Diagnostic and Therapeutic Roles of Microdochectomy and Subareolar Ducts Excision for Pathological Nipple Discharge in Lagos.

BACKGROUND: Pathological nipple discharge (PND) comprises less than 10% of presentation in breast clinics. Data on the management of nipple discharge (ND) in our environment are scarce. AIM: To review management outcome in cohorts of patients with PND in our institution between December 2010 and October 2020. METHODOLOGY: This is a retrospective review of consecutive patients managed for PND between 2010 and 2020. Demographical characteristics, clinical features, investigation results and management outcome were retrieved from the clinical records for analysis. A cross-sectional survey via telephone conversation/clinic consultation was carried out to monitor patients for post-operative complications and recurrence. RESULTS: There were 25 patients (18 microdochectomies and 7 subareolar duct excisions) in the study with a median age of 44 (37.5-49.5) years. The median duration of symptoms before presentation was 3 (2.5-5.5) months. The major characteristics of ND in the study cohort were: single duct orifice in 18 patients (72%) spontaneous ND in 14 patients (56%); right ND in 15 patients (60%); and bloody ND in 21 patients (84 %). Only one patient had a family history of breast cancer. Intraductal papilloma diagnosed in 9 patients (36%) was the most common cause of PND. Breast cancer was an underlying aetiology in 28% of patients in the series. Six out of 7 patients with breast cancer diagnosis were <50years. CONCLUSION: Most women with PND in our practice were young with predominance of spontaneous bloody discharge. Intraductal papilloma was the most common cause of PND in this study. Breast cancer accounted for about a third of cases.

CONTEXTE: L'écoulement mamelonnaire pathologique (EMP) représente moins de 10 % des cas présentés dans les cliniques du sein. Les données sur la prise en charge de l'écoulement mamelonnaire (EM) dans notre environnement sont rares. OBJECTIF: Examiner les résultats de la prise en charge dans des cohortes de patientes présentant un écoulement mamelonnaire pathologique dans notre établissement entre décembre 2010 et octobre 2020. MÉTHODOLOGIE: Il s'agit d'une revue rétrospective des patientes consécutives prises en charge pour un DP entre 2010 et 2020. Les caractéristiques démographiques, les caractéristiques cliniques, les résultats des examens et les résultats de la prise en charge ont été extraits des dossiers cliniques pour analyse. Une enquête transversale par conversation téléphonique/consultation en clinique a été réalisée pour surveiller les complications post-opératoires et les récidives chez les patients. RÉSULTATS: L'étude a porté sur 25 patients (18 microdochectomies et 7 excisions du canal sous-aréolaire) dont l'âge médian était de 44 ans (37,5-49,5). La durée médiane des symptômes avant la consultation était de 3 (2,5-5,5) mois. Les principales caractéristiques de la MN dans la cohorte de l'étude étaient les suivantes : orifice unique dans 18 patients (72 %), MN spontanée chez 14 patients (56%), MN droite chez 15 patients (60 %) et MN sanglante chez 21 patients (84 %). Une seule patiente avait des antécédents familiaux de cancer du sein. Le papillome intraductal diagnostiqué chez 9 patientes (36 %) était la cause la plus fréquente de la MN. Le cancer du sein était une cause sous-jacente chez 28 % des patientes de la série. Six des sept patientes chez qui un cancer du sein a été diagnostiqué avaient moins de 50 ans. CONCLUSION: Dans notre pratique, la plupart des femmes souffrant de DPN étaient jeunes, avec une prédominance d'écoulements sanglants spontanés. Le papillome intraductal était la cause la plus fréquente de DPN dans cette étude. Le cancer du sein représentait environ un tiers des cas. Mots-clés: Cancer du sein, Écoulement, Mamelon, Pathologique.

Mismatch Repair Protein Expressions in Cohort of Colorectal Carcinoma Patients in Lagos.

