Impact of an educational intervention on smoking counseling practice among Nigerian dentists and dental students

Introduction: Oral health professionals are important in smoking cessation and prevention as their role is very crucial given the impact of smoking on oral health. Therefore, dental professionals need adequate education in tobacco use prevention and cessation skills to increase their confidence and be able to help patients to quit smoking. This study was aimed at determining the impact of an educational intervention on the attitudes, willingness, and perceived barriers of a group of Nigerian dental students and dentists to smoking cessation counseling in the dental clinic.Methods: A self.administered questionnaire.based study was conducted in September 2007 at the Lagos University Teaching Hospital Idi Araba, Lagos. This was followed by a series of lectures and seminars using the brief intervention strategies for patients willing to quit using the Ask, Advise, Assess, Assist, and Arrange of cessation. A repeat study was conducted in January 2009 using the same questionnaire. Post intervention attitudes were significantly improved over pre intervention values for each parameter used in the assessment.Results: A significantly higher proportion of the respondents were  interested in providing cessation services after the intervention (P = 0.00002). Most (83.1%) of the respondents were willing to undergo training with a slight increase in the post intervention group from 80.9% to 86%. All the reported barriers were significantly reduced after the intervention (P = 0.000).Conclusion: This study has shown that educational interventions such as didactic instructions and practical training in tobacco use cessation can help to increase the willingness, confidence, and ability to provide information, during encounters with patients.Key words: Educational intervention, dental students, dentists, Nigeria, smoking cessatio

A survey of self-reported oral health practices, behaviour and oral health status of pregnant women attending TBA ante-natal clinics in a Nigerian rural community.

Objectives: To assess the self-reported oral health practices, behaviour and oral health status of pregnant women attending traditional birth attendant (TBA) clinics in a rural community.Methods: A cross sectional survey of the oral health practices and oral health status of sixty-two pregnant women attending traditional birth attendant clinics in a rural community was conducted using interviewer-administered questionnaires.Dental caries experiencewas determined using WHO diagnostic criteria to measure the DMFT,Significant caries (Sic) while oral hygiene status was determined using criteria by Greene and Vermillion. Frequency distribution by age, pregnancy status, occupational status, sugary snack consumption, tooth brushing, exposure to fluoride toothpaste and dental visits were obtained. Data was analyzed using SPSS version 20 and level of significance was placed at p<0.05.Results: Sixty-six percent of the population were in 20-30 years age range and mostly in their third trimester. Caries prevalence was 37%, mean DMFT was 0.87 (SD 1.57) and Sic index was 2.48. Sixty-six percent had good oral hygiene.Seventy-eight percent of the population who had never visited the dentist had some caries experience (p<0.05).Conclusion: Dental utilization was poor and there were a number of unmet treatment needs among pregnant women attending TBA clinics. There is need to train traditional birth attendants to identify simple oral diseases and incorporate them into oral health promotion programmes in order to improve referral of pregnant women, oral health awareness and dental service utilization among pregnant women in the region.Keywords: oral health practices, oral health status, pregnant women, traditional birth attendant clinics, Nigerian rural communit

Changes in the prevalence of dental caries in primary school children in Lagos State, Nigeria

Objectives: To evaluate the changes in the prevalence of dental caries in Lagos State over a 3 years period and the role of age, sex, and playing in the changes observed.Materials and Methods: Three primary schools in Lagos State, Nigeria were randomly selected for the study. Six hundred and thirty‑three children age 2-12 years, were examined for caries in 2000 while 513 children were examined in 2003. The prevalence of tooth decay and the prevalence of untreated tooth decay were calculated for the two years, that is, 2000 and 2003. Also the degree of unmet treatment need among the population with caries experience was measured. Differences in the prevalence and severity of dental caries in the primary and permanent dentition were assessed.Results: Approximately 18% of children had untreated tooth decay in their primary dentition in 2003: A 26.1% increase from 2000. About 12.0% of the decay, extracted, and filled teeth (deft) index was seen with decayed teeth in 2000 and 16.6% in 2003. Extracted primary teeth decreased from 2.5% in 2000 to 1.5% in 2003. The change in mean deft between 2000 (0.42) and 2003 (0.47) was 11.9%. Over the study period, the overall reduction in the prevalence of dental caries was 34.8% in the permanent dentition. The decline was larger among children aged 5-9 years (62.1%) and among females (75%).Conclusion: The study showed no overall changes in caries severity but a decrease in caries prevalence in the permanent dentition over the study  period. The largest decline in caries prevalence in the permanent dentition was observed in children aged 5-9 years and females. On the contrary, there was an increase in the caries prevalence in the primary dentition.Key words: Caries, children, Nigeria, prevalenc

