clinics at a Tertiary Hospital in South-West Nigeria from January to August 2019. Serological typing of Rh c and D was done manually with the tube test using anti-c and anti-D antisera, while indirect antiglobulin test was then performed to screen for Rh antibodies. Subjects and Methods: Data was analyzed using Stata 16.1 software; Categorical data was summarized using frequency and percentages while continuous variables were described using the mean and standard deviation or median and interquartile range. Pearson's Chi-square (or Fisher's exact) test was used to test for association between categorical variables and Rh status. P values of ≤0.05 were assumed to be statistically significant. Results: A total of 700 consenting women, comprising 505 pregnant (72.1%) and 195 non-pregnant (27.9%) women were recruited into this study. The mean age was 30.7 ± 4.9 years. All (100%) participants were Rhc positive while 641 (91.6%) were RhD positive and 59 (8.4%) were RhD negative. All 59 RhD negative subjects tested negative for anti-D. There was no statistically significant difference between proportion of RhD-negative women who had a jaundiced baby and the proportion of RhD-positive women who had a jaundiced baby (15.6% vs. 18.6%, P = 0.540). Conclusions: This study did not identify any Rhc and D alloantibodies in the study population suggesting there is a low risk of alloimmunization and HDFN due to anti-Rhc and D in this population.
  1,964 277 -
Investigating the Effect of Personality Traits and Academic Self-efficacies on Malpractice Tendencies in Health College Students
D Baykal, D Yildirim
Dec 2020, 23(12):1721-1727
DOI:10.4103/njcp.njcp_677_19  PMID:33355826
Background: Prevention of malpractice is crucial for health care professionals since it could lead to morbidity and mortality. Personality traits of students, being health care professional candidates affect their academic self-efficacies and malpractice tendencies. Objective: To investigate the effect of personality traits and academic self-efficacies of midwifery and nursing students on their malpractice tendencies. Materials and Methods: The study was conducted with a total of 437 midwifery and nursing students studying at two universities between May and September 2019. The form of sociodemographic characteristics, Eysenck Personality Inventory, Academic Self-efficacy Scale, and Malpractice Tendency Scale were used to collect the data. Results: In the malpractice tendency scale, the students had the lowest score from patient monitoring and equipment safety subscale (x¯ = 40.59 ± 5.41) and the highest score from the communication subscale (x¯ = 22.78 ± 3.01). In the personality inventory, they were found to have the lowest score from the psychoticism subscale and the highest score from the extraversion subscale. Their academic self-efficacy mean score was 14.69 ± 3 0.49. Academic self-efficacy score was higher in the 1st year compared to the 4th year (P < 0.05). A negative correlation was found between neuroticism and extraversion subscales and academic self-efficacy (P < 0.01). A negative correlation was found between malpractice tendency and academic self-efficacy (P < 0.01). Conclusion: It was observed that neuroticism and extraversion personality traits in students were found to be associated with low academic self-efficacy and increasing malpractice tendencies. Investigation of academic self-efficacy and malpractice tendencies of the students in accordance with their personality traits would contribute to the improvement, arrangement, and updating of educational curricula.
  1,830 267 -
Assessment of Marginal Opening for Different Cementation Techniques for Heat-Pressed Ceramic Veneers
WM S A L Qahtani
Dec 2020, 23(12):1643-1647
DOI:10.4103/njcp.njcp_454_19  PMID:33355815
Aims: The aim of this study is to evaluate the gap distance of two cementation techniques for laminate veneers fabricated on maxillary anterior teeth using heat-pressed ceramic, finger pressure, and ultrasonic cementation techniques. Material and Methods: A total number of 42 extracted natural central incisors were prepared to receive ceramic laminate veneers, laminate veneers were constructed in the laboratory using heat-pressed ceramic according to manufacturer's instructions (IPS e.max). Ceramic veneers were divided into two groups and cemented using two different cementation techniques (Ultrasonic, finger pressure). Marginal gap distance was measured in microns at the margins using a stereomicroscope and special computer software (quantitative assessment). Results: The ultrasonic cementation technique recorded 63.3 ± 27.8 μm, which was significantly lower than the finger pressure technique (91.5 ± 21.4 μm). Conclusions: The ultrasonic cementation technique improved the gap distance at the tooth/ceramic interface when compared to the finger pressure technique using the light cure cement.
