Enrolment and Retention of African Women in Biomedical Research: the Challenges

In Africa, women have had minimal participation in biomedical research especially in clinical trials despite the epidemiologic realities of the trends and burden of diseases in the continent. The purpose of this paper is to critically examine the challenges as well as suggesting ways of over-coming them in recruiting and retainingAfrican women in biomedical research. Relevant biomedical research literatures on Human Research Participants from Scirus, Pubmed and Medline computerized search were critically evaluated and highlighted. Information was also obtained fromresearch ethics training as well as texts and journals in the medical libraries of the research ethics departments of the Universities of Pretoria, Kwazulu-Natal, Johns Hopkins Berman Institute of Bioethics Baltimore and Kennedy Institute of Bioethics Georgetown University, WashingtonDC. Studies reviewed have shown that African women have an unfair participation in biomedical research. Efforts in enrolling and retaining women in biomedical research are hampered by chain reactions ofevents viz: gender perception, cultural barriers, ignorance and  fear  of  adverse  event,  limited  autonomy  to  give consent, lack of confidentiality especially in sensitive trials, and improper research design.Women need to participate in clinical trials because of their different biological and physiological make-up which require proper information about the effects of drugs on their bodies. A variety of harm maytherefore ensue from failure to include adequate numbers of women in biomedical research such as exposure to ineffective treatment, occurrence of unexpected sideeffects and delayed diagnosis and early treatment ofdisease.Keywords: Biomedical research; African women; Participation; Challenge

Clinical Evaluation of the Efficacy of Arthocare Forte, A Chondro-Protective and Anti-Arthritic Drug in the Management of Bacterial Plaque-Induced Chronic Periodontitis

Background: Arthocare forte medication is made up of different  constituents and the advantages offered by this disposition have not been explored in the management of chronic periodontitis. Aim: The aim was to assess the clinical response of bacterial  plaque.induced generalized chronic periodontitis to arthocare medication, and the relationship of age and gender to the prevalence of chronic  periodontal disease. Subjects and Methods: This study was done at the Dental Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria. It was a Prospective randomized  controlled trial evaluating the effect of arthocare treatment on 81/162  patients with teeth mobility over a period of 5 years. All the patients (162) underwent root planing, and 81/162 (50%) were treated with arthocare for comparative analysis. The variables recorded were patientfs age, gender, and degree of tooth mobility, periodontal pocket, and bleeding from the pocket after treatment. Statistical analysis was done using EPI INFO 7. Results: Majority of the patients were between 46 and 75 years in both control (n = 59/81, 72.8%) and experimental groups (n = 52/81, 64.2%). There were 86/162 (53.1%) males and 76/162 (46.9%) females, giving a male.to.female ratio of 1.1:1. Seventy.seven patients (95.1%) in the experimental group had total remission in comparison to 32/81 (39.5%) in control group which was statistically significant (P < 0.001). Conclusion: The arthocare administered to patients in the experimental group speeds up the regenerative capacity and stability of the periodontium when compared with the control. Multicentre clinical trials are recommended to validate the use of arthocare forte in the treatment of generalized chronic periodontitis.Keywords: Arthocare, Bacterial plaque, Chronic periodontiti

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

Evaluation Of Postoperative Facial Swelling Following The Surgical Removal Of Impacted Third Molars Using The Tape Measuring Technique.

Context: The complications associated with the removal of impacted third molars should not be underestimated. The surgery entails incision, stripping of periosteum, bone and tooth removal, and suturing. Swelling is almost universal after this procedure which, affect patients daily life activities. Objectives: To assess the use of tape measuring technique in the clinical evaluation of facial swelling following lower third molar surgery. Patients and Methods: Clinical evaluation of facial swelling after the surgical removal of impacted mandibular third molars using a tape measuring technique was carried out among 50 patients of both genders at the oral and maxillofacial surgery clinic of the University of Nigeria Teaching Hospital and Ntasiobi Specialist Hospital both in Enugu. Postoperative facial swelling was evaluated at 24 hours, 72 hours and five days. The measurements obtained were recorded and converted to relative values, which provided numerical data for comparative analysis Results: The result of our study shows that swelling usually reaches its maximum within 48 – 72 hours after surgery and begins to subside from the day after. We equally observed that there was an increase in the duration of surgical procedure in different molar positions with corresponding increase in amount of facial swelling. Conclusion: Patients are hampered by the level of physical discomfort within 2 – 3 days after surgery, which include perception of their appearance and oral function. Treatment for minimizing this postoperative sequalae should commence immediately after surgery to achieve desired and maximum effect. The tape measuring method is simple, non-invasive, cost effective and time-saving method, which provides numerical data for determination of facial contour changes.Keywords: Third molar surgery, Swelling, Clinical evaluation, Tape measuring Techniqu

Prognosis of teeth in the line of mandibular fracture: 5 - year clinical and radiological follow-up

