Wasiu Lanre Adeyemo
Publications
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An overview of biological basis of pathologic scarring.
The Nigerian postgraduate medical journal. 03/2012; 19(1):40-5.
AIMS AND OBJECTIVES : To review the current mechanisms and biologic processes leading to the formation of pathologic scars. A computerised literature search was carried out using MEDLINE for all published articles on ''pathologic scarring''. The medical subject headings ''sca... [more] AIMS AND OBJECTIVES : To review the current mechanisms and biologic processes leading to the formation of pathologic scars. A computerised literature search was carried out using MEDLINE for all published articles on ''pathologic scarring''. The medical subject headings ''scarring'' were combined with ''mechanisms''. A review of selected relevant literature was then undertaken. Scarless embryonal healing tends to be characterised by minimal inflammatory reaction mediated by reduced IL6,IL8 and hyaluronidase while there are elevated levels of hyaluronic acid MMP1to3, as well as IL10.The multifunctional cytokine TGF-B, its several isoforms as well as its postreceptor signalling mechanisms appears to play the key role in the scarring process . There is also evidence to show that PDGF, IGF and other cytokines regulate scarring . While conventional antiscarring agents target the fibroplasia phase, others such as tamoxifen ,calcium channel blockers, and imidazolaquinolines targets various phases of the scarring process . It appears that multiple mechanisms are involved in the phenotypical appearance of abnormal scarring. A deeper understanding of these mechanisms is pivotal to the development of better antiscarring therapies in the very near future .
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0.43Impact points
Orofacial injuries associated with eclampsia in patients presenting at a Nigerian Tertiary Hospital.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 01/2012; 32(1):54-7.
A prospective study was conducted to determine the incidence and pattern of orofacial injuries among eclamptic patients at the Lagos State University Teaching Hospital between December 2008 and November 2009. The incidence of orofacial injuries was 42%. Most injuries were due to bite and forceful in... [more] A prospective study was conducted to determine the incidence and pattern of orofacial injuries among eclamptic patients at the Lagos State University Teaching Hospital between December 2008 and November 2009. The incidence of orofacial injuries was 42%. Most injuries were due to bite and forceful insertion of hard objects into the patient's mouth by relatives during convulsive episodes. The type of antenatal care received had an influence on the incidence of orofacial injuries and there was a correlation between the number of convulsions and orofacial injuries. The mortality rate from eclampsia was 20.6%, and presence of orofacial injuries was a risk factor for mortality. Obstetricians and other healthcare providers should be familiar with the ways of preventing these injuries and seek early maxillofacial consultation when they occur. There is need for community education on the dangers of forceful insertion of hard objects into the mouth of eclamptics during fits.
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Orofacial manifestation of hematological disorders: Hemato-oncologic and immuno-deficiency disorders.
Indian journal of dental research : official publication of Indian Society for Dental Research. 09/2011; 22(5):688-97.
The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases with special reference to hemato-oncologic, immuno-deficiency disorders, and human immunodeficiency virus infection. A computerized literature search using MEDLINE was conducted for publ... [more] The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases with special reference to hemato-oncologic, immuno-deficiency disorders, and human immunodeficiency virus infection. A computerized literature search using MEDLINE was conducted for published articles on orofacial manifestations of hematological diseases with emphasis on hemato-oncologic and human immunodeficiency virus (HIV) infection. Mesh phrases used in the search were: Oral diseases AND hematological disorders; orofacial diseases AND leukemias; orofacial lesions AND lymphomas; orofacial diseases AND multiple myeloma, orofacial manifestations AND HIV. The Boolean operator "AND" was used to combine and narrow the searches. The full texts of these articles were thoroughly examined. References in these articles also were manually searched non-Medline articles. Only relevant articles were selected for the review. Orofacial manifestation of malignant hematological diseases may present as primary clinical features due to infiltration of orofacial tissues, or as secondary due to the subsequent infiltration of normal bone marrow elements, or tertiary due to the side effects of the treatment. HIV-associated orofacial lesion may be a clinical indicator of HIV infection in otherwise healthy, undiagnosed individuals; an early clinical feature of HIV infection; clinical markers for the classification and staging of HIV disease or may be a predictor of HIV disease progression. Orofacial manifestations of malignant hematological diseases and HIV infection are not uncommon findings in clinical practice. These manifestations may be clinical indicators of hematologic disorders in otherwise healthy, undiagnosed individuals.
