Annals of Ibadan postgraduate medicine最新文献

Background: Age estimation for sporting activities, legal age determination and migration purpose is oftentimes essential, which makes the need for a scientifically proven method of age estimation an important aspect of medical practice. Forensic odontology is an essential aspect of forensic practice and may be a veritable tool in age estimation.

Aim and objective: The objective of this study was to evaluate the usefulness of orthopantomograms (OPG) in age estimation among selected Nigerians.

Methodology: A retrospective assessment of 202 OPGs was done to review the visibility of the periodontal ligament of third molars with completed root formation according to the methods described by Olze et al (2010). Individual ages were then calculated by deducting date of exposure from the date of birth recorded in years. Mean age with standard deviation were calculated for each group.

Results: Assessing the minimum and maximum age at which each of the stages of the radiographic visibility of the periodontal ligament as seen on the OPGs revealed that there was a gradual increase in the age at which the stage increment occurred, with a few exceptions. Comparison of the radiographic visibility of the periodontal ligament revealed that males tend to achieve early periodontal visibility stages compared to females, but the reverse was observed in later stages. Age 17 is more than likely attained in any person found within stages 1 to 3 as the minimum age found in these stages were above 17 years.

Conclusion: With a few exceptions, the assessment of periodontal ligament visibility on OPGs can adequately predict the age of individuals. Thus, the use of this method may need to be combined with other methods in accurate determination of dental age in instances of forensic age estimation.

Objective: To compare the effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide as non-vital bleaching agent of anterior discolored teeth.

Materials and methods: A randomized controlled trial was undertaken among 61 patients who presented with 70 discolored anterior teeth at the Conservative and Family Dentistry Clinics of the University College Hospital, Ibadan, Nigeria. The 70 teeth were randomly allocated into two groups of treatments. In Group A, the test group, the coronal part of endodontically treated teeth was further treated with sodium perborate mixed with distilled water while group B, the control group, the coronal part of endodontically treated teeth were also further treated with sodium perborate mixed with 30% hydrogen peroxide. Information on study participants biodata and satisfaction with treatment were obtained. Tooth shade assessment was done using shade guide units of the vitapan shade guide at baseline and during recall visits on days 7, 14, and 21. Frequencies, means, and standard deviations were generated. The Chi-squared test was used to determine the association between two categorical variables at p < 0.05.

Results: In the control group, the mean ± SD tooth shade was 12.5 ± 3.2, 8.7 ± 3.8, 4.9 ± 2.8, and 3.1 ± 2.2 at baseline, Day 7, Day 14, and Day 21, respectively. In the test group, the corresponding values were 12.8 ± 3.2, 9.6 ± 3.9, 5.6 ± 3.0, and 4.0 ± 2.9. The mean ± SD tooth shade scores of the control and test groups were 12.5 ± 3.2 and 12.8 ± 3.2, respectively (p = 0.15). Twenty-two (62.9%) and 19 (54.3%) of the study participants in the control and test groups, respectively, reported that they were extremely satisfied (p = 0.60).

Conclusion: The effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide in lightening the coronal part of endodontically treated non-vital discolored anterior teeth was similar. Both bleaching agents demonstrated similar patient satisfaction.

Background: Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria.

Methods: A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method.

Results: Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff.

Conclusion: The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.

Background: Congenital Hernia of umbilical cord (CHUC) is a rare presentation. The failure of return of intestinal loops following physiological herniation has been postulated as the embryological basis of this condition. This is usually mistakenly termed as omphalocele minor. We aim to highlight this rare finding, the clinical features, diagnostic dilemma, and management of CHUC.

Case presentation: He is a 4-day old male with obstructed CHUC. He had an oedematous umbilical stump, with circumferential normal abdominal wall skin folds in the form of a collar wrapping round the proximal aspect of the protrusion. The umbilical defect measured about 4 cm in diameter. Subsequently, surgical reduction and repair of defect was done, with resolution of symptoms.

Conclusion: CHUC though a rare entity and easily missed, accurate diagnosis and management offer good prognosis. Also, recognition will prevent iatrogenic bowel injury from careless clamping of the cord with associated morbidity and mortality. It also helps to prevent mis categorization and prevent unwarranted anxiety with misdiagnosis.

Background: Military personnel (MP) are exposed to situations such as loneliness and alcohol use that lead to sexual risk behaviours (SRBs) with serious implications for the spread of sexually transmitted infections (STIs). Compulsive sexual behaviour disorder (CSBD) is a psychosexual condition that is characterized by a consistent failure to control sexual behaviour and continuation of the behaviour despite the consequences. The prevalence of CSBD is underreported due to the sensitive nature of the behaviour. This study thereby assesses SRBs and CSBD and associated factors among MP.

Methods: A cross-sectional study among 406 MP in Ibadan using a convenient sampling method to select the personnel serving in the two military barracks in Ibadan. MP available on the days of data collection were interviewed. A semi-structured, interviewer-administered questionnaire was used to obtain information on SRBs and CSBD. Descriptive and inferential statistics were done and the Chi-Square test was used to test for association between independent and outcome variables at p < 0.05.

Results: The mean age of respondents was 30.1±10.1 years. Above half (52.7%) were aged 20 - 30 years, 70.7% were males, and 56.6% were not living with a partner. The prevalence of SRBs among respondents was 79.6% while the prevalence of CSBD was 6.4%. Gender and marital status were predictors of SRBs.

