Background: Tooth mobility, considered as the extent of horizontal and vertical tooth displacement created by examiners force, is caused trauma and periodontal disease. It is a common presenting complaint in periodontal clinic and may result in occlusal instability, dietary restriction, masticatory disturbances, esthetic challenge, and impaired quality of life. The treatment of tooth mobility involves a combination of treatment of the etiology usually by nonsurgical and surgical periodontal treatment, occlusal adjustment, and splinting. This article reviewed occlusal adjustment and splinting in the management of tooth mobility and reported our experience in University of Benin Teaching Hospital, Benin City, Nigeria on tooth mobility managed with 0.5 mm hard stainless steel wire reinforced composite splint. Results: Composite splinting reinforced with 0.5 mm HSS wire facilitates healing of periodontally compromised teeth with mobility after they have been treated with nonsurgical periodontal therapy and occlusal adjustment. Conclusion: Splinting is a well-accepted integral part of holistic periodontal treatment which results in morale boost, improved patient comfort, and oral functions.

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Introduction: The National Health Insurance Scheme (NHIS) was introduced in Nigeria in 2005, and nine years after its inception only 3.5% of the population have been enrolled in three Sectors of the Scheme. Traders and others in the informal sector are not involvement in the scheme. This study was conducted to assess the level of awareness, and factors that could affect the willingness of traders in Abakaliki main market to participate in the National Health Insurance Scheme. Materials and Methods: A descriptive cross sectional study of 419 traders (53% males and 47% females) was carried out using a three stage sampling technique. Data was collected using interviewer administered semi-structured questionnaire, and was analyzed using SPSS (version 20) and Mathcad 7 Professional software. Frequencies and percentages were calculated, while Chi square test and Z-score were used to test for associations, with P < 0.05 set as level of significance. Results: Only 127 (30.3%) of the 419 traders were aware of NHIS, and significant majority (73.2%) of those aware of the scheme were willing to participate. No factor was significantly associated with willingness to participate. Conclusion: Awareness of NHIS was very poor among the traders, but majority of them were willing to participate in the scheme. Enlightenment campaigns should be embarked upon in the markets to increase awareness of the scheme among the traders, as this could influence their participation.

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Background: Work-related musculoskeletal disorders (WRMDs) among health care workers have increased with little information on ergonomic stressors' exposure. Therefore, the exposure of health care workers to ergonomic stressors and the consequent WRMDs were investigated. Materials and Methods: The descriptive cross-sectional study involved 279 stratified participants from various departments of Olabisi Onabanjo University Teaching Hospital. Standardized Nordic and adapted European Foundation questionnaires were used to obtain data on musculoskeletal pain and ergonomic stressors. The data were analyzed with Statistical Package for the Social Sciences (SPSS) using descriptive and inferential statistics. Results: About 48% of the participants reported WRMDs in at least one part of the body during the 12 months preceding the study while 22.2% reported WRMDs in the last 7days. During the preceding 12 months and the last 7 days, the lower back was the most common site of disorders (29.4% and 9.7%, respectively) while the elbow joint was the least affected site. About 49.7% and 42.7% of the clinical staff and nonclinical staff, respectively, reported WRMDs in the last 12 months while 22.3% versus 22.0% reported WRMDs in the last 7 days. Female participants had a higher prevalence of WRMDs but significant gender difference existed for point prevalence only. A majority of the participants (65.8%) were exposed to 11 or more risk factors. There was a significant association between both 12-month and point prevalences of WRMDs on the one hand and exposure to painful tiring positions on the other. Conclusions: The prevalence of WRMDs was high among health care workers with the lower back being the most frequently affected body region. Work involving painful/tiring positions was the most common ergonomic risk factor associated with WRMDs.

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Background: Limb amputation is a preventable and important public health concern in developing countries. We aimed at determining the pattern, indications, and outcome of limb amputations in our environment. Materials and Methods: A hospital-based retrospective review of the database of all limb amputations in Federal Teaching Hospital in Abakaliki, Ebonyi State, Nigeria from January 2002 to December 2012. Results: In 184 patients, there were 192 limb amputations; 141 (73.9%) of the amputations were major and 51 (26.1%) were minor. The male-to-female ratio was 3.5:1 and the mean age was 33.8 ± 1.95 years. The common indications for amputation were trauma (69.0%), diabetic foot gangrene (16.3%), and malignancy (7.1%). Lower limb was significantly more involved than the upper limb in all indications of amputation (P < 0.001). Wound infection (40.2%), severe anemia (11.4%), and wound dehiscence 9.2% were the three top complications observed. The mean and median lengths of hospital stay were 43.3 ± 3.1 and 36 days, respectively. The mortality rate was 8.7%; it was significantly higher in females than males (17.1% vs 6.3% P < 0.031) and in nontrauma-related amputations than trauma-related ones (15.8% vs 5.5% P < 0.022). The rate of successful prosthetic rehabilitation was 18.5%. Conclusion: In our environment, trauma and diabetic foot gangrene are common causes of limb amputation. The observed pattern of predominantly major amputations and the relatively high morbidity associated with amputation in our environment call for appropriate policy response aimed at prevention and optimum care.

