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Biomedical subjects

J T Arotiba

Publications and source records attributed to J T Arotiba.

At least 19 recordsLinked to original sources

Interspecialty referrals: evaluation of quality and pattern of referral letters to an oral and maxillofacial surgery clinic.

Referral letters are the most desirable means of communication between medical practitioners in patients' management, however many studies have indicated that this form of communication is often lacking in essential information necessary for prompt treatment. This study sets out primarily to evaluate the quality and secondarily pattern of referrals from other specialties within the University College Hospital, Ibadan, Nigeria, to the department of Oral and Maxillofacial surgery of the same institution. The information sought for in each letter were patient's name, age, sex: is the letter dated or not, referring department, history ofcomplaint, management already instituted, reason for the referral, name and the signature of the referring doctor. Each of these ten items was scored I when present and 0 when absent. Thus, a maximum score of 10 was recorded when all items were present. Referrals were graded into grade A-D. A being referrals with the maximum score of 10, B: scores of 7-9, C: scores of 4-6, D: scores of 0-3. There were only 9 grade A letters accounting for 3% of the total. Majority of the letters, 201 (77%) were of grade B while the remaining 52 (20%) were of grade C. The accident and emergency unit provided most of the letters i.e. 176 accounting for 67.7%. Plastic surgery and Accident/ Emergency units individually produced 3 out of the 9 grade A letters, however, no statistically significant association was found between specialty units and grades of letters.

Correspondence as Topic↗

An audit of medical record-keeping in maxillofacial surgery at the University College Hospital, Ibadan using the CRABEL Scoring system.

Standard medical note keeping is an important aspect of patient management, and the importance of completeness of patients' records cannot be overemphasized, especially for the purpose of auditing, research, and medico-legal reasons. It is also an integral part of a good medical practice. However gross inadequacies are often noted. This may be partly due to the fact that until the recent past, cases of medical and professional negligence were uncommon in our environment. This audit exercise was embarked upon to assess the standard in the department using the CRABLE Scoring system with a view to standardizing and improving our practice. The result showed that the subsequent entry part of the medical notes assessed was marginally the best with a score of 66.5%, followed by initial entry which scored 65.3%, while consent had a score of 57.8%. The worst aspect of the notes was the discharge summary with a mean score of 29%. A total mean score of 61.6% was achieved. Despite the limitations of the CRABEL Score such as the subjectivity of the assessment of the legibility of entries under subsequent entries, and perhaps the need to adapt it to our local and peculiar environment. it is useful as a regular auditing mechanism to improve medical keeping.

Hospitals, University↗

Spectrum of oral and maxillofacial surgical procedures in Kano, Nigeria.

The goal of the maxillofacial surgeon is to correct facial deformity while eradicating surgical diseases, prevent recurrence or complication and restore function. The aim of this paper is to review the surgical procedures carried out in a new tertiary teaching hospital. A retrospective study of patients with maxillofacial surgical diseases seen at the Department of Dental and Maxillofacial Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria, between 2001 and 2003, was conducted. A total of 87 patients had various (primary and secondary) surgical procedures during the period under review. There were 51 males and 36 females, a male to female ratio of 1:0.61 with an age range of 3 days to 90 years and a mean age of 34.5 years. The majority of the patients were in the lower socio-economic group. Reduction and immobilization of the jaw fractures (n = 21, 23.3%) was the most common, followed by transosseous wiring (n = 12, 13.3%). The most common complications were malocclusion (n = 14, 29.8%) and facial defects (n = 12, 25.5%). Reduction and immobilization, and tumour surgery of the jaws seem to be the most common surgical procedures while osteotomy was the least. Reduction and immobilization with simple arch bars appeared to be very effective, more so when the patients could not afford more modern methods of treatment. Reconstructive surgeries of ablated jaws are advocated in view of the devastating aesthetic and psychosocial effects that these have on the patients.

Adolescent↗

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↗

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↗

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↗

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↗

Electrical (faradic) stimulation versus active mobilization exercise in the physical management of post-surgical temporomandibular joint hypomobility.

This clinical study compared the efficacy of faradic stimulation and active mobilization exercises in the physical management of patients with post-surgical immobilization of the temporomandibular joint (TMJ) resulting in hypomobility of the joint. Eight volunteer dental patients with post-surgical immobilization TMJ hypomobility at the University College Hospital (U.C.H.), Ibadan, Nigeria participated in the study. Duration of TMJ immobilization was between 6 and 10 weeks (mean 7.13 +/- 1.55). Patients were alternately assigned to two groups as they became available. Patients in group A received mild infra-red radiation to the TMJ region and faradic stimulation to the muscles that move the joint while patients in group B had mild infra-red radiation and TMJ mobilization exercises. Treatment continued until pain relief and full range of the TMJ were attained. However after three treatment sessions, attendance became irregular because the patients were satisfied with their recovery. Pain perception was measured using the visual analogue scale. Interincisal opening was measured using a pair of mathematical set divider and a measuring ruler. The results showed that both faradic stimulation and exercises significantly improved the interincisal opening and pain perception although electrical stimulation improved mouth opening more significantly than active exercise.

Adolescent↗

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↗

Coexisting congenital sublingual dermoid and bronchogenic cyst.

A congenital dermoid together with a bronchogenic cyst at the base of the tongue is extremely rare. We describe a 5-year-old boy who presented with an enlarged anterior segment of mandible, slight swelling of the left submandibular region, and a large swelling of the floor of the mouth that was displacing the tongue posteriorly. Both cysts were successfully excised and the boy made an uncomplicated recovery. Occlusion and mastication returned to normal and his speech improved remarkably.

Bronchogenic Cyst↗