  1,693 294 2
Physical Frailty Phenotype and Depression are Associated with More Severe Disease in Older Subjects Presenting with Acute Coronary Syndrome
A Aggarwal, A Kumar, R Sharma, A Goel, R Kar, R Avasthi, AK Gupta
Dec 2020, 23(12):1711-1720
DOI:10.4103/njcp.njcp_37_20  PMID:33355825
Objective: The primary objective was to determine the occurrence of frailty in elderly patients presenting with the acute coronary syndrome (ACS). The secondary objective was to study the association between the deficits in health with the severity of ACS at presentation among them. Methods: A cross-sectional study conducted in the Departments of Medicine, Community Medicine and Biochemistry in a tertiary care teaching hospital, Delhi, India between November 2014 and April 2016. Patients (≥60 years age) presenting with any one of the spectra of ACS (STEMI, UA, NSTEMI) and giving informed written consent were assessed for frailty and health deficits using questionnaires. ACS assessed by ECG within 24 h and other relevant investigations. Appropriate statistical tests of significance like the Chi-square test were used and correlation coefficients were analyzed. A value of P < 0.05 was considered significant. Results: Seven risk factors apart from old age were studied, in which smoking and dyslipidemia played a major role. 44% of the subjects were frail with the range of frailty scores between 3 and 5. Every one-unit increase in hemoglobin was associated with a reduction in the odds (OR 0.72) for being frail. No association was noted between the severity of ACS and established risk factors like smoking, hypertension, diabetes, family history of CAD, increased waist circumference, dyslipidemia, and male gender. On multivariable linear regression, presence of frailty and depression were associated with severe disease. Conclusions: Nearly one in two patients presenting with ACS were found frail. Depression and frailty were associated with poorer ejection fraction and severe disease. Correction of anemia and improvement of low-normal hemoglobin levels could reduce frailty and in-turn improve outcomes in ACS.
  1,674 289 1
The Effect of Varicocelectomy on the Pregnancy Rate in Patients with Severe Oligospermia
H Turgut
Dec 2020, 23(12):1744-1747
DOI:10.4103/njcp.njcp_173_20  PMID:33355829
Background: Varicocele is the most common correctable cause of male infertility. But, it is still controversial in patients with severe oligospermia. Aim: The aim of this study is to evaluate how varicocelectomy impacts pregnancy rates (natural or assisted reproductive techniques) in infertile couples when the male partner has severe oligospermia and history of varicocele. Materials and Methods: A retrospective examination was made of males with total motile sperm count <5 million/mL with varicocele in the period April 2013 to October 2019. Pregnancy rates were compared at the end of 1-year follow-up of 52 patients (Group 1) who underwent varicocelectomy and 36 patients (Group 2) who applied for assisted reproductive techniques without surgery. The postoperative third-month sperm parameters were compared for Group 1. Spontaneous pregnancy and conception rates with assisted reproductive techniques for Groups 1 and 2 were also investigated after 1 year. Results: In the semen analysis performed in the 3rd month, a statistically significant increase was observed in sperm number, motility, and morphology of the patients in Group 1. Spontaneous pregnancy was obtained in 7 (13.4%) of the 56 Group 1 patients who underwent varicocelectomy, in 7 (13.4%) patients with intrauterine insemination, and in 6 (11.5%) patients with intracytoplasmic injection (ICSI). In Group 2, pregnancy occurred with the help of ICSI in 4 of 32 patients (11.1%). Conclusions: Varicocele surgery before assisted reproductive techniques will be more beneficial in terms of both cost-effectiveness and pregnancy rates.
