Postnatal care services use by mothers: A comparative study of defaulters versus attendees of postnatal clinics in Enugu.

INTRODUCTION: Despite much emphasis on the reproductive health of women, maternal mortality is still high, especially in postnatal period. OBJECTIVE: To assess the prevalence of postnatal care use and reasons for defaults among mothers attending the child immunization clinics in Enugu, Nigeria. METHODS: This was a cross-sectional comparative study of 400 consecutive nursing mothers who presented at the Institute of Child Health of UNTH and ESUTH, Enugu for Second dose of the Oral Polio Vaccine (OPV2) for their babies at 10 weeks postpartum. Data was collected using Interviewer-administered questionnaire and subsequently analyzed with version 22.0 IBM SPSS software, Chicago, Illinois. A p-value of less than 0.05 was considered as statistically significant. RESULT: The prevalence of the 6th week postnatal clinic attendance among the mothers was 59%. The majority of the women (60.6%) who had antenatal care by skilled birth attendants attended postnatal clinic. Unawareness and being healthy were the main reasons for not attending postnatal clinic. Following multivariate analysis, place of antenatal (OR = 2.870, 95% C.I = 1.590-5.180, p < 0.001) and mode of delivery (OR = 0.452, 95% C.I = 0.280-0.728, p = 0.001) were the only significant predictors of postnatal clinic attendance (p < 0.05). CONCLUSION: Postnatal clinic attendance by women in Enugu is still suboptimal. The main reason for non-attendance of the 6th week postnatal clinic was lack of awareness. There is need for healthcare professionals to create awareness about the importance of postnatal care and encourage mothers to attend.

Perception of Synchronized Online Teaching Using Blackboard Collaborate among Undergraduate Dental Students in Saudi Arabia.

Blackboard is a collaborative virtual learning tool used for higher learning that has been found to be an effective and efficient means of interactions between teachers and students and offers effective educational information management. The aim of this research work is to assess the preclinical and clinical dental students' perception of Blackboard Collaborate as a quality teaching and learning tool as well as to find out areas that might appear as barriers to quality teaching and learning. This cross-sectional study was conducted online using survey monkey involving 245 dental students who had participated in the virtual classroom lectures during the pandemic with 18 students not completing the survey. The survey instrument was a nine-item questionnaire that included the age, sex, and year of study of the students as well as previous exposure to online lectures. The data collated was analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for windows version 22. Among 245 respondents that were enrolled in the study, 227 respondents completed the survey, of which 58.1% (n = 132) were male while 41.9% (n = 95) were females. Of the 227 respondents that completed this study, 74.8% (n = 170) of them experienced minimum to moderate technical problems regarding connectivity during the online sessions while 1.8% (n = 4) of the respondents experienced very severe technical problems. The majority of the respondents 54.2% (n = 123) support the continuation of online lectures even after the pandemic. In conclusion, we found a positive perception of our respondents to online lectures using Blackboard Collaborate. Internet connectivity as well as a decline in the comprehension of the lectures as compared to face-to-face learning were found as barriers to online learning.

Modified micromarsupialization technique as an alternative primary treatment for ranulas: A case series in a resource-challenged economy.

OBJECTIVES: Ranula is one of the commonest salivary gland cysts that mostly occur due to mucus extravasation from the sublingual salivary gland. Treatment of this lesion is still somewhat shrouded in controversy and varies from conservative treatment to surgical excision of the causative gland. MATERIALS AND METHODS: This was a case series in quasi-experimental design that evaluated the outcome and complications of the modified micromarsupialization technique as a newly introduced treatment at our center for simple sublingual ranula over a 2-year period. RESULTS: Twenty patients were treated by the modified micromarsupialization technique and followed up for 1 year. There was complete resolution following this technique in 17 patients (85%) with no evidence of recurrence or complications, whereas 2 patients (10%) showed partial resolution and the remaining 1 patient (5%) showed a failure and recurrence. The age of the patient, the size of the ranula, and the retention of sutures throughout the study period did not significantly affect the treatment outcome. CONCLUSIONS: The modified micromarsupialization technique was a simple and effective treatment that should be used as a primary treatment option for simple ranulas and we recommend it to be the first-choice treatment before surgical excision of the sublingual gland, especially in a resource-challenged economy like ours.

