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Objective: This study aims to validate a protocol for a multidisciplinary management of delusional halitosis and to assess their outcome of treatment. Method: A prospective study of 61 patients with complaint of chronic bad breath and initial diagnosis of psychological halitosis after assessment with halitosis questionnaires and clinical examination. A final diagnosis of pseudo halitosis or delusional halitosis was made based on the patients’ response to oral hygiene prophylaxis, antimicrobial treatment and counseling for 2 weeks. The delusional halitosis patients were treated in a ‘Joint Clinic’ of oral medicine physician and mental health experts, using a 5-step treatment protocol over a 4-week period. Treatment outcomes for the delusional halitosis patients were evaluated using patient’s self-assessment, WHO well-being index, psychological score and other mental health instruments. Results: There were 33 (54.1%) delusional halitosis patients among the psychological halitosis patients. Twenty (60.6%) patients out of the 33 (100%) delusional halitosis patients attended the ‘joint clinic’. Six (30.0%) of the 20 treated patients had improved self-esteem, while only 1 (5.0%) and 3 (15.0%) showed improvement in state anxiety and trait anxiety respectively. Normal psychological score was found in 1 (25.0%) out of 4 (100%) patients that claimed to be ‘cured’, and 3 (50.0%) out of 6 (100%) patients had ‘improved’ final self-assessment. Conclusion: Preliminary findings suggest early signs of recovery, with improvement in self-esteem, anxiety and psychological problems in delusional halitosis patients.

The role of alcohol as a major factor in traumatic death worldwide is inestimable, ranging from mortality due to motor vehicle accidents, falls, fires, drowning, homicides, cultism, and suicides. Hence, scientists are globally creating innovative screening tools for blood alcohol concentrations (BAC) to establish a baseline for safety or impairment to drive on the highways. The utilization of these tools has revealed results necessitating enactment of legislation against high BAC in order to protect the population. The dentist, as a healthcare provider, can also play a leading role in screening for alcoholism, as well as restrain from prescribing mouthwash with alcohol, so as not to contribute to higher levels of BAC. The convenience of using various screening tools is highlighted and the dentist can decide the easiest approach to screenings. [ABSTRACT FROM AUTHOR]

TLRs initiate innate immune signaling pathways via Toll/IL-1R (TIR) domains on their cytoplasmic tails. Various bacterial species also express TIR domain-containing proteins that contribute to bacterial evasion of the innate immune system. Bacterial TIR domains, along with the mammalian sterile α and TIR motif-containing protein 1 and TIRs from plants, also have been found to exhibit NADase activity. Initial X-ray crystallographic studies of the bacterial TIR from Acinetobacter baumannii provided insight into bacterial TIR structure but were unsuccessful in cocrystallization with the NAD+ ligand, leading to further questions about the TIR NAD binding site. In this study, we designed a Course-Based Undergraduate Research Experience (CURE) involving 16-20 students per year to identify amino acids crucial for NADase activity of A. baumannii TIR domain protein and the TIR from Escherichia coli (TIR domain-containing protein C). Students used structural data to identify amino acids that they hypothesized would play a role in TIR NADase activity, and created plasmids to express mutated TIRs through site-directed mutagenesis. Mutant TIRs were expressed, purified, and tested for NADase activity. The results from these studies provide evidence for a conformational change upon NAD binding, as was predicted by recent cryogenic electron microscopy and hydrogen-deuterium exchange mass spectrometry studies. Along with corroborating recent characterization of TIR NADases that could contribute to drug development for diseases associated with dysregulated TIR activity, this work also highlights the value of CURE-based projects for inclusion of a diverse group of students in authentic research experiences., (Copyright © 2024 The Authors.)

Tannins, water-soluble phenolic compounds, have been reported to have the ability to form complexes with nutritionally important nutrients such as protein and mineral elements thereby making them unavailable for absorption and utilization. Toxicity of tannin has been demonstrated in experimental animals although no deleterious effect of ingestion of legume tannin on human physiology has been reported. This report highlights the processing effects of soaking and hydrothermal techniques on some underutilised hard-to-cook legume crops and the importance of tannin in legume nutrition. Soaking and hydrothermal processing reduce the tannin content of processed legume seeds and hence improve the availability of protein and mineral elements. In view of the recent findings of the health benefits, classification of tannin which is traditionally regarded as an antinutrient should be reconsidered. Provision of these information will enhance knowledge of legume nutrition and economic utility. Increasing consumption of underutilized nutritionally important legume seeds, it is hoped, will alleviate the problem of protein energy malnutrition in many developing nations., Competing Interests: AUTHOR DISCLOSURE STATEMENT The author declares no conflicts of interest., (Copyright © 2022 by The Korean Society of Food Science and Nutrition. All rights Reserved.)