  1,468 257 1
Accuracy of Estimating Chronological Age from Nolla's Method of Dental Age Estimation in a Population of Southern Saudi Arabian Children
SM Yassin, BA M AlAlmai, SH Ali Huaylah, MK Althobati, FM A AlHamdi, RA Togoo
Dec 2020, 23(12):1753-1758
DOI:10.4103/njcp.njcp_648_19  PMID:33355831
Objectives: The aim of this study was to test the accuracy of estimating chronological age using Nolla's method of dental age assessment in a Saudi Arabian population considering sex and age group variables. Materials and Methods: This cross-sectional study involved a retrospective evaluation of 458 orthopantomographs (187 males and 271 females) of 5–11 years old healthy Saudi children. Seven permanent left mandibular teeth were assessed as per Nolla's method to record dental age. The mean difference between dental age and chronological age was calculated using a paired t-test. Correlation between chronological age and dental age was analyzed using Pearson's correlation coefficient. Results: There was a statistically significant difference (P < 0.05) between the estimated dental age and chronological age in all age groups irrespective of gender. The mean difference between estimated dental age and chronological age in males ranged from −2.68 to −6 months and −2.17 to −4.24 months in females. Pearson's correlation coefficient showed a strong positive correlation (r = 0.95 for males and r = 0.94 for females) between estimated dental age and chronological age. Conclusion: Nolla's method is suitable for estimating chronological age in Southern Saudi children, as the mean difference between estimated dental age and chronological age was within an acceptable range.
  1,481 206 1
CASE REPORTS
Prosthetic and Surgical Reconstruction of the Atrophic Anterior Maxilla with Iliac Bone Grafting and Malo Bridge Design: A Case Report
RG Kocak, A Gulnar, NY Altintas, SH Altintas, R Nalcaci
Dec 2020, 23(12):1767-1771
DOI:10.4103/njcp.njcp_237_20  PMID:33355833
Alveolar bone loss subsequent to long-term edentulism and trauma may be severe and treatment plan is always an esthetic and functional challenge. Implant supported hybrid prosthesis is widely regarded as an effective treatment option for patients with excessive and irregular bone loss. However, implant placement is occasionally impossible without surgical procedures in such cases. This case report presents rehabilitation of 19-year-old maxillary anterior edentulous male patient with maxillary anterior bone defect and excessive cross-bite anterior closure with multidisciplinary approach. The patient was rehabilitated with implant supported hybrid prosthesis with Malo Bridge design following autogeneous iliac bone augmentation, teeth leveling with orthodontic treatment, and surgical placement of three implants. Esthetics, pleasing phonetics and function were achieved as desired with this treatment option and no complications were observed.
  1,418 266 -
ORIGINAL ARTICLES
Degenerative Joint Disease of the Upper Cervical Spines: A Cone Beam Computed Tomography Study
HM Khalifa, AA Alamoudi, AM Jan, FM Jadu
Dec 2020, 23(12):1667-1672
DOI:10.4103/njcp.njcp_628_19  PMID:33355819
Objectives: To investigate the prevalence, imaging features, and predictors (age and gender) of upper cervical spine degenerative joint disease (DJD).Methods: Two oral radiologists retrospectively reviewed the cone-beam computed tomography (CBCT) examinations conducted at a university-based imaging center over 1 year. They recorded the imaging findings related to the upper cervical spine (C1C2) and collected patient demographic data. Then the data of the patients with and without DJD findings in the upper cervical spine were compared. Results: The prevalence of upper cervical DJD was 45.6%. There were no gender-based differences in upper cervical DJD. The prevalence of upper cervical DJD increased steadily with age. There was a statistically significantly difference in the prevalence of upper cervical DJD at all the age ranges. Conclusions: DJD of the upper cervical spine is a relatively common incidental finding frequently captured in CBCT scans acquired for dental purposes.
