Biomedical subjects

A E Obiechina

Publications and source records attributed to A E Obiechina.

At least 19 recordsLinked to original sources

PubMed2006

Concomitant craniospinal injuries with maxillofacial trauma--a review of 266 cases.

Maxillofacial injuries are fairly common and they are usually found in association with multiple injuries. The proximity of the face to the craniospinal axis results in significant association between maxillofacial trauma and craniospinal injuries. Previous studies have enumerated this association but the injury types, classifications and influences of the concomitant injuries on the outcome of management are sketchy. In this study, road traffic accident was the commonest cause of maxillofacial and concomitant c raniospinal injuries: mild closed head injuries was the commonest concomitant injury occurring in almost 60% of the cases whilst mandibular fracture was the maxillofacial injury frequently encountered. The average duration of hospitalization in patients with maxillofacial trauma and concomitant mild head injury was 19 days but it was much higher (average 34.9 days) in patients with concomitant spinal injuries. The high incidence of head injury would suggest that maxillofacial units are best cited in hospitals with functional neurosurgical services.

Accidents, Traffic↗

PubMed2006

Orofacial lesions in 126 newly diagnosed HIV/AIDS patients seen at the University College Hospital, Ibadan.

Human immune deficiency virus (HIV) infection is one of the most devastating infection in modern times. Oral manifestations of HIV infection occur in approximately 30-80% of patients infected with this virus and the factors, which predispose to these lesions include: CD4 count less than 200 cells/mm, viral load, xerostomia, poor oral hygiene and smoking. These manifestations have subsequently become important entry criteria for: clinical trials of various therapeutic regimes, prophylaxis of HIV related opportunistic infections, anti-retroviral trials and vaccine studies. Over a six month period, all newly diagnosed HIV/AIDS patients attending the Special Treatment Clinic at the Haematology Department of the University College Hospital, Ibadan, Nigeria were recruited into this study before anti-retroviral therapy was commenced. As part of the general physical examination of these patients, a thorough orofacial evaluation was also carried out and the findings were documented. The most prevalent orofacial lesions were candidiasis, xerostomia, melanotic hyperpigmentation and herpetic ulcer among others. The aim of this study was to evaluate the pattern of oral lesions found in patients who were newly diagnosed as having HIV infection prior to commencement of anti-retroviral drugs and relate these lesions to the age, sex and occupation of the patients. These findings may suggest the likelihood that there is a pattern of oral manifestation of HIV infection.

AIDS-Related Opportunistic Infections↗

PubMed2004

Periodontal health of the elderly people in South East local government area in Ibadan, Nigeria.

Health problems involving physical and mental conditions directly or indirectly affect the oral health of the elderly. Other ways in which physical and mental health conditions influence their health result from the various drug prescriptions given for these ailments. Periodontal health is the most affected. Various studies have demonstrated that the elderly have the highest rate of gingival bleeding, calculus deposits and periodontal pocketing. It is the aim of this study to determine the health of the supporting tissues of the teeth using periodontal indices such as the C.PI.T.N and mobility index. The study was carried out on 690 elderly individuals (403 males and 287 females) who were 65 years and above living in various wards in the South East Local Government Area of Ibadan (S.E.L.G.A). A multistage sampling technique was used to select elderly individuals for the study. Two interviewers, 2 record clerks and 2 examiners were trained and the examiners were calibrated. The elderly individuals were interviewed and examined concurrently. The results highlighted the high prevalence of periodontal disease in the elderly in this local government area. Only 5.2% were free from periodontal disease. 94.8% had one or another stage of periodontal disease. It also demonstrated the poor oral cleanliness among these elderly. More than 42% had gross accumulation of calculus. Among the elderly in this local government area, 21.6% and 28.8% had shallow and deep pockets, respectively whilst 39.3% had one or more mobile teeth. Pockets and excessive mobility of the teeth represent advance stages of periodontitis. Majority (70.4%) of the elderly in the study claimed they use chewing sticks to maintain oral hygiene. The pattern of deposit of calculus along the interdental surfaces, mesio and distobuccal surfaces as well as lingual surfaces, question the effectiveness of the chewing stick in cleaning these surfaces. This study confirms findings of other authors, on oral hygiene in Nigeria. There is an urgent need to establish a community based outreach programme to prevent and treat periodontal disease among the elderly in this local government area.

