Prevalence of Complete Edentulism in Adults and Older Nigerian Population.

INTRODUCTION: The prevalence of complete edentulism varies from country to country and from one region to another region, and making comparisons between national data challenging because of the impact of lifestyle, socio-economic and educational factors. There is no reported national data for Nigeria. AIMS AND OBJECTIVES: The study was to determine the prevalence of complete edentulism among adult (35-44 years) and older (65-74 years) Nigerians, being part of a national oral health survey of Nigerians conducted in 2014. METHODOLOGY: The study was a cross-sectional survey of oral diseases, specifically dental caries, periodontal diseases, dental trauma, and tooth loss, among adult and older Nigerian populations using a multi-stage stratified sampling technique for all 36 states and the FCT, and clinical examination in field situations using daylight settings, with findings collected using data entry forms (WHO 1997). Ethical approvals were obtained from the FMOH, SMOH and SMLGCA. Data was analysed using SPSS-11 and nominal variables compared using chi-square. A p-value of 0.05 was considered significant. RESULTS: A total of 5,038 adults and 4,658 older Nigerians were examined, of which 4(0.08%) and 84 (1.8%), respectively had complete edentulism. Among the adults, it was reported exclusively in Northern Nigeria; whereas among the older population, 66(2.8%) and 18(0.8%) participants in Northern and Southern Nigeria respectively, were reported to be edentulous (p<0.05). 45 cases (4.7%) of edentulism in older Nigerians were reported from the North West geopolitical zone alone. Edentulism is higher in the older population than the adult population in both Northern and Southern regions (p<0.05). Socio-demographic variation was significant in the North, with a higher prevalence in the rural localities among the older population (p<0.05). CONCLUSION: The study showed that there are variations in the prevalence of edentulism in Nigeria, reflecting lower prevalence in comparison with global trends. National prevalence values did not reflect variations along geographical and socio-political divide.

INTRODUCTION: La prévalence de l'édentation complète varie d'un pays à l'autre et d'une région à l'autre, ce qui rend les comparaisons entre les données nationales difficiles en raison de l'impact des facteurs liés au mode de vie, à la situation socio- économique et à l'éducation. Il n'existe pas de données nationales pour le Nigéria. BUTS ET OBJECTIFS: L'étude visait à déterminer la prévalence de l'édentation complète chez les Nigérians adultes (35-44 ans) et plus âgés (65-74 ans), dans le cadre d'une enquête nationale sur la santé bucco-dentaire des Nigérians menée en 2014. MÉTHODOLOGIES: L'étude était une enquête transversale sur les maladies bucco-dentaires, en particulier les caries dentaires, les maladies parodontales, les traumatismes dentaires et la perte de dents, parmi les populations nigérianes adultes et âgées, en utilisant une technique d'échantillonnage stratifiée à plusieurs niveaux pour les 36 États et le FCT, et un examen clinique dans des situations de terrain utilisant des environnements de lumière du jour, avec des résultats recueillis à l'aide de formulaires de saisie de données (OMS 1997). Les autorisations éthiques ont été obtenues auprès de la FMOH, de la SMOH et de la SMLGCA. Les données ont été analysées à l'aide du logiciel SPSS -11 et les variables nominales ont été comparées à l'aide du chi-carré. Une valeur p de 0,05 a été considérée comme significative. RÉSULTATS: Au total, 5 038 adultes et 4 658 Nigérians âgés ont été examinés, dont 4 (0,08 %) et 84 (1,8 %), respectivement, souffraient d'édentation complète. Chez les adultes, l'édentation a été signalée exclusivement dans le nord du Nigeria, tandis que chez les personnes âgées, 66 (2,8 %) et 18 (0,8 %) participants du nord et du sud du Nigeria respectivement ont été déclarés édentés (p<0,05). 45 cas (4,7%) d'édentulisme chez des Nigérians âgés ont été signalés dans la seule zone géopolitique du Nord-Ouest. L'édentulisme est plus élevé dans la population âgée que dans la population adulte, tant dans les régions du Nord que du Sud (p<0,05). Les variations sociodémographiques étaient significatives dans le Nord, avec une prévalence plus élevée dans les localités rurales parmi la population âgée (p<0,05). CONCLUSION: L'étude a montré qu'il existe des variations dans la prévalence de l'édentation au Nigéria, reflétant une prévalence plus faible par rapport aux tendances mondiales. Les valeurs de prévalence nationale ne reflètent pas les variations géographiques et sociopolitiques. Mots-clés: Édentulisme, Prévalence, Adultes, Personnes âgées, Nigérians.