  1,504 137 -
Clinical Outcomes of Nasopharyngeal Carcinoma Patients Treated with Adaptive Helical Tomotherapy, A 5-year Experience
SA Arslan
Dec 2020, 23(12):1683-1689
DOI:10.4103/njcp.njcp_647_19  PMID:33355821
Objectives: The study aims to retrospectively review the survival and toxicity outcomes of adaptive helical tomotherapy (HT) treatment of nasopharyngeal carcinoma (NPC) patients over 5 years. Methods: Between February 2010 and September 2017, 67 biopsy-proven non-metastatic NPC patients were analyzed. All patients except one received concurrent chemotherapy and treated with adaptive Simultaneous integrated boost- intensity-modulated radiation therapy (SIB-IMRT). The median age was 48.5 years (range, min: 11 max: 78) with male predominance (82.1% vs. 17.9%). Neck mass was the most common presenting symptom followed by hearing problems (52% and 24%). Results: The mean dose with standard deviation (sd) of D50 to patients' parotid glands and cochleae were 33 ± 11 Gy; 31 ± 11 9 Gy and 37 ± 11 14 Gy; 34 ± 11 14 Gy, respectively. Locoregional progression-free survival (LRRFS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and overall survival (OS) estimated at 2 and 5 years were 83% and 63%, 78.4% and 61.7%, 83% and 69%, 86% and 71%, respectively. Acute Grade 3 or higher dysphagia and mucositis observed in 28 (42%) patients who required daily iv fluid transfusion and/or hyperalimentation. None of the patients had grade 3 and higher mucous membranes and salivary gland toxicity beyond 6 months. Two patients had ≥ grade 3 late toxicity. During the median 51 months (range 2–100) follow up, thirteen patients relapsed (19.4%), six of them (8.9%) recurred locoregionally, and 7 (10.4%) of them developed distant metastasis. Conclusion: The present study reemphasizes that adaptive SIB-IMRT with HT is a good option for the management of NPC with comparable loco-regional control rates and low salivary gland toxicity.
  1,312 242 -
Colonoscopy findings in lower gastrointestinal bleeding in Lagos: A comparative study based on age
A Oluyemi, E Odeghe, O Adeniyi
Dec 2020, 23(12):1656-1659
DOI:10.4103/njcp.njcp_341_20  PMID:33355817
Background: Lower gastrointestinal bleeding (LGIB) (hematochezia) is an important indication for colonoscopy, and may be caused by hemorrhoids, diverticulosis, and tumors. Aims: The aim of this study was to compare the endoscopic findings in the young (<50 years) versus older subjects (≥50 years) with LGIB in Nigeria. Subjects and Methods: This was a retrospective study of the endoscopic findings of all adults with LGIB from January 2017 to December 2019 in Lagos, Nigeria. The records of two centers that deliver outpatient gastrointestinal endoscopic services were ploughed for biodata, presenting complaints and findings in these individuals. These data were then analyzed and are thus presented. Results: A total of 1,774 colonoscopies performed during this period, 793 were for LGIB. Of those with LGIB, 548 (69.1%) were males, 245 (30.9%) were female, mean age was 50.7 (±14) years, and 403 (50.8%) were younger than 50 years old. The most frequent findings in patients younger than 50 years were hemorrhoids (316, 78.4%), tumors (35, 8.7%), and polyps (27, 6.7%), while in the older patients, they were hemorrhoids (259, 66.4%), tumors (74, 19%) and diverticulosis (55, 14.1%). Younger age was significantly associated with the presence of hemorrhoids (P < 0.005), while older age was significantly associated with the presence of tumors (P < 0.005) and diverticulosis (P < 0.005). Conclusion: Our study showed that hemorrhoids, tumors, and diverticulosis were the most common causes of LGIB in Nigerian patients - with younger age being significantly associated with hemorrhoids, and older age with tumors and diverticulosis. A third of the tumors in this study were found in younger patients. Unfortunately, this finding of such a high proportion of colorectal tumors being found in young Africans has been shown in previous reports - this work should help heighten concern and provoke further scientific probing into the phenomenon with a view to encouraging policy to help truncate its existence.
  1,351 194 1
Descriptive Epidemiology of Odontogenic Tumors in Nigeria: An African Oral Pathology Research Consortium Multicenter Study
DS Okoh, AO Akinshipo, A Butali, OG Omitola, OF Sigbeku, OO Soyele, OD Osunde, AO Taiwo, AA Ibikunle, KU Omeje, AO Lawal, B Fomete, HA Adeola
Dec 2020, 23(12):1695-1701
DOI:10.4103/njcp.njcp_315_20  PMID:33355823
Background: Many studies have investigated the burden of odontogenic tumor (OT) in Nigeria; however, the true burden and prevalence of these lesions are not known because these studies are based on a center/region. Aims: Hence, the aim of this study is to evaluate the true burden of OTs in Nigeria, using a multicenter approach. Materials and Methods: This is a 10-year retrospective cross-sectional study of OT seen in eight tertiary health institutions in different geographic locations in Nigeria. Results: A total of 990 cases were included in this study. The highest prevalence of OT was in the third decade of life (n = 274, 27.7%). Most lesions were benign (n = 961, 97.1%), with a slight male preponderance; and the mandible was the commonest site (n = 814, 82.2%). There were a significant association between the diagnosed OTs and the age group and site (P = 0.002 and 0.031, respectively). Conclusion: OTs showed a slightly higher preponderance in males, occurring mostly in the third decade. Benign lesions were frequent and ameloblastoma was the commonest OT. Variations exist in the occurrence of OTs from the different geographic locations in Nigeria. This study essentially sheds a broader light on the clinicopathological distribution of OTs across Nigeria, using a large multicenter approach.