BACKGROUND: Colorectal carcinoma (CRC) is a major cause of morbidity and mortality worldwide. Microsatellite instability pathway is important in the pathogenesis of CRC. Immunohistochemistry expression of mismatch repair (MMR) proteins serves as surrogate marker for MMR gene mutation. AIMS: This study aimed to determine MSI status of a cohort of CRC cases using immunohistochemistry. MATERIALS AND METHOD: Surgical pathology blocks of resected colonic carcinoma (CC) between 2011 and 2015 were extracted from our departmental archives and The Specialist Laboratories in Lagos. Immunohistochemical expression profile of 4 MMR proteins was assessed in the representative blocks and this was correlated with the demographic and pathological characteristics. RESULTS: There were 19 males and 16 females with CC, mean age of 51.6 years, and 40% of them were below 50 years of age. Twenty (57.1%) out of the 35 CC cases seen were mismatch repair proficient (pMMR) while the remaining 15 (42.9%) were mismatch repair deficient (dMMR). Seven dMMR cases were seen equally on the right and left colonic tumors respectively. Five (71.4%) out of the 7 mucinous tumors in this study were dMMR, right sided with 3 of them in patients who were below 50 years of age. CONCLUSION: The frequency of mismatch repair deficiency in CC among Nigerians is high, and presence of right-sided mucinous colon cancer in patients below 50 years is highly suggestive of dMMR status. Mutation studies of larger patient samples to determine the percentage with germline mutation will further our knowledge, and influence therapeutic options for CC.

Knowledge of Breast Cancer and Practice of Breast Cancer Screening among Female Teachers in an Urban Local Government Area in Lagos State, Southwestern Nigeria.

BACKGROUND: Breast cancer is a global health concern and a leading cause of death among women in the world. Enhancing breast cancer screening in developing countries is pivotal in improving women's health. Aim of this study was to assess the knowledge of breast cancer and practices of breast cancer screening. METHODS: Study design was a descriptive cross sectional study among 348 public senior secondary school female teachers in Surulere LGA. Data was collected using a pretested, structured, open-ended and close-ended self-administered questionnaire. Questions on knowledge of breast cancer and practice of breast cancer screening were scored and graded as good (>50%) and poor (< 50%). The Univariate and bivariate analyses were carried out. Pvalue <0.05 was considered statistically significant. RESULTS: A total of 332 out of the 348 administered questionnaires were retrieved and analyzed giving a response rate of 95.40%. Respondents' ages ranged from 24-58 years with a mean of 42.61±5.53 years. Overall knowledge of breast cancer was good among 308(92.77%) of the respondents. Majority 264(79.52%) of the respondents performed breast self-examination (BSE), 240(72.29%) have had clinical breast examination (CBE) performed for them by a health personnel and 216(65.06%) of the respondents reported they have had a mammogram. CONCLUSION: Majority of the respondents had good knowledge of breast cancer. Most common practice of breast cancer screening was BSE, followed by CBE and lastly mammogram. Health education/awareness campaigns are therefore recommended to improve and sustain the existing knowledge and breast cancer screening practices.

Development and practice of laparoscopic surgery in a Nigerian tertiary hospital.

