Ricketts' E-line profile preferences among Nigerian orthodontists, orthodontic trainees, and a young undergraduate students' population.

Aim: This study compared the perceptions of orthodontists, orthodontic trainees, and young university undergraduate students in Nigeria regarding facial profile attractiveness and the need for orthodontic treatment. Materials and Methods: We used a photo-editing software to alter the lips on Ricketts' esthetic line (E-line) in a lateral silhouette to produce five silhouette profiles with 2 mm incremental changes in the upper and lower lips from the 'normal' position on the E-line (-4 mm/-2 mm to + 4 mm/+6 mm). Two hundred and thirty-two participants (consisting of six groups) ranked the five profiles on a 5-point Likert scale (least attractive, 1 to most attractive, 5). Participants also assessed whether orthodontic treatment was needed to improve facial esthetics. Data were analysed in SPSS 20. Intra-rater reliability was assessed using Cohen's Kappa. We tested the null hypothesis (P ≤ 0.05) that ranked preferences between groups using the Kruskal-Wallis test. Mann-Whitney U test was also used to assess pairwise comparisons between the groups. Results: Intra-rater reliability for facial profiles and treatment needs were moderately acceptable (perceptions ≥67.7%; treatment needs ≥67.0%). Perceptions between orthodontists and orthodontic trainees were not significantly different. However, orthodontists/trainees tended to rank the 'normal' Ricketts' E-line profile as most attractive, while students preferred more protrusive lips. Participants' age rather than sex significantly influenced esthetic preferences. About one-half of all participants (46.6%) ranked the 'normal' Ricketts' E-line as unacceptable; hence required orthodontic treatment to improve their facial attractiveness. Conclusion: Clinical/professional judgment and age significantly influenced participants' perceptions of facial attractiveness. Most participants preferred slightly protrusive lips.

Misoprostol as first-line treatment for incomplete abortion at a secondary-level health facility in Nigeria.

OBJECTIVE: To determine the feasibility of introducing misoprostol as first-line treatment for incomplete abortion at a secondary-level health facility. METHODS: An open-label prospective study was conducted in a secondary-level health facility in Nigeria. Eligible women diagnosed with incomplete abortion received 400-µg sublingual misoprostol as first-line treatment. Nurse-midwives took the lead in diagnosis, counseling, treatment, and assessment of final outcome. The primary outcome was the proportion of women who completed the abortion process. RESULTS: Complete evacuation was achieved in 83 of 90 (92.2%) eligible women. The most common adverse effects were abdominal pain/cramps (58 [64.4%]), heavy bleeding (21 [23.3%]), spotting (15 [16.7%]), and fever/chills (11 [12.2%]). More than 90% of women reported that the procedure was satisfactory, that pain and adverse effects were tolerable, and that bleeding was acceptable. Eighty-four (93.3%) and 86 (95.6%) women, respectively, would use the method in the future and recommend it to friends. CONCLUSION: Misoprostol is an effective, safe, and acceptable method for treating incomplete abortion. It can be successfully used as first-line treatment by nurse-midwives. Success rates over 90% are consistent with findings from previous studies in which drug administration was controlled solely by physicians.