Multiple perturbed collocation tau method for solving nonlinear integro-differential equations

ABSTRACT: The purpose of the study was to investigate the numerical solution of non-linear Fredholm and Volterra integro-differential equations by the proposed method called Multiple Perturbed Collocation Tau Method (MPCTM). We assumed a perturbed approximate solution in terms of Chebyshev polynomial basis function and then determined the derivatives of the perturbed approximate solution which are then substituted into the special classes of the problems considered. Thus, resulting into n-folds integration, the resulting equation is then collocated at equally spaced interior points and the unknown constants in the approximate solution are then obtained by Newton's method which are then substituted back into the approximate solution.Illustrative examples are given to demonstrate the efficiency, computational cost and accuracy of the method. The results obtained with some numerical examples are compared favorable with some existing numerical methods in literature and with the exact solutions where they are known in closed form

An evaluation of surgical outcome of bilateral cleft lip surgery using a modified Millard's (Fork Flap) technique.

BACKGROUND: The central third of the face is distorted by the bilateral cleft of the lip and palate and restoring the normal facial form is one of the primary goals for the reconstructive surgeons. The history of bilateral cleft lip repair has evolved from discarding the premaxilla and prolabium and approximating the lateral lip elements to a definitive lip and primary cleft nasal repair utilising the underlying musculature. The aim of this study was to review surgical outcome of bilateral cleft lip surgery (BCLS) done at the Lagos University Teaching Hospital. MATERIALS AND METHODS: A review of all cases of BCLS done between January 2007 and December 2012 at the Lagos University Teaching Hospital was done. Data analysis included age and sex of patients, type of cleft deformity and type of surgery (primary or secondary) and whether the cleft deformity was syndromic and non-syndromic. Techniques of repair, surgical outcome and complications were also recorded. RESULTS: A total of 39 cases of BCLS involving 21 males and 18 females were done during the period. This constituted 10% (39/390) of all cases of cleft surgery done during the period. There were 5 syndromic and 34 non-syndromic cases. Age of patients at time of surgery ranged between 3 months and 32 years. There were 24 bilateral cleft lip and palate deformities and 15 bilateral cleft lip deformities. Thirty-one of the cases were primary surgery, while 8 were secondary (revision) surgery. The most common surgical technique employed was modified Fork flap (Millard) technique, which was employed in 37 (95%) cases. CONCLUSION: Bilateral cleft lip deformity is a common cleft deformity seen in clinical practice, surgical repair of which can be a challenge to an experienced surgeon. A modified Fork flap technique for repair of bilateral cleft lip is a reliable and versatile technique associated with excellent surgical outcome.

Pattern of presentation and management of lip injuries in a Nigerian hospital.

AIM: Human lip injuries, although uncommon, present major challenges in terms of reconstructive options and the outcome of surgical management. The reconstructive techniques are usually varied but the ultimate objectives of treatment are to achieve healing, function, and aesthetics. The aim of this study was to report the etiology, pattern of presentation, and surgical management of lip injuries in Lagos University Teaching Hospital (LUTH). MATERIALS AND METHODS: A prospective study of consecutive cases of lip injury was conducted at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital. Data collected included age and sex of patients, etiology, pattern of presentation, and surgical techniques of repair. RESULTS: A total of 13 patients with lip injury to the lip were included in the study (M = 6, F = 7). Human bite (11 cases) was the most common cause of injury followed by electric burns (2 cases). The most (81.8%) frequently affected site was the lower lip. Most patients presented within 72 hours after injury with infected wound. Treatment offered included thorough debridement and primary repair using various surgical techniques. A one-stage surgical technique was employed in all cases. Healing was uneventful in all cases and satisfactory. CONCLUSION: Most of the lip injuries in the present study were due to human bites with almost equal sex distribution. Lower lip was most commonly affected. All cases were successfully treated by debridement, broad spectrum antibiotic coverage, and one-stage surgical repair with a favorable outcome.