BACKGROUND: For the benefits of less postoperative pain, early recovery and discharge, and better cosmesis, laparoscopic surgery is rapidly gaining acceptance amongst surgeons as a better alternative to traditional open procedures. In January 2015, bookings for laparoscopic surgery became a more regular feature on our operation list. AIMS: We reported the indications, management outcome, and challenges in patients who had laparoscopic surgery in our institution. This is to document the trends in our surgical practice. METHODOLOGY: This is a descriptive study of 137 patients who had laparoscopic surgery for general surgical indications in our institution over a period of 5 years. Patients data as collected from the records department were evaluated for demographic characteristics, medical comorbidities, type of procedures done, and perioperative outcome. Data analysis was performed using Statistical Package for Social Sciences (SPSS). RESULTS: A total of 137 Patients had laparoscopic general surgery between January 2015 and December 2019. There were 48 males and 89 females with a male-to-female ratio of 1:1.9. The mean age of the patients was 38.8 ± 3.4 years (range 16-87 years). Laparoscopic cholecystectomy (35%) and laparoscopic appendicectomy (29.9%) were the most common procedures performed. Five (3.7%) cases were converted to open surgery. Superficial surgical site infection (5.8%) following laparoscopic appendicectomy was the most common postoperative complication. There was no 30-day postoperative mortality. CONCLUSION: Laparoscopic surgery is safe and can be applied to wide variety of general surgical conditions in developing countries. Minimal postoperative morbidity of laparoscopy is a major benefit to the patients.

Descriptive Epidemiology of Odontogenic Tumors in Nigeria: An African Oral Pathology Research Consortium Multicenter Study.

BACKGROUND: Many studies have investigated the burden of odontogenic tumor (OT) in Nigeria; however, the true burden and prevalence of these lesions are not known because these studies are based on a center/region. AIMS: Hence, the aim of this study is to evaluate the true burden of OTs in Nigeria, using a multicenter approach. MATERIALS AND METHODS: This is a 10-year retrospective cross-sectional study of OT seen in eight tertiary health institutions in different geographic locations in Nigeria. RESULTS: A total of 990 cases were included in this study. The highest prevalence of OT was in the third decade of life (n = 274, 27.7%). Most lesions were benign (n = 961, 97.1%), with a slight male preponderance; and the mandible was the commonest site (n = 814, 82.2%). There were a significant association between the diagnosed OTs and the age group and site (P = 0.002 and 0.031, respectively). CONCLUSION: OTs showed a slightly higher preponderance in males, occurring mostly in the third decade. Benign lesions were frequent and ameloblastoma was the commonest OT. Variations exist in the occurrence of OTs from the different geographic locations in Nigeria. This study essentially sheds a broader light on the clinicopathological distribution of OTs across Nigeria, using a large multicenter approach.

Laparoscopic Transgastric Sutured Cystogastrostomy for Post-traumatic Pancreatic Pseudocyst in a Low Resource Setting: Case Report and Literature Review.

Pancreatic pseudocyst (PPC) complicating blunt and penetrating abdominal injury is well documented in paediatric age groups. In adults, PPC is often one of the sequelae of acute pancreatitis rather than trauma. Blunt abdominal trauma accounts for most documented cases of post-traumatic PPC. To the best of our knowledge, PPC following penetrating abdominal gunshot injury is a rare event. Laparoscopic drainage of PPC is fast gaining acceptance as the procedure of choice amongst experts as it offers many advantages and benefits of minimal access surgery to the patient. We report our experience and challenges with our first case of laparoscopic cystogastrostomy for a large post-traumatic PPC in a 24-yearold man who was diagnosed 8 months after laparotomy for a penetrating thoraco-abdominal gunshot wound. We also conduct a review of the literature on laparoscopic management of Pancreatic pseudocyst.

Awareness and practice of breast screening and its impact on early detection and presentation among breast cancer patients attending a clinic in Lagos, Nigeria.