Pregnant women utilization of dental services: still a challenge in low resource setting.

BACKGROUND: Poor oral health in pregnancy can be associated with poor pregnancy outcome, however, dental consultation among pregnant women appears to be low. METHODS: This was a questionnaire-based study of 413 women who attended the antenatal clinic of University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu. The information obtained was analyzed using SPSS version 22. A p-value of less than 0.05 was considered statistically significant. RESULTS: Only 36 (8.7%) of the respondents had dental consultations in index pregnancy for complaints such as tooth ache and decay (66.7%) and pain as well as swelling of the gum (33.3%). The most common reason given for not visiting a dentist during the index pregnancy was the visit not being relevant to their pregnancy outcome (69.2%). After counseling them, only 249 (60.3%) agreed to have dental consultation during subsequent pregnancies. The relationship between visiting the dentist and place of residence (< 0.001), occupation (0.019) and frequency of brushing/ changing of brush (0.005, < 0.001 respectively) were statistically significant. CONCLUSION: The prevalence of dental consultation during pregnancy is very low. Pregnant women should be encouraged to have routine dental consultation with oral health counseling and check-up incorporated as part of routine antenatal care.

Evaluation of urinary hydroxyproline and creatinine level in patients with benign mandibular odontogenic tumor.

BACKGROUND: Odontogenic tumors are relatively common oro-facial tumors seen in our environment with challenges encountered with management in terms of inadequate infrastructure and high cost of treatment. They are often associated with bone resorption with concomitant collagen degradation and excretion of their by-products in serum or urine. The aim of this present study was to evaluate urinary hydroxyproline level in patients with benign mandibular odontogenic tumors. MATERIALS AND METHODS: Twenty-two consecutive patients with histologically diagnosed mandibular odontogenic tumors were recruited. Twenty-two controls who matched the study group for sex and age were also recruited. The study group had CT-Scan of their lesions done. All participants were required to fast 12 hours overnight and their early morning second void urine collected between 7 a.m and 8 a.m. The collected urine samples were stored frozen at -20°C until analysis. Colorimetric method of analysis of urinary hydroxyproline and creatinine were done using Biovision hydroxyproline kit and Randox creatinine kit, respectively. The results were recorded as urinary hydroxyproline alone (µg/µl) and as urinary hydroxyproline/creatinine ratio. RESULTS: The mean age of the participants was 28.45 ± 6.8 years. The mean duration of the tumors in the study group was 5.9 ± 4.4 years. A mean urinary hydroxyproline/ creatinine ratio of 0.081 ± 0.129 was noted in the study group as compared to 0.016 ± 0.006 that was noted among healthy Nigerian who served as controls in the study. CONCLUSION: There was a significant increase in urinary hydroxyproline level in patients with odontogenic tumors when compared with healthy Nigerians.

A synchronous presentation of malignant melanoma and dermatofibrosarcoma protuberans in a Nigerian female: A case report.