Aged↗

PubMed2003

Inner city maxillofacial fractures due to road traffic accidents.

A prospective study of 159 patients seen with maxillofacial fractures as a result of road traffic accidents in a Nigerian inner city was performed. The male to female ratio was 2.9:1 and the dominant age group was 21-30 years. Occupants of commercial vehicles were the ones mostly involved; involvement of rear seat occupants was high. Increased numbers of patients were seen on Saturdays and in the month of June. This study substantiates the fact that there is added risk of sustaining facial fractures during the rainy and leisure periods. Therefore, there is a need to stress the importance of common restraint devices and good road habits during these 'high risk' periods to reduce the incidence of maxillofacial fractures due to the road traffic accidents.

Accidents, Traffic↗

PubMed2003

Incidence and pattern of maxillofacial fractures in the elderly.

The results of an audit analysing patients above 60 years and above treated for maxillofacial fractures over a 15-year period at the University College Hospital, lbadan are presented. Of the total number of 1689 patients of all ages treated for facial fractures, 53 (3.1%) were within the age range of the study. The male to female ratio was 1.1:1 and 41 (77.4%) patients were younger than 70 years. Road traffic accidents were the most common cause of facial fractures (58.5%) and the mandible was involved in 91% of cases. Complications were noted in 2 (3.8%) patients. Attention should be paid to update driving courses and home safety instructions in order to reduce the incidence of maxillofacial fractures in the elderly.

Accidental Falls↗

PubMed2003

Prevalence of hepatitis B virus surface antigen (HBsAg) in patients undergoing extraction at the University College Hospital, Ibadan.

Hepatitis B Virus (HBV) infection and its sequelae (liver chirrhosis and hepatic carcinoma) are endemic in Africa. The risk of transmission of the infection during dental treatment is real. This study was carried out to determine the rate of Hepatits B Surface Antigen (HBsAg) as a marker of hepatitis B virus infection in patients undergoing dental extraction in order to highlight the potential risk of nosocomial transmission among the Dental Health Workers (DHW) and their patients. Three hundred (143 males and 157 females) consecutive patients requiring dental extraction who volunteered were enrolled into this study. Their ages ranged from 11 years to 95 years with a mean of 37.2 years (SD = 16.725) and a median of 36 years. The overall HBsAg infection rate was 18.3% (55/300). A higher infection rate (23.1%) occurred among the male patients compared with 14% in females (p = 0.0086). The high rate of HBV infection found among this study population suggests that Dental Surgeons in this environment have a high risk of exposure to hepatitis B virus and should be immunized at the beginning of their professional life. Universal biosafety measures should be observed strictly in all invasive procedures.

Adolescent↗

PubMed2003

Human immuno-deficiency virus (HIV) infection among oral surgery patients at the University College Hospital, Ibadan, Nigeria.

The Human Immuno-deficiency Virus is a World-wide epidemic and evidence abound that the infection is spreading rapidly in sub-Saharan Africa with little or no control. Nosocomial transmission of HIV in the Dental Surgery has been documented. This study was undertaken to determine the prevalence of HIV among dental patients undergoing extraction at the University College Hospital, Ibadan. Three hundred patients requiring dental extraction at the dental clinic, UCH, Ibadan who consented were enrolled for the study. Blood samples from these individuals were tested for the presence of HIV antibodies using commercially available ELISA (Monolisa Sanofi, Pasteur, France). All initially reactive samples were confirmed by a commercial Western immunoblot assay (Bio-Rad Norapath HIV kit). A prevalence of 2.3% (7/300) was obtained among individuals tested for this study. Four (2.8%) of the 143 males and 3 (1.9%) of 157 females were positive for HIV antibodies. All the seropositive patients except one were within the age range 20-39 years and most of them (6 out of 7) do not use condom during intercourse. More than half (57%) of the patients had more than one sexual partner. This study shows that the risk of transmitting HIV to DHCW during treatment is also a potential hazard in this environment. Hence, adequate preventive measure should be observed always.