  1,304 195 -
Resumption of Sexual Intercourse and Family Planning use Among Postpartum Women Attending Infant Welfare Clinics in Ibadan, Southwest Nigeria – A Cross-Sectional Study
B Adedokun, RA Abdus-Salam, T Babawarun, I Morhason-Bello, O Ojengbede
Dec 2020, 23(12):1648-1655
DOI:10.4103/njcp.njcp_76_20  PMID:33355816
Background: Women may resume sexual intercourse anytime during the postpartum period with little consideration for contraceptive. Aim: To determine factors associated with resumption of sexual activity, explore FP practices and influence on sexual resumption among postpartum women. Subject and Methods: A cross-sectional study of postpartum women at the infant-welfare clinic of Adeoyo Maternity Teaching Hospital and University College Hospital, Ibadan between July and October, 2014. Data on socio-demographic characteristics, contraceptive use, and sexual behavior were collected using interviewer-administered semi-structured questionnaires. Associations were tested using Chi-square tests and Logistic regression analysis for crude and adjusted odds ratios. Level of significance was 5%. Results: There were 256 women with mean age of 29.1 years(SD = 5.2). Majority had tertiary education; were currently married in monogamous marriages and had 1-3 children. Ninety-one(38.7%) had started sexual intercourse at the time of interview. Among those who had not started having sex, about a quarter (24.2%) gave no reason and 20% felt it was too early. The fear of pain and child-spacing were reasons given by 5.7% and 5.1% respectively. Current use of contraceptive method was 20.7% among women and 36.4% among women who had resumed sexual activity. On multiple logistic regression, Family-planning users were about five times more-likely than non-users to resume sexual intercourse (Odd Ratio = 5.66, 95% Confidence interval = 2.61 – 12.28). Conclusion: Women commonly resume sexual intercourse during postpartum period without contraceptive use. Interventions during antenatal and early postnatal periods are needed to improve early adoption of Family planning by postpartum women.
  1,281 214 3
CASE REPORTS
Recurrent Extra-gastrointestinal Stromal Tumor of the Vagina: A Case Report and Review of the Literature
J Shi, R Fu, W Hec, A Zhao
Dec 2020, 23(12):1776-1779
DOI:10.4103/njcp.njcp_139_19  PMID:33355835
Gastrointestinal tumors are uncommonly found outside the gastrointestinal tract, and extremely rare in the vaginal wall. In this case report, a 39-year-old female, she was finally diagnosed with an extra gastrointestinal stromal tumor (EGIST) when she presented with a recurrent vaginal tumor, while misdiagnosed after the first surgery. She had definitive surgical clearance and was taking targeted drug therapy with no sign of recurrence after follow-up for 13 months. Immunohistochemistry and cytogenetic's remain the most definitive method to diagnose EGISTs. Surgical resection and postoperative adjuvant targeted therapy are the optimum treatment options.
