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Background: Commercial motor vehicle drivers (CMVDs) have worst health profiles among different occupations, yet the presence of clusters of cardiovascular disease (CVD) risk factors in this group have not been described in a resource-limited setting.Objectives: The prevalence of CVD risk factors and the clusters among CMVDs was evaluated.Design: A cross-sectional descriptive study.Setting: Four motor parks in three local government areas of Ibadan city, Nigeria.Participants: Consented and conveniently sampled 152 intra-city CMVDs aged ≥ 18 years. Main outcome measures: Prevalence of CVD risk factors (hypertension, diabetes, high triglyceride, low HDLc, high waist-hip ratio, central obesity, physical inactivity, smoking, alcohol, and overweight/obesity) and their clusters were determined.Results: All participants were male from 20 – 77 years old. Most of the CMVDs were physically inactive (80, 52.6%), take alcohol (78, 51.3%), and few smokes (35, 12.4%). The prevalence of hypertension, diabetes, hypertriglyceridemia,obesity, and central obesity were 36.2%, 5.9%, 23.7%, 4.6%, and 5.3%, respectively. Four clusters of CVD risk factors in the CMVDs with the prevalence of 36.2%. 33.5%, 17.1% and 13.2% were identified with significant differences (p

Objective: This study assessed the coping strategies of Nigerian medical students during the COVID-19 pandemic.Design: We conducted an online descriptive cross-sectional study among medical and dental students attending three of the largest Colleges of Medicine in the Southwestern zone of Nigeria.Settings: Our study involved students across the pre-clinical and clinical levels of the three Colleges of Medicine.Participants: We selected the respondents through a purposive sampling technique and disseminated questionnaires applied using an online survey platform (Google forms https://forms.gle/19yfEzehJKwsme759). A total of 1010 par-ticipants out of 2404 eligible students completed the questionnaires accurately, giving a response rate of 42%.Methods: The Brief-COPE questionnaire assessed the participants' coping strategies (approach and avoidant) during the COVID-19 pandemic. We conducted a bivariate analysis using the chi-square test and multiple regression analysis (p< 0.05) to determine the predictors of avoidant coping strategies.Results: Respondents mean age was 21.8±2.9 years, results were presented as Odds Ratios(OR) at 95% confidence intervals(CI). About 95% of respondents employed an approach coping strategy, while the minority(5%) adopted an avoidant coping strategy. Females were three times more likely to employ an avoidant coping strategy (OR=3.32 (95% CI 1.67-6.21) compared to male students.Conclusion: This study reveals that the majority of the respondents employed an approach coping strategy towards the COVID-19 pandemic. Females were more likely to employ an avoidant coping strategy. We recommend gender-specific programs to help medical students cope with the COVID-19 pandemic.

Risk behaviours including marijuana use, alcohol consumption and cigarette smoking have a significant impact on the present and future health of adolescents. There are limited studies in sub-Saharan Africa to show evidence, if it exists, of the relationship between parental monitoring practices and the prevalence of substance use among adolescents. The aim of this study is to assess the relationship between parental monitoring practices and alcohol consumption, cigarette smoking and marijuana use among in-school adolescents in Mushin Local Government Area of Lagos State, South-Western Nigeria.This was a cross-sectional survey of 437 in-school adolescents randomly selected from two schools in Mushin Local Government Area of Lagos State, Nigeria. Information on socio-demographic characteristics, the three domains of parental monitoring practices (Parental monitoring; negotiated unsupervised time and parental trust) and substance use were elicited using a modified version of parental monitoring practice scale and the Youth Risk Behaviour Surveillance System (YRBSS) questionnaire. Independent T tests and logistic regression models were used to assess relationship between parental monitoring practices and substance use.The overall prevalence of use of any of the substance was 21.7%. Negotiated unsupervised time was significantly associated with use of alcohol (P0.05), marijuana (P0.05) and cigarette smoking (P0.05). After controlling for age and gender, one unit increase in parental monitoring reduced the odds of engaging in any substance use by 10% (AOR = 0.90, 95% CI = 0.81-0.99) while a similar increase in negotiated unsupervised time significantly increases the odds of any substance use by 7% (AOR = 1.07, 95% CI = 1.01-1.14).Of the three domains assessed, negotiated unsupervised time was consistently associated with substance use among these youth. Efforts to educate parents on the need to restrict unsupervised time of their wards may be warranted.

