Ameloblastoma: analysis of 207 cases in a Nigerian teaching hospital.

OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature.     

Primary infertility associated with schitosoma mansoni: a case report from the Jos plateau,north central Nigeria

Testicular schistosomiasis caused by Schistosoma mansoni is very rare and more so when associated with primary infertility. A 40 years old man from the Jos Plateau, North Central Nigeria presented with primary infertility after ten years of marriage. Sperm count revealed oligospermia and he also complained of inability to sustain erection. Testicular biopsy revealed several ova of Schistosoma mansoni in the connective tissue of the testes. Cases of infertility in endemic areas especially when there is no supply of potable water should raise suspicion of schistosomiasis among other pathologies and possible hormonal disturbances when the testes are involved.     

Predicting long-term dynamics of soil salinity and sodicity on a global scale

Knowledge of spatiotemporal distribution and likelihood of (re)occurrence of salt-affected soils is crucial to our understanding of land degradation and for planning effective remediation strategies in face of future climatic uncertainties. However, conventional methods used for tracking the variability of soil salinity/sodicity are extensively localized, making predictions on a global scale difficult. Here, we employ machine-learning techniques and a comprehensive set of climatic, topographic, soil, and remote sensing data to develop models capable of making predictions of soil salinity (expressed as electrical conductivity of saturated soil extract) and sodicity (measured as soil exchangeable sodium percentage) at different longitudes, latitudes, soil depths, and time periods. Using these predictive models, we provide a global-scale quantitative and gridded dataset characterizing different spatiotemporal facets of soil salinity and sodicity variability over the past four decades at a ∼1-km resolution. Analysis of this dataset reveals that a soil area of 11.73 Mkm² located in nonfrigid zones has been salt-affected with a frequency of reoccurrence in at least three-fourths of the years between 1980 and 2018, with 0.16 Mkm² of this area being croplands. Although the net changes in soil salinity/sodicity and the total area of salt-affected soils have been geographically highly variable, the continents with the highest salt-affected areas are Asia (particularly China, Kazakhstan, and Iran), Africa, and Australia. The proposed method can also be applied for quantifying the spatiotemporal variability of other dynamic soil properties, such as soil nutrients, organic carbon content, and pH.

