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   Table of Contents - Current issue
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July-December 2022
Volume 19 | Issue 2
Page Nos. 93-166

Online since Wednesday, November 23, 2022

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ORIGINAL ARTICLES  

Mortality review in a maxillofacial center in Northern Nigeria Highly accessed article p. 93
Benjamin Fomete, Rowlan Agbara, Modupeola Omotara A. Samaila, Theophilus Ekhosuehi Agho, Ernest A Ikekhuamen
DOI:10.4103/njbcs.njbcs_14_22  
Context: Mortality pattern is an essential component in health delivery globally. It is an important medical appraisal that should be made regularly. Mortality in maxillofacial patients often results from co-morbidity from others diseases as seen in Ludwig's angina and advanced stage malignancies. Aim: To document the causes of maxillofacial mortalities during a 12-year period. Materials and Methods: An analysis of all cases of death recorded in the Department of Oral and Maxillofacial Surgery of a Nigerian tertiary health Centre from January 2006 to December 2018. Results: A total of 3255 oral and maxillofacial patients were seen during 12-year period. About 65 deaths were recorded accounting for 2.0% of all cases of which 69.2% were males, whereas 30.8% females. The age group most affected was 30 to 39 with 23.1% closely followed by 20 to 29 with 21.5%. Conclusion: Cervicofacial infection was the commonest causes of mortality in oral and maxillofacial surgery in our environment.
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Temporomandibular joint dislocation: A 7-year retrospective study in Two Nigerian Teaching Hospitals Highly accessed article p. 96
Moshood Folorunsho Adeyemi, Moninuola Adebusola Ernest, Adebayo A Ibikunle, Abdurrazaq O Taiwo, Ifeanyi Davies Ochingwa, Bruno Ile-Ogedengbe
DOI:10.4103/njbcs.njbcs_15_22  
Context: Temporomandibular joint (TMJ) dislocation constitutes about 3% of all reported joint dislocations worldwide. The study presents our experience with TMJ dislocation and its management at two tertiary healthcare centers in Nigeria. Materials and Methods: A retrospective study of patients managed for TMJ dislocation at two healthcare facilities over a period of 7 years was conducted. The diagnosis was clinical with confirmation by radiographic findings. Bio-data, predisposing conditions, duration of onset of presenting complaints, and treatment techniques were documented. Cases were classified as unilateral (right or left) or bilateral and they were further sub-classified as acute (less than or equal to 2 weeks of presentation to the clinic), chronic (greater than 2 weeks of presentation to the clinic), or recurrent (more than one episode of dislocation before presentation). Results: A total of 25 cases were analyzed. There was a slight male preponderance 13 (52%) observed with a male/female ratio of 1.1: 1. The mean age is 35.52 ± 17.36 years and a range of 15-80 years. Majority 18 (72%) of the patients were diagnosed with acute TMJ dislocation. The principal predisposing factor was yawning 12 (48%) and most of the patients had bilateral TMJ dislocation 19 (76%). Hippocratic maneuver was the treatment main method of choice in 14 (56%) of the patients. Conclusion: Bilateral TMJ dislocation was the most common pattern seen in our environment.
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A single-center detection of adult patients with advanced periodontal disease using surgical assessment and cone-beam computed tomography p. 101
Ajay Chandran, Maneesha Das, Khalid Gufran, Mohammad Shoyab Khan, Abdullah Saad Alqahtani, Meenakumari Chikkanna, C Swarnalatha, J Suresh Babu, Abhishek Singh Nayyar
DOI:10.4103/njbcs.njbcs_66_21  
Context: One of the major limitations of conventional radiological procedures is the presence of considerable overlapping and lack of clear, three-dimensional information. Cone-beam computed tomography (CBCT) has emerged as an effective imaging modality in such situations offering high-quality images and lower radiation exposure to patients. Aim: The aim of the present study was to assess the role of CBCT in the detection of intra-bony defects in patients with advanced periodontal disease. Settings and Design: The present study was designed as a prospective, observational study wherein patients aged between 35–55 years with advanced periodontal disease who were indicated for periodontal treatment in form of periodontal surgeries were selected from the outpatient department (OPD) based on defined inclusion and exclusion criteria. Materials and Methods: Sixty patients with chronic periodontitis with 12 teeth each including 6 anterior and 6 posterior teeth were selected for making measurements pre- and peri-operatively while bone defects were measured first with the help of CBCT software installed in an individualized system devised to be used for storing and analyzing CBCT images and then, during surgical intervention using standardized UNC-15 periodontal probe and compared. Statistical Analysis Used: Statistical analysis was performed using SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). The measurements obtained with the help of CBCT software installed in the personalized system and those obtained on surgical exploration were compared in each anterior and posterior tooth with the help of paired-sample t-test while Pearson's correlation(r) was used to test the correlation between the observed values. The level of statistical significance was set at P < 0.05. Results: The results were found to be highly significant both in terms of statistical (P-value) and clinical (r) significance for various sites in the anterior and posterior teeth in all instances. Conclusions: From the observations made from the present study, it could be concluded that CBCT provided highly precise assessment of bone topography equivalent to the judgment obtained during surgical exposure at the sites of interest preoperatively, which helped in assessing the exact type and depth of defect present and helped in optimizing surgical treatment planning.
