Paediatric orofacial tumours: New oral health concern in paediatric patients

Objective: This study aims to determine the incidence,`age, gender, orofacial sites and histological pattern of paediatric orofacial tumours in a Nigerian population. The yearly findings will be analysed to identify theinterval for increase in the incidence of paediatric orofacial tumours.Patients and Methods: A 21-year (1990 to 2010) retrospective analysis of paediatric orofacial tumours in children younger than 16 years was carried out in the Department of Oral Pathology/Oral Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.Results: Of the 1013 diagnosed lesions within the study period, there were 137 (13.5%) paediatric orofacial tumours, among which 71 (51.8%) cases occurred within the last 6 years (2005 to 2010). There was male predilection for the lesions (78 males to 59 females, ratio = 1.3:1). The mean age was 9 + 4.3 years, with peak age group of 11 to 15 years (n=60, 43.8%). The mandible (n=44, 32.1%), followed by the maxilla(n=42, 30.7%) and orofacial soft tissue (n=19, 13.9%) were the most common sites. The benign tumours (n=72, 52.6%) were slightly more than the malignant tumours (n=65, 47.4%). There were more malignant tumours (n=23, 16.8%) than benign tumours (n=20, 14.6%) within the last 3 years (2008 to 2010) under review. Burkitt’s lymphoma (n=38, 27.7%) was the commonest malignant lesion.Conclusion: This study showed a recent increase in the incidence of  paediatric orofacial tumours, particularly due to a higher incidence of Burkitt’s lymphoma.Keywords: Paediatrics, Orofacial tumour, Benign, Malignant, Oral Healt

Seasonal Variation of Intestinal Parasitic Infections among HIV-Positive Patients in Benin City, Nigeria

BACKGROUND: There are a number of conflicting studies on the prevalence of intestinal parasitic infections in HIV infection with regards to different seasons. This study was conducted to determine seasonal influence on the prevalence of intestinal parasitic infections in HIV-positive persons in Benin City, Nigeria.METHODS: Stool specimens from 2000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts or parasites using standard procedures. RESULTS: More intestinal parasitic infections were observed in the rainy season (17.6%) than the dry season (12.3%) (OR = 1.526, 95% CI = 1.184, 1.967, p = 0.0013). Male patients (18.3) had more episodes of intestinal parasitic infections than their female (13.7) counterparts (OR = 1.403, 95% CI = 1.092, 1.803, p = 0.0096).CONCLUSION: Cryptosporidium species and Strongyloides stercoralis were the only parasitic agents that were associated with rainy season.Keywords: Season, Intestinal Parasites, HIVEthiop J Health Sci. Vol. 21, No. 3 November 201

Ameloblastomatous change in radicular cyst of the jaw in a Nigerian population

Objective: To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population.Method: A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria.Results: From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3rd decade (n=23, 42.6%) with a mean age of 31+ 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3rd and 4th decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%).Conclusion: This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous like change from cystic ameloblastoma arising from radicular cyst.Keywords: Radicular cyst, Inflammation, Ameloblastomatous change, Immunohistochemistry, Jaw lesio

Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites, using standard procedures. In addition, patient’s blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIVpositive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (PB0.0001) risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count B200 cell/ml, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIVpositive patients. The level of education, occupation, and source of water among HIV patients significantly (PB0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count B200 cells/ml was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated.Keywords: intestinal parasites; HIV; CD4 count; Demographics; Benin Cit

