Periodontal status of orthodontic patients and the relationship between dental aesthetic index and community periodontal index of treatment need

This prospective clinic-based study evaluated the pretreatment periodontal status of the orthodontic patients seen at the University College Hospital, Ibadan, Nigeria, and assessed the relationship between dental aesthetic index (DAI) scores and periodontal status according to community periodontal index of treatment needs (CPITN) scores. One hundred forty five patients-70 (48.3%) males and 75 (51.7%) females from 6 to 45 years (mean 15.8 +/- 7.5)-were seen. World Health Organization (WHO) guidelines were followed in the examination and reporting of the periodontal status, and DAI scores were assessed based on WHO guidelines. The chi-square test was used to determine the association between the DAI and the CPITN scores. Most patients were in the 6-15 (55.9%) or 16-25 (35.9%) age groups. Based on the WHO preferred cumulative calculations of treatment need (TN), 35.2% of the patients had TN 0, 64.9% had TN 1, 24.9% had TN 2, and only 0.7% had TN 3. The relationship between DAI scores and periodontal treatment needs was not statistically significant (P >.05). Although many patients were yet to attain the WHO goal of no more than 1 sextant affected by bleeding or calculus at the age of 15, over one third had satisfactory periodontal health.     

Acute Puerperal Coital Headache and Hypertension

Summary: An unusual case of acute headache and hypertension occurring at the height of sexual excitement during the puerperium is presented. The patho-mechanism of this phenomenom is discussed and the literature reviewed.     

Family structure,socioeconomic position and utilization of oral health services among Nigerian senior secondary school pupils

Objective: To test the relationship between socioeconomic position (SEP), family composition, number of siblings, and birth position in the family, and the utilization of oral health services by senior secondary school pupils in Ile‐Ife, Nigeria. Methods: A cross‐sectional study design included senior secondary school pupils in the Central Local Government Area of Ile‐Ife during 2007/2008. Sample size calculation was performed and 1,200 pupils were invited to participate. A multistage, stratified sampling technique was used. Data collection included a self‐administered questionnaire. Data were analyzed using logistic regression. Results: The response rate was 76 percent (n = 1043). The mean age was 15.8 (standard deviation = 1.9) and 49 percent were males. Only 22.5 percent of pupils had ever visited a dentist in their lives. Results from multivariate analyses showed that pupils attending free schools, those paying 1 to 10,000 naira (equivalent to US$ 63.31) and 10,000 to 19,000 naira (equivalent to US$ 120.29) were respectively 1.93, 1.87, and 2.74 times less likely to have attended a dentist in the past than pupils in more expensive schools. Pupils living with single mothers or without a parent were unlikely to have visited the dentist. Number of siblings and birth position in the family were not associated with utilization of oral health services. Conclusions: Adolescents from families with a low SEP growing up without their parents may need extra incentives to visit dentist.     

Neo‐adjuvant Capecitabine Chemotherapy in Women with Newly Diagnosed Locally Advanced Breast Cancer in a Resource‐poor Setting (Nigeria): Efficacy and Safety in a Phase II Feasibility Study

The majority of clinical trials of neo‐adjuvant therapy for breast cancer have been conducted in resource‐rich countries. We chose Nigeria, a resource‐poor country, as the major site for a phase II feasibility open‐label multicenter clinical trial designed to evaluate the efficacy, safety, and tolerability of neo‐adjuvant capecitabine in locally advanced breast cancer (LABC). Planned treatment consisted of 24 weeks of capecitabine at a dose of 1,000 mg/m² twice daily (2,000 mg/m² total per day). The primary endpoints were overall, partial, complete clinical response rate (OCR, PCR, CCR) and complete pathologic response (cPR). A total of 16 patients were recruited from August 2007 to April 2010. The study was terminated early as a result of slow accrual. After the first three cycles of therapy, PCR were seen in five of 16 patients (31%; 95% CI 11–59%). Of the remaining 11 patients, eight had no response (NR) or stable disease (SD), and three had progressive disease (PD). Seven patients proceeded with further therapy of which had SD. OCR at the end of eight cycles was 44% (95% CI 20–70%). Clinical response and radiologic response by ultrasonomammography were highly concordant (spearman correlation 0.70). The most common adverse effect was Grade 1 hand–foot syndrome, which was seen in 75% of patients. Despite several limitations, we successfully carried out this phase II feasibility study of neo‐adjuvant capecitabine for LABC in Nigeria. Capecitabine monotherapy showed good overall response rates with minimal toxicity and further studies are warranted.     

Age-related hearing loss, vitamin B12, and folate in the elderly

Objective

Determine the correlation between the hearing threshold and the serum levels of vitamin B12 (cobalamin) and folic acid among elderly subjects (> 60 years) with age-related hearing loss (ARHL).

Study Design

Cross-sectional.

Setting

Community.

Subjects and Methods

Subjects included elderly who were found apparently healthy following repeated examination by physicians. The pure tone average (PTA) for the speech and high frequencies, and the serum folate and cobalamin were determined and the correlation found.

Results

The mean ± SD values of serum folate among the subjects with normal PTA in the speech frequencies (0-30 dB) was 412.3 nmol/L ± 17.6 nmol/L, while among those with hearing loss (HL), it was 279.1 nmol/L ± 17.2 nmol/L (P = 0.01). In the high frequencies, the mean ± SD values among the subjects with normal PTA was 426.3 nmol/L ± 17.6 nmol/L, while among those with HL, it was 279.14 nmol/L ± 171.2 nmol/L. The serum cobalamin among the subjects with normal PTA within the speech frequencies was 49.7 pmol/L ± 9.4 pmol/L, while among those with speech-frequency HL, it was 42.6 pmol/L ± 10.2 pmol/L. However, for high frequencies, the mean ± SD values among the subjects with normal PTA was 47.4 pmol/L ± 7.3 pmol/L, while among those with HL, it was 41.3 pmol/L ± 9.2 pmol/L. Spearman's correlation revealed that low folate (correlation coefficient = −0.27, P = 0.01) and cyanocobalamin (correlation coefficient = −0.35, P = 0.02) were significantly associated with increasing hearing threshold in the high frequencies. After adjusting for age, serum folate (correlation coefficient = −0.01, P = 0.01) was significant, while vitamin B12 (correlation coefficient = −0.01, P = 0.74) was not.

Conclusion

Serum folate was significantly lower among elderly with ARHL. Trials on nutritional supplementation may substantiate the role of serum folate in ARHL.     

Effect of luminal acidification on guinea pig gastric mucosa

H⁺ secretion was studied in guinea pig fundic mucosa incubated in (A) bicarbonate-Ringer's gassed with 95% O₂-5% CO₂, or (B) HEPES gassed with 100% O₂ before and after luminal pH was lowered to 2.0 for periods up to 90 min. At pH 2.0 for 60 min, H⁺ secretion in group A tissues fell by 35±4% (P=0.02) from a control rate of 1.35±0.09 eq/cm²/hr and in group B tissues by 50±11% (P=0.01) from a control rate of 1.59±0.08 eq/cm²/hr. After 90 min at pH 2.0, H⁺ secretion in group A fell by 53±8% (P=0.02) from a control rate of 1.47±0.07 eq/cm²/hr and in group B fell by 44±6% (P=0.01) from a control rate of 1.38±0.07 eq/cm²/hr. Histamine 1×10^–4 M stimulation following exposure to pH 2.0 for 90 min increased secretion in group A tissues from 0.80 ±0.14 to 1.06±0.13 eq/cm²/hr (P<0.05), compared with an increase in nonacidified controls from 1.15±0.22 to 1.80±0.20 eq/cm²/hr (P<0.05) and in group B tissues from 1.27±0.10 to 1.56±0.19 eq/cm²/hr (P<0.05) compared with nonacidified controls from 1.43±0.22 to 2.23±0.41 eq/cm²/hr (P<0.05). Secretory function and electrical characteristics were adversely affected by luminal acidification to pH 2.0 and suggested a breach in the mucosal barrier with damage to parietal cells.This study was funded by the National Institute of Health Grant No. AM 15681.     

MYOMECTOMY IN PREGNANCY: INCARCERATED PEDUNCULATED FIBROID IN AN UMBILICAL HERNIA SAC

We describe a rare case of a 31-year-old woman at 28 weeks of pregnancy presenting with an incarcerated pedunculated fibroid in an umbilical hernia sac. She had a successful myomectomy and hernia repair and proceeded to have spontaneous vaginal delivery at term. Incarceration of a pedunculated fibroid presents a diagnostic puzzle which can be successfully treated by myomectomy.     

Sexuality in Nigerian Pregnant Women: Perceptions and Practice

EDITORIAL COMMENT: We accepted this paper for publication because it undoubtedly will interest readers and hopefully encourage a similar report on Australian women. We could do with more data on the subject. We can understand that sexual activity can be 'painful' or 'gratifying', that it 'may help to keep the husband around' but need enlightenment on how the activity is 'functional' (table 3 and text). Our interpretation of the data provided is that the term means 'fulfilment of marital obligations'.
Summary: The sexual behaviour and beliefs of 440 pregnant women from South-eastern Nigeria were investigated. The mean frequency of sexual intercourse during pregnancy (1.5 times per week) was less than that before pregnancy (2.3 times per week). The husband was the main initiator of sexual activity (41.6%), while the wife only rarely did so (2.7%). 44.3% of the respondents believed that sexual intercourse during pregnancy widens the vagina and facilitates labour; 34.8% that it improves fetal well-being; 30.2% that it caused abortion in early pregnancy while 21.1% had no knowledge of any repercussions of sexual intercourse in pregnancy.
Coitus during pregnancy was always painful in 22.7% of the respondents; was always gratifying in 46.1%; was functional in 49.3% and helped to keep the husband around, also in 49.3% of the respondents.
The majority of the respondents (83.4%) considered that coitus should not be stopped during pregnancy. Whereas 19.3% of the respondents believed that sexual frequency should be increased during pregnancy, 73.9% considered otherwise, and 63.6% actually felt it should be reduced.
Findings from this study suggest a 'mixed-feeling' effect with a tilt towards a positive attitude to sexuality in pregnancy. Restriction should not be imposed on sexual activity during a normal pregnancy to enhance marital harmony.