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0.88Impact points
Genetic studies in the nigerian population implicate an MSX1 mutation in complex oral facial clefting disorders.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. 07/2011; 48(6):646-53.
Background : Orofacial clefts are the most common malformations of the head and neck, with a worldwide prevalence of 1 in 700 births. They are commonly divided into CL(P) and CP based on anatomic, genetic, and embryologic findings. A Nigerian craniofacial anomalies study (NigeriaCRAN) was set up in ... [more] Background : Orofacial clefts are the most common malformations of the head and neck, with a worldwide prevalence of 1 in 700 births. They are commonly divided into CL(P) and CP based on anatomic, genetic, and embryologic findings. A Nigerian craniofacial anomalies study (NigeriaCRAN) was set up in 2006 to investigate the role of gene-environment interaction in the origin of orofacial clefts in Nigeria. Subjects and Methods : DNA isolated from saliva from Nigerian probands was used for genotype association studies and direct sequencing of cleft candidate genes: MSX1 , IRF6 , FOXE1, FGFR1 , FGFR2 , BMP4 , MAFB, ABCA4 , PAX7, and VAX1 , and the chromosome 8q region. Results : A missense mutation A34G in MSX1 was observed in nine cases and four HapMap controls. No other apparent causative variations were identified. Deviation from Hardy Weinberg equilibrium (HWE) was observed in these cases (p = .00002). A significant difference was noted between the affected side for unilateral CL (p = .03) and bilateral clefts and between clefts on either side (p = .02). A significant gender difference was also observed for CP (p = .008). Conclusions : Replication of a mutation previously implicated in other populations suggests a role for the MSX1 A34G variant in the development of CL(P).
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0.97Impact points
Nigerian dentists' knowledge of the current guidelines for preventing infective endocarditis.
Community dental health. 06/2011; 28(2):178-81.
This study assessed Nigerian dentists' knowledge of current guidelines for the prevention of infective endocarditis. A self-administered questionnaire surveyed a cross-section of Nigerian dentists gathering information on respondent demographics, awareness of the American Heart Association curre... [more] This study assessed Nigerian dentists' knowledge of current guidelines for the prevention of infective endocarditis. A self-administered questionnaire surveyed a cross-section of Nigerian dentists gathering information on respondent demographics, awareness of the American Heart Association current guidelines on preventing infective endocarditis and sources of knowledge regarding that guidance. Respondents indicated: a) whether or not they would prescribe antibiotics before dental treatment in 10 cardiac conditions, b) if antibiotic prophylaxis was reasonable before 10 dental procedures in an endocarditis high-risk patient, and c) a prescription for oral antibiotics for an endocarditis high-risk non-allergic adult about to undergo a dental procedure. Respondents numbered 173 and 41% were aware of the guidelines. Most commonly the sources of this knowledge were undergraduate/postgraduate education. Overall, the correct responses for the 10 cardiac conditions was very low (33%), ranging from 94% for prosthetic heart valves (94.2%) down to 4% for previous coronary artery bypass (3.5%). For clearly invasive procedures, 80% to 96% of respondents indicated that a prophylactic antibiotic was reasonable. For clearly non-invasive procedures, 89% to 92% indicated that antibiotics were not reasonable. Correct antimicrobial agent, dose and timing of administration were prescribed by 89%, 9%, and 57% respectively. A low level of knowledge of the current guidelines was found among Nigerian dentists. Although, most prescribed the correct antimicrobial agent, the numbers prescribing correct dose and time of administration were quite low. Therefore, attempts should be made to teach the current guidelines in Nigerian undergraduate/postgraduate dental education.
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Orofacial manifestations of hematological disorders: anemia and hemostatic disorders.