OBJECTIVE: The purpose of this article is to  highlight our experience with the prognosis of teeth retained in the line of mandibular fracture after treatment of the fracture.PATIENTS AND METHODS: A prospective evaluation of 62 patients with 200 teeth in the line of mandibular fracture seen and treated at the Dental and Maxillofacial Clinic, University of Calabar Teaching Hospital, Calabar south-south Nigeria between 2005 and 2009 was carried out. The focus was on 96 teeth in the line of mandibular fracture retained after reduction and immobilization of the fracture by closed reduction technique. The clinical and radiological follow-up period of patients ranged between six months and 3.5 years.RESULTS: Majority of the patients 33 (53.2%) were in their third decade of life. The age of patients' ranged from seven to 48 years with a mean of 24 + 2.3 years. There were 48 (77.4%) males and 14 (22.5%) females giving a male-to-female ratio of 3.4:1. One hundred and four teeth (52%) out of the 200 were extracted during treatment of the fracture. Of the remaining 96 teeth, 25 (26.0%) were anterior teeth while 71(73.9%) were posterior. Twenty-four (25.0%) of the teeth in the line of fracture developed complications .Of those teeth involved with complications 10 (41.7%) were incisors and canine while 14 (58.3%) premolars and molars. Hypersensitivity and discolouration were the predominant complications..CONCLUSION: Appropriate case selection and thorough clinical and radiological assessment is required to reduce the rate of complications of teeth left in-situ in the mandibular fracture line after treatment. The various complications in this study were managed successfullyKEYWORDS: Teeth in the line of mandibular fracture; Clinical and radiological evaluation; Prognosi

Civilian Gunshot injuries to the Oro-facial region in Calabar, South-South Nigeria, 2002-2006

Background: This article reviews 16 cases of civilian gunshot injuries of the oro-facial region seen at University of Calabar Teaching Hospital, Calabar over a 5-year period and highlights the rising trend in the occurrence of gun shot injuries to the orofacial region as experienced in the south-south region of Nigeria Methodology: Records of 16 patients with different types of gunshot injuries to the oro-facial region seen and treated at the University of Calabar Teaching Hospital, Calabar between 2002 and 2006 were reviewed. The focus was on the patient\'s age, gender, type of weapons used, the surrounding circumstances (accidental or intentional), the time of occurrence and management. Results: Out of 16 patients seen, 14 (87.5%) were males and 2 (12.5%) were females, giving a male to female ratio of 7:1, with the age range from 18 to 50 years. Thirteen (81.3%) of the patients were injured by low velocity missile while 3 (18.7%) by high velocity missile. Violence was responsible for 14 cases (81.7%), and 2 cases (18.3%) was due to the accidental discharge. Conclusion: This study has shown an increasing occurrence of gunshot injuries to the oro-facial region in our environment with males more affected than females. With the changing political situation, social advancement and urbanization, there is a need to regulate the influx of deadly weapons in the country by the relevant agencies. Maxillofacial surgeons should also brace up to the new development as this poses a new kind of challenge to our knowledge of trauma management. Keywords: Gunshot injuries, Oro-facial region, Calabar, South-south Nigeria Nigerian Journal of Medicine Vol. 17 (3) 2008: pp. 257-26

Attendance Pattern amongst Patients at the Dental Clinic of the University of Nigeria

Objective: Dental clinic attendance is one of the indicators of health behaviour which will ultimately impact on the oral health. This study aimed at determining the patients' attendance pattern and the reasons for attendance at the Dental clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu. Methods: A retrospective study was done using the record book of the Oral Diagnosis unit of the Dental clinic in UNTH. Data on patients' age, gender, presenting complaint(s) at first visit were obtained from these books. Patients with incomplete records were omitted. The data were analysed statistically using Statistical Package for Social Sciences (version 15); frequencies of all relevant variables were generated and Chi-square test was used to compare categorical variables at p < 0.05. Results: Data of 1663 patients with mean age of 33.2 ± 18 years were obtained. Six hundred and eighty six (41.3%) were males while 977 (58.7%) were females; a statistically significant difference was found in the quarterly attendances of males and females (p< 0.05). The 20-29 and the 0-9 years age groups had 36.1% and 6.5% records respectively. Eight hundred and twenty five (49.2%) visited clinic because of pain, 7.6% for swellings in the mouth and 5.7%  were without symptom but attended for routine check ups cum professional tooth cleaning. Conclusion: Asymptomatic dental clinic attendance was not common in this report; attendances were mostly prompted by pain. More females than males attended clinic and the second quarter of the year witnessed the highest turn out of patients. Keywords: dental attendance, oral health, patient's complaint

Oral Health And Diabetes: A Review Of 150 Patients Attending The Weekly Diabetic Clinic At The University Of Calabar Teaching Hospital Calabar, Nigeria.

Background: Diabetes mellitus is a metabolic disease which may have an effect on the gingival status and may aggravate pre-existing oral disease. Routine dental evaluation is therefore necessary in its management. The purpose of this article is to investigate the oral health status of one 150 Diabetic patients who attend the weekly diabetic clinic at the University of Calabar Teaching Hospital, Calabar. Patients and Methods: This is a cross sectional questionnaire-based descriptive study. Patients who attended the diabetic clinic of the hospital between January 1st 2004 and December 31st 2006 and consented were randomly recruited for the study. Results: There were 60 (40%) males and 90 (60%) females giving a male-tofemale ratio of 1:1.5. Most of the patients were between 41 and 50 years of age. The diagnosis of a major percentage of the patients were over five years prior to the time of this study. One hundred and eighteen (78%) out of the 150 patients had never visited the dental clinic before presentation. Conclusion: Most diabetic patients in our environment have poor perception and awareness of their diabetic condition as it relates to their oral health. It is important to have a collaborative and combined approach among physicians and the dental surgeons in the management diabetes mellitus Keywords: Assessment, Awareness, Calabar, Diabetes, Oral. Ebonyi Medical Journal Vol. 7 (1&2) 2008: pp. 31-3

Maxillofacial Injuries in Calabar South-South, Nigeria: A 5 Year Study of Jawbone Fractures

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