Gout is a metabolic disease characterised by acute or chronic arthritis and deposition of monosodium urate crystals around joint, bones, soft tissue and kidneys. This is the case of a 51 year old man who re-presented with a nineteen year history of joint pains and five year history of multiple joint swellings. This followed his defaulting from follow up after an earlier presentation 16 years previously with acute gouty arthritis. Clinical evaluation revealed a middle aged man with multiple swellings over the hands, ankles, feet, elbows and knees. Serum uric acid was very elevated and radiographs revealed large tophi involving multiple joints. Abdomino-pelvic ultrasound scan and renal function tests were normal. He was subsequently treated with medications and had significant improvement with clear regression of the size of the tophi. This case demonstrates that delayed treatment of gout or neglected gout over time can lead to tophaceous gouty arthritis.

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Endodontic management of a permanent mandibular molar is challenging owing to its varied morphology and complexity of the roots and root canal system. A thorough knowledge of the root canal systems and their possible variations is of utmost importance in order to reduce the incidence of endodontic failures caused by missed canals, incomplete debridement, and obturation. The most common presentation of a permanent mandibular molar is one mesial root having two canals and one distal root having one or two canals. The present case report describes the diagnosis and nonsurgical endodontic management of a case of permanent mandibular molar having four roots, each having a single canal. Angled periapical radiograph along with cone-beam computed tomography was used for the identification of roots and root canal system.

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We report a rare case of anorexia nervosa in a 20-year-old woman undergraduate of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The patient met the ICD-10 diagnostic criteria for anorexia nervosa. The major reason for presentation was amenorrhea. A significant etiological factor in the patient was her belief that gaining weight was linked to the fact that weight while in a romantic relationship was linked to being sexually active. She received psychotherapy, and her diet was modified on an outpatient basis and she made an significant improvement.

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The human oral cavity is colonized by a complex ecosystem of microorganisms. There are various beneficial and harmful bacteria present in the oral cavity. Beneficial bacteria have numerous and important functions, e.g., they produce various nutrients for their host, prevent infections, and modulate a normal immunological response. In order to achieve, restore, and maintain favorable balance in the ecosystem, the modification of the oral microbiota is necessary, for improved health outcomes. So, the introduction of probiotics, prebiotics, or synbiotics in a human diet could be beneficial. Probiotics are dietary supplements containing beneficial bacteria and yeast, whereas prebiotics are nondigestible dietary supplements that further stimulate the number and activities of probiotics to improve oral health. So, the combination of these two, probiotic and prebiotic, are regarded as “synbiotic.” Synbiotics are emerging as a captivating and desirable field in dentistry, which when consumed provides noninvasive treatment and thus improves the quality of life. This review article highlights the role of synbiotics in oral health and disease, as synbiotics can be considered a potential therapeutic and preventive strategy against various oral diseases.

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Despite the high proportion of adipose tissues in the mature female breast, lipomas arising from the female breast are very rare lesions with a very small number being reported in the scientific literature. Giant lipomas measuring greater than 10 cm in diameter or weighing more than 1 kg are even rarer. Lipomas of the breast may mimic other breast lesions such as phyllodes tumor or mammary hyperplasia, and long neglected cases might also have significant skin changes from pressure mimicking malignancy and creating a diagnostic dilemma. Imaging studies are not usually diagnostic. Detailed clinical examination, followed by complete excision of the mass, can be both diagnostic and also serve as a treatment modality. We present a 50-year-old trader with an 8-year history of slowly growing and discomforting right breast mass with unclear preoperative diagnosis resolved at surgery and at histological examination.

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Optic nerve injuries, though rare, pose a serious threat to vision irrespective of how mild they may appear. We present a case of a 19-year-old poly-traumatized female student who presented with a 2-h history of multiple soft and hard tissue facial injuries with loss of consciousness after a motor vehicular road traffic accident. The patient was admitted and was treated with a multidisciplinary management approach. A total afferent pupillary defect noticed on presentation and confirmed in follow-up examinations was the patient’s pointer to a left optic nerve transection. Total vision loss was confirmed in the left eye, with regain of consciousness and recovery.

