Knowledge and practices of blood pressure measurement among final year students, house officers, and resident dental surgeons in a dental hospital, South West Nigeria.

OBJECTIVES: To assess the knowledge and practices of blood pressure measurement (BPM) among final year students, house officers, and resident dental surgeons. MATERIALS AND METHODS: A cross-sectional study consisting of a convenience sample of all final year students, house officers, and resident dental surgeons in a dental hospital in South West Nigeria was conducted. All participants were requested to complete a 16-item questionnaire about their knowledge of accurate BPM. After completing the questionnaire, the participants were observed by a single research associate as they measured the blood pressure (BP) of patients using a checklist prepared according to the World Health Organization and the American Heart Association (AHA) guidelines for measuring BP. The performance score was based on a 25-element skillset on BP measurement. Data were entered into Statistical Package for the Social Sciences (SPSS) Version 22. Frequencies and means were generated and independent Student's t-tests and Pearson's Chi-square tests were used to test the association between continuous and categorical variables, respectively at P value < 0.05. RESULTS: In total, 139 questionnaires were returned by 59 final year dental nursing students, 29 final year dental students, 14 house officers, 18 registrars, and 19 senior registrars. Overall, 46.0% of the participants had poor knowledge of accurate BPM. The mean [standard deviation (SD)] BPM knowledge score was 5.8 (2.0), dental nursing students had the least 4.8 (1.5) score, and dental students had the highest 6.9 (2.0) score (P < 0.0001). Overall, the mean (SD) BPM knowledge scores for students and dentists were 5.5 (1.9) and 6.4 (1.9), respectively (P = 0.01). One-hundred and thirty-seven (98.6%) participants performed BPM inaccurately. There was a weak positive non-statistically significant correlation between knowledge and performance scores (r = 0.03; P = 0.75). CONCLUSIONS: Overall, 46.0% of participants had poor knowledge of accurate BPM while 98.6% performed BPM inadequately. These findings suggest the need for curriculum review on accurate BPM.

Dental care seeking behaviour of children in a rural Nigerian community.

BACKGROUND: There is sparse information about oral health seeking behaviour of children in rural areas of developing countries. The aim of the Study was to determine the dental care seeking-behaviour of children attending the first rural based community oral health centre in Nigeria. METHODS: A retrospective review of records of patients aged 16 years or younger treated at the Primary Oral Health Care Centre in Ibarapa, Nigeria over six years was conducted. Data on sociodemographic characteristics of the patients, pattern of presentation and their oral hygiene practices were collected and processed using SPSS. RESULTS: A total of 239 paediatric patients were seen during the period with a mean age of 9.7 ± 4.4 years and 132 (55.2%) were males. The majority, 225 (94.1%), were presenting for the first time. All the children sought dental care for one problem or the other and the most common reasons for seeking care were: tooth ache in 105 (43.9%), trauma in 30 (12.6%) and perceived unclean mouth in 20 (8.4%) patients. Older children were more likely to seek dental care because of pain (p < 0.00 1), while younger children sought care principally on account of trauma (p < 0.001) and the under 5 years were seen more often for gum ache (p =0.006). The majority, 175 (73.2%), used toothbrush and 182 (76.2%) cleaned their teeth once daily. CONCLUSION: None of the children presented for routine check-up, rather, consultation was as a result of dental problems with toothache being the most common reason.

Serum micronutrient status and nutrient intake of elderly Yoruba people in a slum of Ibadan, Nigeria.

