Use of oral mucoperiosteal and Pterygo-masseteric muscle flaps as interposition material in surgery of temporomandibular joint ankylosis: a comparative study

Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re‑ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as interpositional material, with pterygo‑masseteric muscles flap after surgical release of TMJ ankylosis. Subjects and Methods: This was a prospective randomized study of all consecutive patients treated for the release of complete TMJ bony ankylosis, from January 2003 to December 2012, at the Oral and Maxillofacial unit of our institution. The patients were randomized into two groups: The pterygo‑masseteric group comprises 22 patients while the oral mucoperiosteal group had 23 patients. Information on demographics, clinical characteristics, and postoperative complications over a 5 year follow‑up period were obtained, and analyzed using the statistical package for social sciences (Statistical Package for the Social Sciences version 13, Chicago, IL, USA). A P < 0.05 was considered significant. Results: The age of the patients ranged from 15 to 28 mean 20.3 (3.35) years while the duration of ankylosis ranged from 2 to 16 mean 5.1 (3.4) years. The baseline demographic (gender; P = 0.92; side; P = 0.58) and clinical characteristics in terms of etiology (P = 0.60) and age (P = 0.52) were comparable in both treatment groups. All the patients presented with complete bony TMJ ankylosis with a preoperative inter‑incisal distance of <0.5 cm. The intraoperative mouth opening achieved ranged from 4 cm to 5 cm, mean 4.6 (0.27) cm and this was not different for either group (P = 0.51). The patients were followed up postoperatively for a period ranging from 3 to 5 years, mean 3.4 (0.62) years. The mouth opening decreased, over the period of postoperative review, from the initial range of 4–5 cm to 2.9–3.6 cm, and this was not different in both groups (P = 0.18). Conclusion: This study suggests that oral mucoperiosteal flap could be an option in the choice of interpositional materials in surgery of TMJ ankylosis.Keywords: Ankylosis, Interpositional materials, Temporomandibular join

Assessment of Heavy Metal Contamination in Soils around Cassava Processing Mills in Sub- Urban Areas of Delta State, Southern Nigeria

The concentrations, contamination/pollution index, anthropogenic input and enrichment factors for metals in soil in the vicinity of cassava processing mills in sub-urban areas of Delta State of Nigeria were examined. The concentrations of metals in all sites and depths ranged from 0.1 to 383.2 mg kg-1 for Mn, 4.0 to 11.3 mg kg-1 for Ni, 1746.4 to 2839.6 mg kg-1 for Fe, 0.01 to 3.70 mg kg-1 for Cr, 3.7 to 29.5 mg kg-1 for Cu, 21.9 to 97.3 mg kg-1 for Zn, 0.01 to 1.60 mg kg-1 for Cd and <0.01 to <0.01 mg kg-1 for Pb. The concentrations of metals at these sites were below the Department of Petroleum Resources target values for metals in soils except for Cd in some sites. A significant fraction of these metals aroses from anthropogenic sources. The percent anthropogenic fraction of metals in the soil follow the order Cd > Zn > Ni > Cu > Fe > Cr > Pb.Keywords: Anthropogenic input, cassava, heavy metals, pollution inde

Heavy Metals in Soils and Tomatoes Grown in Urban Fringe Environment in Asaba, Delta State, Nigeria

Pb, Cu, Ni, Zn, Cr, Mn and Fe in soils and tomato leaves and fruits from peri-urban environments in Asaba, Delta State were determined after acid digestion by using atomic absorption spectrophotometry (AAS). The concentrations of metals in the soil samples were 10.14, 2.28, 3.96, 7.88, 0.15, 14.53 and 66.00 mg/kg site A; 7.01, 2.01, 2.03, 5.53, 0.16, 12.15, and 70.12 mg/kg site B, and 9.12, 2.24, 3.01, 4.35, 0.01, 11.52, and 61.22 mg/kg site C for Pb, Cu, Ni, Zn, Cr, Mn and Fe respectively. The concentrations of metals in the tomato leaves samples were 4.01, 1.91, 1.83, 4.89, 0.16, 4.51 and 7.13 mg/kg in site A; 3.84, 1.56, 2.07, 4.00, 0.41, 4.48 and 8.15mg/kg in site B, and 4.03, 1.75, 2.01, 4.52, 0.01, 4.42 and 8.11 mg/kg in site C for Pb, Cu, Ni, Zn, Cr, Mn and Fe respectively while in the tomato fruits, the concentrations of metals in mg/kg were 2.96, 0.41, 1.35, 3.33, 0.01, 3.83 and 6.38 mg/kg in site A; 3.01, 1.35, 1.88, 2.98, 0.15, 3.01 and 5.09 mg/kg in site B, and 3.92, 1.44, 1.82, 3.73, 0.01, 3.05 and 6.00 mg/kg in site C for Pb, Cu, Ni, Zn, Cr, Mn and Fe respectively. These values obtained in the soils for all sites were below the given values for naturally occurring metals in soil and Department of Petroleum Resources target and intervention values for metals in soil while the values recorded for tomatoes leaves and fruit are below the levels recommended by WHO/FAO and NAFDAC for metals in foods and vegetables but are within the normal range of metals in plants. There was positive correlation among metals except Pb/Cr, Cr/Mn and Cr/Fe. The values of transfer factor (tf) obtained for all the metals except Fe in leaves and fruits for all the sites were above 0.2 indicating anthropogenic contamination of the sites and also high take up and accumulation of the metals from the soil by the tomatoes thus the need for environmental monitoring of the area.Key words: Heavy metals, tomato, anthropogenic, contamination, pollutio

Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states

<p>Abstract</p> <p>Background</p> <p>Nigeria continues to have high rates of maternal morbidity and mortality. This is partly associated with lack of adequate obstetric care, partly with high risks in pregnancy, including heavy work. We examined actionable risk factors and underlying determinants at community level in Bauchi and Cross River States of Nigeria, including several related to male responsibility in pregnancy.</p> <p>Method</p> <p>In 2009, field teams visited a stratified (urban/rural) last stage random sample of 180 enumeration areas drawn from the most recent censuses in each of Bauchi and Cross River states. A structured questionnaire administered in face-to-face interviews with women aged 15-49 years documented education, income, recent birth history, knowledge and attitudes related to safe birth, and deliveries in the last three years. Closed questions covered female genital mutilation, intimate partner violence (IPV) in the last year, IPV during the last pregnancy, work during the last pregnancy, and support during pregnancy. The outcome was complications in pregnancy and delivery (eclampsia, sepsis, bleeding) among survivors of childbirth in the last three years. We adjusted bivariate and multivariate analysis for clustering.</p> <p>Findings</p> <p>The most consistent and prominent of 28 candidate risk factors and underlying determinants for non-fatal maternal morbidity was intimate partner violence (IPV) during pregnancy (ORa 2.15, 95%CIca 1.43-3.24 in Bauchi and ORa 1.5, 95%CI 1.20-2.03 in Cross River). Other spouse-related factors in the multivariate model included not discussing pregnancy with the spouse and, independently, IPV in the last year. Shortage of food in the last week was a factor in both Bauchi (ORa 1.66, 95%CIca 1.22-2.26) and Cross River (ORa 1.32, 95%CIca 1.15-1.53). Female genital mutilation was a factor among less well to do Bauchi women (ORa 2.1, 95%CIca 1.39-3.17) and all Cross River women (ORa 1.23, 95%CIca 1.1-1.5).</p> <p>Interpretation</p> <p>Enhancing clinical protocols and skills can only benefit women in Nigeria and elsewhere. But the violence women experience throughout their lives – genital mutilation, domestic violence, and steep power gradients – is accentuated through pregnancy and childbirth, when women are most vulnerable. IPV especially in pregnancy, women's fear of husbands or partners and not discussing pregnancy are all within men's capacity to change.</p

Osteomyelitis of the Mandible in Sickle Cell Disease: Report of a Case

Abstract: The purpose of this article is to report a case of a known sickle cell anaemia patient who was nor in crisis but suffered from osteomyelitis of the mandible as a component part of the disease process. The patient, a 24-year old women, recovered uneventfully without complication following treatment

Maxillofacial Tumors and Tumor-like Lesions in a Nigerian Teaching Hospital: an eleven year retrospective analysis

BACKGROUND: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population. METHODS: A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant. RESULTS: A total o:f 146 patients, aged 5–70 years (mean 30.5± 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 ±15.72) and this was not different for malignant or benign tumors (P=0.886). CONCLUSION: Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers

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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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

Maxillofacial tumors and tumor-like lesions in a Nigerian teaching hospital: an eleven year retrospective analysis

Background: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population. Methods: A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant. Results: A total o:f 146 patients, aged 5-70 years (mean 30.5+ 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 +15.72) and this was not different for malignant or benign tumors (P=0.886). Conclusion:Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers