Patients` compliance with instructions after oral surgery in Nigeria

Objective: To prospectively study the behaviour of oral surgery patients given verbal and written instructions, verbal instructions alone and written instructions alone after minor surgical procedures to return for review visits, remember correctly form of instruction given, compliance and level of satisfaction with treatment. Method: Patients for minor oral surgery were given one of the following: verbal and written (group A), verbal only (group B) and written only (group C) instructions 30 minutes to one hour after the procedure. Patients in groups A and B were consecutively recruited to have 150 patients in group A and 50 in group B. Group C was made up of 25 patients who all claimed to have had at least six years of formal education in the English language. One week postoperatively, information was sought, through questionnaire administration, from all study patients who came for review on remembrance of form of postoperative instructions given, compliance, expectations from procedure and level of satisfaction with treatment. Results: Patients\' return rate was 93, 54 and 64% for groups A, B and C respectively. Remembrance of correct form in which instructions were given was not significantly different among the various groups (p=0.5). There was significantly better compliance among group B patients to the instruction on the use of warm saline mouthwash (warm saline) than groups A and C, (p=0.04). Non compliance with antibiotic therapy was significantly more among group A than other patients (p=0.03) but no significant difference was observed in analgesic non compliance (p=0.9). Postoperative expectations were not significantly different among the three groups of patients. Patients in group A showed a higher level of satisfaction with treatment (76%) than other patients (63-67%) though the difference was not statistically significant. Conclusion: The study showed that provision of both written and verbal postoperative instructions to patients after minor oral surgery enhances compliance.Keywords: oral surgery, verbal and written instruction, dental complianceJournal of Community Medicine and Primary Health Care 2005, 17(1): 38-4

Helminthic infections among farmers in a rural community in Oyo State, south-western Nigeria

Background: Helminthic infections are occupationally-related diseases which potentially undermine farmers' work capacity, productivity and life expectancy. These infections are usually under-reported among this group particularly in the rural areas. This study was carried out to determine the prevalence, pattern and factors associated with helminthic infections among farmers in a rural community in Oyo State, South-western Nigeria.Methodology: A cross-sectional study was conducted among 400 farmers, selected by a two-stage cluster sampling technique. A structured interviewer administered questionnaire was used to obtain information on respondents' demographic characteristics and farming activities. Stool was examined using microscopy for ova of helminths and Packed Cell Volume (PCV) was determined with anaemia defined as PCV ≤ 30%. Frequencies were generated and Chi-square test was used to determine associations at the level of p≤0.05.Results: Majority of the respondents (71%) were males, aged ≥50 years (67.9%), of Yoruba ethnicity (94.2%), and had no formal education (69.8%). Most respondents (57.0%) were engaged in subsistence farming and 75.8% produced food crops. The prevalence of helminthic infections was 27.9%: the commonest forms were ascaris (68%) and hookworm (29.9%). Co-infections were found in 7.2% respondents with the most frequent combination being ascaris and hookworm. Twenty six (6.5%) of the farmers had anaemia. Significantly higher proportions of those aged ≥60 years and without education had intestinal helminthic infections and higher proportions of those with helminthic infections had anaemia compared with their respective counterparts (p<0.05).Conclusion: Helminthic infection is prevalent among this population. Interventions targeted at prevention and treatment should be implemented.Keywords: Farmers, Helminthic infections, Rural community, South-western, Nigeri

Congenital bilateral fusion of the maxillomandibular alveolar processes with craniosynostosis: report ofa rare case

A rare congenital anomaly of maxillomandibular fusion with pectus excavatum and craniosynostosis in a neonate is presented. The child was kept alive by nasogastric tube feeding.Amodification of classification of syngnathia is proposed. The aetiopathogenesis and difficulty in management in our environment are discussed. Keywords: Bilateral; alveolar fusion; craniosynostosis; pectus excavatum Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.78-8

Factors associated with treatment gap in children and adolescents with epilepsy in a rural Nigerian community.

Background: The campaign against epilepsy is hampered by the difference between those with the active disorder and the number of them receiving appropriate treatment (treatment gap) in sub-Saharan Africa. Identifying the determinants of this gap is crucial to providing and achieving optimal care.Objective: To identify the determinants of epilepsy treatment gap (ETG) in children and adolescents (Subjects) with epilepsy in a rural community.Methods: Subjects were identified through a community house to house survey. Information obtained from Subjects and their care givers included: sociodemographic characteristics, type and frequency of epileptic seizures,current and past treatment options utilized, reasons for treatment options used, and treatment options utilized for other health complaints.Results: Twenty three Subjects (6.4/1000 of the child and adolescent population) were identified as having epilepsy. Their age range was 4-19 years (mean 14.3±4.7 years). Most were males (82.6%) and adolescents (78.3%). Seizures were mostly generalized (95.7%) and occurred most frequently daily. Current treatment modalities were use of traditional medication (100%) and prayers (34.8%).None was currently on orthodox medical therapy (ETG, 100%) but 5(21.7%) had utilized orthodox medical therapy in the past. The main determinants of the ETG were strong cultural belief, weakness in the health system to epilepsy treatment and low socioeconomic status. Fever was the commonest other health complaint and use of orthodox medical therapy was significantly (p˂ 0.05) the main (16, 69.6%) treatment option utilized.Conclusion: Cultural belief, weak health system and low socioeconomic status were determinants of an absolute ETG. It highlights the need to strengthen initiatives that enhance accessibility to standard epilepsy treatment.Key words: Epilepsy treatmentgap, determinants, children, adolescents, rural communit

