Total Salivary Antioxidant and Serum Antioxidant Levels in Recurrent Aphthous Stomatitis: A Case-Control Study.

BACKGROUND: Recurrent Aphthous Stomatitis (RAS) is an inflammatory lesion of the oral mucous lining, accounting for 5 to 25% of the chronic oral lesions. Studies have suggested that RAS patients have increased oxidative stress (OS) and impaired antioxidant capacity, and non-invasive screening using saliva assessment of oxidative stress and antioxidant capacity may be beneficial in RAS. OBJECTIVES: This study determined total salivary antioxidant concentration and compared it to the total serum antioxidant levels in patients with RAS and controls. METHODS: This was a case-control study of subjects with RAS and without RAS. Unstimulated mid-morning saliva was collected using the spitting method, and venous blood was collected into a plastic vacutainer. Saliva and blood samples were assayed for total oxidative stress (TOS), total antioxidant capacity (TAC), ferric reducing antioxidant power (FRAP) and glutathione. RESULTS: A total of 46 subjects, 23 with RAS and 23 healthy controls, participated in the study. Twenty-five (54.35%) were males, and 21(45.65) were females aged 17 to 73 years. We identified an increase in salivary and serum TOS (10.06 ± 7.49, 8.26 ± 2.18/ 15.00 ± 8.92, 9.36 ± 3.55µmol/L) and OSI while the TAC (16.85 ± 1.97, 17.07 ± 2.36/17.07 ± 2.36, 2.97 ± 0.29mM/L) and significantly GSH (0.02 ± 0.02, 0.10 ± 0.02/0.10 ± 0.02/0.19 ± 0.11 µmol/ml) were decreased in serum and saliva of the RAS group compared to controls respectively. In addition, there were positive correlations between salivary and serum levels of FRAP r=0.588, p= 0.003 and glutathione r=0.703, p<0.001 in RAS subjects and controls. CONCLUSION: Oxidative stress is associated with RAS, and saliva can be used as a biological marker for glutathione and FRAP.

CONTEXTE: La stomatite aphteuse récurrente (SAR) est une lésion inflammatoire de la muqueuse buccale qui représente 5 à 25 % des lésions buccales chroniques. Des études ont suggéré que les patients atteints de stomatite aphteuse récurrente présentent un stress oxydatif (SO) accru et une capacité antioxydante altérée, et qu'un dépistage non invasif utilisant l'évaluation salivaire du stress oxydatif et de la capacité antioxydante pourrait être bénéfique dans la stomatite aphteuse récurrente. OBJECTIFS: Cette étude a déterminé la concentration totale d'antioxydants dans la salive et l'a comparée aux niveaux totaux d'antioxydants dans le sérum chez des patients atteints de SRA et chez des témoins. MÉTHODES: Il s'agit d'une étude cas-témoins portant sur des sujets atteints ou non du syndrome respiratoire aigu sévère. De la salive non stimulée a été recueillie en milieu de matinée par la méthode du crachat, et du sang veineux a été prélevé dans un vacutainer en plastique. Les échantillons de salive et de sang ont été analysés pour déterminer le stress oxydatif total (TOS), la capacité antioxydante totale (TAC), le pouvoir antioxydant réducteur ferrique (FRAP) et le glutathion. RÉSULTATS: Au total, 46 sujets, 23 atteints de SRA et 23 témoins sains, ont participé à l'étude. Vingt-cinq (54,35 %) étaient des hommes et 21 (45,65) des femmes âgés de 17 à 73 ans. Nous avons identifié une augmentation des TOS salivaires et sériques (10.06 ± 7.49, 8.26 ± 2.18/ 15.00 ± 8.92, 9.36 ± 3.55µmol/L) et de l'OSI tandis que le TAC (16.85 ± 1.97, 17.07 ± 2.36/17.07 ± 2.36, 2. 97 ± 0.29mM/L) et significativement le GSH (0.02 ± 0.02, 0.10 ± 0.02/0.10 ± 0.02/0.19 ± 0.11 µmol/ml) ont été diminués dans le sérum et la salive du groupe RAS par rapport aux contrôles respectivement. En outre, il y avait des corrélations positives entre les niveaux salivaires et sériques de FRAP r=0,588, p= 0,003 et de glutathion r=0,703, p<0,001 chez les sujets RAS et les témoins. CONCLUSION: Le stress oxydatif est associé au SAPR et la salive peut être utilisée comme marqueur biologique pour le glutathion et la FRAP. Mots clés: Stomatite aphteuse récurrente, Antioxydants, Salive, Stress oxydatif.

Facial nerve palsy: analysis of cases reported in children in a suburban hospital in Nigeria.

AIM: The study describes the epidemiology, treatment, and treatment outcomes of the 10 cases of facial nerve palsy seen in children managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a 10 year period. It also compares findings with report from developed countries. METHODOLOGY: This was a retrospective cohort review of pediatric cases of facial nerve palsy encountered in all the clinics run by specialists in the above named hospital. A diagnosis of facial palsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification codes. Information retrieved from the case note included sex, age, number of days with lesion prior to presentation in the clinic, diagnosis, treatment, treatment outcome, and referral clinic. FINDINGS: Only 10 cases of facial nerve palsy were diagnosed in the institution during the study period. Prevalence of facial nerve palsy in this hospital was 0.01%. The lesion more commonly affected males and the right side of the face. All cases were associated with infections: Mainly mumps (70% of cases). Case management include the use of steroids and eye pads for cases that presented within 7 days; and steroids, eye pad, and physical therapy for cases that presented later. All cases of facial nerve palsy associated with mumps and malaria infection fully recovered. The two cases of facial nerve palsy associated with otitis media only partially recovered. CONCLUSION: Facial nerve palsy in pediatric patients is more commonly associated with mumps in the study environment. Successes are recorded with steroid therapy.