Indian journal of dental research : official publication of Indian Society for Dental Research. 05/2011; 22(3):454-61.
The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases, with particular reference to anemias and disorders of hemostasis. A computerized literature search using MEDLINE was conducted for published articles on orofacial manifestations of hema... [more] The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases, with particular reference to anemias and disorders of hemostasis. A computerized literature search using MEDLINE was conducted for published articles on orofacial manifestations of hematological diseases, with emphasis on anemia. Mesh phrases used in the search were: oral diseases AND anaemia; orofacial diseases AND anaemia; orofacial lesions AND anaemia; orofacial manifestations AND disorders of haemostasis. The Boolean operator "AND" was used to combine and narrow the searches. Anemic disorders associated with orofacial signs and symptoms include iron deficiency anemia, Plummer-Vinson syndrome, megaloblastic anemia, sickle cell anemia, thalassaemia and aplastic anemia. The manifestations include conjunctiva and facial pallor, atrophic glossitis, angular stomatitis, dysphagia, magenta tongue, midfacial overgrowth, osteoclerosis, osteomyelitis and paraesthesia/anesthesia of the mental nerve. Orofacial petechiae, conjunctivae hemorrhage, nose-bleeding, spontaneous and post-traumatic gingival hemorrhage and prolonged post-extraction bleeding are common orofacial manifestations of inherited hemostatic disorders such as von Willebrand's disease and hemophilia. A wide array of anemic and hemostatic disorders encountered in internal medicine has manifestations in the oral cavity and the facial region. Most of these manifestations are non-specific, but should alert the hematologist and the dental surgeon to the possibilities of a concurrent disease of hemopoiesis or hemostasis or a latent one that may subsequently manifest itself.
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0.85Impact points
Blood transfusion requirements in cleft lip surgery.
International journal of pediatric otorhinolaryngology. 03/2011;
OBJECTIVE: Cleft lip surgery is a common procedure performed by surgeons worldwide. The aim of the study was to determine blood transfusion requirements and factors influencing blood transfusion in cleft lip surgery. METHODS: Transfusion rate in 100 consecutive patients who had cleft lip surgery was... [more] OBJECTIVE: Cleft lip surgery is a common procedure performed by surgeons worldwide. The aim of the study was to determine blood transfusion requirements and factors influencing blood transfusion in cleft lip surgery. METHODS: Transfusion rate in 100 consecutive patients who had cleft lip surgery was prospectively evaluated at the Lagos University Teaching Hospital, Nigeria. Data collected included age and sex of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Cardiovascular parameters at the point of transfusion were also recorded. Each patient was made to donate a unit of homologous blood prior to surgery. RESULTS: Mean estimated blood loss during surgery was 26.5±47.1ml. Most patients (92%) lost between 2 and 50ml of blood. Mean estimated blood loss in unilateral cleft lip surgery was not significantly differently from that of bilateral cleft lip surgery (P=0.46). Only five patients (5%) required blood transfusion. The mean blood transfused was 50.0±16.9ml. All the patients transfused had a preoperative haematocrit of <30% (23-27%). The cross-match-to-transfusion ratio for cleft surgery was 20. The transfusion index was 0.05 and overall blood-ordering quotient was 20. CONCLUSION: Cleft lip surgery is a low volume blood loss surgery. Homologous blood donation prior to cleft lip surgery in patients with preoperative haematocrit of 30% or more is not necessary. For patients with preoperative haematocrit of less than 30%, type and screen of donated blood should be adequate.
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0.85Impact points
Orofacial and dental injuries associated with seizures in paediatric patients in Lagos University Teaching Hospital.