Adolescent↗

PubMed2003

A survey of the medical and dental consultants' management skills in University College Hospital, Ibadan, Nigeria.

Good management/administration is vital in the realisation of any business objective whether in a private or public establishment. The aims of this study were to assess the level of knowledge and ability on management/administrative skills by Medical/Dental consultants as perceived by themselves; to stimulate more interest in management/administrative skills acquisition, and to suggest possible ways in achieving such skills by doctors. A self-evaluation questionnaire was distributed to the doctors and 88 of them completed and returned their forms. They consisted of 55 (62.5%) males and 33 (37.5%) females cutting across all the specialities in medicine and dentistry in the University College Hospital, Ibadan, Nigeria. In all, 42 (47.7%) of the respondents reported that they had good ability of management/administration while 46 (52.3%) were below average. Of the 55 males, 28 (31.8%) had good ability while 27 (30.7%) were below average. Fourteen (15.9%) of the females had good ability while (21.6%) were below average. Good knowledge was assumed by 41 (46.6%) of the respondents while 47 (53.4%) were below average. Twenty-seven (30.7%) of the males showed good knowledge as against 14 (15.9%) of the females. Twenty-eight (31.8%) of the males were below average as against 19 (21.6%) of the female respondents. The sex differences were not statistically significant (P>0.05). The surgeons significantly (P<0.05) claimed better knowledge of management/administrative skills than physicians though their claim of ability to perform was higher too but significant (P>0.05). The percentage of the consultants with good knowledge and ability was found to increase with increasing age except for those under 40 years of age. The differences were not significant (P>0.05). A strong positive correlation (r=0.948; P<0.001) was found between ability and knowledge. Knowledge of the respondents was found to be good predictor of the ability using the regression equation: Ability = 11.151 + 0.835 (Knowledge). Suggestions on possible way forward were made. It was concluded that improving the knowledge of the doctors while in training on management/administrative skills will positively affect their performance abilities.

Adult↗

PubMed2003

Unusual presentation of NOMA: a case report.

A case of noma with involvement of other parts of the body from extension and spread of cancrum lesion in the oral cavity and primary herpetic stomatitis in a two-year-old male patient is reported. The possible routes of infection to other parts of the body are discussed. It is expected that this case report will stimulate the awareness of health practitioners to this unusual presentation of cancrum oris.

Child, Preschool↗

PubMed2002

Zygomatic complex fractures at the University College Hospital, Ibadan, Nigeria.

OBJECTIVE: To determine the pattern of zygomatic complex fractures in a Nigerian population. DESIGN: A prospective study of cases managed. SETTING: University College Hospital, Ibadan, Nigeria. SUBJECTS: Seventy six patients seen and managed between 1995 and 1999. RESULTS: The most common aetiological factor was road traffic accidents (81.6%). The male/ female ratio was 5.3:1. Most of the fractures occurred in the age group 21-30 years (51.3%). The most common fracture type was type 3 (32.5%) while open reduction and transosseous wiring was the most commonly performed surgical procedure for the management of zygomatic complex fractures in this study (46.25%). CONCLUSION: There is a need to pay attention to the improvement in automobile safety devices, compliance by motor vehicle occupants and improvement in rules and regulations guiding sporting activities.

Adolescent↗

PubMed2002

Concomitant injuries in 531 patients with maxillofacial fractures.