OBJECTIVE: The present study was conceived in response to a perceived lack of data about the nutritional status of free-living elderly Yoruba people living in a poor urban area in south-western Nigeria. The major focus was to assess the micronutrient status of elderly Yoruba people living in a slum of Ibadan. DESIGN: A cross-sectional descriptive study was designed to collect data on dietary intake and micronutrient status. SETTING: By means of a structured questionnaire and the estimated food record method, nutrient intake was assessed. Blood was taken from 120 people to determine serum micronutrient levels. SUBJECTS: A total of 240 elderly Yoruba people were selected from Ibadan, Oyo State, Nigeria using a random sampling technique. RESULTS: The diet of the elderly Yoruba participants was mainly plant based and inadequate in B vitamins (especially B1, B6 and folic acid) and micronutrients such as Zn. The intake of vitamin A ranged from 269 to 487 µg/d, while vitamin B1 and B2 intakes ranged from 0·20 to 0·82 mg/d in both males and females. The intake of vitamin C varied from 24·8 to 42·8 mg/d. The majority of participants had insufficient serum levels of vitamins and minerals relative to reference values. Forty per cent were deficient in serum Ca, 71% were deficient in serum Zn and 51% were deficient in serum 25-hydroxyvitamin D. CONCLUSIONS: The majority of the elderly Yoruba people were deficient in Zn, ferritin and vitamin B6. This is the result of a diet lacking in vitamins and minerals.

Perception of patients attending a tertiary hospital in Nigeria about good dental practice: a pilot study.

BACKGROUND: Criteria for a good dental practice as expressed by patients have influence on their behavior in terms of compliance with clinical advice, less pain and anxiety and more utilization of dental care. OBJECTIVE: To assess the opinion of patients attending the dental clinic of a tertiary hospital Southwestern, Nigeria about their perception of a good dental practice. MATERIALS AND METHODS: A 16 item semi-structured bi-lingual interviewer-administered questionnaire comprising socio-demographic characteristics and 24 criteria of a good dental practice generated by clinicians and patients was administered to 156 patients who were blinded from knowing which criteria were clinicians' or patients' criteria. Patients were then asked to pick 12 criteria out of the 24 criteria that they considered of greater priority. Frequency of the most picked criteria in a descending order was determined. Student's t-test was used to compare mean scores at P < 0.05. RESULTS: The mean age of study participants was 36.7 ± 13.8 years. The majority 139 (89.1%) of the study participants ranked ''clinician's procedure should be as painless as possible'' as the most important clinician determined criteria of a good dental practice while 31 (19.9%) of them ranked hotlines available for emergencies as the least. The majority 133 (85.2%) of the study participants ranked ''sterile procedure and proper handling of equipment'' as the most important patient determined criteria of a good dental practice while 30 (19.2%) of them ranked patients being attended by just one clinician as the least. There was a statistically significant difference between mean scores of clinicians' criteria and patients' criteria ( P = 0.00001), participants ranked more patients' criteria than clinicians' criteria. CONCLUSION: In determining the criteria for a good dental practice, clinicians' perspective as well as patients' perspective should be considered.

FLUORIDE CONTENT OF COMMERCIALLY PACKAGED SACHET WATER IN IBARAPA LAND, SOUTHWEST, NIGERIA.

Background: Fluoride concentration (F conc) in water is a major determinant for the occurrence of dental caries and dental fluorosis. In most homes of rural communities, especially in developing countries, there is a major reliance on sachet water as an alternate low-cost drinking water. This study aims to determine the fluoride concentrations of common commercially packaged sachet water in Ibarapa land, Southwestern, Nigeria. Methods: An observational study was conducted using convenience sampling of all commercially packaged sachet water for drinking in Ibarapa land, Southwestern, Nigeria. Thirteen samples of sachet water were obtained from Ayete (2), Igboora (6) and Lanlate (5). F conc of the sachet water was determined in triplicate using the Fluoride Ion-Selective Electrode by direct analysis. Temperature and pH of water were also measured. Results were analysed using SPSS version 23. Results: The F conc, temperature and pH range were 0.03 mgF/l - 2 mgF/l, 26.4°C - 27.2°C and 6.90 - 8.19 respectively. The minimum F conc in all samples was 0.03ppm at pH 6.90 while maximum was 2ppm at pH 7.78. F conc in 2 (15.4%), 8 (61.5%) and 3 (23.1%) water samples were 0.5-0.6 mgF/l, <0.5 mgF/ l and >0.6 mgF/l respectively. No sachet water had fluoride levels printed on their labels. Conclusion: F conc of the sachet water varied, with the majority of samples having low concentrations. Attention needs to be paid to both low levels and high levels of fluoride in drinking water to ensure safety and protective benefit.

A RANDOMISED CONTROLLED TRIAL ON CLINICAL EFFICACY OF SODIUM PERBORATE MIXED WITH DISTILLED WATER AND 30% HYDROGEN PEROXIDE IN THE LIGHTENING OF NON-VITAL DISCOLOURED ANTERIOR TEETH.

Objective: To compare the effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide as non-vital bleaching agent of anterior discolored teeth. Materials and methods: A randomized controlled trial was undertaken among 61 patients who presented with 70 discolored anterior teeth at the Conservative and Family Dentistry Clinics of the University College Hospital, Ibadan, Nigeria. The 70 teeth were randomly allocated into two groups of treatments. In Group A, the test group, the coronal part of endodontically treated teeth was further treated with sodium perborate mixed with distilled water while group B, the control group, the coronal part of endodontically treated teeth were also further treated with sodium perborate mixed with 30% hydrogen peroxide. Information on study participants biodata and satisfaction with treatment were obtained. Tooth shade assessment was done using shade guide units of the vitapan shade guide at baseline and during recall visits on days 7, 14, and 21. Frequencies, means, and standard deviations were generated. The Chi-squared test was used to determine the association between two categorical variables at p < 0.05. Results: In the control group, the mean ± SD tooth shade was 12.5 ± 3.2, 8.7 ± 3.8, 4.9 ± 2.8, and 3.1 ± 2.2 at baseline, Day 7, Day 14, and Day 21, respectively. In the test group, the corresponding values were 12.8 ± 3.2, 9.6 ± 3.9, 5.6 ± 3.0, and 4.0 ± 2.9. The mean ± SD tooth shade scores of the control and test groups were 12.5 ± 3.2 and 12.8 ± 3.2, respectively (p = 0.15). Twenty-two (62.9%) and 19 (54.3%) of the study participants in the control and test groups, respectively, reported that they were extremely satisfied (p = 0.60). Conclusion: The effectiveness of sodium perborate mixed with distilled water and sodium perborate mixed with 30% hydrogen peroxide in lightening the coronal part of endodontically treated non-vital discolored anterior teeth was similar. Both bleaching agents demonstrated similar patient satisfaction.

The Journey From Knee to Heart: A Case of Methicillin-Sensitive Staphylococcus aureus Infective Endocarditis Secondary to Septic Prepatellar Bursitis.

Staphylococcus aureus is a cause of life-threatening gram-positive bacteremia and the most common causative organism of septic bursitis. Although there are several case reports of infective endocarditis complicated with septic bursitis and other rheumatic complications, there are very few cases reports of septic bursitis leading to infective endocarditis (IE). We present a patient with a history of recurrent prepatellar bursitis requiring catheter drainage, who presented with sepsis and IE.

Survival rates of two atraumatic restorative treatment (ART) types in occlusal carious permanent teeth after two years.

OBJECTIVE: To compare survival rates of Atraumatic Restorative Treatment (ART) restorations placed with and without conditioners in occlusal cariouspermanent teeth after two years. MATERIAL AND METHODS: The study was an experimental study among children, mean age 13.1 +/- 3.0 years. Two types of ART restorations were randomly placed on 186 occlusal carious permanent teeth on contralateral sides using split mouth design. Ethical clearance to conduct the study was obtained from the UI/UCH Review Committee. ART was performed using GC Fuji IX GP and teeth that were conditioned with GC Dentine Conditioner. Time taken to place restorations and average material cost were recorded. Follow-up of subjects to evaluate integrity of restorations was conducted at 6 monthly intervals by one independent examiner. Proportions and percentages were generated; student t-test was used to compare means. Cumulative survival rates were determined by the coded scores and standard criteria for evaluating ART restorations. RESULTS: There was no significant difference in the mean time for placing ART restorations with or without conditioners and in the cumulative survival rates of both treatment types after 2 years (p > 0.05). CONCLUSION: ART restorations placed without tooth conditioners can achieve similar result as those placed with conditioners.

A Case of Osmotic Demyelination Syndrome in a Chronic Alcoholic With Moderate Hyponatremia.

Osmotic demyelination syndrome (ODS) is a clinical syndrome seen following aggressive correction of severe hyponatremia. Chronic alcohol use, malnutrition, and electrolyte derangement are additional risk factors promoting the demyelination in ODS. A 49-year-old female with a history of untreated mood disorder, hypertension, alcohol, and tobacco abuse presented to the emergency department (ED) with a three-month history of generalized body weakness. She also had a history of recurrent falls, difficulty walking, inadequate food and water intake, progressively worsening jaundice, and confusion which started about the same time. Her vital signs were normal; some of the significant physical examination findings were: sclera icterus, abdominal distension, bilateral pedal edema, hand tremors, rotary nystagmus, paraparesis, 1+ bilateral knee jerk, and absent bilateral ankle jerk. She had moderate hyponatremia, mild hypokalemia, deranged liver function test with a cholestatic pattern and transaminitis, hypoalbuminemia, elevated ammonia, lipase, in keeping with alcoholic liver disease and acute pancreatitis. In the ED, she received a normal saline infusion, and her serum sodium rose by just 6 mmol/L within the first 24 hours. She had drainage of her ascitic fluid and treatment with thiamine, folic acid, prednisone, lactulose, rifaximin, furosemide, spironolactone, and Ceftriaxone with improvement in clinical and laboratory abnormalities. Her lower extremity weakness persisted despite physical therapy, prompting neurologic evaluation. MRI of the lumbar spine showed an old compression fracture and lumbar spinal stenosis, while MRI brain findings were consistent with Osmotic demyelination. At the time of discharge to a rehabilitation facility, her serum sodium was 132 mmol/L, but her leg weakness persisted. Although rare, ODS can occur in the setting of moderate hyponatremia if there are additional risk factors that lower the threshold for demyelination.

Bell's Palsy as a Late Neurologic Manifestation of COVID-19 Infection.

Bell's palsy is acute peripheral facial nerve palsy; its cause is often unknown but it can be triggered by acute viral infection. Coronavirus disease 2019 (COVID-19) infection commonly presents with respiratory symptoms, but neurologic complications have been reported. A few studies have reported the occurrence of facial nerve palsy during the COVID-19 pandemic. We present a case of Bell's palsy in a 36-year-old man with COVID-19 infection and a past medical history of nephrolithiasis. He presented to the emergency room with a day history of sudden right facial weakness and difficulty closing his right eye four weeks following a diagnosis of COVID-19 infection. Physical examination revealed right lower motor neuron facial nerve palsy (House-Brackmann grade IV). Serologic screen for Lyme disease, human immunodeficiency virus (HIV), and herpes simplex virus (HSV) 1 and 2 were negative for acute infection; however, neuroimaging with MRI confirmed Bell's palsy. He made remarkable improvement following treatment with a course of valacyclovir and methylprednisolone. This case adds to the growing body of literature on neurological complications that should be considered when managing patients with COVID-19 infection.

PREVALENCE AND PREDICTORS OF CIGARETTE SMOKING AND ALCOHOL USE AMONG SECONDARY SCHOOL STUDENTS IN NIGERIA.