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Background: External cephalic version (ECV) is the first-line treatment in the management of uncomplicated breech presentation at term. Objectives: The aim of this study was to determine the success rate, factors associated with success, and obstetric outcome of ECV for breech presentation at term. Materials and Methods: This was a longitudinal interventional study of patients with breech presentation at term who underwent ECV at the University of Maiduguri Teaching Hospital from January 1, 2017 to December 31, 2018. Data analysis was performed using IBM SPSS version 25.0 and a statistically significant association was determined using chi-square or Fisher exact test for categorical data as appropriate. Multinomial logistic regression was computed to find factors independently associated with ECV success. A value of P was set at <0.05. Result: The success rate of ECV was 78.5% (62/79). There were no differences in the mean age, parity, and gestational age at ECV between the successful and the unsuccessful groups with P = 0.19, 0.79, and 0.36, respectively. Multinomial logistic regression analysis showed that parous women, women who did not complain of pain during the procedure, women who weighed 80 kg or less, and women with an estimated fetal weight of <3.5 kg were significantly associated with successful ECV. There was an increased risk of postterm pregnancy and induction of labor among women with successful ECV. There were no maternal or fetal complications associated with the procedure. Conclusion: ECV is safe and associated with a high success rate. It should be offered routinely to all eligible women with breech at term.

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Background: There are burgeoning data on the beneficial and deleterious effects of religion on health, especially, mental health worldwide. This complex relationship between religious variables and outcome in patients with schizophrenia is yet to be robustly explored among Africans. This study aimed to determine the relationship between religious variables (i.e., religious coping and orientation) and outcome variables (e.g., disease severity and psychosocial functioning). Materials and Methods: The study was a cross-sectional study done at the Federal Neuropsychiatric Hospital, Enugu, Nigeria. A total of 422 outpatients who met the stringent criteria for schizophrenia were recruited into the study over a study period of 18 weeks. Standard instruments were used to measure religious coping (Brief Religious Coping-Brief—RCOPE), religious orientation (Religious Orientation Scale-Revised—ROS-R), disease severity (The Brief Psychiatric Rating Scale), and psychosocial functioning (Social and Occupational Functioning Assessment Scale). A multivariate linear regression analysis was used to determine the religious variables that predicted disease severity and psychosocial functioning. Results: Religiosity and religious coping variables were not significant predictors of symptom severity among patients with schizophrenia. However, negative religious coping was a significant predictor of poor psychosocial functioning (t = −2.23, P = 0.02, β = −0.28), whereas high score in intrinsic religiosity was a predictor of good psychosocial functioning (t = 3.32, P = 0.001, β = 0.27). Conclusion: Findings from this study support the vast majority of research that suggests that religiosity and religious coping have diverse effects on clinical and functional outcomes.

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Background: CBCT, the modern 3D imaging equipment, eases the intricacies of dental diagnosis. Aims: Our study aimed at assessing the knowledge and attitudes regarding Cone-beam computed tomography (CBCT) among dentists in Maharashtra. Subjects and Methods: A cross-sectional study design was conducted by administering an online questionnaire consisting of 17 questions to the dentists of Maharashtra. The online survey was distributed through Google forms shared on different social media platforms, emails and websites. SPSS version 17 software and Chi-square test was employed. Results: About 91.2% MDS were aware of the use of CBCT for dentomaxillofacial region. Approximately 77.7% general practitioners use digital imaging modality. 70.6% BDS refer patients for CBCT in their daily practice. Greater number of BDS (88.5%) than MDS (79.4%) are satisfied with the use of CBCT. Dentists with more than 10 years of practice (60%) agreed higher on utilization of CBCT in the future for selected dental applications than those with less than 10 years of practice (37.4%). A statistically significant difference with P <0.05 was revealed. Conclusion: Fostering cognizance and positive attitudes among dentists towards CBCT, would tremendously boost the present-day dental diagnosis. Its promotion through optimal hands-on sessions, workshops would aid in its efficient application.