Pattern of periodontal treatments performed at the periodontology clinic of the Lagos University Teaching Hospital: 22 months review.

BACKGROUND: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service. OBJECTIVE: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. METHODS: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software. RESULTS: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments. CONCLUSION: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.

Reasons and pattern of tooth extraction among patients presenting at a Nigerian semi-rural specialist hospital.

BACKGROUND: Oral health is greatly influenced by health teeth. OBJECTIVE: The study is to determine the reasons and pattern of tooth extraction in patients seeking care at the oral surgery/Dental clinic in Rasheed Shekoni Specialist Hospital, Dutse, Jigawa between January 2010 and December 2011. METHODS: A retrospective review of records of dental extraction patients. Patients' records were analyzed for demographics, reason(s) for tooth extraction and tooth/teeth extracted. RESULTS: During the 2 years study period, 349 patients (M:F = 1.3:1) aged 2-65 years (mean = 29.7 years +/- 11.5 SD) had extraction of 377 teeth. Dental caries and its sequelae (91.2%) was the most frequent reason for tooth extraction across all age groups, followed distantly by periodontal disease (3.2%) and recurrent pericoronitis (3.0%). The highest proportion of extraction occurred between age 21 to 30 years of age. Mandibular first molars were the most commonly extracted tooth due to dental caries, followed by maxillary first and mandibular second molars. Mandibular molars were by far the more frequently extracted than maxillary molars. CONCLUSION: Dental caries and its sequelae was the main reason for removal of teeth in this section of Nigerian population. Therefore, there is urgent need to focus on the prevention and treatment of dental caries and its sequelae in order to maintain functional and healthy teeth throughout life.

Mid-facial fractures: a 5-year retrospective review in a Nigerian teaching hospital.

OBJECTIVE: The aim of this study is to establish the pattern and actiology of mid-facial fractures, of patients seen and treated at the Lagos University Teaching Hospital, Lagos, Nigeria over a 5-year period. MATERIALS AND METHODS: All cases of midfacial fractures diagnosed and treated at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Lagos between January 2004 and December 2008 were reviewed. Data collected from case records of patients included age, sex, aetiology of fracture, anatomic site of fracture, associated maxillofacial fracture, types of treatment and postoperative complications. RESULTS: The leading cause of mid-facial fractures was road traffic crashes (RTC) which occurred in 93% of highest incidence of mid-facial fractures (36.5%) occurred in the age group of 21-30 years and the lowest in the age group of 60 years and above (2.6%); with male preponderance in nearly all age groups. Female patients were significantly younger than their male counterparts (P=0.000). The most common site of mid-facial bone fractures was the zygomatic complex (n=89, 44.5%), followed by dento-alveolar (n=26, 13%), and Le fort II (n=23, 12%). Conservative management of the fractures was employed in 2.6% (n=4) of the cases while 97.4% (n=152) of the patients required surgical, intervention CONCLUSIONS: Mid-facial fractures were most common in the 3rd decade of life; with a male-to-female ratio of 3.7: 1. Over 93% of the cases were due to road traffic crashes. Zygomatic complex was the most commonly fractured site. The fact that road traffic crashes still remain the major cause of mid-facial fracture in the studied environment is an indication that the enforcement of legislation to prevent road traffic crashes needs to be re-emphasised.

A survey of facial nerve dissection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria.

OBJECTIVE: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear, Nose, and Throat (ENT) Surgeons. MATERIALS AND METHODS: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear, Nose, and Throat Surgeons in Nigeria, on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy, limited superficial parotidectomy, and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. RESULT: About half (47.5%) of them routinely used the antegrade technique, while only a few (12.5%) used the retrograde technique. A large number of them (40%), however, used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60%) and limited superficial parotidectomy (62%). However, the retrograde approach was the technique of choice by most of them (47%) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. CONCLUSIONS: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated.

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Overweight and obesity among patients attending a Nigerian oral surgery clinic: implications for oral surgical practice in Nigeria.