Soil salinization is one of the main land-degrading threats influencing soil fertility, stability, and biodiversity. Saline soils are ones with excess accumulation of soluble salts in the root zone (1). On the other hand, accumulation of high levels of sodium salt relative to other exchangeable cations is the main attribute of sodic soils (2). Wind, rainfall, and parent rock weathering are the main origins of these salts in “primary” soil salinization, whereas in “secondary” soil salinization excessive salt accumulation is human-induced (3). Saline and sodic soils, or in general salt-affected soils, mostly lie across arid and semiarid climates where the dominance of evaporation over precipitation concentrates the salts in the root zone (1, 4), leading to undesirable alterations in the physical, chemical, and biological functions of the soil (5, 6). Sodicity adversely influences the soil infiltration capacity (7), increases the susceptibility of water and wind-blown erosion (8), and exposes more soil organic matter to decomposing processes (9). Soil salinity, on the other side, distresses the soil respiration, nitrogen cycle, and decomposing functionality of soil microorganisms (9, 10). Salinity stress affects the vegetation growth directly by reducing the plant water uptake (osmotic stress) and/or by deteriorating the transpiring leaves (specific ion effects) (11), in turn reducing organic input to the soil and ultimately leading to desertification of lands (12, 13). Under extreme conditions, dispersion of saline dust (8, 14), poverty, migration, and high costs of soil reclamation are long-term socioeconomic consequences of soil salinization (15).Soil salinity and sodicity levels are spatially, vertically, and temporally dynamic (15, 16), particularly at the top 0- to 30-cm soil layer which is substantially affected by governing climatic conditions. Naturally occurring events, such as flash floods, El Niño and La Niña, alternative wet and dry years, and long periods of drought can considerably affect soil salinization and accumulation/leaching of the salts in/from the root zone at daily to multiyear temporal resolutions. Similarly, anthropogenic activities like irrigation and dryland management can affect soil salinization at different temporal resolutions. Given the high dynamism in soil salinization processes, updated spatial and temporal information on the extent of salt-affected soils is indispensable for devising appropriate sustainable action programs for managing land and soil resources (6, 17–19). This information can be also valuable for enhancing our understanding of terrestrial carbon dynamics (7, 20), food security and agricultural modeling (21, 22), climate change impacts (23, 24), water resources and irrigation management (25, 26), and efficiency of organic/inorganic reclamation practices (27, 28). Several statistics on the global distribution of salt-affected soils (17–19, 29–33) have been generated based on data from soil surveys and statistical extrapolation (1, 19), yet these estimations are mainly purely spatial (17, 34), not necessarily up-to-date (15, 17), and in some cases incomparable (3, 35). Therefore, there is still a need for a methodologically consistent dataset documenting long-term variations of the soil salinity and sodicity at high spatial resolutions (36)To address this need, we focused on two target variables: ground-derived measurements of soil EC_e (the ability of a water-saturated soil paste extract to conduct electrical current, representative of salinity severity) and ESP (exchangeable sodium percentage, representative of sodicity severity). We used 42,984 and 197,988 data, respectively, scattered over time from 1980 to 2018. We trained two-part predictive models for making four-dimensional (4D) predictions of soil salinity and sodicity as target variables (longitude, latitude, soil depth, and time; see Methods). Through mapping data-driven relations between soil EC_e/ESP observations and a collection of associated predictors generated from topographic, climatic, vegetative, soil, and landscape properties of the sampling locations (SI Appendix, Table S1), these two-part models enabled us to make long-term gridded predictions of soil salinity and sodicity at new locations with available predictors’ values. Note that “prediction” refers to the estimation by the trained models of soil salinity/sodicity on a global scale from 1980 to 2018 even in locations where there is no measurement available rather than to future projection of soil salinity/sodicity on the basis of current trends. The first part of the models classified the soil into saline/sodic and nonsaline/nonsodic classes (binary classification) and the second part predicted per-class severity of the salinity/sodicity issue (regression). Meaningful statistics derived from the EC_e and ESP predictions were then used to generate univariate thematic maps of the variability of different aspects of soil salinity/sodicity between 1980 and 2018 at ∼1-km spatial resolution (30 arc-seconds; e.g., Fig. 1). These were delimited to −55° and 55° latitudes, comprising tropics, subtropics, and temperate zones (see Data Availability). We focused on the topsoil layer (or surface soil), referring to the top 30 cm of the soil profile measured from the surface.Open in a separate windowFig. 1.Variability of different aspects of soil salinity and sodicity in the western United States. (A and D) SD of annually predicted soil salinity (EC_e) and sodicity (ESP), respectively, between 1980 and 2018. (B and E) Average of annually predicted EC_e and ESP, respectively (1980 to 2018). (C and F) Change in the likelihood (θ) of soils with an EC_e ≥4 dS⋅m⁻¹ or ESP ≥6% in the period 2000 to 2018 relative to 1981 to 1999 (the likelihood is dimensionelss, calculated by dividing the number of years with EC_e ≥4 dSm⁻¹ or ESP ≥6% by the total number of years in the studied period). Positive θ indicates that the likelihood has increased and negative shows that it has decreased.     

Hepatoprotective Properties of Aqueous Leaf Extract of Persea Americana,Mill (Lauraceae) ‘Avocado’ Against CCL4-Induced Damage in Rats

Background

Natural products from plants have received considerable attention in recent years due to their diverse pharmacological properties, including antioxidants and hepatoprotective activities. The protective effects of aqueous extract of Persea americana (AEPA) against carbon tetrachloride (CCl₄)-induced hepatotoxicity in male albino rats was investigated.

Materials and Methods

Liver damage was induced in rats by administering a 1:1 (v/v) mixture of CCl₄ and olive oil [3 ml/kg, subcutaneously (sc)] after pre-treatment for 7 days with AEPA. Hepatoprotective effects of AEPA was evaluated by estimating the activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and levels of total bilirubin (TBL). The effects of AEPA on biomarkers of oxidative damage (lipid peroxidation) and antioxidant enzymes namely, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione S-transferase (GST) were measured in liver post mitochondrial fraction.

Results

AEPA and Reducdyn® showed significant (p<0.05) hepatoprotective activity by decreasing the activities of ALT, AST, ALP and reducing the levels of TBL. The activities of antioxidant enzymes, levels of malondialdehyde and protein carbonyls were also decreased dose-dependently in the AEPA-treated rats. Pre-treatment with AEPA also decreased the serum levels of glutathione significantly.

Conclusion

These data revealed that AEPA possesses significant hepatoprotective effects against CCl₄-induced toxicity attributable to its constituent phytochemicals. The mechanism of hepatoprotection seems to be through modulation of antioxidant enzyme system.     

Treatment non-adherence among patients with poorly controlled type 2 diabetes in ambulatory care settings in southwestern Nigeria

Background

Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which undermines the benefits of current medical care.

Objectives

To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome.

Methods

A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011.

Results

Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of indication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factorsidentified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%).

Conclusions

The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.     

Odontogenic tumors: a review of 319 cases in a Nigerian teaching hospital

OBJECTIVE: This study sought to determine the relative frequency of odontogenic tumors in a Nigerian population and to compare these data with previous reports. STUDY DESIGN: Records of patients seen at the Lagos University Teaching Hospital between January 1980 and December 2003, with histologic diagnosis of odontogenic tumors (based on World Health Organisation classification, 1992), were analyzed. RESULTS: Odontogenic tumors constituted 9.6% of all the biopsies of oral and jaw lesions seen within the period under study. Three hundred and eight (96.6%) were intraosseous, and 11 (3.4%) were peripheral (peripheral odontogenic fibroma=7; peripheral myxoma=3; peripheral ameloblastoma=1). The mean age of patients was 29.9+/-15.6 years (range, 4-85 years). Among these cases, 96.6% of the tumors were benign and 3.4% were malignant. Ameloblastoma with predilection for the mandible was the most frequent odontogenic tumor (63%), followed by adenomatoid odontogenic tumor (AOT) (7.5%), myxoma (6.5%), calcifying epithelial odontogenic cyst (5.3%), and odontogenic fibroma (5.3%). More cases of malignant odontogenic tumors were seen than cases of calcifying epithelial odontogenic tumor and odontomas. The mean ages of patients with AOT, ameloblastic fibroma, and odontoma were significantly lower than those with ameloblastoma ( P<.05). No significant difference was found between the mean ages of patients with benign odontogenic tumors and those with malignant odontogenic tumors ( P=.058). CONCLUSIONS: Odontogenic tumors, especially ameloblastoma, are not considered rare among Nigerians, whereas odontoma, regarded as the most frequent odontogenic tumor in North and South America, is rare.     

Directly observed short course therapy for tuberculosis--a preliminary report of a three-year experience in a teaching hospital

SETTING: The Chest Clinic of Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, southwest Nigeria is a referral center for tuberculosis patients in the region. Directly Observed Treatment Short Course (DOTS) has been in operation in the center since 1996. OBJECTIVE: To review the outcome of patients on DOTS with the aim of determining factors that may influence compliance. METHODS: Tuberculosis patients were placed on different treatment regimens according to the recommendation of the International Union Against Tuberculosis and Lung Disease (IUATLD) and the Nigerian Tuberculosis and Leprosy Control Program (NTBLCP). The results were recorded and evaluated periodically by the clinic staff under central supervision. The outcome of treatment over a three-year period (1996-1999) was reviewed. RESULTS: Five-hundred-seventy-one patients were treated during this period. Cure/treatment completed rate was 86.1%, and compliance rate was 93.8%. Age, sex category of treatment, and distance from hospital had no significant influence on drug compliance. CONCLUSION: DOTS is an effective means of administering anti-TB drugs. Efforts should be channeled towards developing strategies for implementing DOTS in a more efficient way.