International journal of pediatric otorhinolaryngology. 03/2011;
OBJECTIVE: To determine the prevalence and pattern of presentation of orofacial and dental injuries in children with seizures at the Children's Emergency Unit of the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. METHODS: This was a prospective study of children with febrile or non-f... [more] OBJECTIVE: To determine the prevalence and pattern of presentation of orofacial and dental injuries in children with seizures at the Children's Emergency Unit of the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. METHODS: This was a prospective study of children with febrile or non-febrile convulsion who presented at the Children's Emergency Unit of LUTH between July 2008 and August 2009. The age, gender, type of convulsion and the presence/absence of orofacial and other bodily injuries were recorded in a proforma. Mechanism, type and classification of injury were recorded for patients with orofacial injuries. RESULTS: A total of 257 children (148 males and 109 females) with febrile/non-febrile convulsion were included in the analysis. The mean age (SD) of patients was 32.8±40.5 months. There were 223 (86.8%) cases of febrile convulsion and 34 (13.3%) cases of non-febrile convulsion. Thirteen children sustained orofacial injuries giving a prevalence of 5.1%. There was no significant difference in the prevalence of orofacial injury between patients with febrile convulsion (4.5%) and those with non-febrile convulsion (8.8%) (P=0.282). The most common cause of orofacial injuries was forceful insertion of hard object into the mouth during convulsive episodes. Twelve (92.3%) patients sustained soft tissue injury, while one sustained both soft and hard tissue injuries. The most common site of injury was the lip. CONCLUSIONS: Oro-facial and dental injuries may occur in children with seizures. It is therefore important that these injuries be looked for by the paediatrician and the dentist/oral and maxillofacial surgeons should be involved in managing these children.
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Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery.
Head & face medicine. 01/2011; 7:8.
Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperati... [more] Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery. Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated. There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening. Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.
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Focal Reactive lesions of the Gingiva: An Analysis of 314 cases at a tertiary Health Institution in Nigeria.
Nigerian medical journal : journal of the Nigeria Medical Association. 01/2011; 52(1):35-40.
BACKGROUND: The aim of this study was to review the clinicopathologic features of focal reactive gingival lesions at the Lagos University Teaching Hospital, Nigeria. METHODS: A retrospective review of cases of different focal reactive gingival lesions from the records of the Departments of the Oral ... [more] BACKGROUND: The aim of this study was to review the clinicopathologic features of focal reactive gingival lesions at the Lagos University Teaching Hospital, Nigeria. METHODS: A retrospective review of cases of different focal reactive gingival lesions from the records of the Departments of the Oral Biology/Oral Pathology and Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital between 1970 and 2008 was carried out. Available clinical data regarding age, gender, location, estimated duration of the lesion and treatment modality were obtained and analyzed. RESULTS: Prevalence rate of focal reactive gingival lesions was 5.6%. Pyogenic granuloma (PG) was the most common lesions constituting 57% of the cases. Seventeen (9.5%) of the 179 cases of PG were pregnancy induced pyogenic granuloma. The female-to-male ratio was 1.7:1. All the 4 lesions occurred more in female patients than males. The mean age of patients at presentation was 30 ± 16.5 years. The lesions were commonly seen in the second and third decade of life and least commonly seen above the age of 60 years. The lesions were equally distributed on the maxillary and mandibular gingivae, and were mostly located on the buccal gingival of the jaws. Most (51.6%) of the lesions occurred in incisors/canine region. Recurrence of the lesions was seen in 9 cases (2.9%), all pyogenic granuloma. CONCLUSION: Focal reactive gingival lesions are relatively uncommon lesions of the oral cavity with a prevalence rate of 5.6%. The lesions occurred commonly in females, and in third decades of life. Pyogenic granuloma was the most common lesions constituting 57% of all cases.
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0.34Impact points
Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia.
The West Indian medical journal. 01/2011; 60(1):91-5.
This study was conducted to determine the changes in blood pressure and the pulse rate of patients with controlled hypertension having dental extraction under local anaesthesia utilizing 2% lignocaine with adrenaline, and to evaluate whether these changes in blood pressure were are attributable to a... [more] This study was conducted to determine the changes in blood pressure and the pulse rate of patients with controlled hypertension having dental extraction under local anaesthesia utilizing 2% lignocaine with adrenaline, and to evaluate whether these changes in blood pressure were are attributable to addition of adrenaline. This prospective study was carried out in 33 consecutive hypertensive patients who presented at the exodontia clinic of the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, from December 2004 to August 2005 for intra-alveolar tooth extraction. Patients were randomly allocated to two groups according to the type of anaesthetic solution employed. Group A had tooth extraction done under 2% lignocaine with 1:80 000 adrenaline while group B had tooth extraction done under 2% lignocaine without vasoconstrictor (plain lignocaine). One tooth was extracted from each patient. Blood pressure and pulse rate measurements were recorded in the waiting room before surgery, in the surgery after local anaesthetic injection, during tooth extraction and 15 minutes after tooth extraction. The sample consisted of 20 females and 13 males age range 24 to 75 years (mean +/- SD = 50.1 +/- 11.7 years). There was no statistically significant difference between the systolic and diastolic blood pressure and pulse rate in the two groups after administration of local anaesthesia. However the highest alteration in parameters was observed during tooth extraction in the two groups. The haemodynamic changes induced by injecting 2% lignocaine with adrenaline in patients with controlled hypertension during tooth extraction is within normal range and is not different from that induced by 2% lignocaine without adrenaline. We consider it essential that all precautions to prevent inadvertent intravascular injection be undertaken by the care provider.
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1.58Impact points
Ameloblastic carcinoma: a multicenter Nigerian study.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 09/2010; 68(9):2111-4.
To obtain a national profile on the prevalence and management of ameloblastic carcinoma in Nigerians. Data were collected from the case files of patients with a histologic diagnosis of ameloblastic carcinoma from 4 tertiary referral centers in Nigeria from January 1980 to December 2008. Twenty patie... [more] To obtain a national profile on the prevalence and management of ameloblastic carcinoma in Nigerians. Data were collected from the case files of patients with a histologic diagnosis of ameloblastic carcinoma from 4 tertiary referral centers in Nigeria from January 1980 to December 2008. Twenty patients were seen within the study period. There were 11 male and 9 female patients, with a male-to-female ratio of 1.2:1. Their ages ranged from 16 to 85 years (mean +/- SD, 41.63 +/- 19.8 years). The duration of the lesion before presentation was 6 months to 4 years. Twelve cases occurred in the posterior mandible alone, 1 case occurred in the anterior mandible alone, and 4 cases involved the anterior and posterior mandible. The posterior part of the maxilla was involved in 3 cases. A majority of the cases (17) occurred de novo, and 3 patients presented with carcinoma ex-ameloblastoma. Treatment included surgical resection with or without neck dissection. Eight patients declined treatment after diagnosis. Surgery was planned for 12 patients, but 2 patients died of intractable bleeding episodes before surgery. Mandibulectomies and maxillectomies were performed for 10 patients. Follow-up was carried out for 5 patients. Recurrence ranged from 6 to 96 months after the first surgery. Overall deaths recorded involved 6 patients. Three patients died within 3 years after the initial surgery and 1 patient died about 8 years after the initial surgery. One patient is still alive and well 1 year after surgery. Ameloblastic carcinoma is an uncommon malignancy. Most cases occur in the mandible and arise de novo. Early diagnosis and radical local excision remain the mainstay of treatment.
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Overweight and obesity among patients attending a Nigerian oral surgery clinic: implications for oral surgical practice in Nigeria.
African health sciences. 03/2010; 10(1):40-5.
To determine the prevalence of overweight and obesity among patients attending oral and maxillofacial outpatient clinic of the Lagos University Teaching Hospital, Nigeria; and discuss the clinical and surgical implications that obesity has on the delivery of oral and maxillofacial surgical and anaes... [more] To determine the prevalence of overweight and obesity among patients attending oral and maxillofacial outpatient clinic of the Lagos University Teaching Hospital, Nigeria; and discuss the clinical and surgical implications that obesity has on the delivery of oral and maxillofacial surgical and anaesthetic care. Consecutive patients presenting to the oral and maxillofacial surgery outpatient clinic at the Lagos University Teaching Hospital, Nigeria over a 4-month period (May-August 2004) were screened for age, sex, height and weight. All of the patients were treated for dentoalveolar surgical procedures (routine and surgical extractions), incisional and excisional biopsies, and enucleation under local anaesthesia. The BMIs of the studied patients ranged from 16.7 to 39.8 kg/m(2), with a mean of 24.6 +/- 4.5 kg/m(2). Prevalence of excess weight was 39.1%. Thirty-one (11.4%) patients were obese and 75 (27.7%) patients were overweight. A significant difference was observed in the BMIs of male and female patients (P=0.000). The age groups < 30 years had mean BMIs that were considered normal; whereas other age groups above 30 years had mean BMIs that were considered overweight. Prevalence of obesity increases with increasing age. Obese individuals were seen in all the age groups except those < 20 years. The prevalence of excess weight (overweight and obesity) in patients presenting in the studied oral and maxillofacial outpatient setting was 39.1%. Oral and maxillofacial surgeon needs to be aware of obesity-/overweight-related medical and surgical issues and take them into consideration when treating these patients.