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Facial heights as predictors of occlusal vertical dimension in a Nigerian population: A pilot study p. 107
Tope Emmanuel Adeyemi, Chikaodi Obinna Oguchi, Paul Ikhodaro Idon, Yewande Isabella Adeyemo, Sabeer Muhammad Iya, Oluwafeyisayo Francis Ikusika
DOI:10.4103/njbcs.njbcs_21_22  
Context: Facial height measurements may aid in predicting occlusal vertical dimension (OVD). Aim: To compare facial third measurements among individuals with healthy occlusions for a predictive ratio for occlusal vertical dimension determination. Setting and Design: A cross-sectional prospective observational study at the Dental Clinic of Aminu Kano Teaching Hospital. Sampling was purposive. Materials and Methods: A digital caliper was used to measure the upper facial height (UFH), the midfacial height (MFH), and the lower facial height (LFH) of 103 participants. Statistical Analysis Used: The data collected were analyzed with IBM Statistical Package for the Social Sciences (SPSS) version 25. The level of statistical significance was set at P ≤ 0.05. Results: There were 69 male (67%) and 34 female (33%) members in the cohort analyzed. The ages of the participants ranged from 18 to 58 years, with a mean age of 27.3 ± 6.8 years. The UFH ranged from 60 to 110 mm with a mean value of 82.2 ± 9.8 mm. The MFH ranged from 55 to 100 mm with mean value of 74.6 ± 9.9 mm. The LFH ranged from 60 to 90 mm with a mean of 73.2 ± 7.4 mm. There was a significantly positive correlation between UFH and LFH (r = 0.22). This was similar to that of MFH and LFH (r = 0.61). The best fit model equation for the prediction of LFH was found to be LFH = 31.495 + (0.442 × MFH). Conclusions: This study found MFH to be a predictable factor for LFH estimation which can be used for OVD determination.
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Perceptions of exercise interventions in pregnancy; A cross sectional survey of health care workers in Kaduna State p. 113
Amina Mohammed-Durosinlorun, Fatima Sani, Rukayya Abubakar, Funmi Egwu, C Mohammed, M Taingson
DOI:10.4103/njbcs.njbcs_11_21  
Context: The potential benefits of exercise to pregnant women and their unborn children are immense, yet regular exercise prescription may not be the norm. Aims: Our study aimed to investigate the perceptions and practices of obstetric care providers regarding exercise in pregnancy. Materials and Methods: The study was a cross-sectional survey done in Kaduna state between July and December 2020. A pretested questionnaire was given to obstetric care providers and information was obtained about demographics, professional and facility characteristics of respondents, their perceptions, and practices related to exercise in pregnancy, and information they routinely give pregnant women regarding exercise. Descriptive analysis was done using frequencies, percentages, mean, and standard deviation. Results: There were 265 respondents with a mean age of 34.23 ± 9.29 years. They were mostly females (215, 82.1%), married (171, 65.3%), Muslim (137, 52.3%), and Hausa (107, 40.8%). There were more nurses (153, 58.4%) from the public (212, 80.9%) and tertiary (133, 50.8%) health facilities. Almost all respondents agreed that exercise during pregnancy was beneficial (258, 98.5%). The commonest indication for exercise was cited as obesity and diabetes, whereas it was mostly contraindicated with bleeding while pregnant. The commonest barriers to exercise in pregnancy were the fear of pregnancy complications, inadequate knowledge, and high workload. Conclusion: Healthcare workers in this study generally had positive perceptions and practices toward exercise during pregnancy, except for the fact that they feel pregnant women should avoid strength-building exercises, and do not usually recommend individualized programs. Local guidelines need to be developed for EIP and providers better trained.
