Physical Activity and Pattern of Blood Pressure in Postmenopausal Women With Hypertension in Nigeria

Background: Hormonal changes during menopause have been attributed to hypertension-a common public health concern. This study investigated physical activity (PA) and pattern of blood pressure (BP) in postmenopausal women newly diagnosed with hypertension and referred for treatment at the medicine outpatient clinic of a tertiary health facility in Ibadan, Oyo State, Nigeria. It compared BP pattern and adiposity variables [body mass index (BMI) and waist-hip ratio (WHR)] between two PA groups.Methods: Purposive sampling technique was used to recruit 220 participants in this cross-sectional survey after obtaining their informed consent. International Physical Activity Questionnaire was used to assess PA level, while a 16-item questionnaire was used to assess socio-demographic and clinical profiles of the women. BP, BMI and WHR were assessed using standard measurement procedures. Descriptive statistics of mean ± standard deviation were used for data summarization and independent t-test was used to compare variables between low level and moderate to vigorous level PA groups.Results: Participants’ mean values include: age 61.6 ± 8.5 years, years since menopause 12.75± 8.15, BMI 28.63±4.99kg/m2, WHR 1.11±0.08, SBP and DBP 145.9±17.9; 93.7±11.4 mmHg respectively. Mean values of SBP, DBP, BMI and WHR were higher among participants with low PA compared to those with moderate to vigorous even though the difference was not statistically significant (P>0.05).Conclusion: Involvement in moderate to vigorous physical activities among menopausal women in Nigeria should be encouraged. This may reduce hypertension and adiposity with a possible control of cardiovascular disease risk.Keywords: Postmenopausal, Hypertension, Physical Activity, Blood Pressure, Adiposit

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Pattern of Malocclusion at the Orthodontic Unit, Lagos State University Teaching Hospital, Lagos Nigeria

Objective The aim of this study was to determine the pattern of malocclusion among patients attending the orthodontic clinic, Dental department, of the Lagos State University Teaching Hospital. Method A retrospective study of one hundred and sixty nine patients who attended the orthodontic clinic, LASUTH from January 2007 to December 2008 was conducted. Information regarding age, sex, and type of malocclusion and index of orthodontic treatment need (The dental health component) was obtained from the patients’ record files. Results The patients’ ages ranged from 4 to 34 years with a mean age of 14.08 ± 5.80. There were 95 (55.9%) females and 74 (44.1%) males. The commonest type of malocclusion was Angle’s class 1 seen in 136 (80%), while Class 2 and Class 3 accounted for 26 (15.4%) and 7 (4.1%) respectively. Crowding was noted in 64 (38.1%) patients while 73 (42.3%) had spacing. Only 14 (8.2%) had associated oral habits such as thumb-sucking, lip sucking, tongue sucking and tongue thrusting. No crowding, spacing or associated oral habit was observed in 18 (11.4%)of the patients. Assessment of need for treatment ,using the dental health component of the index of orthodontic treatment (IOTN), showed 62 (36.7%) had mild need, 76 (45.0%) moderate need , 24 (14.2%) severe treatment need and 7 (4.1%) extreme need for treatment. The degree of need for treatment was not significantly related to patient’s age or gender (p-value>0.005). Conclusion The pattern of malocclusion seen among patients attending orthodontic clinic, LASUTH is comparable to the outcome of previous studies done in other centers in Nigeria. There also seems to be an increasing number of adult patients seeking orthodontic treatment. Majority of the patients require mild to moderate orthodontic intervention. Keywords: malocclusion, Angles classification, oral habits, index of orthodontic treatment nee

The Perception of Caregivers Attending A Nigerian Teaching Hospital on Teething

Background: in November 2008. There was a national tragedy which recorded about eighty four Nigerian infant deaths due to the consumption of adulterated teething syrup- 'my pikin' administered to children by mothers to prevent 'teething problems''. This could have been prevented if they had been well informed about the teething process.Objective: to determine the knowledge, understanding and beliefs of caregivers attending LASUTH immunization clinic about teethingMethods: An interviewer administered questionnaire was used to collect data from 260 caregivers of children aged 4- 36 months attending the immunization clinic in LASUTH over a six weeks period. The questionnaire assessed their knowledge, understanding, beliefs about teething and the teething experience in their wards.Results: The mean age of the respondents was 30.4 5.3years. Fifty seven percent had tertiary education. However, none of the caregivers obtained information about teething from the dentist. There was an association between educational level and attitude to teething (p=0.002) as well as their understanding of the teething process (p=0.0009). Gum irritation was the most reported symptom observed in this study. Many of the caregivers had erroneous beliefs regarding the systemic symptoms such as fever, diarrhoea and vomiting which they attributed to teething.Conclusion: Many of the caregivers studied still had erroneous beliefs regarding teething. Thus there is a need to disseminate the right information about teething to care givers in this environment in order to discourage the use of the term '' teething'' for a serious childhood illness that might require prompt medical attention.Key words: Teething, Caregivers and Perception

Knowledge and awareness of orthodontics among Nigerian school children in selected private and public schools in Lagos

Objective: This study sought to assess the knowledge and awareness of Nigerian adolescents concerning orthodontics, to determine possible factors influencing their knowledge of orthodontics as well as to find out if socioeconomic status has any effect on their knowledge and awareness. Method: This cross-sectional descriptive questionnaire based study was conducted in two secondary schools (one private and one public) in Lagos State. Result: A total of 408 students, participated in the study of which only 98 (24.0%) had ever heard the term ‘orthodontics’, and of this number only 16 could correctly explain the meaning of the term orthodontics. Majority of the respondents with correct responses attended a private school. Significantly more of the private school students correctly identified that orthodontists are involved in rearranging the teeth (p=0.006) and not involved in cleaning the teeth (p=0.008). There was a significant difference in the knowledge of the students from the public and private school concerning the impact of malocclusion on speech (p=0.002) and appearance (p=0.000). The overall orthodontic knowledge is deficient. However knowledge was better among the children from the private school compared to those from the public school. The results obtained from this study, clearly show that there is need to provide oral health education especially to improve the orthodontic knowledge of these adolescents especially about malocclusion and its consequences. It is expected that this would improve their knowledge and consequently increase the demand for and the uptake of the available orthodontic services.Nig Dent J Vol 20 No. 1 Jan - June 201

Post-thyroidectomy chronic asthenia: self-deception or disease?

There is clinical evidence that post-total thyroidectomy (TT) patients can present persistent asthenia. The aim of this study was to evaluate the prevalence of asthenia symptoms in such patients, assess whether a chronic asthenia syndrome could be caused by TT or become evident after it. An observational study was carried out comparing two groups of 100 patients each, all with homogeneous characteristics. Group A was treated with total lobectomy (TL), Group B with TT. All patients presented normal thyroid hormone levels. The patients were interviewed in order to identify the ones affected by post-operative asthenia persisting for at least six months, with reduced ability to perform physical and mental work, not showing improvement with rest. The severity of the symptoms has been measured by means of the brief fatigue inventory (BFI). Statistical analysis was performed to evaluate statistically significative differences between groups and prognostic factors in TT group. The incidence of post-operative asthenia was 0 % after TL and 25 % after TT, with the operation being the only significant variable. Asthenia is well known as symptom of post-thyroidectomy, but it has not been adequately investigated as consequence of surgery. We demonstrated that the complete removal of the thyroid gland could determine chronic post-thyroidectomy asthenia, although with intensity limited to low/moderate. Post-thyroidectomy asthenia is a relevant sequela interfering with quality of life of at least 25 % of patients operated, suggesting the need to identify its real causes and limit the indication to TT only when strictly required