Comparison of sensitivity of bacteria isolated in odontogenic infections to ceftriaxone and amoxicillin-clavulanate

Background: Odontogenic infections is a cause of mortality and morbidity in maxillofacial patients. This is largely due to resistance of organisms to antibiotics prescribed.Objectives: To isolate organisms involved in odontogenic infections and compare the sensitivity of the organisms to Ceftriaxone and Amoxicillin-Clavulanate.Methods: The causative organisms and antibiotic sensitivity were determined by the following steps: Aspiration of pus done with needle, sample of pus or exudate collected using sterile swab if aspiration was unsuccessful and specimen were placed in transport media (thioglycolatebroth) and sent immediately to microbiology laboratory for culture of organisms and antibiotic sensitivity.Results: Out of a total 55 samples taken for bacteriology, 42 (76.4%) yielded positive culture for bacteria. A total number of 21 bacteria species were identified from the positive cultures. Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics (Table 3). Ceftriaxone was statistically significantly more potent in inhibiting bacteria growth than amoxicillin-clavulanate (P =0.009).Keywords: Sensitivity of bacteria, odontogenic infections, ceftriaxone, amoxicillin-clavulanate

Comparison of sensitivity of bacteria isolated in odontogenic infections to ceftriaxone and amoxicillin-clavulanate

Background: Odontogenic infections is a cause of mortality and morbidity in maxillofacial patients. This is largely due to resistance of organisms to antibiotics prescribed. Objectives: To isolate organisms involved in odontogenic infections and compare the sensitivity of the organisms to Ceftriaxone and Amoxicillin-Clavulanate. Methods: The causative organisms and antibiotic sensitivity were determined by the following steps: Aspiration of pus done with needle, sample of pus or exudate collected using sterile swab if aspiration was unsuccessful and specimen were placed in transport media (thioglycolatebroth) and sent immediately to microbiology laboratory for culture of organisms and antibiotic sensitivity. Results: Out of a total 55 samples taken for bacteriology, 42 (76.4%) yielded positive culture for bacteria. A total number of 21 bacteria species were identified from the positive cultures. Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics (Table 3). Ceftriaxone was statistically significantly more potent in inhibiting bacteria growth than amoxicillin-clavulanate (P =0.009)

Knowledge, opinions, and practices about oral cancer among general medical practitioners in Lagos, Nigeria

Objectives: To evaluate the knowledge and practices of general medical practitioners (GMPs) in Lagos on screening for oral cancer (OC). Materials and Methods: A 43-item self-administered questionnaires was filled by each GMPs recruited into the study. Analysis was done using the SPSS version 17.5. Descriptive analyses were used and results were presented in percentages, graphs, and tables. Results: One-hundred and twenty GMPs participated in the study, 58.7% were males and 41.3% females; their ages ranged 22-61 years (36.1 ΁ 7.97). While most participants answered correctly that smoked tobacco (96.1%), increasing age >45 years (97%), oral sex (99%), and patient with a previous OC (93.7%) were risk factors for OC; there was misinformation on the nonrisk factors as only 5.5%, 7.9%, and 18.9%, respectively, answered correctly that family history of cancer, dental infections, and poor oral hygiene were not identifiable risk factors associated with OC. Furthermore, although majority of subjects (81.1%) identified the floor and the tongue as the most common sites of OC and leukoplakia (75.6%) as a common precursor of OC; only 29.1% identified correctly that OC had one of the worst morbidity and mortality rates of the most common cancers due to late presentation. Only 0.8% of GMPs had a consistent high score in the indexes. Conclusion: The knowledge and practices of GMPs in the Lagos environment on OC needs a lot of improvement for them to become significant in the screening for the disease entity

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

Management of dental anxiety: A survey of Nigerian dentists

Background: Dental anxiety is a major issue with respect to provisions of and access to dental care. We evaluated the knowledge and management of anxiety among Nigerian dentists. Materials and Methods: The study population included 192 Nigerian dentists recruited during an annual national dental conference in Abuja. The conference was a meeting point for dentists with post graduation experience ranging between 1 and 32 years and from different part of the country. They completed a structured questionnaire on dental anxiolysis. Data analysis was performed using SPSS version 16. Results: Of the interviewed dentists, 122 (55.1%) practiced in teaching hospitals and 24% had their specialization in child dental health. A total of 34 (19.8%) dentists had been exposed to formal trainings on the practice of dental anxiolysis. Of this number, 66% had basic life support training and only 11.8% had refresher training programs. The most preferred route of administration of anxiolytic drugs was oral (57.3%). Most of the respondents were of the view that dental anxiolysis should not be instituted for all dental patients. Conclusion: The interviewed Nigerian dentists were knowledgeable and managed dental anxiety. Although some of them had no formal training on dental anxiolysis, the major consensus is that dental anxiolysis should not be instituted for all dental patients

Perception of oral and maxillofacial surgery specialty among physicians in Sokoto, Northwest Nigeria