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Evaluation of urea, creatinine levels, and proteinuria among obese individuals within abakaliki metropolis p. 120
Ugomma A Ude, Michael E Kalu, Chinenye L Ogbonna, Victor U Usanga, Simon O Azi
DOI:10.4103/njbcs.njbcs_74_21  
Context: The deleterious effects of obesity on human health are systemic, and kidney dysfunction is now recognized as a health risk posed by obesity. Aim: The study was aimed at evaluating serum urea, creatinine levels, and proteinuria among obese individuals living in Abakaliki Metropolis. Settings and Design: This was a cross-sectional study of individuals living within Abakaliki Metropolis between August 2020 and September 2021. Materials and Methods: A total of 242 participants made up of 168 obese and 74 non-obese who consented to the study were recruited. Blood and urine samples were collected for the estimation of urea, creatinine levels, and proteinuria. Anthropometric data were collected using meter rule and digital scale for calculation of body mass index (BMI). Demographic data were collected using structured questionnaires. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using a digital sphygmomanometer under standard conditions. Statistical Analysis: The data generated were analyzed using Statistical Package for Social Sciences, version 20.0 (SPSS Inc. Chicago Illinois). Results: The results showed a higher BMI, SBP, DBP, urea, and creatinine levels in those with obesity than the non-obese. Females with obesity had non-significantly higher levels of urea and creatinine than males with obesity (P > 0.05). BMI, age, and SBP were observed to positively correlate with urea and creatinine levels among the obese. Participants in class II obesity had the highest urea level (6.37 ± 4.65) compared to other groups. Conclusion: A good control of weight helps to forestall progressive renal impairment.
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Pattern and outcome of heart failure amongst children admitted in an emergency pediatric unit of a Tertiary Hospital in Sokoto State, North-Western Nigeria p. 126
Khadijat O Isezuo, Usman M Sani, Usman M Waziri, Bilkisu I Garba, Lukman K Coker, Abdulrasheed Folorunsho
DOI:10.4103/njbcs.njbcs_17_22  
Context: Heart failure (HF) is a major cause of mortality in the emergency pediatric unit (EPU). It is the usual presentation of many structural cardiac and non cardiac diseases. An audit of the causes of heart failure is necessary to ensure adequate management and prevention. Aim: We describe the pattern and outcome of children with HF admitted to an EPU of a tertiary hospital in Sokoto. Materials and Methods: This was a cross-sectional study conducted in the EPU over 24 months (May 2019 to April 2021). Children aged 1 month to 15 years admitted with heart failure were recruited consecutively. The demographic characteristics, cause of heart failure, and outcome were entered into a proforma. Data were analyzed using IBM SPSS version 25. Results: One hundred and fifty-five out of 7158 children (2.2%) had HF. Majority of these 103 (66.5%) were aged 1 month to 5 years. The age range was 1–180 months with a mean of 55.4 (±53.7) months and a median of 36 (IQR: 86 months). Males accounted for 84 (54.2%) with a ratio of 1.18:1. The commonest causes of heart failure were congenital heart disease (CHD) 40: 25.8%; severe anemia 34: 21.9%; bronchopneumonia 30: 19.4%; rheumatic heart disease (RHD) 18: 11.6%; and dilated cardiomyopathy 16: 10.3%. There were 45(29.0%) deaths, of which CHD, RHD and severe anaemia accounted for the highest mortality. Conclusion: Structural heart diseases like CHD and RHD, in addition to severe anemia and bronchopneumonia, are significant causes of heart failure and mortality in this environment. A holistic approach to prevention is necessary to reduce the burden.
