Nigerian quarterly journal of hospital medicine最新文献

Background: Tooth loss diminishes the quality of life and is also related to poorer general health. Premature tooth loss in children can have devastating effects such as compromised aesthetics and function, mesial and distal drifts of adjacent teeth leading to crowding and impaction of the permanent successors and other forms of malocclusion.

Objective: To assess the causes and pattern of tooth loss in children and adolescents at the Paedodontic Clinic of the Lagos University Teaching Hospital, Lagos.

Methods: This retrospective study was carried out at the Paedodontic Unit of the Lagos University Teaching Hospital, Lagos using clinical records over a period of time from January 2008 to April 2010. Information obtained included age, gender, missing and extracted teeth, and reasons for extraction/tooth loss. Exfoliated primary teeth and congenitally missing teeth were excluded. Data was analysed using Epi info 2007 statistical software. Chi-square test was used to compare proportions of tooth loss among age groups. The level of significance was set at P < 0.05.

Results: A total of 493 patients aged 1-16 years had lost one or more teeth due to various reasons. There were 244 (49.5%) males and 249 (50.5%) females. Majority of the subjects lost their teeth due to caries and its sequelae (64.3%) compared to trauma (10.8%) and orthodontic reasons (23.5%). Seven (1.4%) lost their teeth due to failure of previous treatment such as pulp therapy.

Conclusion: Extraction largely due to caries and its sequelae was responsible for most of the tooth loss among the study population. There is the need for intensified oral health education and awareness programmes in the populace with emphasis on prevention of dental caries and early presentation for dental treatment in order to avert premature tooth loss in children and adolescents.

Background: Orbital cellulitis is a devastating acute infection of orbital soft tissues located posterior to the orbital septum. It is both vision and life-threatening. It is an ocular emergency which most often present in childhood.

Objective: This article reviewed cases presenting during the study period with the view of examining the pattern of presentation, clinical course and management challenges.

Methods: A retrospective study was conducted on patients presenting with orbital cellulitis between January 2008 and June 2011. Socio-demographic data, entry and discharge visual acuity, presenting complaints, predisposing factors, duration of complaints, admission period and complications were extracted from clinical records and analyzed.

Results: Seventeen (17) patients presented with orbital cellulitis constituting 6.2% of ocular emergency admissions during the study period. Twelve (70.6%) were males. Thirteen (76.5%) were children. The major predisposing factors were upper respiratory tract infections, and facial and globe injuries in five (22.7%) cases respectively. Only five (29.4%), presented within three days of disease onset. Average duration of admission was 10.6 days. Complications during the course of disease were category 4 and 5 blindness in five (23.5%), orbital abscess four (23.5%), cavernous sinus thrombosis two (11.8%), contralateral preseptal cellulitis two (11.8%) and exposure keratopathy in one (5.9%).

Conclusion: Orbital cellulitis has remained a disease with high ocular morbidity. The major management challenges were poor financial status of patients precluding necessary diagnostic laboratory and imaging studies. Early recognition, diagnosis and treatment are crucial to the preservation of vision and reduced occurrence of complications. The importance of record keeping is also highlighted.

Background: Scientometric is one of the emerging concepts used to analyze the growth, structure, interrelationships amongst the disciplines and the productivity of the volume of intellectual publications. For the sake of qualitative acquisition of the relevant information resources from the avalanche of the information world, scientometric or bibliometric is relevant research methodological approach that will enhance quality collection and determines the core texts, core journals, core information and core research areas. Hence its absence of application may negate medical libraries collection development.

Objective: The essence of the research work is to determine the quantum volume of research output, patterns of research collaboration by authorship, geographical, subject, and citations distributions.

Methods: Information was transcribed on cataloguing cards for the generation of databank. Subject analysis was done by using medical subject headings 2010 edition and Bradford's Statistical methodology was used to analyze the data.

Results: Results showed that a total number of articles produced was 576. The most productive research year was 2007 which pooled 80 (13.9%) articles and 12,182 was the total number of references cited.Also, year 2007 pooled the highest number of references cited 1722 (14.1%). December issues ranked the highest with 151 articles, September issues produced the highest citations with 3,409; two authorship collaborations accounted for the highest number with 162 (28.1%) articles.

Conclusion: Adoption of scientometric or bibliometric or informetric in analyzing journal for a period of time is a useful strategy to know the direction of publication of a journal, its strengths and weaknesses, unravels high concentration areas and the low concentration areas and helps to harmonize the deficiencies.

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of total cancer cases and 14% of cancer deaths worldwide. The developing countries are catching up with this trend. Breast ultrasound when properly performed and interpreted, is an indispensable tool in breast imaging. The early diagnosis and treatment of breast masses reduces the morbidity and mortality associated with delayed diagnosis of breast carcinoma. The use of breast ultrasound is gaining ground in recent time, this is due to current advances in ultrasound technology which permit greater spatial and contrast resolution and shortened scan time.

Objective: To determine the sensitivity, specificity and positive predictive value of ultrasound in the detection of palpable breast masses and to correlate the findings of ultrasound with the findings of fine needle aspiration cytology, or histopathology.

Methods: Breast ultrasound scanning was done in 100 patients with signs and symptoms of breast lesion referred from the Surgical out Patient Clinic to the Radiodiagnosis Department of Lagos University Teaching Hospital (LUTH). Histology reports were collected from either the case note or Morbid Anatomy department to correlate the findings with ultrasound diagnosis.

Results: The mean age was 41.7 +/- 11.34 (18-59) years. Symptoms of breast lesion were highest in the age group 41-50 years 38 (38%), and least in 18-20 years 4 (4%). When the use of ultrasonography was compared with the histopathology report in the diagnosis of breast lesion in the studied population, the sensitivity was 100%, specificity (96.6%), accuracy (97%), posting predictive value (PPV) 81.3%, and negative predictive value (NPV) 100%. The accuracy, specificity and PPV however decreased with increasing age.

Conclusion: Ultrasonography of the breast is useful in the diagnosis of breast lesions, because of the high sensitivity, specificity and diagnostic value it exhibited with histopathologic findings.

Pipkin fracture is the fracture of the head of the femur. It can be associated with neck of femur fracture or/and posterior dislocation of the hip. This fracture is very rare fracture and has not been reported at our sub-region. We present this fracture in a 26 year old with a type I Pipkin fracture treated with closed reduction and percutaneous k-wire fixation. Five (5) year after, she was very appreciative of her management with satisfactory remodeling of her femoral head.

Background: Kidney transplantation is a popular modality of RRT in the developed world.

Objective: To assess the willingness of the general population of Nigerians across the country to donate a kidney

Methods: This is a multiregional, cross sectional, questionnaire based study. One thousand Three hundred respondents participated in the study. This study was carried out in four major Towns and cities across Nigeria between January 2009 and December 2010. The locations are Birnin Kebbi in the north, Ilorin in the middle belt, Iddo Ekiti in the south and Lagos, the economic capital of Nigeria. The respondents were randomly selected within the four localities. Those below the age of 16 or above the age of 65 years were excluded from the study

Results: There were 727 (55.9%) males. The mean age (S.D) of respondents was 39.5 (10.7) years. The largest population of participants, 494 (38.3%) were non health workers and 692 (53.2%) of them were Muslims. Eight hundred and fifty eight (66%) of the participants were willing to donate a kidney. Twenty five percent (25% were not willing and 115 (8.9%) were not sure. Majority of those who were unwilling to donate a kidney, 325 (99.4%) will not change their minds even if they were to be given incentives

Conclusion: Nigerians are willing to donate a kidney irrespective of geographical location, religion or gender and many are willing to do so altruistically.

Background: Several groups in recent times have related the pathogenesis of renal haemodynamic changes in diabetes and most of the experimental diabetic conditions studied so far were carried out using streptozotocin injection only.

Objective: The aim of the present study was to examine the effects of streptozotocin, fructose and sucrose induced insulin resistance on plasma and urinary electrolytes. Closely related to this aim, was the view to suggest which profoundly potentiate insulin resistance more between fructose and sucrose.

Methods: Thirty-six male Sprague-Dawley rats were randomly divided into 6 groups Group 1 > control group. Group 2 > served as streptozotocin group, rendered diabetic by a single dose IP injection of Streptozotocin 45 mg/kg in 0.1 M freshly dissolved in Na+ citrate buffer pH 4.5. Hyperglycaemia confirmed after 48 hours. Groups 3 and 4 > served as 25% fructose and 50% fructose groups respectively; fed on a diet containing 25% and 50% fructose (W/W) for 12 weeks. Groups 5 and 6 > served as 25% sucrose and 50% sucrose groups respectively; fed on a diet containing 25% and 50% sucrose (W/W) for 12 weeks. Hyperglycaemia confirmed at the 12th week.