AIM: To determine the prevalence of overweight and obesity among patients attending oral and maxillofacial outpatient clinic of the Lagos University Teaching Hospital, Nigeria; and discuss the clinical and surgical implications that obesity has on the delivery of oral and maxillofacial surgical and anaesthetic care. METHODS: Consecutive patients presenting to the oral and maxillofacial surgery outpatient clinic at the Lagos University Teaching Hospital, Nigeria over a 4-month period (May-August 2004) were screened for age, sex, height and weight. All of the patients were treated for dentoalveolar surgical procedures (routine and surgical extractions), incisional and excisional biopsies, and enucleation under local anaesthesia. RESULTS: The BMIs of the studied patients ranged from 16.7 to 39.8 kg/m(2), with a mean of 24.6 +/- 4.5 kg/m(2). Prevalence of excess weight was 39.1%. Thirty-one (11.4%) patients were obese and 75 (27.7%) patients were overweight. A significant difference was observed in the BMIs of male and female patients (P=0.000). The age groups < 30 years had mean BMIs that were considered normal; whereas other age groups above 30 years had mean BMIs that were considered overweight. Prevalence of obesity increases with increasing age. Obese individuals were seen in all the age groups except those < 20 years. CONCLUSIONS: The prevalence of excess weight (overweight and obesity) in patients presenting in the studied oral and maxillofacial outpatient setting was 39.1%. Oral and maxillofacial surgeon needs to be aware of obesity-/overweight-related medical and surgical issues and take them into consideration when treating these patients.

Prevalence of beryllium sensitization among aluminium smelter workers.

BACKGROUND: Beryllium exposure occurs in aluminium smelters from natural contamination of bauxite, the principal source of aluminium. AIMS: To characterize beryllium exposure in aluminium smelters and determine the prevalence rate of beryllium sensitization (BeS) among aluminium smelter workers. METHODS: A population of 3185 workers from nine aluminium smelters owned by four different aluminium-producing companies were determined to have significant beryllium exposure. Of these, 1932 workers participated in medical surveillance programmes that included the serum beryllium lymphocyte proliferation test (BeLPT), confirmation of sensitization by at least two abnormal BeLPT test results and further evaluation for chronic beryllium disease in workers with BeS. RESULTS: Personal beryllium samples obtained from the nine aluminium smelters showed a range of <0.01-13.00 µg/m(3) time-weighted average with an arithmetic mean of 0.25 µg/m(3) and geometric mean of 0.06 µg/m(3). Nine workers were diagnosed with BeS (prevalence rate of 0.47%, 95% confidence interval = 0.21-0.88%). CONCLUSIONS: BeS can occur in aluminium smelter workers through natural beryllium contamination of the bauxite and further concentration during the refining and smelting processes. Exposure levels to beryllium observed in aluminium smelters are similar to those seen in other industries that utilize beryllium. However, compared with beryllium-exposed workers in other industries, the rate of BeS among aluminium smelter workers appears lower. This lower observed rate may be related to a more soluble form of beryllium found in the aluminium smelting work environment as well as the consistent use of respiratory protection.

Pregnancy epulis associated with life threatening haemorrhage in a Nigerian woman.

Pregnancy tumour is a clinical term used to identify a pyogenic granuloma that occurs in pregnant women. Pregnancy tumour is not uncommon, but severe bleeding associated with the lesion necessitating blood transfusion is rare. We report a rare case of mandibular gingival pregnancy tumour with a life-threatening haemorrhage in a 25-year-old Nigerian woman. The patient had lost an estimated 2 litres of blood before presentation. Her packed cell volume was 8% at presentation. The patient was managed by infusion of fluid, transfusion of 4 units of blood and ligation of the facial artery; and excision of the lesion. Following an uneventful healing, she was discharged 10 days later with a PCV of 40.5%. Following subsequent review there was a recurrence 2 months later that regress after 1 month. She was subsequently lost to further follow up.

Pregnancy Epulis Associated With Life Threatening Haemorrhage in a Nigerian Woman

Pregnancy tumour is a clinical term used to identify a pyogenic granuloma that occurs in pregnant women. Pregnancy tumour is not uncommon; but severe bleeding associated with the lesion necessitating blood transfusion is rare. We report a rare case of mandibular gingival pregnancy tumour with a life-threatening haemorrhage in a 25-year-old Nigerian woman. The patient had lost an estimated 2 litres of blood before presentation. Her packed cell volume was 8at presentation. The patient was managed by infusion of fluid; transfusion of 4 units of blood and ligation of the facial artery; and excision of the lesion. Following an uneventful healing; she was discharged 10 days later with a PCV of 40.5. Following subsequent review there was a recurrence 2 months later that regress after 1 month. She was subsequently lost to further follow up

Indications for extraction of permanent teeth in a Nigerian teaching hospital: a 16-year follow-up study.