Access to oral health care for HIV patients in Nigeria: Role of attending physicians

Objective: To assess the knowledge of attending physicians on oral manifestations of HIV infection and their attitude and practice towards dental referral for HIV patients. Method: A self-administered questionnaire survey of attending physicians in outpatient clinics of two teaching hospitals in Lagos and the National hospital, Abuja. Results: seventy-eight (78) doctors returned questionnaires. 16 of them (20.5%) could list correctly three oral lesions in HIV infection, 40 (51.3%) listed two, 18 (23.1%) listed one while 4 (5.1%) could not list any. In managing oral health complaints by patients, 59 (75.5%) agreed that their patients had complained of oral symptoms, of these, only 18 had ever referred a patient for dental care. Majority (84.6%) agreed that HIV patients should have regular dental check ups. Conclusion: The education of both patients and health providers in Nigeria on the importance of good oral health in the quality of life of the HIV patient is necessary. HIV patients in Nigeria should be referred for dental checkups and prophylaxis at least twice a year Key Words: Access; oral health; HIV; physician. African Journal of Oral Health Vol.1(1) 2004: 37-4

Oral Candidosis in a group of HIV positive Nigerians

Oral candidosis is one of the commonest oral manifestations of HIV  infection. The objective of this study was to determine the prevalence of oral candidosis in relation to CD4 counts and use of antiretroviral drugs among Nigerian HIV infected patients. Design: A cross-sectional study in which an interviewer administered questionnaire was used to collect data from 244 consecutive HIV patients aged 16-65years. They were examined for oral lesions including Oral candidosis. The presumptive criteria as defined by ECC Clearing House were used for diagnosis of oral lesions. Result: Forty-six (18.9%) patients presented with oral candidosis of various types. Pseudomembraneous candidosis was the commonest variant seen in 60.0% of those who presented with intra oral candidosis. Prevalence of oral candidosis was significantly associated with use of antiretroviral drugs (

Effect of salt loading and gender influences on plasma atrial natriuretic peptide levels and cardiovascular parameters in normotensive and hypertensive Nigerians

Background: Prevalence of hypertension is higher among Sub-Saharan Africans than whites and there is a sex difference in the prevalence. Though, salt retention has been implicated in pathogenesis of hypertension, the basis is not completely known. Atrial natriuretic peptide (ANP) might play a role.Method: 43 apparently healthy normotensive male and female Nigerians and 37 aged-matched hypertensive counterparts were orally administered 11.6g of dietary salt each per day for 5 days. Their plasma ANP levels, heart rate (HR), systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MABP) were determined before and after salt loading.Results: Normotensive and hypertensive male and female subjects had similar basal ANP levels. However, salt loading significantly raised the ANP concentrations (p = 0.0001) in normotensive subjects but not significantly in hypertensive counterparts. ANP levels rose significantly in the normotensive males (p = 0.0024) and females (p = 0.0002) but not significantly in the hypertensive counterparts. Besides, salt significantly decreased HR in normotensive (p = 0.0095) and hypertensive (p = 0.0397) subjects but increased SBP (p < 0.01) and MABP (p< 0.01) in both study groups and DBP (p = 0.0014) in hypertensive group only. SBP, DBP and MABP were all significantly elevated (p < 0.05) in hypertensive males and females but not significantly in normotensive females.Conclusion: Although, basal ANP levels were similar in the study normotensive and hypertensive subjects, other findings in this study suggest that ANP as well as female gender could ameliorate increased blood pressure response to salt loading especially in a normotensive state.Keywords: Atrial natriuretic peptide, blood pressure, salt loading, gender, hypertensio