Background: This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non-odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non-odontogenic tumors in a Nigerian population., Methods: A 9-month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non-odontogenic tumors were selected for the study., Results: There were 40 (83.3%) histopathologically diagnosed non-odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non-Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non-odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%., Conclusion: The accuracy of FNAC in the diagnosis of orofacial malignant non-odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool., (© 2020 Wiley Periodicals LLC.)

Objective: The aim of this study is to compare the proliferative capacity and antiapoptotic capacity of unicystic ameloblastoma (UA), odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) by assessing the Ki-67 labeling index (LI) and Bcl-2 LI, respectively., Materials and Methods: Formalin-fixed, paraffin-embedded tissue blocks of twenty-three histopathologically diagnosed UAs, 6 OKCs, 8 DCs and 10 RCs were selected from the archival specimens. Five micrometer thick sections of tissue blocks of the lesions were processed for immunohistochemical staining with Ki-67 and Bcl-2. The Ki-67 LI and Bcl-2 LI were determined for the cases with a positive reaction., Results: Ki-67 expression was seen in 6 (26.1%) cases of UA, 4 (66.7%) OKC, 1 (12.5%) DC and 1 (10.0%) RC. There was a statistically significant difference between the mean Ki-67 LI of UA and OKC ( P = 0.024). Bcl-2 expression was seen in 16 (69.6%) UA, 5 (83.3%) OKC, 5 (62.5%) DC and 5 (50.0%) RC. The mean Bcl-2 LI of UA was significantly higher than that of DC ( P = 0.048). Furthermore, cases of OKC had significantly higher mean Bcl-2 LI compared to DC ( P = 0.026) and RC ( P = 0.049)., Conclusion: This study suggests that the Ki-67 LI may help in differentiating OKC from UA. The Bcl-2 LI may be useful in differentiating UA from DCs, and differentiating OKC from DC and RC., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Oral and Maxillofacial Pathology.)

Objective: This study aims to determine the clinical features which are helpful as significant indicators in the diagnosis of malignant and nonmalignant nonodontogenic orofacial tumors., Materials and Methods: This was a prospective study performed on patients with swellings in the oral and maxillofacial region clinically suspicious of being tumors of nonodontogenic origin in a Nigerian Tertiary Health Institution. The statistical variables that were analyzed included patients' resume, clinical and radiological features as well as the histopathological diagnosis of the lesions. The level of significance was set at P < 0.05. Inferential analysis was done using Student's t-test, Chi-square, binary logistic regression, and adjusted odds ratio as appropriate., Results: There were forty patients histopathologically diagnosed as nonodontogenic tumors of the orofacial region. Twenty-five (62.5%) were females and 15 (37.5%) were males with mean age of 36 ± 21.9 years. Histopathological features showed three different categories of the lesions: Reactive and benign (nonmalignant) and the malignant lesions. Lymphadenopathy (P = 0.035) and nonmobility of the swellings (P = 0.029) were significant clinical indicators that were strongly associated with histological diagnosis of the malignant nonodontogenic tumors., Conclusion: This study showed that the nonodontogenic tumors occurred mostly in younger patients with a female preponderance. The mandible and the preauricular region were the most common sites. Lymphadenopathy and nonmobility of the swellings were strong clinical indicators for the diagnosis of the malignant nonodontogenic tumors., Competing Interests: None