AIM: The aim of the present study was to investigate reasons for permanent tooth extraction at the Lagos University Teaching Hospital, Lagos, and compare this with a study done 16 years previously in the same institution, with a view to evaluating trends in reasons for tooth extractions in the studied environment. METHODS: A retrospective review of patients who had nonsurgical extraction of their teeth at the Lagos University Teaching Hospital, Nigeria between January and December, 2006 was carried out. The following data were retrieved: Age and sex of patients, reason for the extraction and types of tooth removed. The data obtained was compared with similar study done 16 years previously in the same institution. RESULTS: Caries and its sequelae and periodontal diseases were the main reasons for tooth extraction in both study periods. Caries and its sequelae as a reason for dental extraction in the second period increased by a factor of 1.2 in comparison with the first period, whereas periodontal disease as a reason extraction in the second period decreased by a factor of 2.7. In addition, orthodontic reasons and tooth impaction as a reason for dental extraction increased by a factor of 4 and 1.3 in the second period respectively. In both study periods, most extractions were carried out in patients within age group 11-40 years (1990, 77%; 2006, 62.3%). Teeth most frequently extracted were posterior teeth (1990, 89.2%; 2006, 89.4%). CONCLUSIONS: Dental caries and its sequelae, and periodontal disease despite being preventable diseases, still remain the two most common reasons for dental extraction in our environment. Therefore, efforts must be made to improve the dental health awareness and status of Nigerian populace to reduce the morbidity associated with the two preventable causes of tooth loss.

Indications for extraction of third molars: a review of 1763 cases.

OBJECTIVE: Third molars have been described as different from other teeth in the oral cavity. They have the highest rate of developmental abnormalities and, most importantly, are last in the eruption sequence. We investigated reasons for third molar teeth extraction in patients attending the outpatient oral surgery clinic of the Lagos University Teaching Hospital, Nigeria. MATERIALS AND METHODS: A retrospective review of patients who had third molar extractions between January 2001 and June 2006 was conducted. Data retrieved and analysed were: age and sex of patients, indication for extractions, type of teeth extracted, technique of extractions (surgical and non-surgical) and angulations of impaction in case of impacted lower third molars. RESULTS: A total of 1763 patients (mean age +/-SD, 33.74+/- 13.3 years; range 15 - 92 years) had their third molars extracted during the period. Majority (58%) of them were females. Surgical extraction was carried out in 506 (28.7%) patients while 1257 (71.3%) patients had non-surgical extractions. Caries and its sequela (63.2%) was the major reason for teeth extraction followed by recurrent pericoronitis (26.3%) and periodontitis (9.2%). Only 11 (0.6%) cases were removed for prophylactic reason. Patients who had their teeth removed for caries were significantly younger than those for periodontitis (P=0.000) but older than those for pericoronitis (P=0.000). CONCLUSIONS: Caries and periodontal diseases occurring in relatively older age group were the major reasons for non-surgical extraction of third molars while recurrent pericoronitis occurring in relatively younger age was the major reason for surgical extraction of impacted third molars. Prophylactic surgical extraction of third molars is not a common practice in our environment.

Incidence and pattern of presentation of dry socket following non-surgical tooth extraction.

OBJECTIVES: To determine the incidence and pattern of presentation of dry socket as a complication of intra-alveolar dental extraction at the Lagos University Teaching Hospital. METHODS: Patients who were referred for intra-alveolar dental extractions under local anaesthesia at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital between July and December 2002 were included in the study. The following data were recorded for each patient: biodata, reason for extraction, number and type of teeth extracted, time taken for the extraction to be done, smoking habit, and use of oral contraceptives. Onset of symptoms and type of teeth involved for those with diagnosis of dry socket were also recorded. RESULTS: Thirty-one teeth (5.6%) of a total of 554 teeth extracted during the period of the study developed dry socket. The mean age (SD) of the 27 patients who developed dry socket was 32.2 +/- 13.0 years, (m; f ratio of 1: 4.4). Most (44.5%) of the patients who presented with dry socket were in the 3rd decade of life, with more than half (59%) of them presenting on the 3rd day following extraction. Mandibular and maxillary teeth were equally affected. Molars and premolars were exclusively affected. Difficulty of extraction was significantly associated with the development of dry socket (p<.05). CONCLUSION: The incidence of dry socket in our centre is similar to previous reports. Female patients were significantly affected. Difficulty of extraction was significantly associated with the development of dry socket. Non-dressing treatment provided satisfactory relief of the symptoms and subsequent granulation of the socket.