Conclusion: The majority of MP engaged in SRBs while less than one-tenth had CSBD. Gender and marital status were predictors of SRBs. Risk reduction counseling was recommended for MP.

Introduction: Diabetes mellitus is a disease with diverse macrovascular and microvascular consequences. One of the unusual effects of hyperglycemia is involuntary movement, termed hyperglycemia-induced involuntary movement. This could range from hemibalismus, chorea, choreo-atethosis, tremors to dystonia. Chorea associated with dystonia is a less commonly reported manifestation. When it is focal, it can be misdiagnosed as stroke or seizure disorder. To the best our knowledge, there is hitherto no case report in sub-Saharan Africa describing the occurrence of focal choreo-dystonia in type 2 Diabetes Mellitus.

Case presentation: Here, we present a case of a middle-aged Nigerian woman with focal choreo-dystonia of the right upper limb accompanying the diagnosis of type 2 diabetes. Achieving euglycemia with insulin resulted in complete resolution of the choreo-dystonia.

Conclusion: Doctors in resource-constrained settings should be aware of this presentation to avoid misdiagnosis and to provide prompt and goal-oriented management with a view to reducing morbidity and attendant health-care costs.

Background: Pre-eclampsia, an important cause of maternal and perinatal morbidity and mortality world-wide has been linked to subclinical infections, with maternal infection and inflammation postulated in its aetio-pathogenesis including asymptomatic bacteriuria which is common in pregnancy. The Obejctive of the study is to determine the relationship of asymptomatic bacteriuria as a risk factor for pre-eclampsia.

Methodology: A hospital-based case-control study among 28 pre-eclamptic pregnant women (cases) and 56 healthy pregnant women (controls) at gestational age of at least 28 weeks at the University College Hospital, Ibadan, between January 2019 and August 2019. Controls were matched with cases in age, parity and gestational age. Asymptomatic bacteriuria was determined with mid-stream urine analysis for microscopy and culture and data collected using an interviewer administered questionnaire with other details from medical records extracts. Chi- square, and multivariate regression analysis were used to assess statistical significance, odds ratio and adjusted odds ratio respectively, with P-value <0.05 and 95% confidence interval (CI).

Results: There was a significant association between asymptomatic bacteriuria and pre-eclampsia. The rate of asymptomatic bacteriuria was about three times higher in women with pre-eclampsia compared to those without pre-eclampsia and 1.23 times higher after adjusting for confounders (OR: 2.9, AOR:1.23). There was no significant relationship between sterile pyuria and pre-eclampsia (p-value: 0.92).

Conclusion: This study supports the proposition that asymptomatic bacteriuria is a risk factor for pre-eclampsia. It has not however shown whether the association is causal or casual. Further studies will be needed to explain this.

Introduction: Most cases of Meckel's Diverticulum (MD) are asymptomatic and when symptomatic, preoperative diagnosis of MD maybe a dilemma. Intestinal obstruction is a major complication in the adult population.

Case presentation: We report a case of a 24-year-old female presenting with intestinal obstruction from Meckels Diverticulum.

Conclusion: MD is largely asymptomatic in adults, however may be present and should be included in our array of differential diagnoses.

Introduction and aims: Today, smoking is recognized as the biggest cause of preventable premature death. dentists can play a very important role in motivating and providing smoking cessation counseling and play this role of line requires gaining sufficient knowledge and education during the student period. Therefore, the purpose of this study is to determine the knowledge and attitude of dental students in Kerman in the field of smoking cessation counseling.

Methods and materials: This study was descriptive-analytical and crosssectional. The study population was fourth, fifth and sixth year dental students. A questionnaire was used to assess participants knowledge and attitude towards smoking cessation, using the 5 As of smoking cessation. Data were collected using a questionnaire and analyzed using SPSS 21, t-test and chi-square software.

Results: This study showed that the mean score of students' knowledge was 2.13 ± 14.12. There was a significant relationship between knowledge score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, 0.001, respectively). Also, the mean attitude score was 36.25 41 5.41. There was a significant relationship between attitude score, gender (women more than men) and the presence of a smoker in the family (P = 0.01, respectively).

Conclusion: Results of this study showed that the students have good knowledge of the 5As (Ask, Advice, Assess, Assist, Arrange) but that they did not have much information about some parameters under Assess. Also, they have a positive attitude in this regard. Moreover, students believed that time limitations in dental visits and concerns on the effectiveness of smoking cessation consultations are the major obstacle in implementing a smoking cessation plan.

Introduction: Colonic volvulus is a common cause of large bowel obstruction with the sigmoid colon most commonly affected. Volvulus of the transverse colon is an uncommon occurrence. Rarer still is a transverse colon volvulus developing after surgery for a sigmoid colon volvulus. Early diagnosis is critical as delay in detection and intervention is associated with the risk of complications - perforation, peritonitis, and death.

Case presentation: We report the case of an 86-year-old man who presented with features of large bowel obstruction 14 months following a sigmoid colectomy for a sigmoid colon volvulus.

Conclusion: A metachronous transverse colonic volvulus is uncommon. Preoperative diagnosis is challenging as there are no defining radiographic features compared to the volvulus of the sigmoid colon with the classical omega sign. Most cases are diagnosed intra-operatively. Bowel resection and anastomosis in a single stage is a safe option.