The seed of Cassia hirsutta was subjected to aqueous soaking and four hydrothermal processing techniques (atmospheric boiling, atmospheric steaming, pressure boiling, and pressure steaming). Soaking of the seed to varying hydration levels before hydrothermal treatments induced the reduction in the concentration of the antinutritional components. The lowest concentration of each of the antinutritional components was observed at 100% hydration level. The effects of hydrothermal techniques on the antinutritional components and protein digestibility were investigated. All the hydrothermal techniques caused significant reduction ( P <0.05) in the antinutritional components. Boiling at elevated pressure resulted in greater reduction of antinutrients. The hydrothermal techniques caused total elimination of trypsin inhibitor activity. Reduction in the concentration of the antinutritional components after hydrothermal processing led to the increase in in vitro protein digestibility. The highest in vitro protein digestibility of 86.82% was observed after the legume seed was boiled at elevated pressure. Adoption of this underutilised legume will strengthen dietary diversity, improve feeding patterns, and prevent protein energy malnutrition especially in developing countries since the seed is a good source of nutritionally important nutrients., Competing Interests: AUTHOR DISCLOSURE STATEMENT The author declares no conflict of interest.

Irrational drug use is associated with adverse consequences including drug resistance and avoidable adverse drug reactions. Studies of rational drug use in psychiatric facilities are scanty. This study evaluated prescription practices and perception of health care professionals regarding causes of irrational drug use. A retrospective study conducted at the outpatient clinic of Federal Neuropsychiatric Hospital, Yaba, Lagos. Data on drug use indicators were analyzed. A cross-sectional assessment of perception of prescribers and dispensers regarding rational drug use was conducted. A total of 600 prescriptions were analyzed. Mean number of drugs per encounter was 3.5 and percentage generic prescribed was 58.5%. Poly-pharmacy (P=0.024, 95% CI=1.082-1.315) and non-generic prescribing (P=0.032, 95% CI=1.495-1.821) were significantly associated with young prescribers. Factors associated with irrational drug use include demand from patients, patients' beliefs about injection drugs and influence of pharmaceutical sale representatives. Certain aspect of prescribers indicators are still poor in the hospital studied. Health care professionals identified possible associated factors for irrational drug use. Concerted efforts are required to ensure rational drug use especially in psychiatric facilities in Nigeria., Competing Interests: Conflict of interests: the authors declare no potential conflict of interests.

Objective: This study aims at contributing to the definitive diagnosis of ossifying fibroma (OF) based on histomorphological features. The study also aims to determine some demographic features of OF, common sites of occurrence and to determine whether behavior correlates well with the histomorphological variations seen in the lesion., Materials and Methods: A total of 80 patients who were diagnosed either as cementifying fibroma CF, OF and cemento-ossifying fibroma (COF) of the jaws from the files of the Oral Pathology Department of the University of the Witwatersrand Dental School were retrieved and the histology slides of each case were reviewed with the most recent diagnostic criteria for OF and the authors additional criteria. A total of 56 cases that met the set criteria were analyzed., Results: The patients were clustered within the third and fourth decades of life ( n = 39, 69.6%). Majority of the patients were black (83.93%), whereas the rest were whites (12.50%) and Asians (3.57%). There were 17 males (30.4%) and 39 females (69.6%), giving a male to female ratio of 1:2.3. Most of the lesions (70.3%) occurred in the mandible, involving the premolar molar region (56.7%). Scanty fibrous tissues in highly cellular lesions were found in 36 (64.3%) of the cases. There were globular, dystrophic or granular calcifications mixed with irregularly shaped trabeculae of lamellar or cellular woven bone or osteoid were found, in 36 (64.3%) cases., Conclusion: Demographic data, clinicoradiologic features, combined with histopathology will continue to be relevant in the definitive diagnosis of OF and in predicting its behavior. Highly aggressive lesions with shorter duration in people below 15 years were called juvenile OF and treated as such, while OF applies to other conventional ones.

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.