KNOWLEDGE, ATTITUDE AND PRACTICE OF NIGERIAN MEDICAL STUDENTS TOWARDS COMPLEMENTARY AND ALTERNATIVE MEDICINE IN COVID-19 MANAGEMENT.

OBJECTIVE: Complementary and alternative medicine (CAM) is commonly used, but many physicians have limited knowledge of CAM despite its widespread use. Therefore, this study sought to assess the knowledge, attitude, and practice of medical students on complementary and alternative medicine in the management of COVID-19. METHODOLOGY: A descriptive cross-sectional study was conducted among 150 medical students from three Federal Universities in South West, Nigeria. A self-administered semi-structured online Google Forms questionnaire was used to collect information. Chi-squared and Fisher's exact test was used to analyze the bivariate relationship between KAP status and sociodemographic characteristics. Spearman's correlation coefficient matrix was computed to determine the association between knowledge, attitude, CAM, age, and religiosity practice. RESULTS: The median age was 22 years (interquartile range: [IQR]: 21-23 years). Median self-rated score for religion was 4.00 (IQR: 3.00-4.25). Median knowledge score was 4.00 (IQR: 3.75-5.00), median attitude score 2.75 (IQR: 2.38-3.00) and median practice score 2.00 (IQR: 1.00-2.00). Thirty-seven respondents (24.7%) were considered to have poor knowledge about CAM use in COVID-19 while the rest (75.3%) had good knowledge. Thirty-eight (25.3%) had a poor attitude towards using CAM in COVID-19 and 112 (74.7%) had a good attitude. CONCLUSION: Medical students have good knowledge and a positive attitude towards CAM modalities as adjunct management for COVID-19. However, their practices do not reflect wide acceptability. There is a need for clinical trials on the efficacy of CAM as an adjunct treatment for COVID-19 to further inform its use.

GEOGRAPHIC TONGUE: PATTERN OF PRESENTATION IN A SOUTH WESTERN NIGERIAN TEACHING HOSPITAL.

BACKGROUND: Geographic tongue (GT) is one of the commonly seen lesions in Oral Medicine Clinic. It tends to show varying pattern of presentation. Excessive immune response and immune modulation has been implicated in the pathogenesis and this justified the use of steroid in the management. OBJECTIVE: This study describes the epidemiology, clinical presentations and treatment outcomes of the 21 cases of GT seen at the Oral Medicine Clinic of Obafemi Awolowo University Teaching Hospitals' Complex, Ile Ife (OAUTHC) over a period of 10 years and compared the findings with the results from other parts of the world. METHODS: This was a retrospective cohort review of cases of geographic tongue seen in the Oral Medicine of OAUTHC over the period of 10 years of Oral Medicine practice in the center from May 2007 to May 2017. The diagnosis of GT was made based on its typical clinical presentation. Information retrieved from the case notes included age, sex, presenting complaints, clinical findings, treatment and treatment outcomes. RESULTS: Only 21 cases of GT were diagnosed during the study period, giving a prevalence of 2.1% consisting of 11males and 10 females with mean age of 29.5 ± 13.9 years. About half (10 cases) were diagnosed following routine oral examinations while burning tongue sensation, itchy sensation and taste impairment accounted for the presenting complaints among the symptomatic cases. Lesions were mostly seen in the anterior two-third of the tongue (9 cases). All patients responded well to topical steroids. CONCLUSION: This study had shown that GT was more prevalent in younger age group with slight male predilection. More than half of patients presented with symptoms. Successes were recorded with topical steroids.

PATTERN OF PRESENTATION OF ORAL ULCERATIONS IN PATIENTS ATTENDING AN ORAL MEDICINE CLINIC IN NIGERIA.

AIM: This study aimed at describing the epidemiology and pattern of presentation of oral ulcerations among patients seen in Oral Medicine clinic of Obafemi Awolowo University Complex, Ile-Ife. METHODOLOGY: This study was a retrospective cohort study of all cases that presented with oral ulcers in the oral medicine clinic between May 2015 and May 2017. The clinical diagnosis of oral ulcers was based on the WHO guidelines for oral mucosa diagnosis. All the case notes in the unit were retrieved and reviewed. Information extracted from the case notes included age, sex, medical history, clinical findings and treatment received. The data was analyzed using STATA 13 statistical software. RESULTS: Out of 250 patients seen in the Oral Medicine Clinic during the study period, oral ulcerations were seen in 50 patients comprising 34(68%) males and 16(32%) females, giving a prevalence of 20%. The mean age was 35.4 ±14.7 years and patients were most frequently seen in the third decade of life 16 (32%). The commonest site was lower lip (20; 40%) and ulcers were rare on the gingiva (1, 2%). More than half of the ulcers were solitary (26; 52%) and painful at presentation. Recurrent aphthous ulceration accounted for 47 cases (94%), others were traumatic ulcer (2; 4%) and Chemical burns (1; 2%). Physical stress was the most frequent implicated predisposing factor observed in 38 (76%) patients. CONCLUSION: Recurrent apthous ulcer was the most frequent form of oral ulceration and was commoner in males. Physical stress was the most frequently implicated predisposing factor.