The belief among mothers that teething is a cause of purulent ear discharge: fact or fiction?

Background: Various myths and health beliefs have been associated with teething. Some of these beliefs and myths have dire health consequences on children especially in Africa. This raises the need for further research into the subject with the aim of establishing the persistence of such beliefs and offering appropriate health education..Methodology: This was a cross-sectional, multi clinic study involving 265 mothers whose children had erupted at least a tooth and attending the children`s out-patients, dental and the ear, nose and throat clinics of a tertiary hospital in south-west Nigeria. An interviewer administered questionnaire was used to collect data from the mothers.Results: The age range of the mothers was 23 to 51years with a mean of 32.5 years. 15.1%, 20.7%, 25.7% and 38.5% had, no formal, primary, secondary and tertiary education respectively. About two-third (61.9%) believe that teething is a cause of purulent ear discharge while 12.1% and 26.0% did not believe in, and were unsure of, any association between teething and ear discharge respectively. Peers, parents, health care workers and personal experiences were the sources of beliefs associating teething with purulent ear discharge in 62.8%, 21.9%, 6.0% and 9.3% of the cohorts respectively. None (0%) of the respondents had prior knowledge of proven causes of ear discharge.Conclusion: Many of the mothers had erroneous beliefs regarding teething and ear discharge and peer inuence appears to be a key factor in the promotion of such beliefs. There is a need to educate mothers on correct information about teething and proven causes of ear discharge.Keywords: Teething, Myths, Ear discharge, Peer influenc

Team approach to management of oro.facial cleft among African practitioners: A survey

Background: An interdisciplinary team approach concept has been proposed for management of oro.facial cleft in the last two decades. Our objective was to evaluate the practice of the team approach concept and practices of the specialists involved in oro.facial cleft care in Africa.Materials and Methods: A snapshot survey was conducted among the attendees of the 2nd Pan.African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria, in February 2007.Result: Of the 120 questionnaires distributed, 91 were returned for analysis (75.8% response rate). Mean age of respondents was 43.6 } 4.97 years and the range was 36-62 years. Male.to.female ratio was 3.5:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (34.1% and 29.7% respectively). Only 48.4% (44 respondents) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (65.9 and 79.5% respectively), while Speech Pathologists and  Orthodontists were less represented (18.2% and 40.9% respectively).Conclusion: Findings from this study have shown that interdisciplinary care for the cleft patient is not yet fully established in Africa. The result obtained also suggests that cleft care in African population is young, and team care is perhaps many years behind the global trend. This may be a result of several reasons ranging from lack of sufficient specialistsin African population generally to the relatively young age of cleft care practice in that part of the world Key words: Africa, cleft, interdisciplinary care, lip, palat

Red Eye: The Red Herring of Otolaryngologic Diseases

Background: Red eye of otolaryngologic origin could present a diagnostic conundrum. A clear understanding of the otolaryngologic differential diagnosis is required to clinch a diagnosis. In this paper, we describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin. Objective:To describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin with a view to facilitate early diagnosis and treatment. Methods: Records of patients with red eyes of otolaryngologic origin were reviewed. The otolaryngologic culprits and features that proved their culpability were highlighted. Results: In all, 32 patients with red eyes of otolaryngologic origin were seen. Majority had used eye drops as primary eye care. About 71.9% seen by the general practitioners were referred to ophthalmologists on account of persistent ocular symptoms. The otolaryngologic culprits were mostly nasal and paranasal diseases. Eight(25%) required conservative treatment, 24(75%) required surgical intervention and 3(9.4%) developed complete blindness. Conclusion: This study shows that red eyes of otolaryngologic origin are mostly caused by nasal and paranasal sinus diseases. However, both patients and general practioners could be misled to believe the eye is the primary source of the ocular symptoms. Such diagnostic conundrum are associated not only with increased morbidities but also cost of treatments. The need to have a clear understanding of the otolaryngologic differential diagnosis of red eyes is hereby stressed. Also, the public must desist from arbitrary use of eye drops and the slogan: “If symptoms persits after 2 days consult your doctor” should be a community watchword

Retrospective evaluation of necrotizing fasciitis in university college hospital, Ibadan

Context: Cervicofacial necrotizing fasciitis (CNF), although a potentially fatal fulminant infection has been largely under‑reported in the dental literature.Aims: To report our experience with cases seen and treated at the University College Hospital, Ibadan, Nigeria.Settings and Design: A descriptive retrospective clinical study.Materials and Methods: A retrospective survey of cases treated between January 2002 and January 2007 was done. Diagnosis of CNF was established by fascia necrosis found on surgical exploration. Patients’ age, sex, medical status, etiology of infection, bacteriology, and treatment received and complications were reviewed.Statistical Analysis Used: SPSS version 15.Results: Of the 48 cases of cervicofacial infection admitted during the study period, only 12 cases of CNF were found. Male:Female ratio was 4:8. The mean age of patients was 58.83 ± 11.91 years while the age range was 42–83 years. Those that had immunocompromised medical conditions included three cases each of diabetes mellitus and chronic nutritional anaemia and one case of retroviral infection. Mixed bacterial isolates of anaerobes and enterobacteriaceae were found in 10 cases while beta hemolytic streptococci were the sole isolate in two cases. All patients had serial debridement combined with intravenous antibiotic medications. Complications included anterior chest wall infection in three patients and one case of pleural effusion. The only mortality occurred in the patient with retroviral infection.Conclusions: We advocate early recognition, surgical debridement and intensive medical care for treatment of CNF in order to reduce morbidity and mortality from this condition