Aim: The aim of this study was to identify the causes and patterns of tooth loss among Nigerian adults., Background: Tooth loss continues to be a major problem in clinical dentistry and has received significant attention in everyday dental practice. In Nigeria there is a discernible lack of current data that would explain the reasons and patterns of tooth loss from its different geopolitical zones., Methods and Materials: The reasons for tooth extractions during a period of 12 months were obtained from the hospital records of teaching and specialist hospitals in Nigeria's six geopolitical zones and the Federal Capital Territory (FCT). Data were analyzed using Statistical Package for the Social Sciences for Windows (SPSS) version 9.0., Results: A total of 4,204 teeth were extracted from 3,431 patients. Of these teeth 52.4 percent were lost due to dental caries while 30.2 percent were removed because of periodontal disease, 5.0 percent were missing as a result of trauma, and 3.9 percent were impacted and required extraction. The remaining 8.5 percent were extracted for a variety of reasons such as orthodontic treatment, overeruption, neoplasms, supernumerary teeth, attrition, a cystic lesion, and hypoplasia. Dental caries was the most common diagnosis given for tooth loss in the South-South (79 percent), South-East (68 percent), North-East (47 percent), North-West (69 percent), and North-Central (35 percent) zones followed by periodontal disease. In contrast, periodontal disease was the most common cause of tooth loss in the South-West zone (65 percent) and in the FCT (55 percent), followed by dental caries at 22 percent and 33 percent, respectively., Conclusion: Although teeth were extracted based on a variety of diagnoses, dental caries was identified as the common reason cited for tooth loss in Nigeria and to a lesser extent periodontal disease. Also different reasons were given for tooth loss among the various geographical zones., Clinical Significance: Tooth loss among Nigerians was attributed largely to dental caries and secondarily to periodontal disease. Both conditions can be prevented if diagnosed early enough and treatment is instituted in a timely manner.

Objective: To assess the occupational exposure to needlestick and sharps injuries and hepatitis B vaccination status among dental auxiliaries., Subjects and Methods: A descriptive cross-sectional survey of 83 dental auxiliaries was conducted that included 12 technologists, 11 therapists, 53 nurses/surgical assistants, and 7 record officers. The survey included demography, history of needlestick and sharps injury, hepatitis B vaccination, knowledge and attitude towards HIV-infected patients, and the dental auxiliaries' information needs on HIV-related issues., Results: Of the 83 dental auxiliaries, 34 (41%) had experienced needlestick and sharps injury in the last 12 months. At the time of the study, only 43 (51.8%) had been immunized against hepatitis B. 62 (74.7%) of the respondents thought that it was easier to contract HIV than hepatitis B through needlestick in a dental clinic. 21 (25.3%) would not assist dentists treating HIV-positive patients. However, 76 (91.6%), a majority, agreed that they needed more information on HIV-related issues, with 59 (71.1%) specifying a single area of need and 17 (20.5%) more than one area of need. The single areas of need specified in descending order were infection control (n = 22, 26.5%), HIV counseling (n = 12, 14.5%), oral manifestations of HIV/AIDS (n = 11, 13.3%), postexposure prophylaxis (n = 9, 10.8%), and antiretroviral therapy (n = 5, 6.0%)., Conclusion: The data from this survey underscore the urgent need for educational interventions to encourage safe work practices. Hepatitis B vaccination, HIV-related knowledge and proper postexposure prophylaxis are needed to prevent occupational transmission of blood-borne viruses., (Copyright 2010 S. Karger AG, Basel.)

Purpose: We aimed to determine the contributory percentage of histopathologic diagnoses of routine biopsies and to ascertain the possible indicators for histopathologic examination to confirm the clinical diagnosis of periradicular lesions of extracted teeth., Patients and Methods: This was a prospective study carried out over a period of 8 months on patients who had single tooth extraction and routine histopathologic examination of recoverable periradicular tissues from extracted teeth., Results: A total of 136 patients participated in this study. There was a male/female incidence ratio of 3:2 and most of the patients with histopathologically diagnosed lesions were within the first, second, and third decades of life (n = 49, 36.0%). Seventy-five (55.2%) cases had histopathologically diagnosed periradicular lesions, which were mostly periapical abscess (n = 30, 22.8%) and inflammatory (periapical) granuloma (n = 23, 16.9%). Some clinical and radiologic features were associated significantly with histopathologic diagnosis of some periradicular lesions (P < .05). There also was a significant correlation of clinical diagnosis with histopathologic diagnosis of inflammatory (periapical) granuloma, periapical abscess, chronic osteomyelitis, and Burkitt's lymphoma (P < .05)., Conclusions: This study shows a higher contributory percentage of histopathologic diagnoses after routine biopsies, compared to previous reports from selected biopsies of periradicular lesions. We identified clinical indicators for predicting possible histopathologic diagnosis of some periradicular lesions, in particular, those that predict possible histologic diagnosis of neoplastic periradicular lesions.

