Call hour maxillofacial emergencies presenting to a Nigerian teaching hospital

Objective: The study was undertaken to document the pattern of maxillofacial emergencies presenting to the accident and emergency unit of the Obafemi Awolowo University Teaching hospital, Ile-Ife between January 2001 and December 2002. Method: The patients' demographics, the time of presentation, duration of emergency and mode of arrival was documented. Injuries of the oro-facial soft and hard tissues, injuries in other parts of the body, the investigations carried out and the management instituted was also recorded. Results: 106 patients representing 1.3% of all the Accident and Emergency admissions were seen by the maxillofacial unit. Males predominated (90 males against 16 females), mean age was 31.3 years, students (28%) were the most frequently encountered and weekends recorded the highest number of emergencies (50 patients or 47.2%). Trauma was the main reason for presentation (102 patients or 96.2%) and commercial vehicles were the commonest means of transportation to the hospital in 63 patients (59.4%). About a third of the subjects (31 or 36.1%) presented within the first hour, and the soft tissues of the midface were most often involved. The mandible was the most commonly fractured bone (20 patients or 19.6%) and limb injuries were the most commonly observed injury in other parts of the body (43 patients or 42.2%). Sixty-eight out of the 88 patients who required a surgical procedure were treated in the accident and emergency unit and 49 patients (46.2%) were admitted into the wards. The outcome was not significantly affected by the time or mode of presentation. Conclusions: There is a need for an oral and maxillofacial trauma registry at different locations in the country to ensure a long-term data collection for the development and evaluation of preventive measures. Key Words: Maxillofacial trauma; emergencies. African Journal of Oral Health Vol.1(1) 2004: 17-2

Reconstruction of Mandibular Defects Using Nonvascularized Autogenous Bone Graft in Nigerians

Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile‑Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.Keywords: Mandibular defect, mandibular reconstruction, nonvascularized bone graf

Meningococcal, influenza virus, and hepatitis B virus vaccination coverage level among health care workers in Hajj

Abstract Background The objective of this study was to assess the compliance of health care workers (HCWs) employed in Hajj in receiving the meningococcal, influenza, and hepatitis B vaccines. Methods A cross-sectional survey of doctors and nurses working in all Mena and Arafat hospitals and primary health care centers who attended Hajj-medicine training programs immediately before the beginning of Hajj of the lunar Islamic year 1423 (2003) using self-administered structured questionnaire which included demographic data and data on vaccination history. Results A total of 392 HCWs were studied including 215 (54.8%) nurses and 177 (45.2%) doctors. One hundred and sixty four (41.8%) HCWs were from Makkah and the rest were recruited from other regions in Saudi Arabia. Three hundred and twenty three (82.4%) HCWs received the quadrivalent (ACYW135) meningococcal meningitis vaccine with 271 (83.9%) HCWs receiving it at least 2 weeks before coming to Hajj, whereas the remaining 52 (16.1%) HCWs received it within Conclusion The meningococcal and hepatitis B vaccination coverage level among HCWs in Hajj was suboptimal and the influenza vaccination level was notably low. Strategies to improve vaccination coverage among HCWs should be adopted by all health care facilities in Saudi Arabia.</p

Lipona of the tongue in an elderly Nigerian: a case report

Nigerian Quarterly Journal of Hospital Medicine Vol.10(1) 2000: 49-5

Facial plexiform neurofibroma: a surgical challenge

Introduction: Plexiform neurofibroma occurring in the Head and Neck region can be disfiguring, causing cosmetic embarrassment to the affected patients. Surgical management is the mainstay of therapy. This is however a challenging undertaking because of the vascularity and the risk of primary haemorrhage, infiltration of facial soft tissues against the need to preserve functions and maintain aesthesis.Subjects and methods: We present case reports of four patients managed in our institution over the pasttwo years with a discussion on some practical points of management.Results: All the four patients had surgical excision and refashioning. Post–operative results of surgical excision alone are satisfactory.Conclusion: Plexiform neurofibromatosis is a benign tumour of nerve sheath amenable to surgical intervention when attended by meticulous details in well prepared patients.KEYWORDS: Plexiform neurofibromatosis; facial, surgical excisio

Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in South-west Nigeria

Background: Diagnosis of upper gastrointestinal (UGI) diseases is often made on clinical grounds alone in Nigeria due to lack of endoscopic facilities. The validity of using such diagnosis is presently unknown. Objective: The study aimed to determine: age and sex distribution of patients presenting for UGI endoscopy; pattern of clinical and endoscopic diagnoses in patients with UGI diseases; and, the validity of clinic-based diagnosis. Methods: Medical records of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria for UGI endoscopy between September 1999 and August 2003 were reviewed. Data was analysed for sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis using endoscopic diagnosis as “gold” standard. Results: Males constituted 53.4% of subjects and mean age was 45 years (+ 1.69 SD). Peptic ulcer disease (PUD) constituted 67.6% of referral diagnosis but 33.9% of endoscopic diagnosis. PUD had the highest sensitivity value (0.72) while gastritis had the least (0.04). Specificity ranged from 0.40 for PUD to 1.00 for corrosive oesophagitis. Positive predictive value ranged from 0.29 (oesophageal cancer) to 0.67 (corrosive oesophagitis) and negative predictive value ranged from 0.66 for gastritis to 0.99 for corrosive oesophagitis. Conclusion: The validity of clinical diagnosis in UGI conditions varied widely, and in general, there is poor agreement between clinical and endoscopic diagnoses. African Health Sciences Vol. 6(2) 2006: 98- 10

Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in south-west Nigeria

BACKGROUND: Diagnosis of upper gastrointestinal (UGI) diseases is often made on clinical grounds alone in Nigeria due to lack of endoscopic facilities. The validity of using such diagnosis is presently unknown. OBJECTIVE: The study aimed to determine: age and sex distribution of patients presenting for UGI endoscopy; pattern of clinical and endoscopic diagnoses in patients with UGI diseases; and, the validity of clinic-based diagnosis. METHODS: Medical records of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria for UGI endoscopy between September 1999 and August 2003 were reviewed. Data was analysed for sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis using endoscopic diagnosis as “gold” standard. RESULTS: Males constituted 53.4% of subjects and mean age was 45 years (± 1.69 SD). Peptic ulcer disease (PUD) constituted 67.6% of referral diagnosis but 33.9% of endoscopic diagnosis. PUD had the highest sensitivity value (0.72) while gastritis had the least (0.04). Specificity ranged from 0.40 for PUD to 1.00 for corrosive oesophagitis. Positive predictive value ranged from 0.29 (oesophageal cancer) to 0.67 (corrosive oesophagitis) and negative predictive value ranged from 0.66 for gastritis to 0.99 for corrosive oesophagitis. CONCLUSION: The validity of clinical diagnosis in UGI conditions varied widely, and in general, there is poor agreement between clinical and endoscopic diagnoses

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ABstRAct Background: The advent of antiretroviral (ARV) drugs has transformed HIV/AIDS into a chronic manageable disease and strict adherence is required for the medication to be effective. However, factors influencing adherence to ARV therapy (ART) vary from country to country. A f fi l i a t i o n s: