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Biomedical subjects

A O Fasola

Publications and source records attributed to A O Fasola.

At least 19 recordsLinked to original sources

Intra-oral squamous cell carcinoma in Nigerians under 40 years of age: a clinicopathological review of eight cases.

Intra-oral squamous cell carcinoma (SCC) is a disease commonly seen in patients aged 50 and above. A recent report on intra-oral SCC in the Nigerian population placed the mean age of occurrence for the disease at 50.7 years for male and 49.6 years for females. Age is recognized to be an important factor in the onset and outcome of diseases like cancer. The focus of this study was to conduct a clinicopathological review on the incidence, pattern of presentation, management and outcome of the disease in patients aged 40 years and below seen at the University College Hospital Ibadan, between 1980-1995. During the period under review the total number of cases of SCC was 104, out of which 8 (7.7%) occurred in patients aged 40 years and below. The figure is higher than that of 1-3% obtained in Caucasian studies. The 5 year survival rate of our patients was nil.

Age Factors↗

Oro-facial soft tissue injuries in Nigerian children: a five-year review.

A review of 64 soft tissue maxillofacial injuries in 50 children seen and managed at the University College Hospital, Ibadan over a five-year period was made. The age range was from 3months to 15years. The highest occurrence was in the 0-5 years old children (60%). The predominant type of soft tissue injuries was lacerations (75.0%). Falls (66.0%) were the most common aetiology followed by road traffic accidents (18.0%). There was a higher involvement of males, than females (M: F of 2.3:1). The tongue (31.3%) was the most commonly affected site of soft injury followed by the lips (29.7%) and cheeks (10.9%). Slightly less than half (46%) of the patients presented within 24 hours of injury. Direct suturing was done in 24% of the children while debridement and conservative management was carried out in 76%.

Accidental Falls↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

Dentofacial findings in Down's syndrome: report of case.

Provision of dental services to the mentally subnormal in our society is relatively neglected. A patient with Down's syndrome who sought dental treatment is reported. Following the assessment of the patient, he needed orthodontic-surgical treatment and scaling and polishing. The former was not given due to the cost, complications and stress of such an involving procedure vis-a-vis the benefit to such a patient. However, patient received thorough scaling and polishing with emphasis on routine 6-monthly dental check-ups given. Handicapped individuals are beginning to seek dental services and the percentage of them doing so is likely to increase as more of such individuals are now staying in the normal home setting. Early preventive treatments for such patients are encouraged. Therefore, the dentists and the rest of the therapy team should be sensitized to face the challenge of providing services to them.

Adult↗

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↗

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↗

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↗

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↗

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↗

Cancrum oris (noma): Level of education and occupation of parents of affected children in Nigeria.

A total of 173 cancrum oris patients who were brought by their parents to the University College Hospital, Ibadan, Nigeria, were analyzed. Ninety-one (52.6%) were males and 82 (47.4%) females. Their ages ranged from 1.5 to 11 years with a mean of 4.36 (standard deviation 2.13) years. One hundred and twenty-one (69.9%) and 52 (30.1%) were from monogamous and polygamous family respectively. The average number of children per family was 7.0. The number of parents with no formal education was 148 (85.5%) and 98.3% were low-income earners. The relationships between occupation, income and educational status were highly significant. This study suggests that apart from poverty, large family units and low educational status of parents are contributing factors in the aetiology of cancrum oris.

Chi-Square Distribution↗

Soft tissue injuries of the face: a 10 year review.

A review of 1,173 soft tissue injuries seen and managed at the University College Hospital, Ibadan over a 10 year period was made. The age range was from 4 months to 85 years with a dominant age group range of 21-30 years. The commonest type of soft tissue injury was laceration while the commonest aetiology was road traffic accidents followed by falls. Males were generally more involved than females and the commonest complication was wound dehiscence.

Adolescent↗