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1.51Impact points
Implant restoration of partially edentulous ridges: a review of 121 Nigerian patients.
Implant dentistry. 02/2010; 19(1):65-72.
Because of increasing health awareness, many Nigerian patients are demanding that their lost tooth/teeth be replaced with dental implants. This study reports the pattern and distribution of implant replacement of lost tooth/teeth in a private dental practice in Lagos, Nigeria. A retrospective review... [more] Because of increasing health awareness, many Nigerian patients are demanding that their lost tooth/teeth be replaced with dental implants. This study reports the pattern and distribution of implant replacement of lost tooth/teeth in a private dental practice in Lagos, Nigeria. A retrospective review of implant replacement of lost tooth/teeth over a period of 6 years at Schubbs Private Dental Clinic, Lagos, was carried out. Data analysis included age, sex, occupation, habits and medical condition of patients, augmentation procedure, technique of implant placement (immediate vs conventional loading) tooth/teeth replaced, and follow-up period. A total of 227 implants (Bicon, Boston, MA) with complete superstructure were placed in 121 patients(males = 68, females = 53; age range: 15-74 years). Majority of the patients were of high socioeconomic class. Ten (8.3%) patients had immediate implants and 111 (91.7%) undergone 2-stage implant procedures. The highest number (39.2%) of implants was placed in the molar region, and the replacement of the canines was the lowest (3.1%). Success rate over a period of 6 years was 96%. Of the 9 (4%) implants that failed, 2 were repeated and remained functional till date. Dental implant therapy as a means of tooth replacement is gaining popularity among Nigerian social upper class. Success rate in this series is comparable with previous reports from Europe and America.
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Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery
Indian Journal of Plastic Surgery. 01/2010;
Aim: The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. Setting and Design: A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teachin... [more] Aim: The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. Setting and Design: A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. Material and Methods: One hundred consecutive patients who required cleft lip and palate surgery were recruited into the study. Data collected included age, sex and weight of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Each patient was made to donate a unit of homologous blood prior to surgery. Results: There were 52 females and 48 males with a mean age of 64.4 ± 101.1 months (range, 3-420 months). The most common cleft defect was isolated cleft palate (45%) followed by unilateral cleft lip (28%). Cleft palate repair was the most common procedure (45%) followed by unilateral cleft lip repair (41%). The mean estimated blood loss was 95.8 ± 144.9 ml (range, 2-800ml). Ten (10%) patients (CL=2; CP=5, BCL=1; CLP=2) were transfused but only two of these were deemed appropriate based on percentage blood volume loss. The mean blood transfused was 131.5 ± 135.4ml (range, 35-500ml). Six (60%) of those transfused had a preoperative PCV of < 30%. Only 4.9% of patients who had unilateral cleft lip surgery were transfused as compared with 50% for CLP surgery, 11% for CP surgery, and 10% for bilateral cleft lip surgery. Conclusions: The frequency of blood transfusion in cleft lip and palate surgery was 10% with a cross-match: transfusion ratio of 10 and transfusion index of 0.1. A "type and screen" policy is advocated for cleft lip and palate surgery.
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Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery.
Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India. 01/2010; 43(1):54-9.
The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. One ... [more] The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. One hundred consecutive patients who required cleft lip and palate surgery were recruited into the study. Data collected included age, sex and weight of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Each patient was made to donate a unit of homologous blood prior to surgery. There were 52 females and 48 males with a mean age of 64.4 ± 101.1 months (range, 3-420 months). The most common cleft defect was isolated cleft palate (45%) followed by unilateral cleft lip (28%). Cleft palate repair was the most common procedure (45%) followed by unilateral cleft lip repair (41%). The mean estimated blood loss was 95.8 ± 144.9 ml (range, 2-800ml). Ten (10%) patients (CL=2; CP=5, BCL=1; CLP=2) were transfused but only two of these were deemed appropriate based on percentage blood volume loss. The mean blood transfused was 131.5 ± 135.4ml (range, 35-500ml). Six (60%) of those transfused had a preoperative PCV of < 30%. Only 4.9% of patients who had unilateral cleft lip surgery were transfused as compared with 50% for CLP surgery, 11% for CP surgery, and 10% for bilateral cleft lip surgery. The frequency of blood transfusion in cleft lip and palate surgery was 10% with a cross-match: transfusion ratio of 10 and transfusion index of 0.1. A "type and screen" policy is advocated for cleft lip and palate surgery.
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A comparative study of surgical morbidity associated with mandibular third-molar surgery in young and aging populations.
The journal of contemporary dental practice. 01/2010; 11(4):E001-8.
Prophylactic surgical extraction of impacted third molars is a common practice throughout the world justified on the presumption that the risk of surgical morbidity increases with increasing age, among other reasons. The aim of this study was to analyze and compare surgical morbidity associated with... [more] Prophylactic surgical extraction of impacted third molars is a common practice throughout the world justified on the presumption that the risk of surgical morbidity increases with increasing age, among other reasons. The aim of this study was to analyze and compare surgical morbidity associated with third-molar extractions in young and aging populations. A review of records for all patients who underwent the surgical extraction of impacted third molars between April 2001 and June 2006 at the Lagos University Teaching Hospital was carried out. A total of 506 patients had surgical extractions of impacted third molars under local anaesthesia during the period of the study. Of these, 470 (92.9 percent) patients were below the age of 40 years (Group A) and 36 (7.1 percent) patients were 40 years of age and older (Group B). No incidences of severe intraoperative complications (excessive bleeding or mandibular fractures) were recorded in either group, but other postoperative complications were reported in 70 (13.8 percent) patients. Of these 70 patients, 65 (92.9 percent) were from Group A and 5 (7.1 percent) were from Group B, and their complications included infected socket, dry socket, paraesthesia, and buccal space abscess. No significant difference in post-operative complications following surgical removal of mandibular third molars was found between patients 40 years old and greater and those below age 40. Prophylactic surgical extraction of impacted mandibular third molars, based on the assumption that surgical morbidity increases with age, may not be justifiable. Age does not predispose patients who had surgical extraction of mandibular third molars above 40 years of age to any additional surgical complications when compared to patients below the age of 40 years receiving comparable treatment.
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Evidence-based dentistry in a developing economy - the nigerian example.
The open dentistry journal. 01/2010; 4:51-4.
Evidence-based dentistry (EBD) is becoming popular all over the world with the increasing global involvement of dental practitioners in the debates on the relevance or otherwise of EBD. However, very little has been known on the evolutionary trend of EBD in the developing countries of the world. Thi... [more] Evidence-based dentistry (EBD) is becoming popular all over the world with the increasing global involvement of dental practitioners in the debates on the relevance or otherwise of EBD. However, very little has been known on the evolutionary trend of EBD in the developing countries of the world. This pilot study was designed to assess the state of EBD in the accredited dental schools in Nigeria as an example of a developing economy. An electronic search was conducted for articles on the subject of EBD emanating into the world dental literature from Nigeria as a measure of activities in the field of EBD in the country. Further investigation was done by way of interviews of faculty members and resident doctors in the four fully accredited dental schools in Nigeria. The subject of the interview was premised around the evaluation of activities in the field of EBD. Only 6 relevant articles were found in the search. The interviews however revealed an increasing awareness but low level of knowledge of the principles of EBD in the dental schools. Major obstacles were infrastructural limitations and lack of personal motivations. The enthusiasm of the younger faculties and resident doctors was notable. It was obvious that EBD is yet to assume the desired momentum in the 21(st) century in Nigeria. It is however gladdening that there is a promising future for EBD with the rising enthusiasm noted among the younger generation of clinicians.
