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Inadequate consumption of fruit and vegetable is a risk factor for morbidity and mortality associated with non-communicable diseases (NCDs). An understanding of the barriers and facilitators to consumption is important for effectiveness of intervention in Africa. We present insights among church members before developing a church-based multi-component intervention to address the inadequate consumption of fruit and vegetable.We conducted eighteen focus group discussions among 163 church members. All discussions were audio-taped, transcribed verbatim, and were analyzed for thematic content.We identified five main themes; Personal: awareness and knowledge of benefits, choice, habits, and curiosity, dietary restrictions and gastrointestinal symptoms following fruit and vegetable consumption. Familial: practices promoting the ready availability of fruit and vegetables in the home or habits that encourage children to eat vegetables as they transition into adulthood, pre-existing health problems of family members and the long preparation time of some traditional vegetables. Socio-cultural: Cultural practices that encourage FV consumption, the high cost of fruits and vegetables, alternatives foregone, and cultural taboos. Environmental: inadequate farmland and storage facilities, seasonality of several fruit and vegetables, and sharp practices of force-ripening with chemicals. Church-related: inadequate space provided by the church for arable cultivation and lack of knowledge of the benefits among church leaders, church activities that involve serving fruits and vegetables and the biblical support for the consumption of fruits and vegetables.It is essential to leverage practices that promote fruit and vegetable intake and address barriers mentioned by the participants when designing such interventions.

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.

Introduction: Limited research exists describing young people's knowledge and risk perception of e-cigarettes and hookah in Nigeria. This qualitative study explored the knowledge and risk perception of e-cigarettes and hookah amongst young people in Lagos, Nigeria. Methods: Participants (n = 20), aged 15–24 years who had used e-cigarettes or hookah at least once in the past 12 months, participated in three focus group (FG) discussions in January 2020. Each FG session consisted of 6–7 participants, was facilitated by a trained moderator and lasted approximately 60 min. Sessions were recorded, and notes were taken after informed consent. Recordings were transcribed verbatim and analysed using NVIVO 10 software. Results: An essential element of our findings was that the majority of the participants seemed to be more aware of hookah and used hookah compared to e-cigarettes. The participants mentioned they used these tobacco products mainly to reduce stress, for pleasure and for social acceptance. Most of the study participants reported that they were aware of some adverse health effects associated with e-cigarette or hookah use. Although some participants felt that the use of e-cigarettes or hookah could transform to cigarette smoking, many felt that e-cigarette was a harm reduction tool. Conclusion: Young users of e-cigarettes and hookah continue to use these products though they are aware of some associated adverse health effects. These products are used primarily for relieving stress and for social reasons. Raising awareness of the risks associated with the use of these tobacco products may help to reduce the acceptability of these products amongst youths.

Background:The Nigerian Report card on Physical Activity (PA) in Children and Youth was first developed in 2013 to inform practice and policy on healthy living and prevention of noncommunicable diseases among Nigerian children and youth. This article summarizes the results of the 2016 report card and provides updated evidence on the current situation in Nigeria.Methods:A comprehensive review of literature was undertaken by the Report Card Working Group. Grades were assigned to 10 PA indicators based on the criteria used for the 2013 edition.Results:Grades assigned to the indicators were Overall PA, D; Active Play and Leisure, C; Active Transportation, B; Sedentary Behaviors (screen-based, F and nonscreen-based, D); Overweight and Obesity, A; PA in Schools, C-; Government/Nongovernment Organizations/Private Sector/Policy, B. The following indicators were graded as Incomplete: Organized Sport and PA, Community and Built Environment, and Family and Peers.Conclusions:The overall PA levels of Nigerian children and youth seemed to be declining compared with the 2013 Report card but with slight improvement in active play and leisure, and PA in school settings. A substantial number of Nigerian children and youth still have high sedentary behaviors, overweight and obesity. Efforts are needed to promote PA among them.

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.

Sexually transmitted infections constitute economic burden for developing countries, exposure to causative agents is an occupational hazard for female sex workers. Targeted interventions for this population can reduce the incidence and prevalence of sexually transmitted infections including human immunodeficiency virus, but barriers exists which can hinder effective implementation of such programs. This descriptive cross sectional study sought to assess the prevalence, knowledge and treatment practices of sexually transmitted infections among brothel based female sex workers. Three hundred and twenty three consenting female sex workers were surveyed using pre tested, interviewer administered questionnaires. More than half of the respondents (54.2%) had poor knowledge of symptoms of sexually transmitted infections. Only 13.9% were aware that sexually transmitted infections could be asymptomatic. The self reported prevalence of symptomatic sexually transmitted infections was 36.5%. About half of those with sexually transmitted infectionss sought treatment in a hospital or health centre while 32.5% from a patent medicine vendor. Most respondents (53.8%) mentioned the perceived quality of care as the main reason for seeking treatment in their chosen place. More of the respondents with good knowledge of sexually transmitted infections reported symptoms compared to those with fair and poor knowledge. The knowledge of sexually transmitted infections among these female sex workers is poor and the prevalence is relatively high. Efforts to improve knowledge promote and encourage preventive as well as effective treatment practices must be made for this population.

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.

Cervical cancer is the commonest gynaecological cancer in Nigeria and women of low socio-economic status are at high risk of this condition. A study was conducted on the awareness of cervical cancer, attitude towards the disease and screening practice of women residing in two urban slums of Lagos, Nigeria. It also determined the prevalence of major risk factors for cervical cancer among the women. Multistage sampling was used to select 240 women who were interviewed with a structured questionnaire and data collected was analyzed with Epi-info version 3.5.1 statistical software. Only 10 (4.2%) women in this study were aware of cervical cancer and none of them believed they were at risk of developing the disease. Most (73.3%) were willing to undergo a cervical cancer screening test. Age, education and previous history of vaginal examination were positively associated with willingness to undergo screening (p0.05). The respondents had a high prevalence of major risk factors for cervical cancer such as early age at sexual debut, multiple sexual partners and male partner with other female partners. Efforts need to be intensified to increase awareness of this condition and to promote low-cost cervical cancer screening among this underserved population.

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.

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.

The quality of Ogun river in South-West, Nigeria was studied by a field survey for a period of 1 year (covering dry season and rainy season). Water samples were collected from thirteen sites and analysed for physico-chemical and bacteriological parameters as well as heavy metals using standard methods. Generally, the values obtained for turbidity, phosphate, oil and grease, iron and faecal coliform from all the sites in both seasons were above the maximum acceptable limit set by the World Health Organization (WHO) for drinking water. Also, the manganese content from all the sites in the dry season, lead concentrations from three sites in the dry season and cadmium concentrations from some sites in both seasons were above the WHO limit. The values obtained for total dissolved solids, dissolved oxygen and chloride at site M in the dry season and nitrate at site J in the rainy season were also above the WHO limit. Pollution of Ogun river water along its course is evidenced by the high concentrations of pollution indicators, nutrients and trace metals above the acceptable limit. This poses a health risk to several rural communities who rely on the river primarily as their source of domestic water. The study showed a need for continuous pollution monitoring programme of surface waters in Nigeria.

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 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.

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.