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Background: The study examines the pattern of impacted lower third molars in Calabar, Southern Nigeria. Patients and Methods: A retrospective analysis of the medical record of all patients, who were treated for symptomatic impacted lower third molar at the Dental and Maxillofacial Surgery Clinic of our institution over a 3-year period was undertaken. Information obtained included patients' demographics, location, type of impaction, presence of caries in the second molar, and indication for extraction. Results: A total of 2,156 patients were seen at the Dental and Maxillofacial Surgery Clinic over the 3-year period of study and of these patients, 118 impacted mandibular third molars were surgically extracted in 97 patients and thus giving a prevalence of 4.7%. The patients' ages ranged 18-48 years, the mean (SD) age was 27.5 (5.60) years. Impaction of the lower third molar occurred equally in both gender with an approximate ratio of 1:1. Mesioangular impaction was the most common type (N = 53; 44.9%), followed by horizontal impaction (N = 34; 28.8%). About half of the impacted teeth were located on the left side (N = 51; 43.2%). There was bilateral location in 21 (17.8%) cases. Recurrent pericoronitis (N= 65; 55.1%) and apical periodontitis (N= 41; 34.7%) were the most common indications for extraction. Conclusion: The prevalence of impacted mandibular third molar in Calabar is lower than previous reports from other urban cities in Nigeria. Mesioangular impaction was the most common impaction type, but unlike previous reports, horizontal impactions constitute a great proportion of third molar impactions seen in this environment.

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Context: Cytomegalovirus infection is potentially neurotoxic to the fetus when it occurs during pregnancy. The prevalence is not known within our population. Aims: To determine the seroprevalence of Cytomegalovirus antibodies in pregnant Nigerian women at a tertiary health facility in Southeast Nigeria. Methods: This was a laboratory-based cross sectional descriptive study. Pregnant women who consented to the study were recruited from the antenatal clinics of the Teaching Hospital. Blood samples were collected from them and analysed using ELISA techniques. The relationships between positive CMV antibodies and socio-demographic variables were analysed using Chi square test and linear regression analysis. Results: Two hundred and four (204) serum samples were analysed. CMV seroprevalence was 96.08%. Two hundred and one (98.5%) participants were not aware of CMV infection. Lower socioeconomic class was associated with increased seroprevalence of Cytomegalovirus (P=0.004). Multiparous women were more likely to acquire CMV infection than primigravide women (P=0.009). There was a strong association between maternal place of residence and CMV seropositivity (P=0.023). The association between increasing maternal age and CMV seropositivity did not achieve statistical significance (P=0.246). Conclusion: Cytomegalovirus seroprevalence is high among participants and awareness of this disease is low. There is need to create further awareness of this disease.

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Background: Septic arthritis remains one of the most rapidly destructive and potentially lethal forms of arthritis hence necessitating early and adequate treatments. Epidemiological data on septic arthritis are limited in Nigeria especially in the Northern region. This study was aimed to determine the pattern of distribution, presentation, treatment, and outcome of septic arthritis in a tertiary hospital in Northern Nigeria. Methods: A retrospective study of all patients that presented with septic arthritis at Aminu Kano Teaching Hospital, Nigeria over a 6-year period was carried out. The patient's case notes were retrieved from the medical record department. Information extracted and analyzed included demographic data; joints affected cultured organisms, treatment offered, and outcomes. Results: A total of 36 patient case files (23 males and 13 females) with septic arthritis involving 48 joints were studied. Patient's age ranged 3 months to 60 years with mean age of 4.5 years. The knee was the most commonly involved joint (58.5%) followed by hip (25%) and then shoulders (10.5%). The common presenting symptoms were joint pain, fever, joint swelling, limping, and joint trauma. Staphylococcus aureus was the most common (52.8%) organism involved. About 58.3% of the patients had arthrotomy with antibiotics and 27.8% patients had arthrocentesis with antibiotics while only 13.9% had antibiotic treatment alone. Complications of joint stiffness (31%) and fixed flexion deformity (19%) were recorded whereas 41.7% had a complete resolution in this study. Conclusion: From the result of this study, the outcome of septic arthritis management in our environment was unsatisfactory. It is recommended that prompt recognition, rapid, and adequate treatments are critical to restore normal function of affected joints and minimize complications.