  1,248 184 -
ORIGINAL ARTICLES
Elective Incisional Hernia Repair: Risk Factors and Evolution of Treatment in a Low-Income Setting
AU Ogbuanya, LN Onah
Dec 2020, 23(12):1728-1735
DOI:10.4103/njcp.njcp_309_20  PMID:33355827
Background: The steady rise in laparotomy rates, particularly resulting from gynecologic and obstetric procedures in our environment has given rise to corresponding increase in the proportions of incisional hernias (IH). Over the years, discussion on the appropriate repair technique for IH has continued, nevertheless, with advances in laparo-endoscopy and introduction of prosthetic meshes, the surgical treatment has been revolutionized. Aims: The aim of this study is to examine the risk factors and the evolutionary trend in surgical repair in our center. Methodology: This is a descriptive prospective study of adult patients with incisional hernias. The study was carried out in a tertiary health institution from January 2011 to December 2017. Results: A total of 177 patients were recruited, 147 (83.1%) females and 30 (16.9%) males. Nearly two-thirds, 115 patients (65.0%) received prosthetic mesh repair, the rest, 62 patients (35.0%) were fixed using suture-based techniques. Among the 115 mesh repairs, 110 (995.7%) were in females and the remaining five (4.3%) were in males. The most frequent precipitating surgery was caesarean section in 72 patients (40.7%), followed by gynecology operations, 45 patients (25.4%), none-obstetrics and gynecology laparotomies, 50 patients (28.2%) and others, 10 patients (5.7%). Of the 177 patients evaluated, in 99 patients (55.9%) there was history of wound infection in the previous surgery while 24.9%, 5.1%, 4.5% and 1.1% reported that they had prolonged cough, diabetes, jaundice, and urinary obstruction in the peri-operative period of the initiating operations. The rate of recurrence was 17.7% in the non-mesh repairs and 0.0% in the group that had mesh repair. Conclusion: In our locality, the trend over time shows a shift from predominantly anatomic suture-based repair to a tensionless mesh implant with far lower recurrent rates. Laparotomy incisions for obstetric and gynecologic procedures are the most common precipitating incisions.
  1,221 171 -
Partner Violence During Pregnancy and its Affecting Factors a Province in Eastern Turkey
E Celebi, E Pirincci, AB Durmus
Dec 2020, 23(12):1673-1682
DOI:10.4103/njcp.njcp_104_19  PMID:33355820
Background: The violence experienced by a woman during her pregnancy period has a direct impact on both mother and child, and it generally harms the development of the family and society. Aim: This study was conducted to determine spouse violence experiences of married women aged 15 years and older during their pregnancy period who live in a province in eastern Turkey. Materials and Methods: This descriptive study was carried out with 712 married women living in a city center in Turkey. Participants were selected by systematic sampling from the records by reaching to all family health centers in the city. The field study was conducted between April and June 2015. The questionnaire was prepared by the researchers. The findings of the study were evaluated in “SPAS version 22 software package.” Chi-square test and multidimensional logistic regression analysis were used in the analysis. P < 0.05 was considered statistically significant in the comparisons. Results: In our study, having a kinship relationship with her husband, lack of education of herself and her husband, and lack of employment by the woman were found to be the risk factors for violence during pregnancy period (P < 0.05). The fact that she was exposed to physical violence from her husband during her no pregnancy period, and that the woman was beaten by her father during her childhood period increased the risk of violence during pregnancy period (P < 0.05). Conclusion: The rate of exposure to physical violence by her spouse during pregnancy period is high. The provision of education and employment can increase a woman's social networks and improve her status within the family.
  1,185 196 1
CASE REPORTS
Combined Spinal and TAP Blocks for Laparoscopic Cholecystectomy for a Patient with Crigler-Najjar Type 2: A Case Report
M Bicak, H Akelma, F Salik, S Kaya
Dec 2020, 23(12):1772-1775
DOI:10.4103/njcp.njcp_19_20  PMID:33355834
Crigler-Najjar syndrome is a rare disease which is associated with congenital deficiency of uridine-diphosphate-gulukronyltransferase (UDP-glucuronosyltransferase, UGT) enzyme. In the surgery of these patients, it is necessary to use an anesthetic method that causes less damage to the liver. Spinal anesthesia is a good alternative to general anesthesia in these patients. Transversus abdominis plane block is a new method for ultrasound guided abdominal wall block. It is less invasive and relatively safer than conventional regional anesthetic techniques. Our case is a 30-year-old male patient with the diagnosis of Crigler-Najjar type 2 (Arias syndrome). There was a history of gallbladder edema, multiple stones and thickened gallbladder wall. We applied Transversus abdominis plane block in addition to spinal anesthesia as primary anesthesia for our patient who underwent laparoscopic surgery. We didn't experience any postoperative complications in our patient. In conclusion, laparoscopic surgery performed under combined spinal anesthesia and transvesus abdominis plane block in a Criggler Najjar type 2 (Arias syndrome) patient may be a simple and effective technique.