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Background: The treatment of ocular pterygium overtime has been subjected to the development and application of various new strategies towards simpler, quicker, and more comfortable surgical procedures that have foster the development suture-less technique with conjunctival autograft to reduce recurrent rate. Aims: To evaluate the long-term follow-up of recurrent rate and immediate complication in primary pterygium excision with Inferior Limbal Conjunctival Autograft (ILCA) a 5 years follow-up in a Tertiary Ophthalmic Centre. Materials and Methods: The medical record of 68 patients (80 eyes) who underwent pterygium excision and free ILCA for primary nasal pterygium who completed the 5 years follow-up were retrospectively reviewed for recurrence and immediate postoperative complication, of these 59 patients met the criteria. Result: In this study, 59 patients (71 eyes) completed the 5 years follow-up that account for 86.8%, 9 patients defaulted accounting for 13.2%. Two (3.4%) out of the 59 patients had recurrence, one male at 3 months and a female at 2 months that were 21 and 40 years old, respectively. The early complication that was seen in this study was mild conjunctival hyperemia secondary to suture irritation. Conclusions: After a long follow-up period for ILCA for primary pterygium surgery, the success of conjunctival autograft was high with little or no complication seen, this may be related to a significant learning curve or differing surgical techniques for this procedure. The greatest risk factors for recurrence were young age and type of pterygium.

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Pharmacology is concerned with the study of action of drugs and is a branch that comes under biology and medicine. The two chief concerns are the effect of the drugs on the human systems and the effect of the human systems on the ability and metabolism of drugs. Prosthodontics is the dental specialty that deals with different age groups of patients, and it is necessary to understand the different effects of drugs. This article describes information regarding the drugs used during the prosthodontic treatment.

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Human resources for health (HRH) migration is a growing problem globally. Most of the migration is from the low and middle-income (source) countries where the HRH density is low to the more affluent (destination) nations. Poor career pathways, limited opportunities for growth and development, poor compensation, and socio-economic challenges are the main reasons for migration. The effects manifest as health inequalities with a lower density of HRH, and poorer health indices including lower life expectancy in the source countries making the achievement of the third sustainable development goal (SDG3) very challenging. The world has the tools in various codes and resolutions needed to tackle HRH migration but the political commitment to faithfully implement them is lacking. Solving HRH migration requires a holistic approach with collaboration and commitment between both source and destination countries and should be based on the principles of transparency, fairness, and mutual benefits. Each nation should urgently commit to producing adequate numbers of HRH to meet the health needs of its people, retain them, and reduce dependence on foreign-trained HRH.

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Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has affected peoples of all ages, gender, and income groups. Public health measures to limit the spread of the disease have not been well adhered to in Nigeria, due partly to poor public awareness and perception of the disease. Aim: This study assessed the knowledge of COVID-19, its perception, and practice of preventive measures, among patients attending the General Practice Clinic (GPC) of a tertiary hospital in Nigeria, with the hope of obtaining insights to guide strategic policy intervention to enhance adherence to prescribed public health measures. Subjects and Methods: This was a descriptive cross-sectional study conducted among patients attending the GPC of a tertiary hospital in Nigeria. A pretested semi-structured questionnaire was used to obtain data from study participants. Data analysis was done using the IBM SPSS statistics version 22.0 (Chicago, IL, USA) statistical software. Results: Virtually all the respondents (99.2%) were aware of COVID-19. Majority had a good knowledge of COVID-19 (55.1%), good perception of COVID-19 (51.6%), and good practice of preventive measures against COVID-19 (50.4%). Most respondents (57.0%) were of the view that government agencies are not sincere in the fight against COVID-19. Conclusion: A majority of the study participants had a good knowledge and perception of COVID-19 and a good practice of preventive measures. There was a positive correlation between knowledge and perception; knowledge and practice; and perception and practice. We recommend that information and educational messages should be timely and transparently delivered to the people, with public and political office holders showing exemplary leadership.