BACKGROUND: Breast cancer is the most common malignancy among females in Nigeria. The concept of breast screening (BS) is that it would result in presentation at earlier stages. We evaluated the impact of BS on early detection and presentation of breast cancer and determined the aspects BS need improvement. PATIENTS AND METHODS: All patients with a diagnosis of malignant breast lump attending clinics at a tertiary hospital in Nigeria were recruited into the study over a 2-year period. Self-administered questionnaires were given to patients. Data collected were demographics, knowledge about BS, practice of BS, the motivation to practice BS and the source of information on BS. RESULTS: Of 218 patients seen, 147 (67.4%) patients presented at the surgical outpatient clinic and 71 (32.6%) at the radiotherapy clinic, with age 48.01 ± 0.80 years. A total of 156 (71.6%) were aware of BS, while 62 (28.4%) were not aware. A logistic regression analysis showed that only the level of formal education predicted awareness of BS, P = 0.001 Nagelkerke's R2 = 0.126. Awareness of BS was mainly from electronic media 87 (55.7%). There was no significant difference in the ages of those aware and practicing BS 48.03 ± 1.05 years, and those not practicing BS 46.32 ± 1.94 years, P = 0.446. There was no significant difference in presentation for those practicing BS 7.41 ± 1.30 months, and those not practicing BS 11.38 ± 2.91 months, P = 0.175, with 64% practicing BS presenting late, while 77% not practicing BS presenting late, χ2 = 2.432, P = 0.488. A logistic regression analysis did not show any demographic or clinical parameters as predictive P = 0.225 Nagelkerke's R2 = 0.126. CONCLUSION: The high level of awareness and practice of BS was not translated into the presentation with early breast cancer.

Oro-facial sarcomas: a review of 88 cases in a Tertiary Institution in Nigeria.

BACKGROUND: A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period. METHODS: All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18. RESULTS: Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade. CONCLUSION: The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.

Gross surgical features and treatment outcome of ameloblastoma at a Nigerian tertiary hospital.

BACKGROUND: Ameloblastoma is a benign odontogenic tumour which is locally infiltrative and may cause severe craniofacial deformities. Its epidemiology, clinical and histologic configurations are replete in local and international literature, but data about its gross surgical patterns and treatment outcome in Nigeria is sparse. We therefore describe the clinical, gross surgical configuration, histopathologic features and the outcome of management seen at a Nigerian tertiary hospital. METHODS: Records of all histologically diagnosed Ameloblastoma from January 2000 to December 2011 at the University College Hospital, Ibadan, Nigeria, were retrieved from the departments of Oral and Maxillofacial Surgery and Oral Pathology. Patients' biodata, clinical, radiographical, gross surgical and histological features of the tumours, type of treatment, mode of jaw reconstruction and post-surgical follow up period data were documented. RESULTS: One hundred and sixty-three ameloblastomas were diagnosed during the study period, only 92 had complete records and were therefore included in the study. The mean age was 34.2 years (+/- 14.25) and the male to female ratio was 1:1.1. Majority of the patients were in the low socioeconomic class (67.4%). Majority of the patients (76.5%) had segmental jaw resection and reconstruction was done mainly with non-vascularised iliac crest grafts. The gross surgical configurations were described as solid, cavitated and cystic. CONCLUSION: Despite the locally aggressive nature of ameloblastoma, patients presented late for treatment and majority of them had segmental jaw resection as a mode of treatment. Three gross surgical configurations of the specimens were described.

Lipid, lipoproteins, total antioxidant status and organ changes in rats administered high doses of cadmium chloride.

OBJECTIVE: To determine the possible association between cadmium (Cd) exposure and alterations in plasma lipid and lipoprotein levels and total antioxidant status (TAS) in rats. MATERIALS AND METHOD: Twenty male albino rats assigned to 2 groups of 10 rats each (test and control) were used for the study. Each test animal model was given 1.0 mg CdCl(2)/kg body weight, administered intraperitoneally for 4 weeks. Blood samples obtained from both groups at the beginning (baseline) and after 4 weeks of Cd exposure were analysed for triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), TAS and Cd. Kidney and liver sections from the rats were examined. RESULTS: The plasma TG, TC and LDLC levels were significantly higher in exposed rats than controls (p < 0.0001, p < 0.0001 and p < 0.001, respectively). Plasma HDLC was reduced in the exposed rats compared to controls (0.41 ± 0.22 and 0.68 ± 0.14 mmol/l, respectively). CONCLUSION: The observed dyslipidaemia and decrease in TAS could be due to increased free radical production causing oxidative stress. Damage to liver and kidney sections in the exposed group suggests that Cd toxicity results in detrimental histological changes and may be implicated in the aetiology of cerebrovascular diseases.