Objectives: The aim of this study is to describe the experience and outcome of higher order multiple (HOM) births in a private tertiary health facility in Nigeria.Materials and Methods: This was a retrospective review of records of HOM over 3 years in a private tertiary health facility in Nigeria. Relevant data on HOM births were extracted from both the patients’ case notes, admission registers and maternity ward and delivery records of the hospital using a predesigned pro forma. Data were analyzed using Statistical Package for Social Sciences Version 22.0.Results: The prevalence of HOM births was 0.72% of 1950 births over the 3 years study period; while for triplets, quadruplets, and quintuplets were 0.56%, 0.1% and 0.05%, respectively. The mean gestational age was 32 ± 3 weeks, and all except three sets of triplets were by Assisted Reproductive Technology (ART). Respiratory distress syndrome, neonatal jaundice, and neonatal sepsis accounted for more than 80% of the neonatal complications noted in HOM births. However, there was no significant difference between neonatal survival of HOM as compared to twin deliveries, P = 0.08.Conclusion: HOM is becoming increasingly common in Nigeria. The strongest risk factor is ART, and neonatal complications are common reinforcing the need to streamline ART protocols in Nigeria.Keywords: Higher order multiple births, neonatal outcome, Nigeria, private health facility

Tobacco use among youth is a major public health problem. Youth outside of formal school settings are often understudied but may be at increased risk.A descriptive cross- sectional study was carried out among 326 young people aged 15-24 years in four randomly selected motor parks in Lagos state. Interviewer-administered questionnaires were used to collect data.The mean age of the respondents was 21.0±2.3yrs. Many 252 (77.3%) dropped out before the end of the third year of secondary schooling. The majority were aware that active (78.2%), and passive smoking (77.3%) are harmful to health. Nearly two-thirds of the respondents disagreed with an outright ban of cigarettes (63.2%) and restriction of cigarette sales to persons below 18 years (67.9%) while 254 (66.8%) supported a ban on tobacco smoking in enclosed public places. One hundred and fifty (46.0%) respondents had experimented with smoking of which 106 (32.5%) had progressed to become current smokers. Half of the current smokers, 54 (50.9%), felt the need for a cigarette first thing in the morning. A multivariate analysis for smoking initiation, showed that for every increasing year of age, respondents were 1.08 times more likely to have initiated cigarette smoking; males and respondents who lived alone or with peers were 2.34 times and 1.77 times more likely to have initiated smoking respectively; those who consume alcohol and marijuana were 7.27 and 1.89 times respectively more likely to have initiated smoking while those who consumed alcohol were 6.17 times more likely to be current smokers.

Epidemiological evidences indicate close association between inorganic arsenic exposure via drinking water and cardiovascular diseases. While the exact mechanism of this arsenic-mediated increase in cardiovascular risk factors remains enigmatic, epidemiological studies indicate a role for paraoxonase 1 (PON1) in cardiovascular diseases. To investigate the association between inorganic arsenic exposure and cardiovascular diseases, rats were exposed to sodium arsenite (trivalent; 50, 100, and 150 ppm As) and sodium arsenate (pentavalent; 100, 150, and 200 ppm As) in their drinking water for 12 weeks. PON1 activity towards paraoxon (PONase) and phenylacetate (AREase) in plasma, lipoproteins, hepatic, and brain microsomal fractions were determined. Inhibition of PONase and AREase in plasma and HDL characterized the effects of the two arsenicals. While the trivalent arsenite inhibited PONase by 33% (plasma) and 46% (HDL), respectively, the pentavalent arsenate inhibited the enzyme by 41 and 34%, respectively. AREase activity was inhibited by 52 and 48% by arsenite, whereas the inhibition amounted to 72 and 67%, respectively by arsenate. The pattern of inhibition in plasma and HDL indicates that arsenite induced a dose-dependent inhibition of PONase whereas arsenate induced a dose-dependent inhibition of AREase. In the VLDL + LDL, arsenate inhibited PONase and AREase while arsenite inhibited PONase. In the hepatic and brain microsomal fractions, only the PONase enzyme was inhibited by the two arsenicals. The inhibition was more pronounced in the hepatic microsomes where a 70% inhibition was observed at the highest dose of pentavalent arsenic. Microsomal cholesterol was increased by the two arsenicals resulting in increased cholesterol/phospholipid ratios. Our findings indicate that decreased PON1 activity observed in arsenic exposure may be an incipient biochemical event in the cardiovascular effects of arsenic. Modulation of PON1 activity by arsenic may also be mediated through changes in membrane fluidity brought about by changes in the concentration of cholesterol in the microsomes.