Utilization of insecticide-treated nets by under-five children in Nigeria: Assessing progress towards the Abuja targets

<p>Abstract</p> <p>Background</p> <p>The Abuja target of increasing the proportion of people sleeping under insecticide-treated nets (ITNs) to 60% by the year 2005, as one of the measures for malaria control in Africa, has generated an influx of resources for malaria control in several countries in the region. A national household survey conducted in 2005 by the Malaria Control Programme in Nigeria assessed the progress made with respect to ITN ownership and use among pregnant women and children under five years of age since 2000. The survey was the first nationally representative study of ITN use assessing progress towards the Abuja target amongst vulnerable groups.</p> <p>Population and Method</p> <p>A cross-sectional survey of a sample of 7,200 households, selected by a multistage stratified sampling technique from 12 randomly selected states from the six geopolitical zones of the country. Data collection was done during the malarious rainy season (October 2005) using a modified WHO Malaria Indicator Survey structured questionnaire about household ownership and utilization of mosquito nets (treated or untreated) from household heads.</p> <p>Results</p> <p>Household ownership of any net was 23.9% (95% CI, 22.8%–25.1%) and 10.1% for ITNs (95% CI, 9.2%–10.9%). Education, wealth index, presence of an under-five child in the household, family size, residence, and region by residence were predictive of ownership of any net. The presence of an under-five child in the household, family size, education, presence of health facility in the community, gender of household head, region by residence and wealth index by education predicted ITN ownership.</p> <p>Utilization of any net by children under-five was 11.5% (95% CI, 10.4%–12.6%) and 1.7% (95% CI, 1.3%–2.2%) for ITN. Predictors of use of any net among under-five children were fever in the previous two weeks, presence of health facility in the community, caregiver's education, residence, and wealth index by caregiver's education; while religion, presence of health facility and wealth index by caregiver's education predicted the use of ITN among this group.</p> <p>Conclusion</p> <p>This study demonstrated that the substantial increase in ITN utilization among children under five years of age in Nigeria is still far from the Abuja targets.</p

Orchidectomy Ameliorates the Vascular Hypertrophic Effect of A High Salt Diet in Sprague-Dawley Rats

Sodium overload, which is present in a high salt diet (HSD), induces hypertension by mechanisms that include change in the shear stress and geometric modifications of the blood vessels. Salt sensitivity exhibits sex difference, which is higher in males when compared withfemales. This has been attributed to the effect of androgens on blood vessels in males. Therefore, experiments were designed to study the vascular smooth muscle histomorphometry in weanling male rats that were either sham-operated or ochidectomised under (90mg/kg bodyweight ketamine and 10mg/kg bodyweight xylazinei.p) anesthesia, with or without testosterone replacement (TR) (10mg/kg sustanon 250® i.m) once in 3 weeks. They were either placed on a diet with normal 0.3% or high 8% NaCl content for 6 weeks. Histological examination of thoracic aorta and mesenteric artery were carried out with specific dyes; hematoxylin and eosin stain for the cytoplasm and nucleus and Verhoeff – Van Geison and Picro-sirius red stains for elastin and collagen content estimation respectively. Histomorphometric analysis was carried out using a programmed software IMAGE-PRO 3DS 6.1. Tunica media thickness, cross sectional area, elastin and collagen contents of the blood vessels were all significantly elevated (p&lt;0.05) in the rats placed on HSD, while orchidectomy prevented the increase in these parameters but concomitant administration of testosterone restored them to the levels observed in intact rats. Orchidectomy ameliorated vascular hypertrophic effect of a HSD by reducing vascular smooth muscle proliferation and extracellular matrix protein deposition in the blood vessels.Keywords: Orchidectomy, Testosterone, Vascular hypertrophy, Extracellular matrix protein, media thickness, Histomorphometr