Mandibular defect reconstruction with nonvascularized iliac crest bone graft

Context: Reconstruction of mandibular defect is a challenge to the head and neck surgeon because of associated functional and esthetic problems. Our experience with the use of nonvascularized iliac crest bone graft is hereby reported.Aim: The aim was to report our experience with the use of nonvascularized iliac crest bone for mandibular defect reconstruction at University College Hospital, Ibadan. Nigeria.Settings and Design: A retrospective descriptive study was performed.Materials and Methods: Cases of mandibular reconstruction with iliac crest bone graft between January 2001 and December 2007 were included in this study. Grafts were secured with either a stainless steel wire or a titanium plate.Preoperative diagnosis, postoperative follow-up records including investigations, diagnosis of graft infection and subsequent treatment modalities were extracted from the available records.Statistical analysis used: Descriptive variables were analyzed with SPSS version 14.Results: A total of 47 patients had mandibular defect reconstruction with nonvascularized iliac crest block bone during the study period. Thirty-eight patients had graft secured with transosseous wire [NVIBw] while 9 had a titanium plate [NVIBp]. The male:female ratio was 26:21 while the mean age of the patients was 24.6±4.25 years. Ten patients (21.3%) developed persistent graft infection during the postoperative period. All cases of infection occurred in patients who had transosseous wiring and analysis showed that 60% of the infected grafts revealed mixed microbial isolates containing klebsiela spp, pseudomonas aeurogenosa, and e coli. Six (60%) of the infected grafts were removed as a result of unabated infection while 4 (40%) were successfully treated by exploration and pus drainage.Conclusions: Nonvascularized iliac crest bone graft provides an affordable and less technical choice for mandibular reconstruction with minimal complications in a resource-limited economy

An audit of impacted mandibular third molar surgery

Background: Mandibular third molar impaction is a major oral health burden globally. The associated morbidity and increasing public awareness necessitate the need for more researches into the subject of third molar impaction.Objective: To audit cases of third molar impaction and its management in our institution.Methodology: We carried out a descriptive clinical study involving patients who presented for management of impacted third molar between January 2010 and December 2011. Demography of the patients including third molar spatial relationship, indications for surgery and pre- and post-operative visual analogue score for pain, were analysed.Result: Demography of the patients revealed a mean age of 27.67±7.19 (range 19-56 years) and male to female ratio of 1:1.15. The most common indication for surgery was peri-coronitis, and the mesio-angular variety was the most common form of impaction in our series (46.5%, N=40). Analysis of mean pre-operative and post-operative pain perception with paired t-test revealed statistically significant difference (p=0.00 & 0.01, respectively). Only 14% of the patients developed post-operative infection.Conclusion: Management of impacted mandibular third molar constitutes a sizeable workload of oral surgeons and dental practitioners globally. Early surgery for symptomatic impacted third molar tooth is hereby advocated

Pattern of Assault-induced Oral and Maxillofacial Injuries in Ado-Ekiti, Nigeria

Background: Assault, though a major cause of maxillofacial injuries in the developed nations, has not been adequately investigated among Nigerian population. This study aimed to analyze the pattern of maxillofacial injuries caused by assault in our institution.Methods: A descriptive clinical survey of patients with assault-induced oral and maxillofacial injuries presenting to our maxillofacial surgery clinic/emergency ward was carried out. Demographic data and pattern of injuriesobtained from patients’ record and department trauma databasewere analyzed. Results: 156 patients presented with oral and maxillofacial injuries between October 2009 and December 2010. Thirty-four cases were due to assault and male to female ratio was 1.8:1. The mean age of the patients was 21.4±6.26 years (age range 2–48 years). 23.6% (n=8) of the injuries were due to domestic violence between spouses while 35.3% (n=12) resulted from fight. Students unrest and armed robbery attack accountedfor six cases each (17.7%, n=6), while there were two cases due tochild battering. 64.3% (n=22) of the injuries sustained involved soft tissues while 35.7% involved hard tissues. Contusion was the most common isolated soft tissue injury accounting for 56% (n=10) while dentoalveolar fracture was the most encountered hard tissue injury (62.5%, n=16). Conclusion: There is need for preventive strategies to reduce the incidence of assault-induced maxillofacial injuries.Keywords: Assault, oral and maxillofacial injuries, patter