Tumours and tumour-like lesions of the lower face at Korle Bu Teaching Hospital, Ghana – an eight year study

<p>Abstract</p> <p>Background</p> <p>The oro-facial region including the jawbones, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla, especially, in West African children. We report results from a retrospective study spanning eight years on the frequency, clinical presentation, sites and character of lower face tumours seen in the main referral hospital in Ghana.</p> <p>Patients and methods</p> <p>Records of consecutive patients of all age and sex seen by the first author's team at the Department of Oral and Maxillofacial Surgery, Korle-Bu Teaching Hospital with tumours affecting the lower part of the face from January 1996 to December 2003 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology.</p> <p>Results</p> <p>A total of 394 patients with oro-facial swellings were retrieved from the registry out of which 210 had lower face tumour and tumour-like lesions. The complete data set was obtained for 171 patients, comprising 99 (58%) males and 72 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), pain (41%) and ulceration (29%). The tumours were predominantly found in the right (43%), anterior (19%) and left (18%) aspects of the lower face. The remainder making up 20% were found in the floor of the mouth, tongue and lips. Seventy eight (45.6%) of the patients presented with lesions that were classified as malignant of which 54 (62%) were diagnosed as squamous cell carcinoma (SCC). Sixty-two (36.3%) had benign odontogenic tumours and thirty-one (18.1%) had non-odontogenic tumour-like lesions. Fifty-four (62%) of malignant tumours were squamous cell carcinoma; 58 (93.6%) of the benign odontogenic tumours were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged between 11 and 30 years. Malignant tumours were more commonly detected in patients between 41 and 70 years (63%).</p> <p>Conclusion</p> <p>Tumours and tumour-like lesions of the lower face comprising the mandible, tongue and adjacent structures are a diverse group of neoplasm and are seen commonly in practice of Maxillofacial surgery. Both malignant and benign tumours are seen in the Ghanaian population. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumours seen respectively; the two representing more than 65% of all tumours.</p

Odontogenic tumors and giant cell lesions of jaws - a nine year study

<p>Abstract</p> <p>Objectives</p> <p>A definite geographic variation has been observed in the frequency of odontogenic tumors and giant cell lesions of the jaws reported from different parts of the world. However, there are a few studies on these lesions, especially giant cell lesions, reported from India. Hence, this study was designed to provide a demographic data on the odontogenic tumors and giant cell lesions reported from our institute located in the city of Hyderabad. Hyderabad is the capital city of the southern state of Andhra Pradesh in India. A retrospective analysis of odontogenic tumors and giant cell lesions of jaws reported in our institute between the years 2000 and 2009 was done and this data was compared with previous reports from different parts of the world and India.</p> <p>Methods</p> <p>Biopsies of the lesions received between the years 2000 and 2009 were reviewed and patient's history, clinical, radiological and histopathological characteristics were analyzed.</p> <p>Results</p> <p>A total of 77 biopsies were received during the nine year study period. These lesions were more frequently seen in the males, in a younger age group and showed a predilection for the mandible. Most of them presented as radiolucent, slow growing and painless lesions. Ameloblastomas (71.4%) constituted the majority of odontogenic tumors while central giant cell granulomas (7.8%) constituted the majority of giant cell lesions.</p> <p>Conclusion</p> <p>These lesions showed a definite geographic variation with ameloblastomas being the most common odontogenic tumors and odontomas being relatively rarer lesions in our region.</p

Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods: We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings: In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation: The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.Valery L. Feigin … Andrew T Olagunju … Lalit Yadav … et al. (The 2019 Stroke Collaborators

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Background: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings: Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation: In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations

Global and regional burden of disease and injury in 2016 arising from occupational exposures : a systematic analysis for the Global Burden of Disease Study 2016

Objectives This study provides an overview of the influence of occupational risk factors on the global burden of disease as estimated by the occupational component of the Global Burden of Disease (GBD) 2016 study. Methods The GBD 2016 study estimated the burden in terms of deaths and disability-adjusted life years (DALYs) arising from the effects of occupational risk factors (carcinogens; asthmagens; particulate matter, gases and fumes (PMGF); secondhand smoke (SHS); noise; ergonomic risk factors for low back pain; risk factors for injury). A population attributable fraction (PAF) approach was used for most risk factors. Results In 2016, globally, an estimated 1.53 (95% uncertainty interval 1.39-1.68) million deaths and 76.1 (66.3-86.3) million DALYs were attributable to the included occupational risk factors, accounting for 2.8% of deaths and 3.2% of DALYs from all causes. Most deaths were attributable to PMGF, carcinogens (particularly asbestos), injury risk factors and SHS. Most DALYs were attributable to injury risk factors and ergonomic exposures. Men and persons 55 years or older were most affected. PAFs ranged from 26.8% for low back pain from ergonomic risk factors and 19.6% for hearing loss from noise to 3.4% for carcinogens. DALYs per capita were highest in Oceania, Southeast Asia and Central sub-Saharan Africa. On a per capita basis, between 1990 and 2016 there was an overall decrease of about 31% in deaths and 25% in DALYs. Conclusions Occupational exposures continue to cause an important health burden worldwide, justifying the need for ongoing prevention and control initiatives