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Factors associated with 12-month psycho-active substance use among police officers in Kano Metropolis, Kano, Nigeria p. 132
Kefas J Kwaghe, Fatimah I Tsiga-Ahmed, Taiwo G Amole, Musa M Bello, Rabiu I Jalo, Aminatu A Kwaku, Usman I Ibrahim, Hadiza M Abdullahi, Aliyu Aminu
DOI:10.4103/njbcs.njbcs_56_21  
Context: Substance use is a widely recognized and pressing public health issue with grave consequences. It is important to prevent mishaps of substance use among the police. Aim: This study assessed the prevalence and factors associated with 12-month psycho-active substance use among police officers in Kano, Nigeria. Settings and Design: A cross-sectional study was conducted among police officers serving within metropolitan Kano. Methods and Materials: Pre-validated, adapted, semi-structured questionnaires were used to collect socio-demographic, work-related data and information on psycho-active substance use. Statistical Analysis Used: Multi-variate logistic regression modeling was used to determine factors associated with psycho-active substance use. All analyses were performed using STATA/IC 15.0. Results: Among 275 officers with a mean age of 35.1 ± 7.7 years, 14.9% (n = 41) recently used one or more psycho-active substances within the last 12 months, and tobacco was the most commonly used (n = 41, 100%). A lower likelihood of substance use was found among officers who were in their fifth decade of life (aOR = 0.29, 95% CI: 0.10–0.55), had tertiary education (aOR = 0.32, 95% CI: 0.14–0.77), were inspectors (aOR = 0.15, 95% CI: 0.16–0.61), were at the rank of ASP or higher (aOR = 0.58, 95% CI: 0.30–0.78), and had been in service between 16 and 20 years (aOR = 0.23, 95% CI: 0.11–0.65). Conclusion: Demographic and work-related characteristics influence the use of psycho-active substances among police officers in Nigeria. There is a need to revamp existing substance monitoring strategies to avoid catastrophic consequences of substance use among the society's gatekeepers.
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Prevalence and factors influencing exclusive breastfeeding practice among nursing mothers: A prospective study in North-Western Nigeria p. 139
A Adamu, KO Isezuo, M Ali, FI Abubakar, FB Jiya, UM Ango, EU Yunusa, MM Bello
DOI:10.4103/njbcs.njbcs_23_22  
Context: Exclusive breastfeeding (EBF) is a key to achieving sustainable development goals (SDGs), but its practice has remained low in Nigeria, despite the strong evidences in support of EBF for the first six months of life. Setting and Design: This was a nine months descriptive cross-sectional study carried out among nursing mothers with children 6–24 months attending pediatric follow-up clinic and family health clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: Interviewer administered questionnaire was used to obtain information on the sociodemographic characteristics and EBF practices of mothers. Statistical Analysis Used: Data were analyzed using SPSS version 20. Results: A total of 240 mothers were interviewed. The mean age of the mothers was 29.7 ± 6 years. All the respondents breastfed their children, 82 (34.2%) practiced EBF for six months. Higher level of maternal education (P = 0.001), ANC attendance (P = 0.001), maternal occupation (P = 0.007), hospital delivery (P = 0.007) significantly influence the practice of EBF for six months. Conclusion: EBF practice was sub optimal. Thus, improving utilization of antenatal care, female education, and hospital delivery are crucial interventions to increase EBF practice toward achieving SDG-2 and 3 in Sokoto.
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Sub-acute toxicity studies of the hypocotyl extract of Borassus Aethiopum on hepato-renal functions, and haematological indices in wistar rats p. 145
Mansur A Ramalan, Adamu B Shuaibu, Umar S Abdussalam, Abdullahi H Yaro
DOI:10.4103/njbcs.njbcs_8_22  
Context: Borassus aethiopum is a tropical plant found in the most parts of West Africa. The fruits, sap, and hypocotyl are used for nutritional purposes and in traditional herbal medicine for the treatment of various diseases and infertility. Despite its widespread use, there is insufficient data on its safety profile. Aim: This study is aimed to evaluate the safety of the plant on the hematological indices, liver, and kidney function. Materials and Methods: Twenty Adult male Wistar rats were divided into 4 groups of 5 rats each and were orally administered with different doses of the extract (250, 500, and 1000 mg/kg) and 1 ml of distilled water, respectively, for 28 days. The median lethal dose (LD50) was determined using Lorke's method. The hematological indices, liver and kidney functions of the animals were assessed using standard procedures with the aid of an autoanalyzer. Result: The oral median lethal dose (LD50) was determined to be greater than 5000 mg/kg. No mortality was recorded in the rats after 28 days of daily treatment. With sub-chronic administration, no adverse toxicological effect was observed. There was also no significant difference observed in the hematological, liver, and kidney function parameters between the control group and extract-treated groups. Conclusion: The present study shows that methanol hypocotyl extract of Borassus aethiopum is pre-clinically safe in Wistar rats at the doses tested and may not likely produce any toxic effect on prolonged administration.