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Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in a bid to forestall further bowel fistulae in a hostile abdomen. However, the role of early bowel diversion for source control of peritoneal fecal contamination in situations of overwhelming sepsis is illustrated with three postoperative enterocutaneous fistulas successfully managed with early bowel diversion.

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Background: Established markers of cardiovascular risk have become important in the evaluation of patients with diabetes and hypertension. This study correlated plasma fibrinogen with indices of cardiovascular risk in patients with type 2 diabetes, hypertension, and diabetes coexisting with hypertension. Materials and Methods: This study was cross-sectional, carried out at the Medical Outpatient (MOP) clinic of our hospital, from May to August, 2014. Eighty subjects were enrolled and were categorized into three groups, according to the following diagnoses: Diabetics, hypertensives, and patients with diabetes coexisting with hypertension. Fasting lipid profile [total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride] and fibrinogen level were estimated while body mass index (BMI) was calculated. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20. Results were presented as means (and standard deviations), percentages, and proportions, and variables were compared using the chi-square test, analysis of variance (ANOVA), and the Pearson's correlation coefficient. The level of significance was set at P = 0.05. Results: Plasma fibrinogen levels were significantly higher in patients with hypertension, diabetes, and diabetes coexisting with hypertension than in control subjects (469.15 ± 67.99 mg/dL, 440.10 ± 45.63 mg/dL, 473.75 ± 82.61 mg/dL vs. 378.95 ± 31.37 mg/dL, respectively, P = 0.001). The total cholesterol, LDL, HDL, and BMI were significantly different in all the patient groups compared to the controls; while HDL and triglyceride correlated significantly with plasma fibrinogen in those with hypertension and diabetes coexisting with hypertension. Conclusion: Plasma fibrinogen could serve as a marker of cardiovascular risk in patients with hypertension and diabetes coexisting with hypertension.

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Sinus Histiocytosis is rare benign lymphadenopathy. This has a recurrent course and at times requires cytotoxic therapy. Systemic involvement is very rare. Here a case with systemic involvement is described.

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Introduction: Approximately 2.5 million children below 15 years are infected with the human immunodeficiency virus (HIV), with 90% in sub-Saharan Africa. The Federal Teaching Hospital Abakaliki has been a treatment center for HIV since 2006. Objective: The aim of this study was to analyze the sociodemographic and anthropometric characteristics of pediatric HIV-positive patients seen at this facility. Methods: This was a cross-sectional and descriptive study carried out from January to July 2014 of all HIV-positive children aged 0–18 years. The sociodemographic and anthropometric indices were obtained from the patients and/or their accompanying caregiver. Results: There were 89 children (mean age 7.12 ± 4.10 years; range 2–16 years), of which, 54 (60.7%) were male and 35 (39.3%) were female, with a male:female ratio of 1.5:1. Fifty-two children (58.4%) belonged to the lower socioeconomic class by Olusanya, of which, 25 (28.1%) orphans, 15 (16.9%) had stopped schooling whereas 66 (74.2%) were fully immunized according to National Programme on Immunization schedule. Maternal HIV-status was positive in 87 (97.8%) of the children whereas 33 (37.1%) of their fathers were HIV-positive. Paternal HIV-status was unknown in 32 (36.0%). Orphans were more likely to drop out of school. Conclusion: Most children with HIV are from parents of low socioeconomic status while a good number have been orphaned by acquired immunodeficiency syndrome. Vertical transmission was the means of acquiring the infection in most cases. Reinforcement of services for prevention of mother-to-child transmission of HIV is therefore recommended.

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Background: The family physician is usually the first contact between patients and the health care system at the tertiary level, and they play an important role in the screening for chronic kidney disease (CKD), treatment of reversible causes, and timely referral to the nephrologist. We do not know if the future family physician in Nigeria is prepared for this important role, prompting us to carry out this study. Materials and Methods: Self-administered questionnaires were given to family medicine trainees attending a nationally organized revision course. Results: Two hundred questionnaires were distributed and 172 were returned Guidelines for the management of CKD were correctly identified by only 18% of the participants. The screening methods that were identified for CKD included urinalysis (43.6%), serum creatinine alone (72.7%), estimation of glomerular filtration rate (70.3%), and renal ultrasound (30.5%). Less than 50% were aware of the recommended frequency of screening for diabetic and elderly patients while less than 25% were aware of coronary artery disease and stroke as complications of CKD. After a diagnosis of CKD, 40.4% would refer immediately to the nephrologist, while 33%, 13%, and 2% would use the serum creatinine level alone, estimated glomerular filtration rate (GFR), and clinical features, respectively, as guides in taking decisions on referral. Conclusion: A good number of the participants had poor knowledge in the aspects of identification of patients with CKD, initial evaluation of such patients and eventual referral to nephrologists. Concerted efforts are needed to improve this knowledge in the family physician trainees of Nigeria.

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