Aerobic bacterial isolates from infected wounds

Background: Wound infection causes great distress in terms of associated mortality and morbidity, increased length of hospital stay, profound discomfort and significant increased in healthcare cost. Infection in a wound delays healing and may cause wound break down, herniation of the wound and complete wound dehiscence.Therefore the knowledge of the causative agents of wound infection will be helpful in the control of wound infection and selection of empiric antimicrobial therapy as aninfection control measure.Methods:A total of 207 wound specimens collected from patients attending the University of Benin Teaching Hospital were used for this study. All specimens were collected using sterile swabs sticks. Specimens were processed using standard microbiological methods.Results:A total of 278 bacterial isolates were obtained from 207 wound specimens processed in this study. Positive growth were observed in 185 (89.4%) of the wound cultures and no bacterial isolates were obtained in 22 (21.1%) of the cultured materials. Staphylococcus aureus (26.9%) was the most predominant isolate followed by Klebsiellapneumoniae (17.6%), Pseudomonas aeruginosa (16.9%) and Escherichia coli (12.6%). All isolates were resistant to ampicillin, amoxyillin-clavulanate and tetracycline but show variable susceptibility to other antibacterial used. Majority of theisolates produced beta lactamase. Conclusion: A high proportion of the wounds were infected.The variety of microorganisms observed in this study support the need to obtain culture specimen from infected wounds for microbiological evaluation and antibiotic susceptibility determination, so that adapted chemotherapy can be prescribed.Key words:wound infection, polymicrobial, immune status, hos

Periapical granuloma associated with extracted teeth

Objective: This article aims to determine the incidence of periapical granuloma from extracted teeth and correlate the clinical diagnoses with the histopathological types of periapical granuloma.Patients and Methods: Over a period of eight months, a prospective study designed as a routine biopsy of recoverable periapical tissues obtained from patients who had single tooth extraction was carried out.Results: One hundred and thirty-six patients participated in the study, with 75 (55.1%) histopathologically diagnosed periradicular lesions. There were 23 (16.9%) cases of periapical granuloma, with a male to female ratio of 2: 1. The lesion presented mostly between the third and fourth decades of life (n=9, 6.6%). Clinically diagnosed acute apical periodontitis was significantly associated with periapical granuloma, with predominantly foamy macrophages and lymphocytes (P<0.05).Conclusion: Periapical granuloma appears to be a less common periapical lesion in this study compared to the previous reports. In contrast to reports that relate to an acute flare of the lesion with abundant neutrophilic infiltration, this study has shown marked foamy macrophages and lymphocytes at the acute phase, which are significantly associated with the clinical diagnosis of acute apical periodontitis. We recommend the classification of periapical granuloma into early, intermediate, and late stages of the lesion, based on the associated inflammatory cells

Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

Background: Candiduria is a common finding. However, in  immunocompromised patients like HIV-infected individuals, it has high risk of morbidity and mortality as it could be a pointer to systemic candidiasis. Unfortunately, there are no clear criteria for differentiating between colonization and infection or between upper or lower urinary tract infections.Objective: This study focused on determining the spectrum of Candida species implicated in candiduria among HIV-infected individuals and theirsusceptibility to fluconazole and voriconazole in a tertiary hospital.Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV individuals were used for this study. Clean catch midstream were collected from each individual and processed using standard  microbiological techniques. Emergent Candida isolates were identified with CHROMagar Candida and sugar fermentation tests.Results: The overall prevalence of candiduria among HIV patients was 13.5%. HAART-naive patients had a significantly higher prevalence  (OR=4.165, 95%CI=1.602, 10.828; P=0.0038) than their counterpart on highly active antiretroviral therapy (HAART). Female gender was a  significant risk factor for acquiring candiduria. Age had no significant effect on the prevalence of candiduria in this study. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candiduria only among  HAART-naive patients (OR=11.711; 95%CI=3.943, 34.780; P= 0.0001). The three species of Candida recovered from this study were C. albicans, C. krusei and C.parapsilosis. C. albicans (64.52%, 83.36%) and C. krusei (66.67%, 100.00%) were resistant to fluconazole and voriconazole  respectively.Conclusion: There is a significant relationship between  antiretroviral therapy, CD4+ counts, and the prevalence of candiduria among the study population.Keywords:HAART, HAART-naive, candiduria, CD4+ counts, Candida,  prevalence. Contexte: La candidurie est un problème commun de sante publique. Cependant, chez les patients immunodéprimés comme les individus infectés par le VIH, elle présente un risque élevé de morbidité puisqu’elle peut évoluer vers la candidose systémique. Malheureusement, il n'existe pas de critères clairs permettant de distinguer la colonisation et l'infection de même que les infections des voies urinaires supérieures et inférieures.Objectif: Cette étude a porté sur la détermination du spectre d'espèces de Candida impliqués dans la candidurie chez les personnes infectées par le VIH et leur sensibilité au fluconazole et voriconazole dans un hôpital tertiaire.Methodes : Un total de 300 sujets comprenant 200 patients atteints du VIH et 100 personnes non -VIH ont été utilisés dans cette étude. Les echantillons d’urine ont été collectées auprès de chaque personne par la methode de ‘‘Clean catch midstream’’et traitées en utilisant des techniques microbiologiques standard. Les isolats émergents de Candida ont été identifiés avec CHROMagar Candida et les tests de fermentation de sucre. Résultats : La prévalence globale du VIH chez les patients atteints de candidurie était de 13,5%. Les patients en naïfs de la multithérapie HAARTavaient une prévalence significativement plus élevée (OR = 4,165, IC à 95% =1,602, 10,828, p = 0,0038 ) par rapport a leurs homologues sous traitement antiretroviral hautement actif (HAART ) . Le sexe feminin etait un facteur de risque important d'acquisition de candidurie. L'age n'avait pas d'effet significat nif sur la prevalence de candidurie dans cette etude. Un compte de CD4 + < 200 cellules / µl ete un facteur de risque important pour l'acquisition de candidurie que chez les patients en multitherapie naifs (OR = 11,711 ; IC a 95% = 3, 943, 34, 780, p = 0,0001). Les trois especes de Candida recuperes de cette etude etaient C. albicans, C. krusei et C.parapsilosis. C. albicans(64,52%, 83,36 %) et C. krusei (66,67%, 100,00 %) etaient resistants respectivement au  fluconazole et voriconazole.Conclusion: Il existe une relation significative entre le traitement  antiretroviral, CD4 +, et la prevalence de candidurie parmi la population de l'etude..Mots-cles: multitherapie HAART , naifs , candidurie , CD4 + , Candida , prevalence

Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites, using standard procedures. In addition, patient's blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIV-positive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001) risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200cell/µl, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIV-positive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/µl was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated

Culture in sustainable infrastructure: the polycentric cultural framework model

The state of infrastructure and services is widely perceived as a measure of development and a major catalyst for growth in both developed and developing economies. However, financing, maintaining and replicating existing infrastructures in areas of need have been mostly ineffective. In view of the widespread failures and poor state of infrastructure and services, there is a need to review current delivery and procurement frameworks. Given that sustainable infrastructure is also an essential prerequisite for sustainable development, this paper presents a polycentric cultural framework for infrastructure and service delivery; a framework which emphasises the integration of infrastructure users, communities, public and private sectors throughout the process of conceptualisation to actual delivery of infrastructure, by taking the recipients’ culture, beliefs and values into account. The framework also emphasises the use of systemic referendum among stakeholders by way of the traditional consultative processes and the collaborative consensus paradigm to achieve an effective and sustainable delivery of infrastructure and services

Oral health practices and self-assessed dental status of an adult population in Benin City, Nigeria

Objective: To determine the self- assessed oral health status and dental practices among an adult population in Benin City.Method: The cross sectional convenience study involved 190 Christian religious leaders aged 24- 73 years, comprising 155 (81.6%) males 35 (18.4%) females. Data was collected by means of self administered questionnaire which included their personal characteristics previous dental visits, oral self-care behaviour, halitosis.Result: Twenty five percent of the pastors had experienced toothache; only 3.2% had visited a dentist within 6 months prior to the study, 7.4% in more than a year but less than 3 years and, 67.9% had never been to a dentist. Only 25.3% visited for routine checkup and 8.4% felt they had bad breath out of which 14.7% thought it affected their communication with others. However, 69.5% rated their oral health as good. Furthermore, 81.1% used toothbrush and paste, 16.3% a combination of toothbrush and chewing stick, while 51.1% cleaned their mouths once daily and 43.2% twice daily. Only 15.8% had done scaling and polishing. While 47.4% claimed to have previously received instruction on maintenance of proper oral health.Conclusion: The findings from this study indicated a low utilization of dental services and significant need for oral health education. The role of the subjects who participated in this study stake holders in assisting to improve the health of members of the oragnisation and local community is advocated.Key words: Oral health, practices, status, adult, Benin Cit