The knowledge and experience of personal and professional oral care among secondary school students in Ibadan.

OBJECTIVE: Many developing nations of the world have experienced an increase in the incidence and prevalence of oral diseases in the last few decades. This study assessed the knowledge and attitude as well as the experience of personal and professional oral care of secondary school students in Ibadan, in order to understand how to promote a better oral health habit amongst them. PATIENTS AND METHODS: Questionnaires including items relating to knowledge, attitude as well as personal and professional oral care were administered to the subjects. RESULTS: A total of 267 students from Ibadan North Local government area of Ibadan, Oyo state participated in the study. Of these 71.5% clean their mouth twice daily, only 4.1% of the students have used dental floss at least once before. 55.5% of them have been to the dentist before. Only 16.2% of those that have been to the dentist before went for a check. 6.7% of the students know that dental floss is an interdental cleaning device. About 75 % of the students believe that routine dental check-up helps in maintaining a good oral health while about 22 % were of the opinion that it is not necessary or that it is burdensome. CONCLUSION: In conclusion, there is the need for oral health education and promotion that links healthy behaviours and habits to the general well being of individuals because as seen from this study, knowledge is not enough to motivate individuals to adopt a healthy behaviour.

Serum antioxidant vitamins and the risk of oral cancer in patients seen at a tertiary institution in Nigeria.

OBJECTIVES: Tobacco and alcohol are major risk factors of oral cancer, but nutritional deficiency may also contribute to development of oral cancer. This study compared serum antioxidant vitamin levels in oral cancer patients and controls in order to validate the role of vitamin deficiencies in the etiology of oral cancer. MATERIALS AND METHODS: Serum vitamin A, C, and E levels of 33 oral cancer patients and 30 controls at University College Hospital, Ibadan, Nigeria, were determined using standard methods. The data obtained were analyzed using the Student t-test, odds ratio, and logistic regression. RESULTS: Mean vitamin A, C, and E levels were significantly lower in oral cancer patients (P=0.022, P=0.000, and P=0.013 respectively). Risk of oral cancer was 10.89, 11.35, and 5.6 times more in patients with low serum vitamins A, C, and E, respectively. However, on logistic regression analysis, only low serum vitamin E independently predicted occurrence of oral cancer. CONCLUSIONS: The lower serum vitamin A, C, and E levels in oral cancer patients could be either a cause or an effect of the oral cancer. Further studies using a larger sample size and cohort studies with long-term follow-up of subjects are desirable.

"Hybrid" ameloblastoma: a report of two cases.

Ameloblastoma is the most common odontogenic tumour. The tumour has been described as a benign but locally invasive polymorphic neoplasm. Hybrid lesions have been described, which combine histological features of desmoplastic and conventional ameloblastoma. The hybrid ameloblastoma is rare and only few cases have been reported worldwide. We present two cases seen from a review of 195 ameloblastoma cases seen over a ten year period. The cases presented with clinical features of the conventional ameloblastoma such as bucco-lingual bone expansion and multilocular radiololucency. Larger clinical series of hybrid ameloblastoma need to be reviewed in order to better characterize the clinical behaviour, aggressiveness and prognosis of this rare variant of ameloblastoma.

Management of mass casualty: a review.

AIMS AND OBJECTIVES: The aim of this article is to discuss the management of mass casualty and sensitise authorities at various levels and trauma surgeons the need for awareness and training in the management of mass casualty. MATERIALS AND METHODS: Thorough Medline and bibliography search and available local literatures relevant to the management of mass casualty was reviewed. The available articles were reviewed in order to decipher the management pattern in various forms and degree of disasters resulting in mass casualty. RESULTS: Little attention was paid to mass casualty management in civilian population until mid nineties, even, in developed countries. Knowledge in this area has expanded in the last 10 years due to terrorist attacks in the United State America. In developing countries, nothing is known to be on the ground in form of planning for appropriate response to mass casualty. CONCLUSION: Mass casualty usually associated with straining of existing facilities, and with high morbidity and mortality. Pre-incident and adequate training is necessary to reduce morbidity and mortality from major incident which occurrence is often not predictable.