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Background: Vitamin D deficiency (VDD) in pregnancy is of major public health concern because of the effect it may have on maternal and fetal outcomes. Some of these effects include gestational diabetes mellitus, preeclampsia, infections, increased rate of cesarean sections, fetal growth restrictions, and poor fetal and infant bone mineralization. Aims: The aim of this article is to determine the serum vitamin D levels of pregnant women and the influence of some sociodemographic factors on vitamin D status. Subjects and Methods: This prospective, cross-sectional study, involving 256 consecutive parturient Igbo women, was carried out at two locations in Anambra State of southeastern Nigeria. Ethical approval and appropriate participatory consent were elicited and obtained from the participants. Blood samples were taken from the women during labor. Serum obtained from each maternal blood sample was labeled, stored in a refrigerator at -80°C, and ultimately assayed for 25-hydroxyvitamin D₃ using high performance liquid chromatography. A proforma eliciting the biosocial characteristics was also completed for each of the pregnant woman. Data analysis was performed using SPSS version 23. Serum vitamin D level of ≥32 ng/mL was reported as normal, whereas that of <32 ng/mL was reported as deficiency. Comparison of variables was carried out using the χ² test and Student’s t-test with P-value less than 0.05 at 95% confidence interval, which was considered to be significant. Results: In this study, VDD occurred in 36 (14.1%) women. VDD occurred significantly higher among multiparous women (para 1–4), P = 0.011. All 36 (100%) women with VDD occurred at term gestational age (37–42 weeks). VDD was more prevalent in dark complexion compared with others. Women with indoor work location had higher prevalence of VDD than those of outdoor, and all the women with VDD were of urban domicile. Conclusion: VDD is low in this study and is significantly influenced by parity, gestational age, complexion, location of work place, and place of domicile. It is recommended that pre- and early pregnancy administration of vitamin D supplements be individualized on the basis of certain biosocial factors: multiparity, term gestational age, dark complexion, indoor work location, and urban domicile.

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Despite pockets of incidences in different places, from all indications, the world might has experienced the worse phase of the COVID-19 pandemic. We must however admit the obvious – the pandemic caught the world poorly prepared. The relatively high case-fatality rates and socioeconomic losses from the pandemic could have been effectively mitigated assuming the global healthcare systems were more proactive in their preparedness. However, there is no time to cry over spilled milk. We must quickly learn our lessons and prepare for future disease outbreaks. Another pandemic in the future without adequate preparedness may be too grievous to the fragile interconnected global healthcare and economic systems. The objectives of the article are to briefly discuss the global ageing population and the role such phenomenon might have played in the recent global COVID-19 outbreak and may play in future disease outbreaks, especially in Africa. Accordingly, a review of related online full articles published from 2000 to 2022 from reliable scientific search engines was done. Results revealed that the world is presently experiencing a change in age demography to older age groups, and such phenomenon might have played a significant role in the different COVID-19 incidence and case-fatality rates that were experienced by different regions of the world. Due to the fast-changing age demography in Africa, the continent might suffer the most unfavourable outcomes from future pandemics. Stakeholders must closely monitor the fast-changing age demography in Africa and institute evidence-based health-promotional measures that will adequately prepare the continent for future disease outbreaks.

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Aims: This study aims to determine the frequency of occurrence of odontogenic lesions and compare the prevalence of odontogenic tumors and odontogenic cysts, according to age, gender, origin, malignancy, and recurrence rate among patients diagnosed with odontogenic lesions in a Nigerian teaching hospital. Materials and Methods: This is a retrospective cross-sectional study that examined all the records of the patients diagnosed histologically with jaw lesions at the Department of Oral and Maxillofacial Surgery of the University of Benin, for a period of 9 years from 2013 to 2021. The information recorded were age, gender, type of jaw, cell of origin of lesion, type of lesion, histopathological diagnosis, and the number of malignant and recurrent lesions. All data were analyzed using the IBM Statistical Package for Social Sciences (IBM SPSS), version 23.0 (IBM Corp., Armonk, NY, USA). The level of significance adopted was less than 0.05. Results: Of the 513 patients whose data were analyzed, 210 had odontogenic lesions giving a prevalence of 40.9%. The age range was 7–78 years with a mean age of 35.2 ± 15.0 years. More than half of the patients were less than 45 years old. The ratio of males to females was 1.3: 1. The prevalence of odontogenic tumors and cysts was 86.2% and 13.8%, respectively. More than half (52.4%) of the odontogenic lesions were ameloblastoma followed by ameloblastic carcinoma (8.60%), dentigerous cyst (4.80%), and calcifying odontogenic tumor being the least common (1.00%). Only 18.6% of the odontogenic lesions were malignant. There was a recurrence of 24.3% in the odontogenic lesions. The ratio of malignancy was 3.1: 1 in the odontogenic cysts and 4:1 in the odontogenic tumors, but these trends were not significant. The prevalence of recurrence of odontogenic tumors and cysts was 25.4% and 17.2%, respectively, but this finding was not significant (P = 0.31). Conclusion: There was a relatively high frequency of odontogenic lesions of 40.9% in our environment. The frequency of occurrence of odontogenic tumors was 86.2%, whereas that of odontogenic cysts was 13.8%.

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