Objectives: To emphasize the origin of aneurysmal bone cyst as "primary" or "secondary" to other lesions of the jaws and 2. Report two cases of the cyst that illustrate its controversial origin in the hope that it will add to the literature on the subject in Africa., Report: Two cases of aneurysmal bone cyst occurring in the mandible and maxilla are reported. One of the cysts that occurred in a 13-year-old was a primary lesion while the other in a 5-year-old was associated with a cementifying fibroma., Method: The diagnoses of both lesions were confirmed by biopsy. The lesion that occurred in the 13-year-old was treated by curettage while the other in the 5-year-old was treated by excision under general anaesthesia respectively., Result: While the lesion in the 13-year-old was haemorrhagic with 'welling up' of blood, the second lesion though haemorrhagic was not associated with this phenomenon. Both patients were transfused with 2 pints and 1 pint of blood respectively. There has not been recurrence of the lesions after two years post operatively., Conclusion: Aneurysmal bone cyst can arise as a primary lesion or associated with a fibro-osseous lesion as demonstrated by these two cases. There is a need to serially section biopsy specimens of the cyst to detect coexisting lesions.

Introduction: The number of deaths due to trauma from road traffic accidents (RTAs), and from the use of firearms either for homicide or armed robbery, ethnic conflicts, and other events, such as flooding, explosions from petroleum products, and religious violence, is on the rise in Nigeria. This preliminary study is a comparative analysis of the frequency of deaths caused by RTAs and the deaths caused by the use of firearms during armed robbery. The study sought to identify the number of traumatic deaths caused by RTAs or armed robbery as well as the number of victims who sustained injuries in the process of RTA or armed robberies., Methods: An indigenous, non-governmental organization (NGO) network was used to abstract data for the frequency of RTAs associated with death or injuries and for deaths caused by armed robberies and was supplemented with data obtained from the Nigerian police., Results: For RTAs, the victims included drivers, passengers, and pedestrians. In 3,032 cases of RTAs, the total number of deaths was 1,239 (29.1%): one Nigerian dies for every three to four crashes. The total number of deaths due to RTAs was significantly higher than was the number of deaths due to the use of firearms in commission of robbery. Police reports relative to the use of firearms during armed robberies indicate that of a total of the 652 victims who were killed, 348 (68.1%) were the armed robbers, 134 (26.2%) were bystanders, and 29 (5.7%) were policemen., Conclusions: The enormity of the problems of traumatic deaths from RTAs and armed robberies in a developing country has been highlighted.

A case of midline lethal granuloma in a 28-year- old female Nigerian patient is reported. Oral, ocular and nasal lesions were present and these preceded a spontaneous abortion of a three month old pregnancy. The clinical course of the disease and its similarity to other granulomatous diseases, which are generally classified as midline granuloma syndrome, are highlighted. The prognosis is poor but early diagnosis and treatment appears to improve a patient's condition

This paper reports the frequency of tooth transposition in Nigerians in an attempt to determine the treatment needs of the population under study. The frequency of tooth transposition in this study is 0.135 per cent consisting of 4 males (36.36 per cent) and 7 females (63.64 per cent), which is higher than those reported by some authors in Caucasian. The higher figure may be due to small sample size or due to greater penetrance of this anomaly in blacks. There were 17 transpositions of which 7 were of mandibular lateral incisors and canines (41.18 per cent) 5 maxillary lateral incisors and canines (29.4 per cent) 4 maxillary canines and premolars (23.5 per cent) and one mandibular canine and central incisors (5.88 per cent). The possible aetiologic factors and challenges to management are discussed in view of the dearth of qualified orthodontists for a population of about 88.5 million people.

Fifty nine patients with histologically confirmed cases of oral malignant neoplasia were included in this study. There was a male preponderance with the male to female ratio being 2.5 to 1.0. The average waiting period before presentation was 8.9 +/- 6.5 months (range: two to 24 months). Squamous cell carcinoma was the predominant variety, 50.8%, of all malignancies recorded. The alveolar ridge and the gingivae were the commonest sites accounting for 40.7% of all cases. Majority of the patients with squamous cell carcinoma, (80.8%), presented with stage IV of this disease. The pattern of oral malignancies in the population studied appears slightly different from earlier observations in Western Europe and Asia. The necessity to strengthen research on the epidemiology of the disease in Nigeria and other African countries is highlighted.