Diesel exhaust particles and endothelial cells dysfunction: An update.

Epidemiological studies have shown a consistent positive correlation between exposure to particulate matter (PM) and increased mortality largely due to increased rates of cardiovascular morbidity and mortality. Diesel exhaust particles (DEPs) are major constituents of atmospheric PM and have been shown to cause disruption of the endothelial cell monolayer integrity, thereby affecting organ functions. Endothelial cells are very active metabolic components of biological tissue that performs a number of important physiological functions. Therefore, anything that compromises the integrity and functions of the endothelium will lead to organ dysfunction and disease. This review focuses on scientific evidence that link DEP exposure to endothelial cell dysfunction in various pathophysiological conditions affecting the cardiovascular system. The various mechanisms involved in the DEP-induced endothelial cell dysfunction are also addressed together with the preventive and therapeutic approaches to overcoming these challenges.

Cystic ameloblastoma: a clinico-pathologic review.

OBJECTIVE: Cystic ameloblastoma represent 10-15% of all intra osseous ameloblastomas and appear to be less aggressive than the solid ameloblastomas. The aim of this study was to examine the clinico-pathologic characteristics of cystic ameloblastomas seen at a tertiary health care centre. MATERIALS: All cases diagnosed as cystic ameloblastoma in the Oral Pathology Department of University College Hospital, Ibadan over a 10 year period were investigated for age, gender, location of lesion, treatment, and follow-up. The cases were classified as luminal, intraluminal or mural, based on Ackermann classification. The data was entered into the statistical package for the social sciences version 18 (SPSS 18) and results expressed as percentages. RESULTS: Fifteen cystic ameloblastomas, representing 14.3% of a total of 105 ameloblastoma cases were seen. The mean age was 28.9(±14.5) years with 73.4% occurring in the second and third decades. The male:female ratio was 2:3. Fourteen (93.3%) of the lesions were in the mandible while only one (6.7%) was in the maxilla. The mural variant was the most common histological variant with 6(40%) cases while the luminal and intra-luminal had 4(26.7%) and 5(33.3%) respectively. The multilocular radiologic appearance was more common than the unilocular in this study (ratio 8:4). Cystic ameloblastoma with multilocular appearance occurred in a higher age group (mean age 31yrs) when compared with the unilocular type which had a mean age of 16.3years. CONCLUSION: This study shows similar findings with previous studies but shows a higher multilocular radiological appearance as compared to unilocular variant and no case of recurrence.

Odontogenic tumours in children and adolescents: a review of forty-eight cases.

OBJECTIVES: Odontogenic tumours comprise a large heterogeneous group of lesions originating from odontogenic epithelium and/or ectomesenchyme and its vestiges. The aim of this study was to analyze odontogenic tumours in children and adolescents seen at a tertiary institution in South Western Nigeria and compare with results from previous studies. MATERIAL AND METHODS: Archival records of the Department of Oral Pathology, University College Hospital Ibadan were reviewed. All histologically diagnosed odontogenic tumours in patients 19 years and below spanning a period of 21 years (1990-2011) were retrieved. Data regarding age, gender, and tumor topography were analyzed using SPSS for Window (version 18.0; SPSS Inc. Chicago, IL). RESULTS: One hundred and forty seven jaw swellings were seen in children and adolescents aged 19 or less during the study period, out of which 48 (32.7%) were odontogenic tumours. More cases were seen in males than females with a male: female ratio of 7:5. The mandible was the commonest site of occurrence with mandible: maxilla ratio of 11:4. Ameloblastoma was the commonest odontogenic tumours with 14 (29.1%) solid ameloblastoma and 9 (18.8%) cystic ameloblastoma cases followed by fibromyxoma with 8 (16.7%) cases. calcifying epithelial odontogenic tumour , calcifying cystic odontogenic tumour and odontogenic fibroma were occasionally seen. CONCLUSION: This study showed that ameloblastoma was the most common odontogenic tumour in children and no case of odontoma was seen. Odontogenic tumours in children and adolescents may not be as rare as previously reported by some authors and inclusion of keratocystic odontogenic tumour in this study slightly affected the relative incidence of odontogenic tumors in children and adolescents.