INTRODUCTION: The simultaneous occurrence of multiple primary malignancies in a patient has been widely reported. Oral mucosal malignant melanoma is a rare lesion of the oral cavity. The occurrence of this lesion with a very rare skin sarcoma at the same time has never to the best of our knowledge been reported previously. PRESENTATION OF CASE: A 64 year-old Nigerian woman with a 27-year history of a dark lesion in the right maxillary buccal and palatal mucosa with an anterior abdominal swelling of 24 years which was discovered on systemic examination. Both lesions were later discovered to be malignant melanoma and dermatofibrosarcoma protuberans respectively. She had a right hemimaxillectomy for the maxillary lesion and wide excision of the abdominal wall lesion, followed by six courses of chemotherapy. She has been undergoing regular reviews for the past 5 years and remains free of all malignancy; however, she died shortly after noticing the reappearance of both lesions. DISCUSSION: While evaluating patients with a tumor, it will be rewarding to rule out other similar swellings in the body. This is important to avoid metastasis or multiple primary malignancies, which can help prolong patient life. CONCLUSION: The synchronous occurrence of two different neoplastic lesions is rare. Our literature search revealed no previous report of such occurrence of oral malignant melanoma and DFSP at the same time in one patient. The importance of thorough examination of patients cannot be overemphasized as concurrent lesions may be missed.

Does preoperative dental anxiety play a role in postoperative pain perception after third molar surgery?

Background: Surgical removal of the impacted third molar is associated with inflammatory morbidities which include swelling, trismus, and pain. Pain is the most common postsurgical morbidity associated with third molar surgery. It remains an important factor in patients' perception of recovery after third molar surgery with dental anxiety reported to exert influence on its threshold. Objective: The aim of the study was to determine if preoperative dental anxiety has any significant role on postoperative pain perception after third molar surgery. Materials and Methods: This was a cohort study involving sixty consecutive adult patients requiring extraction of impacted mandibular third molars under local anesthesia. Modified Dental Anxiety Scale Questionnaire was administered to each participant in the waiting area before the surgery. The visual analog scale was also given to each participant to be completed once daily at approximately the same time as the surgery time until day 7 after the surgery. Data collected were analyzed using SPSS version 23. Results: Sixty participants who consented to third molar surgery took part in this study. Five participants were lost to follow-up. There were slightly more males (50.9%) than females (49.1%). Nineteen participants in this study had moderate dental anxiety (34.5%) and 6 participants (11%) had severe dental anxiety with more females having moderate-to-severe dental anxiety. The correlation between pain perception at different days and dental anxiety was not significant (P > 0.05). Conclusion: Preoperative dental anxiety may not significantly influence pain perception after third molar surgery.

RésuméContexte: L'extraction chirurgicale de la troisième molaire incluse est souvent accompagnée d'un gonflement, d'une difficulté à ouvrir la bouche et de douleurs. La douleur est la morbidité post-chirurgicale la plus courante associée à la chirurgie de la troisième molaire. C'est un facteur important qui détermine la façon dont les patients perçoivent la guérison après une chirurgie de la troisième molaire. Il est rapporté que l'anxiété dentaire a une influence sur le seuil de douleur des patients. Objectif: Pour déterminer si l'anxiété dentaire préopératoire a un rôle significatif sur la perception de la douleur postopératoire après une chirurgie de la troisième molaire. Méthodes: Soixante patients adultes nécessitant l'extraction des troisièmes molaires incluses sous anesthésie locale ont été inclus dans cette étude de recherche. Un Modified Dental Anxiety Scale Questionnaire a été administré à chaque participant dans la salle d'attente avant la chirurgie. Le Visual Analogue Scale (VAS) a également été donnée à chaque patient à compléter une fois par jour à peu près au même moment que l'heure de la chirurgie jusqu'au jour 7 après la chirurgie. Les données obtenues ont été analysées à l'aide de la version 23 de SPSS. Résultats: Soixante patients ayant consenti à une chirurgie de la troisième molaire ont participé à cette étude. Cinq patients ont été perdus de vue. Il y avait un peu plus d'hommes (50,9%) que de femmes (49,1%). Dix-neuf patients avaient une anxiété dentaire modérée (34,5%) et 6 (11%) une anxiété dentaire sévère, un plus grand nombre de femmes ayant une anxiété dentaire modérée à sévère. La corrélation entre la perception de la douleur à différents jours et l'anxiété dentaire n'était pas significative (P> 0,05). Conclusion: L'anxiété dentaire préopératoire peut ne pas avoir d'effet significatif sur la perception de la douleur après une chirurgie de la troisième molaire.