Chronic exposure to high environmental temperature exacerbates sodium retention and worsens the severity of salt-induced hypertension in experimental rats via angiotensin receptor activation

Background: There is paucity of information on how exposure to high environmental temperature interacts with high dietary salt to influence cardiovascular outcome in the face of global warming.Method: This study investigated the impact of high environmental temperature (HET) on the cardio- renal indices of an animal model of hypertension (fed on high salt diet, HSD), and evaluated the effectiveness of angiotensin II receptor blocker (ARB), telmisartan, in modulating these indices. Fifty-six male Sprague Dawley rats (70-90g , 7 week old) were randomly assigned into seven groups of 8 rats, which include control rats (I), fed 0.3% NaCl diet; salt loaded rats (II), fed with 8% NaCl (high salt) diet; Heat rats (III), exposed to HET (37.5-38.5oC) 4 hours daily per week; salt loaded + Heat rats (IV), fed with 8% NaCl diet and exposed to HET daily. Next, salt loaded + ARB rats (V) , fed 8% NaCl diet and treated with telmisartan (30mg/kg); Heat +ARB rats, exposed to HET and treated with telmisartan (30mg/kg); salt loaded +HET+ARB rats (VI), fed with 8% NaCl diet, exposed to HET and treated with telmisartan (30mg/kg). Experiment lasted 8 weeks. Blood Pressure and heart rate were determined invasively and electrolytes by selective ion electrode method. Data analyzed using ANOVA, with P&lt;0.05 significant.Results: Systolic and Diastolic BP, Mean Arterial Pressure, Rate Pressures Product (RPP) (P&lt;0.05), and plasma Na+ (P&lt;0.05) were significantly higher with associated suppressed Na+ excretion (P&lt;0.05) in salt loaded rats exposed to HET compared to rats fed a high salt diet alone. Telmisartan significantly attenuated the elevated blood (P&lt;0.05) and RPP (P&lt;0.05), in the HSD rats exposed to HET, with no corresponding reduction in the rats fed a HSD alone.Conclusion: This indicates that chronic exposure to hot environment exaggerated cardiovascular response to high salt diet possibly via angiotensin II pathway with consequent enhanced ARB action.Keywords: Angiotensin II receptor; high salt diet; hot environment; environmental temperature; heat exposure; hypertensio

Differential responses to endothelial–dependent relaxation of the thoracic and abdominal aorta from male Sprague-Dawley rats

Regional heterogeneity exists in reactivity of different vascular beds to vasoactive substances. Experiments were designed to determine if there are differences between thoracic and abdominal aorta response to acetylcholineinduced relaxation. Ten male Sprague-Dawley rats with a weighing between 200g–250g were used. The aorta was isolated and 3mm aortic rings were cut and suspended in organ baths containing physiological salt saline (PSS). Contractile and relaxation responses to noradrenaline (NA) and ACh, in the presence or absence of L-NNA and high K+ concentration were studied. Contractile response to NA was similar along the aorta. At the higher doses, ACh elicited a greater (p \u3c 0.05) relaxation in the abdominal aorta when compared with the thoracic aorta. However, inhibition of eNOS was more effective (p\u3c0.05) in preventing ACh-induced relaxation in the thoracic aorta when compared with the abdominal aorta. Conversely, inhibition of endothelial hyperpolarizing factor (EDHF) by high K+ concentration blocked ACh-induced relaxation to a greater extent in the abdominal aorta (p\u3c0.05) when compared with the thoracic aorta. ACh-induced relaxation differs in the thoracic and abdominal aorta. Differences in the EDHF activity along the aorta underlie the differential response of the thoracic and abdominal aorta to ACh-induced relaxation