Background: Cigarette and alcohol use are the most common causes of noncommunicable diseases. Studies related to cigarette and alcohol use among Nigerian adolescents have shown increases in the habits and require urgent intervention. Nationally representative data is needed to develop effective national policies and interventions, but this is lacking. Hence, this study aimed to provide nationally representative empiric information about cigarette and alcohol use prevalence and predictors among Nigerian secondary school students. Methods: This study included 2,530 Nigerian students in Nigeria from five of the six geopolitical zones in Nigeria. A self-administered questionnaire was used to obtain information about the participants' sociodemographic and school-based characteristics, cigarette and alcohol use status, and harm perception of tobacco and alcohol use. Data were analysed with SPSS version 25 at p<0.05. Results: Participants' mean age (±SD) was 16.34 (±2.0) years. The prevalences (95%CI) for ever-cigarette and current-cigarette smoking were 11.1% (95%CI:9.9-12.4) and 8.4% (95%CI:7.3-9.5), respectively. While 21.0% (95%CI:19.4-22.7) and 15.6% (14.2-17.1) were the prevalences for lifetime and current alcohol use, respectively. The predictors of current cigarette smoking were studying in northern-Nigeria (aOR:1.94;95%CI:1.10-3.44), attending private-schools (aOR:1.56;95%CI:1.03-2.38), boarding-student (aOR:1.75;95% CI:1.15-2.69), male-gender (aOR:3.03; 95%CI:1.80-5.10), current alcohol use (aOR:12.50;95%CI:8.70-18.18), having no (aOR:2.59;95%CI:1.58-4.26) or low tobacco harm perception (aOR:2.04;95%CI:1.18-3.53). The predictors of current alcohol use were male (aOR:1.32; 95%CI:1.01-1.72) and current cigarette smoking (aOR:12.5;95%CI:8.77-17.86). Conclusion: The prevalences of cigarette and alcohol use were high among Nigerian secondary school students, and both habits were strongly associated. Their predictors were school-related factors, sociocultural characteristics, and tobacco harm perception.

A Retrospective Study of Hospitalizations in the USA: Proportion of Hospitalizations With Non-Alcoholic Fatty Liver Disease in Non-Obese Population.

Background Non-alcoholic fatty liver disease (NAFLD), one of the leading causes of end-stage liver disease, is known to be associated with obesity. However, only a few studies in the United States (US) have described non-obese NAFLD, most of which were on the outpatient population. Aim We aimed to investigate the proportion of hospitalizations in the US with a diagnosis code that included NAFLD in the non-obese population. Methods We analyzed adult discharges from the Nationwide Inpatient Sample with a diagnosis of NAFLD from January 2010 to December 2014. We created two groups: obese (overweight or obese) and non-obese (normal or underweight) groups. Basic demographic and clinical characteristics were compared using the chi-square test and Student's t-test. Results A total of 194,787 hospitalizations with NAFLD were identified over the five-year period. It was observed that the prevalence of non-obese NAFLD hospitalizations increased yearly. Non-obese NAFLD hospitalizations had a higher mean age (57.5 vs 51.5 years, p < 0.0001) and a higher proportion of males (43.3% vs 36.1%, p < 0.0001) than obese NAFLD hospitalizations. With univariate analysis, non-obese NAFLD hospitalizations had lower odds of hypertension (OR 0.74, p < 0.0001), diabetes mellitus (OR 0.65, p < 0.0001). Non-obese hospitalizations had higher odds of cirrhosis (OR 1.30, p < 0.001) and decompensated cirrhosis (OR 1.30, p < 0.001) after adjusting for age, sex, race, diabetes mellitus, and dyslipidemia. Hospitalizations with non-obese NAFLD had higher odds of death (OR 1.49, p < 0.001) after adjusting for age, gender, race, co-morbidities, cirrhosis, and liver decompensation. Conclusion There is a continued rise in the proportion of non-obese NAFLD among hospitalizations in the US. Non-obese NAFLD hospitalizations were less likely to have hypertension and diabetes, but more likely to have decompensated liver disease. Further studies are needed to better characterize these patients to enable early detection, treatment, and reduction in complications of liver disease.

Rapidly Progressive Granulomatous Amoebic Encephalitis in a Diabetic Individual.