  1,102 175 1
ORIGINAL ARTICLES
Etiology of Optic Disc Swelling in a Tertiary Care Center in Nigeria
VB Osaguona, DH Kayoma
Dec 2020, 23(12):1690-1694
DOI:10.4103/njcp.njcp_333_20  PMID:33355822
Background: Optic disc swelling in clinical practice is worrisome. It may be associated with benign, sight- or life-threatening conditions. The common etiologies of optic disc swelling are variable in different communities. Aims: To determine the etiology of optic disc swelling at the Eye Clinic of the University of Benin Teaching Hospital, Nigeria. Method: The case files of all patients with optic disc swelling seen over a 7-year period were retrieved. Demographics and clinical information were obtained from their case files. The data was analyzed with the IBM SPSS Statistics Version 21 software. Descriptive analyses such as frequency, mean, and standard deviation were utilized. Results: There were 66 patients with bilateral or unilateral disc swelling. These included 23 males with a male: female ratio of 1:1.87. The age range was from 3 years to73 years; mean age 36.9 years (SD15.3). A total of 109 eyes were affected with bilateral involvement in 43 patients. Papillitis 15 (22.7%), brain tumor 8 (12.1%), and tilted disc 6 (9.1%) were the most frequent diagnosis. Papilledema in 20 (30.3%) patients, optic neuritis 19 (28.8%), and pseudopapilledema 11 (16.7%) were the most frequent etiologic processes of optic disc swelling. Conclusions: Papillitis, brain tumors, and tilted disc were the most frequent etiologies of optic disc swelling in this study. These etiologies should be excluded in patients with optic disc swelling in our clinics.
  1,110 128 1
Prevalence of Cytochrome P450 2B6 Single Nucleotide Polymorphism in an HIV-Positive Cohort in Jos, Nigeria: Implication for HIV Therapy
AO Isaac, DD Wetkos, AO Oche, I Godwin, K Phyllis, AC John
Dec 2020, 23(12):1736-1743
DOI:10.4103/njcp.njcp_348_20  PMID:33355828
Background: Africans exhibit great diversity in cytochrome P450 2B6 isoenzyme (CYP2B6), the major enzyme in efavirenz metabolism. Aim: We examined the frequency of two functional single nucleotide polymorphisms (SNPs) of the CYP2B6 pharmacogene in HIV-infected Nigerians on efavirenz-based antiretroviral therapy. The potential implications of the SNPs for HIV therapy were discussed. Materials and Methods: A cross-sectional study conducted from July 2018 to December 2018 in a tertiary health facility in Nigeria. A random sample of a clinic cohort of HIV-infected adult Nigerians of different ethnicities was characterized for two key SNPs; CYP2B6:516G>, and CYP2B6:983T > C, defining the alleles CYP2B6*6 and CYP2B6*18, respectively. Hardy–Weinberg equilibrium was calculated to evaluate the genotype frequency distribution. Results: Genotyping was successful for 262 (83%) of the 316 study participants. Of those with genotype results, mean age was 41 ± 8 years and 182 (69.5%) were female. The CYP2B6:516 G/G (extensive metabolizers), CYP2B6:516 G/T (intermediate metabolizers), and CYP2B6:516 T/T (poor metabolizers) genotype frequency was 35.9%, 46.6%, and 17.6%, respectively. Also, 88.9% and 11.1% of participants were carriers of the CYP2B6:983 T/T and CYP2B6:983 T/C (poor metabolizers) genotypes, respectively. There were no gender or age-related differences in the genotype distribution. The CYP2B6:516G >T allele frequencies showed no significant deviations from the Hardy-Weinberg equilibrium (P = 0.66). Conclusions: The intermediate metabolizer genotype was more common than the extensive and poor metabolizer genotypes in our study sample. We recommended further studies to investigate the risk of efavirenz underexposure and overexposure in carries of the extensive and poor metabolizer genotypes respectively in our patient population.
  953 165 -
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