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0.34Impact points
Tumours of the submandibular salivary gland: a clinicopathologic review of cases over a 17-year period.
The West Indian medical journal. 09/2009; 58(4):388-91.
This study presents a clinicopathologic review of cases of submandibular salivary gland tumours at the Lagos University Teaching Hospital, Nigeria, over a period of 17 years. The records of all patients with histological diagnosis of submandibular salivary gland tumours at the Lagos University Teach... [more] This study presents a clinicopathologic review of cases of submandibular salivary gland tumours at the Lagos University Teaching Hospital, Nigeria, over a period of 17 years. The records of all patients with histological diagnosis of submandibular salivary gland tumours at the Lagos University Teaching Hospital over a period of 17 years (January 1990 to December 2006) were retrospectively reviewed. Parameters studied were; age and gender of patients, symptoms and duration of symptoms, and histological diagnosis. A total of 36 patients with submandibular gland tumours were seen during the period. Male-to-female ratio was 1.8:1 (male=23, female=13). Mean age (+/- SD) at presentation was 43 (+/- 19) years (age range, 17-84 years). There were 19 malignant tumours and 17 benign ones. Pleomorphic adenoma (36.1%) was the most frequent tumours, followed by adenoid cystic carcinoma (11.1%), anaplastic carcinoma (11.1%) and malignant lymphoma (11.1%). Patients with histological diagnosis of malignant tumours were significantly older than those with benign tumours (p = 0.01). Most patients (80.6%) presented with painless swelling. Malignant submandibular salivary gland tumours were slightly more than the benign ones in the studied population. Painful swelling or ulceration is indicative of a malignant submandibular gland tumour
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1.51Impact points
Knowledge and perceptions of facial plastic surgery among a selected group of professionals in Lagos, Nigeria.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 04/2009;
This was a questionnaire-based study among a selected group of professionals in Lagos, Nigeria to assess their knowledge, attitude and perceptions to facial plastic surgery. A well-structured questionnaire was administered to a group of professionals in the banking industry and the civil service. Th... [more] This was a questionnaire-based study among a selected group of professionals in Lagos, Nigeria to assess their knowledge, attitude and perceptions to facial plastic surgery. A well-structured questionnaire was administered to a group of professionals in the banking industry and the civil service. The respondents were asked if they had heard of 'facial plastic surgery' before and if they were familiar with some selected facial plastic surgery procedures. They were also asked if they had ever considered undergoing facial plastic surgery for any real/perceived facial abnormalities; if they knew any close relatives/friends who had undergone facial plastic surgery and if they considered the result satisfactory or not. A total of 130 respondents participated in the study; of these, 102 (78.5%) respondents had some knowledge of 'facial plastic surgery' while 28 (21.5%) respondents had no prior knowledge of facial plastic surgery. Fifty-five of the 102 respondents had some knowledge of liposuction of the face and neck. Nineteen of the 130 respondents expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and excess fat on the cheeks and neck. Only 17 (13%) of the respondents had ever thought of undergoing facial plastic surgery; of these 17 respondents, nine claimed that their facial appearance was the main reason. Respondents with perceived facial abnormalities were more likely to undergo plastic surgery than those without perceived abnormalities (P=0.000). Twenty-four (18.5%) of the 130 respondents knew of a friend/close relative who had undergone facial plastic surgery before, and the majority (19 of the 24) considered the result of the surgery satisfactory. We conclude that most of the study participants had some knowledge of facial plastic surgery; however, only a few expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and folds/fat on the cheeks and neck. The fact that only a few of the respondents knew someone who had undergone facial surgery may reflect the low level of availability of facial plastic surgery procedures in Nigeria.
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Olufem Omitola
University of Port Harcourt