We present a case of rapidly progressive granulomatous amoebic encephalitis caused by Balamuthia mandrillaris in an individual with diabetes mellitus. Our patient presented with occipital headache, blurry vision, confusion, and gait imbalance of one week's duration. Brain imaging revealed numerous peripheral ring-enhancing lesions concerning malignancy. Brain biopsy was consistent with Balamuthia mandrillaris infection. He passed away 45 days after presentation despite being treated with a five-drug regimen. This case highlights the importance of considering amoebic brain infections, especially with ring-enhancing lesions on imaging. There are opportunities to design modalities for rapid diagnosis and better treatment.

MISSED DIAGNOSIS OF ISOLATED BILATERAL TRANSVERSE FACIAL CLEFT: A CASE REPORT.

INTRODUCTION: Bilateral transverse facial cleft is the most common of the rare facial clefts and early presentation is a key element for successful management and prevention of possible complications like poor esthetics, speech and eating difficulties. Though several studies have documented reasons for late presentation, none has highlighted non-referral due to missed diagnosis by healthcare workers as a reason. CASE REPORT: A nine-year-old girl was brought by her parents to the Primary Oral Health Clinic on account of "very wide mouth" noticed at birth. The mother noticed the anomaly few hours after she gave birth to her and immediately pointed the attention of the nurses and birth attendants to it but they dismissed her concern. Subsequently, the mother took the girl to the maternity centre for routine immunization appointments, but none of the healthcare workers she encountered recognized the birth defect. The parents further reported that the girl received jests and abuses from her peers. A diagnosis of Isolated Bilateral Tessier number 7 cleft was made based on clinical examination findings. She was referred to a cleft centre where the repair was successfully carried out at no cost to the patient through the Smile-Train® sponsorship program. Subsequent follow-up visits to the primary healthcare clinic in the sixth and ninth month post-surgery revealed remarkable improvement in both patient's and parents'self-reported psycho-social wellbeing. CONCLUSION: This case report presents a rare presentation of delayed isolated congenital bilateral macrostomia because of healthcare workers failure to diagnose.

POTENTIAL OF TELEDENTISTRY IN THE DELIVERY OF ORAL HEALTH SERVICES IN DEVELOPING COUNTRIES.

In developing countries, access to qualified medical personnel especially oral health care specialists by inhabitants of rural and remote areas remain a challenge due to the fact that these personnel are mostly located in urban communities. Teledentistry is an approach that will eliminate the problem of distance between qualified oral health care personnel and potential patients in rural and remote communities. The objective of this review is to investigate the history of teledentistry and its practical application in overcoming the rural-urban oral health care problems. A scoping search of literature using keywords associated with telemedicine and teledentistry and its application was undertaken via PubMed and Scientific Electronic Library Online (SciELO). Literature published in English in the last 10 years (2008 - 2018) were selected. The review summarises the available literature related to origin and method of delivering teledentistry and its use in dental practice and education. It shows that teledentistry has the ability to improve access to and delivery of oral health care at a relatively lower cost as well as supplementing traditional teaching methods in dental education. However, despite the promising nature of teledentistry in improving oral health care provision, it is associated with some attending problems and challenges.

SELF-MEDICATION PROFILE OF DENTAL PATIENTS ATTENDING A NORTH EASTERN TERTIARY HOSPITAL IN NIGERIA.

