Caregivers' perceptions of cleft deformity and experiences in accessing cleft services at a tertiary public hospital in Sokoto, NorthWest, Nigeria

Magister Public Health - MPHCleft lip and/or palate deformity is the most common facial birth defect with an incidence of 1 in 600 for every live birth worldwide. Despite the availability of specialised cleft care in Nigeria, many cleft patients are not aware that CL±Ps can be repaired and, thus, present late for treatment. As a result, there is a high incidence of unoperated CL±P in the country which has a grim negative health impact on the population. Furthermore, it was noted that the family caregivers including parents and other members of the extended family are crucial in getting early care for these children with CL±P. Therefore, understanding the perception of CL±P, attitude and experience with cleft services would go a long way in reducing the problem of late presentation and under-utilisation of these services. Therefore, the aim of the study was to explore the care givers’ perception and experience in accessing cleft services at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. In this study, we employed an exploratory qualitative methodology that gave deep insights and provided clear understanding of the perceptions by caregivers of children with CL±P on the aetiology of cleft, family reactions and their experience in accessing cleft services at our hospital. Data analysis was done following verbatim transcription using thematic analysis. Ethics statement: Before commencement of the study, ethical approval was obtained from the Institutional Review Boards of the University of Western Cape and the Usmanu Danfodiyo University Teaching Hospital Health Research and Ethics Committee. Informed consent was sought from each prospective participant and the signed form appropriately documented

Clinico-Pathological Analysis of Osteomyelitis in Cancrum Oris (Noma) Patients Seen in Noma Children Hospital, Northwest Nigeria

Background: Cancrum oris is a rapid and devastating infectious disease of the orofacial region, which can be life threatening in its fulminant stage. Infection of bone (osteomyelitis) is a possible sequelae of Noma (cancrum oris) and is more likely due to late presentation especially in our environment. A literature search revealed scanty research describing osteomyelitis in Noma patients. Objective: To analyze the clinico–pathology of osteomyelitis in Noma patients diagnosed and treated at Noma Children Hospital, Sokoto. Methods: The design was a 2-year retrospective study of records of Thirty–two patients who had sequestrectomy secondary to osteomyelitis in Noma (Cancrum oris). Age, gender, jaws affected and side of involvement were analyzed Results: The age ranged from 2–11 years with mean ±standard deviation 5.47 ± 2.68 years was recorded. Osteomyelitis in Noma patients was found among 17 (53.10%) males compared to 15 (46.90%) females. In 20 (62. 50%) of the cases, anterior maxillary involvement was observed and the remaining 12 (37. 50%) was found at the mandibular posterior region and it is more common on the left side. Result of histopathology showed both acute and chronic inflammatory cells. Necrosis and bone hyperactivity was observed in most of the slides. Conclusion: Osteomyelitis is a common complication of Noma and its treatment is of paramount importance for adequate management of Noma patients. &nbsp

A concise overview of dental implantology

Background: The emergence of osseointegrated dental implants has resulted in several applications in diverse clinical settings. Hence, has contributed to the suitable replacement of missing teeth and the realization of an optimal facial appearance. This paper describes the benefits, applications, contraindications, and complications of dental implants in contemporary dental practice. Materials and Methods: An electronic search was undertaken in PUBMED without time restriction for appropriate English papers on dental implants based on a series of keywords in different combinations. Results: Fifty-eight acceptable, relevant articles were selected for review. The review identified the various components of dental implants, classification, and brands. It also looked at osseointegration and factors promoting and inimical to it. It also explored primary and secondary stability; and patients' selection for a dental implant. Complications of dental implants were also highlighted. Conclusion: With over 95% success rate, dental implants remain the gold standard for achieving aesthetic and functional oral rehabilitation

A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria

Abstract Background There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery. Methods A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software. Results One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)]. Conclusion Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted

Oral and maxillofacial malignancies: An analysis of 77 cases seen at an academic medical hospital

Introduction: Oral and maxillofacial malignancies (OMMs) consist of a wide range of lesions, which constitute varying proportions of the total incidence of malignancies in the human population. Available epidemiological data vary across racial, geographical, gender, and occupational divides. They are often associated with significant impairment of patients' quality of life. Materials and Methods: A review of hospital records of patients with histologically diagnosed primary OMM, who presented to the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, over a 5-year period, was done. Data including age, gender, site, and type of tumor, and histological grade of tumor were retrieved and analyzed with the SPSS version 20.0. Results: A total of 77 cases of OMMs were identified with a male/female ratio of 1:1.03. The mean (±standard deviation) age was 50.1 (17.8) years. Squamous cell carcinoma was the most frequently seen epithelial malignancy constituting 35.1% of all malignancies, with most patients in advanced stages of the disease. Osteosarcoma was the most frequently diagnosed sarcoma, constituting 11.7% of all malignancies seen. Salivary gland malignancies constituted 29 (37.7%). Other malignancies seen include, malignant peripheral nerve sheath tumor, leiomyosarcoma, and malignant melanoma. Conclusion: OMMs constitute a significant health burden in our region. Thus, adequate resources should be allocated toward improving awareness among the populace. Policy shifts and regular dental visits which may increase the likelihood of early intervention should be instituted

Pattern of utilization of dental services at Federal Medical Centre, Katsina, Northwest Nigeria