First-dose analgesic effect of the cyclo-oxygenase-2 selective inhibitor lumiracoxib in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled comparison with celecoxib [NCT00267215].

Cyclo-oxygenase-2 selective inhibitors are frequently used to manage osteoarthritis. We compared the analgesic efficacy of the novel cyclo-oxygenase-2 selective inhibitor lumiracoxib (Prexige) versus placebo and celecoxib in patients with knee osteoarthritis. This seven day, double-blind, placebo and active comparator controlled, parallel group study included 364 patients aged > or = 50 years with moderate-to-severe symptomatic knee osteoarthritis. Patients received lumiracoxib 400 mg/day (four times the recommended chronic dose in osteoarthritis; n = 144), placebo (n = 75), or celecoxib 200 mg twice daily (n = 145). The primary variable was actual pain intensity difference (100 mm visual-analogue scale) between baseline and the mean of three hour and five hour assessments after the first dose. Actual pain intensity difference, average and worst pain, pain relief and functional status (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) were measured over seven days. Patients also completed a global evaluation of treatment effect at study end or premature discontinuation. For the primary variable, the superiority of lumiracoxib versus placebo, the noninferiority of lumiracoxib versus celecoxib, and the superiority of lumiracoxib versus celecoxib were assessed by closed test procedure adjusting for multiplicity, thereby maintaining the overall 5% significance level. In addition, celecoxib was assessed versus placebo in a predefined exploratory manner to assess trial sensitivity. Lumiracoxib provided better analgesia than placebo 3-5 hours after the first dose (P = 0.004) through to study end. The estimated difference between lumiracoxib and celecoxib 3-5 hours after the first dose was not significant (P = 0.185). Celecoxib was not significantly different from placebo in this analysis (P = 0.069). At study end 13.9% of lumiracoxib-treated patients reported complete pain relief versus 5.5% and 5.3% of celecoxib and placebo recipients, respectively. WOMAC total and subscales improved for both active treatments versus placebo except for difficulty in performing daily activities, for which celecoxib just failed to achieve significance (P = 0.056). In the patient's global evaluation of treatment effect, 58.1% of patients receiving lumiracoxib rated treatment as 'excellent' or 'good', versus 48.6% of celecoxib and 25.3% of placebo patients. Lumiracoxib was well tolerated. The overall incidence of adverse events was similar across treatment groups.

Biochemical changes elicited by isosaline leaf and stem-bark extracts of Harungana madagascariensis in the rat.

Isosaline leaf and stem-bark extracts of Harungana madagascariensis (L) administered intraperitoneally into healthy albino rats of the Sprague-Dawley strain at a dose of 400 mg/kg body weight resulted in a significant elevation of liver, kidney and serum alanine and aspartate aminotransferase activities. Serum urea, total proteins, total triglyceride, cholesterol, pyruvate and lactate were also significantly elevated in the treated rats. While the stem-bark extract significantly increased the blood glucose level, the leaf extract significantly lowered it. However, both extracts significantly reduced supernatant protein concentrations of the liver and kidney. The significant increase in aminotransferase activities and the concomitant reduction in protein concentrations of the liver and kidney suggests increased catabolism of proteins in these organs, while the catabolites produced are probably channelled to other metabolic pathways resulting in the observed hyperpyruvicaemia, hypertriglyceridaemia and lactic acidaemia in the treated animals. The increased serum cholesterol also suggests a probable degenerative change that these extracts may have on membranes. The results obtained clearly indicate that these extracts alter metabolic activities in both the liver and kidney of treated rats and hence, should be employed in herbal preparations with caution.