BACKGROUND: Self-medication is widely practiced worldwide. Literatures abound on its use for medical ailments but there is paucity of information for dental complaints especially in Northeastern Nigeria. Hence, this study was designed to determine the prevalence of self-medication for dental problems before dental consultation and its associated factors among patients attending Federal Teaching Hospital (FTH), Dental and Maxillofacial Outpatient Clinic, Gombe, Gombe State, Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study based on a structured pretested close-ended interviewer-administered questionnaire was distributed among adults visiting FTH outpatient dental clinic, Gombe, Nigeria for a period of 8 months. The questionnaire was composed of two main sections: demographic characteristics and questions assessing the behaviour of self-medication. The non-probability convenient sampling technique was used and data was stored and analysed using IBM-Statistical Package for Social Sciences (SPSS) version 23.0. RESULTS: The results showed that the prevalence of self-medication was found to be 41.5% (194/468), with a higher prevalence among females (55.1% or 107/194) than males (44.9% or 87/194). The majority (52% or101/194) of the patients were in the 2-4th decades of life. Educational status was significantly associated with self-medication. Analgesics accounted for the greatest percentage (98/164 or 59.8%) of orthodox drugs used followed by antibiotics (62/164 or 37.8%). However, with respect to individual medication consumed, paracetamol accounted for the majority (28.7%). A greater number (55/194 or 28.4%) could not remember the name of the orthodox drugs they took before consultations. Street hawkers were the main source of these medicaments (36.6 or 71/194%). Fear of dental treatment (20.1% 39/194), ailment is simple and the need not to see a dentist (20.1% 39/194) were claimed to be the main reason for practicing self-medication with periodontitis (53.1% or 103/194), pulpitis (13.9% or 27/194) and pericoronitis (10.8% or 21/194) the main predictors. CONCLUSION: The prevalence of self-medications to dental problems in this study was discovered to be high with the use of both orthodox and unidentified traditional drugs. National Health Insurance Scheme should be made to cover all social group of Nigerians in order to encourage easy accessibilities of all people to wide range of medical and dental consultations, thereby discouraging the practice of self-medication.

Co-existence of maternal overweight and obesity with childhood undernutrition in rural and urban communities of Lagos State, Nigeria.

BACKGROUND: The coexistence of over-nutrition and under-nutrition is emerging as a public health problem in many low and middle income countries. This study aimed at determining prevalence of coexisting maternal overweight and obesity with childhood stunting (MOCS) and the associated socio-demographic factors in rural and urban communities of Lagos State, Nigeria. METHODS: This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Maternal overweight and obesity and undernutrition in children were determined using standard criteria. RESULTS: The prevalence of overweight and obesity among mothers was significantly higher in urban than rural areas (50.7% vs. 41.3%; p=0.022) while the prevalence of childhood stunting was significantly higher in rural than urban areas (43.3% 12.6%; p<0.001). Coexisting maternal overweight and obesity with childhood stunting was observed in 31 (10.3%) mother-child pair with a significantly higher prevalence in rural than urban areas (14.7% vs. 6.0%, p=0.014). In multivariate logistic regression, maternal short stature (OR 3.3, 95% CI=1.2-9.0, p=0.02) and living in rural area (OR 0.2, 95% CI=0.1-0.5, p=0.001) were the identified risk factors for coexisting maternal overweight and obesity with childhood stunting. CONCLUSION: The prevalence of coexisting MOCS is high especially in rural areas. Effort at reducing childhood malnutrition should focus on appropriate interventional measures aimed at improving maternal nutritional status.

Fluoride intake and urinary fluoride excretion in 4- and 8-year-old children living in urban and rural areas of Southwest Nigeria.