Serum levels of 25-hydroxy-vitamin D in patients with oral squamous cell carcinoma: Making a case for chemoprevention.

OBJECTIVES: Serum level of vitamin D has been used as a predictor for cancer development. We intend to measure the baseline vitamin D level in patients with oral squamous cell carcinoma (OSCC) and to compare same with non-cancer controls to determine any association. MATERIALS AND METHODS: Patients with OSCC presenting to our clinics were included in this study. Their baseline serum vitamin D levels were measured prior to cancer treatment after obtaining their consents. These patients were then matched with at least 2 cancer-free subjects to serve as controls and whose serum vitamin D levels were also measured. The serum vitamin D levels obtained for the two groups were then categorized into normal (>35 ng/ml), mild deficiency (25-35 ng/ml), moderate deficiency (12.5-25 ng/ml), and severe deficiency (<12.5 ng/ml). The data were analyzed statistically and the two groups compared. RESULTS: A total of 51 patients with OSCC (Male 22 [43%] and female 29 [57%]) and 113 cancer-free controls (Male 36 [31.86%] and female 77 [68.14%]) were included in the study. The commonest site for OSCC was the tongue, accounting for 45% of the cancer cases. Mean age for cancer patients was 59.33 years ±12.54 and 49.24 years ±15.79 for the control. Among the OSCC patients, 74.51% had moderate to severe vitamin D deficiencies, whereas only 20.35% had a moderate deficiency in the control group with no severe deficiency. CONCLUSION: Logistic regression analysis shows a positive association between vitamin D deficiency and OSCC risk especially in levels below 25 ng/ml. This further corroborates the assertion that vitamin D deficiency may be a useful indicator of OSCC. It may, therefore, be necessary to routinely prescribe vitamin D supplements to subjects with moderate to severe deficiencies in order to decrease the chances of OSCC development.

Prevalence and Predictors of Alcohol Consumption during Pregnancy in South-Eastern Nigeria.

INTRODUCTION: Alcohol consumption during pregnancy is a major public health problem because of the enormous deleterious effects on a developing fetus. Sub-Saharan Africa (SSA) is among the highest per capita rates of alcohol consumption in the world, thus suggesting a high burden of Fetal Alcohol Syndrome Disorder (FASD) in the sub-region. Despite this, there is limited data on alcohol exposed pregnancies for most SSA countries including Nigeria. AIM: To determine the prevalence and predictors of alcohol consumption during pregnancy in Enugu, South-Eastern Nigeria. MATERIALS AND METHODS: It was a cross-sectional study of 380 consecutive consenting parturients accessing antenatal care at the University of Nigeria Teaching Hospital, Enugu, Nigeria. The information sought for, included the women's socio-demographic characteristics, alcohol use in pregnancy, awareness of the harmful effects of alcohol on the babies including FASD, sources of initial information on awareness, type and quantity of alcohol ingested, reasons for taking alcohol and willingness to stop alcohol ingestion in pregnancy after counseling on the risk of alcohol use in pregnancy. Statistical analysis was both descriptive and inferential at 95% confidence level. A p-value of less than 0.05 was considered statistically significant. RESULTS: The prevalence of alcohol consumption in pregnancy was 22.6%. The most common brand of alcoholic beverage consumed was stout beer (62.8%, 54/86). A total of 135 (35.5%) respondents were aware that alcohol is harmful to the fetus. Maternal age 30 years or less, nulliparity, less than tertiary education, pre-pregnancy alcohol consumption and lack of awareness of the harmful effect of alcohol on the fetus, were associated with alcohol consumption during pregnancy (p< 0.05). CONCLUSION: The prevalence of alcohol consumption during pregnancy among women in Enugu, South-Eastern Nigeria is high and lack of awareness of harmful effect of alcohol on fetus was a major predictor. There is need for a concerted public health campaign to improve the awareness of harmful effects of alcohol on the fetus.