Background: Oral health has been demonstrated to be an integral component of general health, with a serious impact on the quality of life and the overall well-being. Dental care utilization is an indispensable facilitator of oral health. Reports from the African continent highlight poor utilization of dental services across urban and rural populations. Hence, this study aims to determine the use of dental services by patients attending the dental clinic of Federal Medical Centre, Katsina between January 2011 and December 2012. Materials and Methods: The patients′ records were retrieved and analyzed for demographic data, diagnosis, and treatment. Results: During the 2-year study period, a total of 2021 patients [1083 (53.6%) males and 938 (46.4%) females] were treated. The age of the patients ranged from 4 months to 94 years [mean ± standard deviation (SD) =28.6 years ± 16.2; median 28 years]. Approximately 80% of the patients were below the age of 40 years, with 21-30 years age group recording the highest frequency (28%). Most of the patients had caries and its sequelae, followed by periodontal disease (n = 352, 17.4%). Restorative and surgical procedures (n = 808, 40%) were the major treatment utilized by this cohort, with periodontal procedure trailing (n = 3951, 8.6%). Tooth extraction (n = 755, 37.3%) was the primary treatment accessed, followed by amalgam filling (n = 651, 32.2%) and scaling/polishing (n = 355, 17.6%). Conclusion: Our data demonstrate preponderance of male gender and young age group in the utilization of dental services among the study population. Tooth extraction was the most frequently provided dental treatment. We recommend preventive oral care as a means of reducing dental burden in the center

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines

Maxillectomy defects - to reconstruct or not? Pilot survey of Nigerian oral and maxillofacial surgeons

Background: The choice of reconstruction options for maxillectomy defects varies significantly. Factors affecting it range from the type of defect to the surgeon's expertise. This study aims to evaluate the practice of Nigerian Oral and Maxillofacial surgeons in the reconstruction of post-maxillectomy defects. Materials and Methods: The survey was conducted by use of questionnaires administered at the annual scientific meeting of the oral and maxillofacial surgeons of Nigeria in Ibadan 2012. Results: A response rate of 66.7% was achieved. All of our respondents are consultant oral and maxillofacial surgeons, 80% of whom practice in a teaching hospital. All but one of them perform maxillectomies, however only 25% of them offer surgical reconstruction of the resulting defects to patients. Flaps have been used by 25% of the respondents, while none of them has employed microvascular reconstruction. Prosthetic rehabilitation of patients is pervasive among the respondents. Conclusion: Maxillectomy defects have far-reaching consequences on patients' quality of life and attempts should be made to reconstruct such defects. Although maxillectomy is a commonly performed procedure among oral and maxillofacial surgeons in Nigeria, especially for malignancies of the oral and paranasal sinuses, surgical reconstruction of resulting defects is not so frequently done. Microvascular surgery, which is becoming a frequently utilized option among surgeons in developed nations, is still infrequently used in our environment. There is a need for oral and maxillofacial surgeons in our climes to improve their skills so as to increase the range of reconstructive options offered

Challenges in the management of cervicofacial necrotizing fasciitis in Sokoto, Northwest Nigeria

Introduction: Necrotizing fasciitis (NF) is a rapidly progressive, potentially fatal tissue infection with primary involvement of the subcutaneous fascia and resultant necrosis of the skin and subcutaneous tissues with relative sparing of the underlying muscles and bones. It pursues a fulminant, unrelenting course if treatment is not instituted early and aggressively. The aim of this paper was to document the clinical features and challenges encountered in the management of cervicofacial NF (CNF) in Usmanu Danfodiyo University Teaching Hospital, Sokoto. In addition, the hypothesis that there is a correlation between the duration of disease at presentation and length of hospital stay was tested. Patients and Methods: A retrospective review of cases of CNF managed between December 2014 and November 2015 at our center was done. Demographic and clinical data were retrieved. Patients were managed in strict adherence to the established hospital protocol. Results: Thirteen cases managed for CNF were included in this study, all of whom were of low socioeconomic status. The duration of symptoms before presentation ranged from 2 to 21 days with a mean (΁standard deviation [SD]) of 7.6 (5.2). The length of hospital stay ranged from 7 to 44 days, with a mean (΁SD) of 19.5 (11.3). A statistically significant correlation between the duration of disease before presentation and length of hospital stay was observed (P < 0.05). Conclusion: NF, though rarely seen in some climes, is still a present health challenge in our environment. Despite improvements in healthcare indices, the associated morbidity and mortality rate is still quite high. The management of CNF in a resource-limited environment like ours presents grim challenges

Prevalence of Dental Caries Among Children and Young Adults with Disabilities Attending a Special Needs School in Sokoto, Nigeria: Caries Prevalence of Students with Disabilities in Sokoto

Objective: To determine the prevalence of dental caries among children and young adults with disabilities attending a special needs school in Sokoto, Nigeria. Methods: This study was a descriptive cross-sectional survey among children and young adults with disabilities attending a special needs school in Sokoto, Nigeria. Data collected were the social demographic and dental caries status of the participants. Data were analysed using IBM SPSS Statistics for Windows, Version 23.0. The socio-demographic characteristics, as well as the dental caries prevalence of the participants, were determined using descriptive statistics. The results were presented in frequency tables and charts. A p-value less than 0.05 was considered significant. Results: Prevalence of caries was 35.6%. Participants with hearing impairment had the highest caries prevalence (16.5%, n= 39). The highest caries prevalence per age group was amongst the 20 years and above age group (50.0%), followed by the 6-12year old group (46.2%). The Pearson chi-square test result for prevalence per age group was statistically significant (p= 0.029). Analysis by grade (class) showed a higher prevalence in the primary school section (39.3%) than in the secondary school section. Conclusion: The prevalence of dental caries was 35.6%.&nbsp; It was significantly higher in the hearing and intellectually impaired groups than in their visually and physically impaired counterparts. Also, it was higher among the age group 20 years and above than in other age groups. &nbsp