To determine the perception of pain and discomfort associated with orthodontic separator placement in patients attending the Lagos University Teaching Hospital, Lagos, Nigeria.Sixty four patients scheduled for treatment with fixed orthodontic appliances completed questionnaires before insertion of separators and after placement at 4 hours, 24 hours and 7 days. The level of pain and discomfort during these time periods was assessed by a visual analogue scale.There was a significant increase in the level of pain/discomfort 4 hours and 24 hours after placement of the separators for all the activities. The level of pain/discomfort peaked at 4 hours but did not return to baseline levels after 7 days. Patients more than 16 years old reported significantly more pain/discomfort over time than those 16 years and under. No significant difference in pain/discomfort was found between the sexes.Patients experience pain/discomfort following placement of orthodontic separators. Pretreatment counselling and analgesics are recommended.

Odontogenic myxoma (OM) is a locally aggressive neoplasm whose clinicopathological characteristics have not been extensively reported in Nigerians.To describe the clinicopathological characteristics of cases of OM seen at the Lagos University Teaching Hospital in Nigeria.A review of both clinical and histopathological records of sixty-three cases of OM diagnosed over a period of thirty-seven years was undertaken. The cases were analyzed for age, sex, site, size, duration and histological contents of collagenization, odontogenic epithelium and calcification.Odontogenic myxoma represented 63(11.2%) cases of odontogenic tumours, was commonest in the second to forth decades and rare below age 10 and above 70 years. It was more common in females. Maxillary lesions were more common with respect to both central and peripheral histologic types, but occurred in equal frequencies in mandible and maxilla with respect to the central histologic type. Forty-seven (74.6%) cases were fibromyxoma and sixteen (25.4%) myxoma. Odontogenic epithelium was rare and observed in 5 (9.5%) cases while calcific material was present in sixteen (25.4%) cases. Late presentation was a common feature and surgical excision was the treatment of choice.Odontogenic myxoma is un-common among Nigerians when compared with ameloblastoma. Clinicopathological characteristics in this series are similar to information in the scientific literature.

This article reports 3 cases of melanin pigmented lesions among 75 histologically diagnosed periradicular lesions of extracted teeth. Case 1 was a 25-year old male who presented with one week history of toothache involving a tender carious left mandibular second molar tooth (37), with periapical radiolucency and diagnosed clinically as acute apical periodontitis. The lesion was diagnosed histologically (using Haematoxylin and Eosin) as periapical granuloma, while histochemical examination (using Masson-Fontana technique) showed the presence of round/oval shaped melanin pigmented macrophages (melanophage) in the lesion. Case 2 was a 54-year old male with one week history of toothache associated with tender carious right maxillary first molar tooth (16) with periapical radiolucency. A clinical diagnosis of acute apical periodontitis was made, but histological and histochemical examination showed a melanin pigmented periapical granuloma with spindle shaped melanophage. Case 3 was a 28-year old female who presented with 4 days history of toothache, involving the tender left mandibular first molar tooth (36). The lesion had periapical radiolucency and a clinical diagnosis of acute apical periodontitis. On examination histologically and histochemically, the lesion was diagnosed as an intraosseous melanocytic naevi with dark-brown nests of round naevus cells. In conclusion, this article shows the rarity of melanin pigmented periradicular lesions in the jaws. The cases reported suggest that the trigger for formation of melanin-pigmented cells in the periradicular lesions may be related to the acute phase of the lesions. Further study is recommended to determine if the remnants of the migratory neural crest cells are the precursors of melanin-pigmented cells in the periradicular region.

OBJECTIVE: We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. METHODS: One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36 degrees C-37 degrees C) or hypothermia (32.5 degrees C-33.5 degrees C). Fever (> or =38.5 degrees C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). RESULTS: Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever-related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. CONCLUSION: These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

Clinicopathological analysis and growth rate study of 100 cases of ameloblastoma was undertaken. The tumour had site predilection for the mandible (91.0%) and occurred more in males than in females (ratio 1:0.9). 62.0% of patients in the series were less than 20 years of age. The estimated monthly growth rate (EMGR) of ameloblastoma was observed to be slower in males although the mean tumour volume recorded in females was lower than males in the series. The biologic aggression of 4 various types of ameloblastoma was predicted using EMGR and average volume of tumour at hospital presentation as predictive markers. Solid multicystic ameloblastoma was observed with the fastest EMGR of 0.81 cm(3)/month. Peripheral ameloblastoma was observed with the slowest EMGR of 0.17 cm(3)/ month. It was concluded that all the 4 types of ameloblastoma observed were clinically distinct and showed varying biologic aggression. The solid multicystic type with the highest growth rate (0.81 cm(3)/month) was considered the most aggressive while the peripheral type (growth rate = 0.17 cm(3)/month) was the least aggressive. It is therefore necessary to distinguish between the various clinical types of ameloblastoma before a clinician proceeds with definitive treatment.