OBJECTIVES: To estimate and compare total daily fluoride intake (TDFI), daily urinary fluoride excretion (DUFE), daily fluoride retention (DFR), fractional urinary fluoride excretion (FUFE) and fractional fluoride retention (FFR) in 4- and 8 year-old Nigerians and explore associations between these outcomes to improve understanding of fluoride metabolism. METHODS: Using a cross-sectional observational study, 72 four-year-olds and 72 eight-year-olds were recruited from nursery and primary schools (respectively) in lower and higher water F areas of urban and rural localities in Oyo State, southwest Nigeria. TDFI from diet and toothpaste ingestion was assessed using a validated Food Frequency Questionnaire and visual scale of toothpaste used during toothbrushing. DUFE was measured by collecting a 24-hour urine sample, FUFE estimated as the ratio between DUFE and TDFI, DFR estimated as TDFI-TDFE (where TDFE = DUFE + estimated faecal F excretion (ie TDFI × 10%), and FFR was estimated as [(TDFI-DFR)/TDFI] × 100. Data were analysed using ANOVA with post hoc tests and Student's t tests and strengths of associations between key variables measured. RESULTS: Mean (SD) TDFI, DUFE, DFR, FUFE and FFR were 0.137 (0.169) mg/kg bw/d, 0.032 (0.027) mg/kg bw/d, 0.091 (0.147) mg/kg bw/d, 44% (44%) and 46% (44%), respectively, for 4-year-olds. Corresponding values for 8-year-olds (n = 63) were 0.106 (0.130) mg/kg bw/d, 0.022 (0.017) mg/kg bw/d, 0.073 (0.107) mg/kg bw/d, 36% (30%) and 54% (30%), respectively. Dietary contribution to TDFI was 79% and 75% (respectively), for 4- and 8-year-olds. Mean (SD) TDFI from toothpaste ingestion was 0.021 (0.013) mg/kg bw/d in 4-year-olds, 0.014 (0.010) mg/kg bw/d in 8-year-olds (P = .002) but with no differences between areas. Differences in dietary F intake determined the main differences in F exposure between areas. The positive correlation between TDFI and DUFE was weak for 4-year-olds (r = +.29) and strong for 8-year-olds (r = +.64). A strong positive correlation was observed between TDFI and DFR for both age groups: (r) = +.98 for 4-year-olds and (r) = +.99 for 8-year-olds. CONCLUSION: Fluoride intake in these 4- and 8-year-old Nigerians was much higher than the "optimal range" of 0.05-0.07 mg/kg bw/d in rural, higher F water areas, with diet as the main contributor. F retention was similar in both age groups, with almost half of TDFI retained in the body. In terms of risk vs benefit for fluorosis and dental caries, this finding should be considered when mitigating against excessive fluoride exposure and planning F-based prevention.

Dental caries experience among the elderly population in South East local government area in Ibadan, Nigeria.

OBJECTIVE: To determine the caries experience of the elderly people in South East Local Government Area (S.E.L.G.A) in Ibadan. SUBJECTS AND METHODS: A randomly selected sample of 690 elderly people from 23 wards in S.E.L.G.A were examined by two trained and calibrated examiners according to WHO criteria. RESULTS: Majority of them (85.5%) had no caries experience. Their mean DMFT was 0.46. More teeth in the mandible (160) than the maxilla were affected by caries or treated for caries. Their MNI was 25.5% and RI was 21%. CONCLUSION: The elderly in S.E.L.G.A have low caries experience and very high-unmet dental health needs.

DEVELOPMENT OF A TOOL FOR DISPELLING MYTHS ASSOCIATED WITH NATAL/NEONATAL TEETH: "ADUNNI" A HEALTH EDUCATION VIDEO IN A NATIVE NIGERIAN LANGUAGE.

Studies have revealed that Nigerians irrespective of social class have negative attitudes and practices towards children born with natal teeth and those who erupt teeth within the first 30 days of life. This has been associated with the strong cultural myths and beliefs that exist among the populace. Children with natal teeth and their families have been stigmatized and are believed to be cursed. This stigmatization affects their social life and consequently impacts on their quality of life. Therefore, there is a need to develop an intervention such as a video to help dispel these myths. Videotapes have been shown as an intriguing means of communication and valuable tool in health education. To help dispel the myths associated with natal teeth, and neonatal teeth a twenty-eight-minute culturally appropriate video in the a local Nigerian language (Yoruba) titled "Adunni" targeted for people from the low social class was developed. This film has been sent to primary health care centers in suburban and rural areas and will be shown to mothers, pregnant women, nursing mothers and traditional birth attendants with a view to appropriately inform them and the entire communities that eruption of natal or neonatal teeth is not a curse.