Background: Oral and maxillofacial surgery (OMS) evolves from the anatomical region within the head and neck region. Contrary to common belief, its scope does not start and end with teeth. This study is to assess the awareness of physicians in Sokoto, Northwest Nigeria, about the scope of practice of OMS. Materials and Methods: This is a prospective cross-sectional study carried out during annual general meeting of the Nigerian Medical Association in Sokoto. This is the largest gathering of physicians in the state. Data were stored and analyzed using IBM SPSS Statistics for Windows version 20 (IBM Corp., Armonk, NY, USA) and results presented in simple descriptive statistics and frequencies only. Results: One hundred and twenty-five questionnaires of the 150 distributed were returned and analyzed with a response rate of 83.3%. The analysis showed that there is high awareness of the respondents about the scope of oral and maxillofacial surgeons (OMFS) in facial bone fracture, jaw deformities, orofacial tumors, and temporomandibular joint ankylosis (81.0%, 88.1%, 88.1%, and 82.5%) respectively. There is, however, low awareness about its scope in sinus problems, cleft lip and palate, and esthetic facial surgery (9.5%, 12.7%, and 14.3%) respectively. Conclusion: The awareness of the scope of OMS practices needs to be increased among physicians, especially in cleft lip and palate, sinus problems, and esthetic facial surgeries. It is imperative as OMFS specialty to raise awareness of our specialty among physicians

Neck dissection: Clinicosurgical appraisal of 21 cases in a sub-Saharan African tertiary referral hospital

Background: Neck dissection constitutes an essential part of overall management of cancer of the head-and-neck region. Once the tumor involves neck nodes, survival drops by almost 50%. The aim of this present study is to present our experience in neck dissections. Patients and Methods: This was a retrospective study of neck dissection carried out in the department of dental and maxillofacial surgery of a tertiary referral hospital. Information retrieved includes age, sex, diagnosis, type of primary surgery, type of neck dissection, complications, and prognosis. Data were stored and analyzed using IBM SPSS Statistics Version 20 (IBM Corp., Armonk, NY, USA). Results: A total of 21 neck dissections were carried out during the study period. The patients' age ranged from 23 to 72 years with a mean ± standard deviation of 55.1 ± 11.9. There are 12 (57%) males and 9 (42.9%) females with an M:F ratio of 1.3:1. Squamous cell carcinoma (14 [66.7%]) was the main indication for neck dissection. Modified radical neck dissection (RND) (Type 1) was the commonest type of neck dissection carried out (7 [33.3%]), while 4 (19.0%) cases and 3 (14.3%) cases of modified RND Type II and Type III, respectively, were performed. Three (14.3%) cases of selective neck dissection (SND) (Type III) and one (4.8%) case of SND (Type II) were performed. Extended neck dissections were carried out in three (14.3%) patients. Overall, 11 (52.4%) patients survived, while 7 (33.3%) were lost to follow-up and 3 (14.3%) passed away. Conclusion: Patient selection is essential in neck dissection in the overall management of oncologic head-and-neck diseases

A Comparative Clinical Evaluation of the Effect of Preoperative and Postoperative Antimicrobial Therapy on Postoperative Sequelae after Impacted Mandibular Third Molar Extraction

Objectives: To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. Material and Methods: This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. Results: The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I. Conclusions: This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions

Pattern of tissue destruction among patients diagnosed with cancrum oris (Noma) at a Northwestern Nigerian Hospital, Sokoto

Background: Cancrum oris is a debilitating and rapidly progressive gangrenous disease. It is life-threatening and results in severe devastation. Tissue loss constitutes a formidable cause of morbidity in patients and also poses an enormous challenge to a reconstructive surgeon. This study aims to describe the pattern of tissue loss among patients with cancrum oris at our center. Methods: A review of the data of patients treated for cancrum oris at Noma Children Hospital, Sokoto, Nigeria, from December 1999 to 2011, was done. Data on the age, gender, and pattern of tissue loss were retrieved. The pattern of tissue loss was assessed anatomically and clinically. Analysis of data was done using SPSS (IBM SPSS Statistics for Windows Version 20 [Armonk, NY: IBM Corp]). Results: A total of 159 cases of cancrum oris were included in this study. The age range was 1–33 years with a mean (± standard deviation) of 3.5 (3.23) years. A male/female ratio of 1:1.2 was observed. A total of 425 sites were affected in 159 patients. In 109 (68.6%) patients, only soft tissue involvement was seen, while a combination of soft and hard tissue destructions was observed in 50 (31.4%) patients. The most frequently affected site was the cheek, 268 (63.1%), followed by the lips, 106 (66.7%). The nose was affected in 40 (25.2%) patients. Osseous involvement was observed in 50 (7.6%) patients. Conclusion: Cancrum oris, though considered to be a rare disease, continues to constitute a grievous cause of orofacial tissue loss and consequent morbidity in our environment