One hundred and twenty-six Nigerian cases of epithelial jaw cysts were retrieved from case notes and biopsy records of the Department of Oral and Maxillofacial Surgery and Department of Oral Pathology and Oral Biology of the Lagos University Teaching Hospital. The cases were analysed for age, sex, site and methods of management. Results show that developmental odontogenic cysts (57.14%) were more common than inflammatory odontogenic cysts (26.94%). Dentigerous cyst (22.22%) was the most common epithelial jaw cyst, followed by radicular cyst (21.43%). Developmental non-odontogenic cysts were more than twice as common in females as in males. Sixty-eight per cent of epithelial jaw cysts were treated by enucleation, 10% by marsupialisation, 13% by jaw resection and 9% by surgical excision.

Two cases of orofacial granulomatosis are reported. One case is that of a 24-year-old Nigerian female, who presented with a complete form of Melkersson-Rosenthal syndrome. The second case is that of a 32-year-old Nigerian male who presented with a form of orofacial granulomatosis which is consistent with Miescher's cheilitis granulomatosa, and who also gave a history of intolerance to some food items. The relevant literature is reviewed.

A panoramic radiographic study was carried out on 404 dentate Saudi Arabians, to locate positions of the mental foramen. Results show that 83.7% of the mental foramen locations occurred in the interdental space between the mandibular premolars and apical to the mandibular second premolar. 9.35% occurred posterior to the mandibular second premolar, and 6.95% occurred apical/anterior to the mandibular first premolar. In female Saudis, the most common location of the mental foramen was apical to the mandibular second premolar (45.9%), while the most common location in male Saudis was the interdental space between the mandibular premolars (45.5%). Asymmetry of the mental foramen location, which was observed in 15.6% of the cases, was observed more often in males (17.9%) than in females (12.3%).

A clinicopathological analysis of 45 cases of pleomorphic adenoma of minor and major salivary glands was undertaken. The tumour presented in the age range from 11 to 75 years (mean 31 years), and was slightly more prevalent in males than females in a ratio of 8:7. Nearly seventy percent (68.9 pc) of the cases presented in the minor salivary glands and 31.1 pc in the major salivary glands. Histological examination revealed that chondroid tissue was less observed in tumours of minor salivary glands than those of major salivary glands. Tumours with epithelial tissue predominance (ETP) were generally bigger than those with mesenchymal tissue predominance (MTP). Majority of the tumours showed histologically, mesenchymal tissue predominance.

An exfoliative cytologic study of the palatal mucosa was undertaken in 96 Nigerian male volunteers aged between 17 and 65 years. The volunteers were categorised into the following four groups: Group 1--Smokers, kolanut chewers; Group 2--Smokers; Group 3--Kolanut chewers; and Group 4--Non-smokers, non-kolanut chewers, Variation in the degree of palatal keratinization was evaluated using karyopyknotic indices. Statistical analysis based on one way analysis of variance showed that smoking and kolanut chewing had a statistically significant influence (P less than 0.05) on the variation of palatal keratinization among the volunteers. Distribution of karyopyknotic indices among groups was such that Group 1 greater than Group 2 greater than Group 3 greater than Group 4. Observation from this study suggests a potentiation of the cigarette smoking-induced palatal keratinization by kolanut.

A total of 106 patients with squamous cell carcinoma of the oral cavity and maxillary sinus in Nigerians were studied and analysed clinicopathologically for sex, age, site distribution as well as histological differentiation. The lesion was commoner in males than females (ratio 1.3 to 1.0) and was recorded in the age range 14 to 80 years. The mean age at presentation was 49 +/- 15.2 years, median age 49.5 years and a mode value at 51-60 years. The mandibular gingiva was the commonest anatomical site for the lesion, accounting for 28.6% of the total. Almost half of the cases (47.2%) presented histologically as well differentiated squamous cell carcinoma. Poorly differentiated squamous cell carcinoma was seen at a lower mean age 43 +/- 16 years when compared to other histological types.

This paper presents a review of Burkitt's lymphoma of the jaws seen at the Lagos University Teaching Hospital. The debate on certain aspects of the disease, particularly the pathogenesis, has also been reviewed, while the experience gained in the management has been included.

A case of odontogenic carcinoma of the mandible is reported. Clinical and microscopic evaluations of the case are suggestive of a specific diagnosis of ameloblastic carcinoma. The case occurs at a lower age than previously reported for ameloblastic carcinoma. There has been no recurrence three years following treatment with a combination of surgery and radiotherapy.