A ten-year review of five hundred and thirty one patients with facial fractures who sustained six hundred and forty eight associated injuries was presented. The male to female ratio was 2.7:1 and the highest incidence was in the 21-30 years age group. Road traffic accident was the commonest aetiology while the most frequently associated injury was soft tissue lacerations (71.0%). Neurological injuries constituted 9.9% of the total number of concomitant injuries. Other associated injuries seen were orthopaedic injuries 9.5%, ophthalmologic injuries 6.6%, chest injuries 1.9%, abdominal injuries 0.6% and urological injuries 0.5%. It is mandatory that the surgical team should be organised in the treatment of patients with concomitant injuries coexisting with maxillofacial fractures.

Accidental Falls↗

PubMed2001

Necrotizing fasciitis of odontogenic origin in Ibadan, Nigeria.

We reviewed eight patients with necrotizing fasciitis of odontogenic origin. There were three women and five men, mean age 58 (range 46-72), and none had any associated medical condition such as diabetes. All cases had symptoms of toothache for a mean duration of 34 days (range 26-42) before they sought treatment. Infection originated in the molar teeth region, and initially presented as an odontogenic or periodontal abscess. The clinical features of necrotizing fasciitis became apparent only after the superficial fascia had been invaded. The transient unusually reddish hue for a dark skin might be explained by the fact the deep fascia and muscles were affected before the superficial fascia and skin. Necrosis of the skin began in the submandibular region and progressed downwards. The necrotic area was less than the extent of infection. Antimicrobial treatment, debridement, and fasciotomy improved healing. Delay before appropriate treatment had an adverse affect on outcome, and one patient died.

Aged↗

PubMed2001

Fractures of the mandible in children.

OBJECTIVE: To determine the pattern of occurrence of mandibular fractures in a paediatric population. DESIGN: A retrospective study. SETTING: University College Hospital, Ibadan, Nigeria. SUBJECTS: Seventy two paediatric patients seen and managed between 1989 and 1998. RESULTS: Road traffic accidents were the most common (52.8%) cause of mandibular fractures. The majority of the patients (57.0%) were within the age group (12-16 years). The body of the mandible was involved in 43.4% of the fractures. Eyelet wires with intermaxillary fixation was used in 41.7% of the cases. CONCLUSION: There is a need to enforce legislation aimed at preventing road traffic accidents to reduce maxillofacial injuries among children.

Accidents, Traffic↗

PubMed2001

Third molar impaction: evaluation of the symptoms and pattern of impaction of mandibular third molar teeth in Nigerians.

Three hundred and thirty eight patients between the ages of 16 and 54 years (mean 24.4, standard deviation 6.1 years) were seen. They presented with 473 impacted mandibular third molars. A total of 341 (72.09%) impaction were seen in patients between the ages of 16 to 25 years, while 420 (88.8%) impaction were seen between the ages of 16 to 30 years. Assessing the level of impaction using Pell and Gregory classification showed that 358 (54.55%) impaction were in position A, 151 (31.92%) were in position B while 64 (13.53%) were in position C. One hundred and seven (22.62%) were in position I, 288 (60.89%) were in position II, while 78 (16.49%) were in position III. Of the 473 impacted mandibular third molars, 323 (68.29%) had symptoms of pain. Two hundred and seventy two (57.51%) impacted teeth were associated with pathology. Out of these, 203 (42.92%) were pericoronitis and periodontal disease, 66 (13.95%) were caries, while 3 (0.63%) were associated with cysts. In conclusion, the level of impaction suggests that a remarkable number of impacted mandibular third molars should be removed under general anesthesia. There is need for further studies to determine the levels of impaction, the types of anesthesia used during extraction and the outcome.

Adolescent↗

PubMed2001

Evaluation of precautions adopted by dental surgeon using local anaesthesia.