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Prescription patterns of evidence-based heart failure medications in a Tertiary Hospital in North-Western Nigeria—A retrospective study p. 151
Aishatu M Nalado, Hadiza Saidu
DOI:10.4103/njbcs.njbcs_34_22  
Context: Several large clinical trials on the use of medical therapy in the management of heart failure have shown angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers (BBs), and mineralocorticoid receptor antagonists (MRAs) to be of proven benefit and are recommended by guidelines. Aim: The aim of this study is to describe the trend of prescription and dosing of evidence-based medications used for chronic heart failure (CHF) in our population. Settings and Design: This is a retrospective study on the pattern of prescription of evidence-based heart failure medications on 200 consecutive patients with CHF who attended the cardiology clinic or were admitted into the Medical wards from January 2020 to December 2020 at Murtala Muhammed Specialist Hospital, Kano, North-Western Nigeria. The data was obtained from patients' records. Statistical Analytics Used: Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 23 software. (SPSS Inc. Illinois, USA). Results: ACE inhibitors or ARBs were prescribed in 89 (44.5%), BBs in 76 (38%), and MRAs, in 192 (96%). None of the patients were prescribed angiotensin receptor-neprilysin inhibitors (ARNi) or sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors). Conclusion: Evidence-based heart failure medications are underutilized in patients with CHF in our population. Improved uptake and up-titration are needed for better patients' outcomes.
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CASE REPORTS Top

Massive maxillary peripheral giant cell granuloma in a 12-year-old male: Case report p. 157
George Ewansiha, Abdulrahman A Goshi, Imam M Ibrahim, Abdulmanan Yahaya, Babatunde O Bamgbose, Jun Ichi Asaumi
DOI:10.4103/njbcs.njbcs_18_21  
Peripheral giant cell granuloma (PGCG) is a benign, hyperplastic reactive lesion arising from the mucoperiosteum of the alveolar ridge following chronic irritation or trauma. It is characterized by the presence of multinucleated giant cells. We report a 12-year-old male with massive maxillary PGCG where ultrasonography was used as the first line of investigation to determine the severity and vascularity of the lesion based on differential diagnosis. The ultrasonographic findings showed well-defined hyperechoic multifocal echogenic areas and low-resistant spectral waveforms obtained on Doppler were consistent with benign soft tissue lesions. The histopathological examination showed that of a typical multinucleated giant cell with the diagnosis of PGCG.
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Papillary thyroid carcinoma presenting at entopic and ectopic sites: A diagnostic conundrum p. 161
Auwal Adamu, Abdulrazak Ajiya, Dauda E Suleiman, Yakubu B Shirama
DOI:10.4103/njbcs.njbcs_75_21  
Papillary thyroid carcinoma (PTC) mostly occurs within the thyroid gland (entopic site), with its occurrence within an ectopic thyroid tissue being rare comprising less than 1% of all thyroid cancers. The coexistence of PTC in entopic and ectopic sites is even rarer, and differentiating ectopic PTC from a metastatic cervical lymph node may pose a diagnostic conundrum. This report is aimed at highlighting the diagnostic challenges and treatment of this rare condition.
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Successful application of Maggot Debridement Therapy (MDT) on a Fournier's gangrene: First case report in Nigeria p. 164
Mustapha Ahmed Yusuf, Bashir Mohammad Ibrahim, Abdullahi Abubakar, Sani A Aji, Firdausi Abubakar, Mohammed Kabir Abubakar, Abdulrahman Abba Sheshe, Shamsuddeen Muhammad, Mustapha Ibrahim, Usman Bello, Muhammad Adamu Abbas, Abdullahi Muhammad, Kabir Musa Adamu
DOI:10.4103/njbcs.njbcs_42_22  
Fournier's gangrene is a rapidly progressing soft tissue infection and a urological emergency affecting the external genitalia or the perineum. Maggot debridement therapy (MDT) has resurfaced as a result of the steep rise in the emergence of antibiotic-resistant strains of pathogenic bacteria and the need for an effective non-surgical method for wound debridement. This case study reports on a 66-year-old known diabetic who presented to our facility with complaints of scrotal swelling and multiple foul-smelling ulcers around the genital area. There was associated history of pain and fever for twelve-day duration. Sterile first instar larvae of L. sericata were applied using the free-ranged method. Significant decrease in the peri-wound oedema, rapid epithelization and increased vascularity were observed in the patient after the therapy. Maggot debridement therapy was successfully used in the debridement of Fournier's gangrene in Nigeria for the first time, and the clinical outcome is encouraging.
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