Serum uric Acid levels in oral cancer patients seen at tertiary institution in Nigeria.

INTRODUCTION: Toxicity by oxygen radicals has been considered as an important cause of cancer. It is proposed that the antioxidant properties of uric acid may act to prevent formation of oxygen radicals and thereby protect against carcinogenesis. This study aims to assess the role of uric acid in the aetiology of oral cancer. MATERIALS AND METHODS: Thirty one oral cancer patients and thirty normal patients had serum uric acid measured using spectophotometer. The data obtained was analyzed using the Statistical Package for the Social Sciences, version 19.0 (SPSS19). Statistical significance was determined at P < 0.05. RESULTS: The mean serum uric acid level in oral cancer patients was 5.18 mg/dl (SD±1.96) while the mean was 7.09 mg/dl (SD±1.84) for the control group and this difference was statistically significant (p=0.000, t= -3.914, C.I. = - 2.885 to - 0.933). The risk of oral cancer was 3.98 times more in patients who had low serum uric acid. CONCLUSION: This study showed that serum uric acid was lower in oral cancer patients compared with healthy volunteers and low serum uric acid was associated with increased risk of oral cancer development. However, further prospective cohort studies are suggested to better understand the role of serum uric acid in aetiology of oral cancer.

Florid cemento-osseous dysplasia: a report of two cases seen at the university college hospital ibadan.

SUMMARY: Florid cemento-osseous dysplasia (FCOD) is commonly seen in black women, but few cases have been reported in sub-Saharan Africa. This article presents two cases of FCOD seen at the University College Hospital Ibadan. Two women aged 70 and 60 years were initially diagnosed as chronic osteomyelitis but both were eventually diagnosed as florid cementoosseous dysplasia after radiological examination by orthopanthomogram. Diagnosis of florid cemento-osseous dysplasia is possible by clinical examination and the distinct radiological presentation, especially on orthopanthomogram and a biopsy may not be required.

Quality of documentation of urethral catheterization in a Nigerian teaching hospital.

BACKGROUND: Urethral catheterization is a common minimally invasive procedure with well-known complications some of which may be severe. Quite often, a clinician is invited to manage the short and long-term complications of the procedure without adequate records of the procedure itself. OBJECTIVES: This study aims to determine the quality of documentation of urethral catheterization in our health institution. METHODS: This prospective study was carried out over a period of 1 month. The documentations in the medical notes and nursing records with respect to urethral catheterisation were assessed using 10 different parameters with the aid of a pro-forma. Statistical analysis was done with the Wilcoxon signed ranks test. RESULTS: A total of 89 patients were catheterised in the wards, the emergency departments and the theatre. All the catheterizations were performed by doctors. The overall quality of documentation of catheterisation was poor: It was significantly worse in the medical notes than the nursing records with 28% of all cases documented by the nurses not documented by the physicians. Documentation in the theatre and emergency were worse, while there was no documentation of aseptic technique in any patient. An 11% incidence of complications was noted. CONCLUSION: The quality of record keeping concerning urethral catheterization was inadequate. This is important not only for patients' care, but also for medico-legal purposes. We therefore recommend regular audit and introduction of protocols for proper documentation.