Results: Plasma and urinary sodium and potassium were significantly higher (P < 0.05) in the 25% and 50% sucrose groups compared to the other groups. Plasma and urinary chloride was significantly higher (P < 0.05) in the 25% and 50% fructose groups compared to the other groups. Plasma creatinine and urea was significantly higher (P < 0.05) in the streptozotocin, 25% and 50% Sucrose groups compared to all the other groups. Urinary creatinine and urea was significantly higher (P < 0.05) in the streptozotocin, and 25% Fructose groups compared to all the other groups.

Conclusion: The elevated levels of plasma and urinary electrolytes are presumptive markers of diabetes associated lesions in the kidneys of rats. Fructose potentiated insulin resistance effect more than sucrose though sucrose might have more effect on renal sodium handling.

Background: Repair of defective composite resins restorations is being increasingly recognized as a viable alternative to replacement. there is however no consensus yet on the treatment protocol.

Objective: To determine the views and practice of specialists in Conservative Dentistry in Nigeria as regard to repair procedure of defective composite resin restorations.

Methods: A cross sectional study was conducted among conservative dentists in Nigeria using anonymous structured and open-ended questionnaire as instrument for data collection, the data collected were: socio demographic variables; views and practice of the respondents as regards the indications, benefits and longevity of composite resins repair treatment option and type of surface preparation usually employed, summary statistics was performed.

Results: The respondents comprise 9 (37.5%) males and 15 (62.5%) females. Marginal defect (91.7%) was the strongest indication and preservation of tooth structure (95.8%) was regarded as the topmost benefit, majority of the respondents (75.0%) considered repair procedure as a definitive treatment and etching with phosphoric acid was the most utilized surface preparation (87.5%).

Conclusion: The views and practice of the respondents is in the literature.

Background: An emergency is a medical condition demanding immediate treatments.

Objective: The aim of the study was to determine the knowledge and ability of dental surgeons in the management of medical emergencies and the availability of emergency drugs and equipment in government dental clinics and hospitals in Lagos State.

Methods: The study was a descriptive cross-sectional study of knowledge and ability of Dental Surgeons in the management of medical emergencies, prevalence of medical emergencies in dental practice and availability of emergency drugs and equipment in dental practice in government dental clinics and hospitals in Lagos State. The study covered 22 government dental clinics and hospitals in Lagos State. Data obtained was entered into a computerand analyzed using Statistical Package for Social Science (SPSS) Version-16 data analysis software. Chi Square and cross-tabulations were used for the analysis. A 95% Confidence Level was used and a p-value of less than or equal to 0.05 was considered statistically significant.

Results: Of a population of 255 Dental Surgeons on the nominal rolls of all the health institutions, 224 (87%)responded.Of the total respondents, 204 (91.1%) stated they had no emergency kit in their dental clinics (p < 0.05) while 158 respondents (70.5%) stated they had no emergency drugs in their dental practice to manage medical emergencies (p < 0.05). The commonest emergencies reported was syncope 104 respondents (33.8%). 161 respondents (71.9%) claimed they are able to manage medical emergencies encountered in their dental practice if kits and drugs are available.

Conclusion: The findings of the study show that government dental clinics/hospital in Lagos seem not to be adequately prepared to manage medical emergency. Although 71.9% of the dentist claimed they could mange such emergencies should they arise 91.1% and 70% of the respondent claimed they and no emergency kits and drugs to manage such emergencies in their hospital respectively should they arise.

Background: Honey promoteswound healing.

Objective: In this study, we described the anatomical perspective of honey on wound healing in male rats.

Methods: The twenty-four male rats used were randomly divided equally into treated Experimental (E) and Control (C) groups. Infliction of wound done under anaesthesia; honey was used for wound dressing in E, distilled water firmly held by plaster in C. Monitoring of wound contraction were carried out at the interval of three days till the wound healed. The histology of granulation tissue excised from the wounds of rats was also done.

Results: Mean wound contraction (%) of rats in E on days 3, 6, and 9 were: 35.32 +/- 5.5; 57.56 +/- 0.7 and 82.30 +/- 0.9% compared to 26.50 +/- 1.2; 46.69 +/- 0.4 and 61.24 +/- 1.0% of rats in C. Honey treated groups showed significant increase (p < 0.05) in percentage of wound contraction in all treatment days. Complete wound closure day was also significantly shorter. On day 3, E showed a more intense infiltration by neutrophils and macrophages as well as features suggestive of edema and necrosis. On day 9, the connective tissues of E revealed markedly increased fibroblasts, less neutrophils, and presence of numerous new capillary blood vessels.

Conclusion: The use of honey accelerates the wound healing process.