There were 62 surgeons consisting of 38 (61.3%) males and 24 (38.7%) were females. Thirty-one (50%) were from private and state government owned clinics while the rest were from teaching hospitals. Thirty-three (53.2%) were dental house surgeons, senior dental house surgeons and dental officers, while 29 (46.8%) were within the rank of registrar and senior dental officer, senior registrar, principal dental officer and consultant. Six (9.7%) use aspirating syringe all the time. 11 (17.7%) use aspirating syringe occasionally and 45 (72.6%) use non aspirating syringe. All the surgeons wear facemasks and latex gloves. On the replacement of the needle guard after injection, 58 (93.5%) indicated that the needle is first inserted into the needle guard and then secure 4 while 4 (6.5%) pick-up the guard with their fingers, place it over the needle and secure the guard. Eight (12.9%) indicated that the maximum dose of 2% lignocaine with adrenaline 1:80,000 is 7 mg/kg body weight or less, 5 (8.1%) indicated 10 mg/kg body weight, while 49 (79.0%) did not complete this section. On the maximum number of 1.8 ml cartridges, all the surgeons indicated that the maximum is 12 or fewer cartridges. This study revealed that the risk of intravascular injection is high. Although of the most dental surgeons take necessary precautions to avoid complications arising from the use of local anaesthetics, there is a need for total compliance in view of fatal complications that may ensue. It also underscores the need for continuous dental education program to update practitioners.

Anesthesia, Dental↗

PubMed2001

Impacted mandibular third molars: depth of impaction and surgical methods of extraction among Nigerians.

This study was conducted in three centres. 717 impacted mandibular third molars were extracted from 517 patients. 69.1% of the extractions were in patients aged 25 years and below. A total of 96.1% extractions were done under local anaesthesia while 3.9% were under general anaesthesia. The lingual bone split technique was used in 2.5% extractions while the bur was used in 97.5% extraction. The patient's preference, the number of teeth to be extracted, and the depth of impaction were the main predicators in the choice of anaesthesia. Majority of third molars with a depth of 5 mm or more were extracted under local anaesthesia. Paraesthesia of the inferior dental nerve and alveolar osteitis were more frequent when extractions were done using the bur technique under local anaesthesia, while paraesthesia of the lingual nerve was more when extractions were performed using the lingual bone split technique under general anaesthesia.

Adolescent↗

PubMed2001

An audit of midfacial fractures in Ibadan, Nigeria.

A prospective study of 103 patients with middle third fractures of the facial skeleton seen and managed over a five-year period was done. Males were more involved in midfacial fractures than females (M : F of 7.6 : 1). Most of the fractures occurred in the 21-30 year age group. Road traffic accidents were responsible for the majority of the fractures (78.7%). The zygomatic complex/arch was the most frequently involved area (63.0%) while the most common treatment was open reduction of zygomatic complex/arch fractures with trans-osseous wiring of suture lines (29.13%).

Adolescent↗

PubMed2000

Attitude to facial marks in South Western Nigeria.

A survey was conducted in three communities. A total of 1800 respondents of equal sexes were randomly selected, and their attitudes to facial marks were analysed. Of this number, 31.39% dislike facial marks and were unhappy or embarrassed by the scar, 36.56% were happy with the marks, while 32.06% were indifferent. The study revealed that those who were unhappy and embarrassed were predominantly within the age groups of 10-29 years representing 66.52% within the age groups. Those aged 40-49 years were largely indifferent (52.23%), while most of those aged 50 years and above were happy with facial marks (81.29%). Of the 565 respondents that would like to remove facial marks, 54.16% were males while 45.84% were females. Among the 577 that were indifferent to facial marks, 47.31% were males while 52.69% were females. The relationship between the age groups and response on facial marks was significant (p < 0.01), while the relationship between gender and response on facial marks, was not. This study suggests that facial marking is becoming less fashionable, and that there is a relatively high level of ignorance about the treatment for the removal of facial marks.

Adolescent↗