This article discussed the history, problems and development of General Dental Practice (GDP) Faculty. It also delves into the status of the Faculty of GDP of the National Postgraduate Medical College of Nigeria (NPMCN) Lagos from its inception in 1979 until it was declared moribund in 1988 and later suspended in 1989. It also discussed the history of the resuscitation of GDP Faculty, the training philosophy, conduct of examination and the role of individuals who made important contributions. The role of the writer in the resuscitation effort and his election as the Faculty secretary during the teething period is also highlighted. Finally appropriate recommendations are suggested to prevent future reoccurrence of the episode of nineteen eighties. Other recommendations are for the consolidation of the achievement so far made.

This study examined the malaria situation in a malarial endemic area of Nigeria. Structured questionnaire was applied to 300 doctors practising in Enugu urban, Nigeria and confirmation of the clinical diagnosis by laboratory technique was done using 468 patients. The result shows a high prevalence of Plasmodium falciparum infection (96.4% in children, 87.0% in adults). Malaria positivity rate was 51.9% in children and 42.8% in adults. Fever, vomiting and anorexia were the commonest malaria symptoms in children, while headache, fever, chills and rigors were the commonest malaria symptoms in adults. The diagnostic practice of the doctors was clinical. Fever, vomiting and cough were found to be more associated with malaria parasitaemia in children, while in adults fever was found to be more associated with malaria parasitaemia. Chloroquine and sulphadoxine-pyrimethamine were the commonest drugs used for treating uncomplicated malaria, while quinine was the commonest drug used for treating severe malaria.

The objective of this study was to determine the effect of low-dose combined oral contraceptive pill, Lo-femenal, on the following haemostatic parameters: platelet count (PC), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen, of apparently healthy Nigerian women over a period of three months. A total of sixty-seven women were recruited for the study consisting of forty-seven subjects and twenty age-matched controls, who were aged between 17 and 37 years. All haemostatic parameters were determined using standard haematological techniques described by Dacie and Lewis, before, and three months after continuous use of oral contraceptive pills in the subjects. The same parameters were determined three months apart in control subjects who were on oral contraceptive pills. Statistical analysis of data was done using the chi-squared test and statistical significance was based on p value < 0.05. The mean values of platelet count and fibrinogen were significantly increased (p=0.0000 and 0.0003 respectively), while the PT and TT reduced significantly (p=0.007 and 0.0000 respectively) after three months of contraceptive use. There was no significant difference in the value of APTT (p=0.17) before and after oral contraceptive use. No differences were observed in the values in the controls. The findings in this study indicate some degree of pro-coagulant activity in the subjects, and the need to properly assess and monitor haemostatic parameters in pills users before commencement and while on them.

The advent of HIV/aids has led to a renewed interest in infection control and occupational safety in dentistry. The full implementation of "Universal Precautions" to prevent cross-infection of HIV, hepatitis B, and other blood borne pathogens would have a heavy financial implication on developing countries like Nigeria which are faced with the arduous problem of coping with scarce resources. Dentistry is bound to cost more when effective infection control is practised. This paper therefore proposes recommendations for minimum, practicable and acceptable infection control standards which are not only cost effective but also attainable.

BACKGROUND: Despite the claims that umbilical hernia (UH) is common among Nigerian children, the socio-economic class-related prevalence or incidence rate of UH in the Nigerian children is not known. We therefore undertook this study to determine the prevalence of UHs among Nigerian children of high socio-economic class. PATIENTS AND METHODS: This 7- years prospective study assessment of the prevalence of primary umbilical hernias among a private school admission seeking Nigerian children. Clinical evaluations of the umbilicus were conducted on 7,968 Nigerian children, attending interview into Nigerian Airforce Military schools from across the country. RESULTS: Umbilical hernia was present in 102 (1.3% ) out of 7968 children, giving a prevalence of 12.8 per 1,000. Fifty-three (52.% ) were boys and 49 (48% ) were girls; their ages ranged from 6 to 9 years (mean 6.5 years). Umbilical hernia was 1.4 times as common in the girls as in the boys, with a prevalence of 15.3 per 1,000 and 11.1 per 1,000, respectively. The overall prevalence in this study is comparatively lower than those previously reported. CONCLUSION: Our study suggests that there is a low prevalence rate of UH among the children of high socio-economic class in Nigeria.

A total of 28 children with severely displaced supracondylar fractures of the humerus were operated between January 1997 and December 2001 using the posterior approach raising a tongue of triceps and stabilisation of the fractures with two crossed Kirschner wires. All the supracondylar humeral fractures were extension type. The mean age was 6.9 years with male/female ratio 1.5:1. Fall at home accounted for 85.7% of the cases while 67.9% presented with injury to the left elbow. In 92.9% of the children the triceps muscle power was grade 5, 71.4% could flex the elbow joint beyond 120 angle and only 10.7% had 15 degrees of extension lag at the elbow joint at six months. All had within normal carrying angle with 64.3% having carrying angle between 0 degrees - 10 degrees. The scar was cosmetically acceptable in 27 patients (96.4% ) at six-months.

BACKGROUND: Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. OBJECTIVES: To describe the pattern of glomerular filtration rate abnormalities and its clinical correlates in Nigerians with type 2 diabetes mellitus. METHODS: Glomerular filtration rate as determined by the endogenous creatinine clearance was measured in 90 patients with type 2 diabetes mellitus and 60 controls at the Jos University Teaching Hospital, Jos. RESULTS: Twelve subjects (13.3% ) in the diabetic group had hyperfiltration (GFR > 125 ml/min) compared to 3 (5% ) in the control group, although the mean glomerular filtration rates were similar in the two groups (96.19 +/- 29.14 ml/min and 88.38 +/- 24.13 ml/min respectively, p > 0.05). All the subjects with hyperfiltration had been diabetic for less than 5 years. Only one of the diabetics had renal insufficiency (GFR < 50 ml/min). CONCLUSIONS: This study demonstrates that hyperfiltration is common in patients with type 2 diabetes mellitus and that it occurs early in the course of the disease.

Twenty-eight eyes of 26 age-matched patients who had planned extracapsular cataract extraction with or without intraocular lens implantation were enrolled into a double blind randomised actively controlled study of 2 groups. Each group of 14 eyes was assigned to receive 0.1% diclofenac sodium (Naclof) eye drops or 1% prednisolone acetate eye suspension. The patients received either 0.1% Diclofenac sodium eye drops or 1.0% prednisolone acetate eye suspension four times a day as their post operative anti-inflammatory medication for a period of four weeks. No significant difference was noticed in the subjective assessment of pain and conjunctival injection in the 28 days follow-up period except day 1 in the diclofenac sodium group (0.05> p >0.01). Other measured objective variables of inflammation such as anterior chamber cells and flare showed no significant difference from the 3rd-28th postoperative days (0.05< p > 0.20). The result demonstrated that 0.1% diclofenac sodium eye drops was as effective as 1% prednisolone acetate eye suspension in the control of postoperative inflammation after cataract surgery, and could serve as a viable alternative to topical steroids in Nigerians who are steroid responders.

CONTEXT: A large number of our female adolescents are at risk of reproductive ill health. This may have its roots in their sexual behaviour. There is need to unfold our female adolescent sexual behaviour as this will establish the necessity or otherwise for interventions. METHODS: Senior secondary school adolescents in Calabar were studied with the help of a pre-tested, self-administered questionnaire. This was to unfold their age at menarche and their sexual behaviour. RESULTS: the average age at menarche in Calabar is 12.86 years. About 37.4% of senior secondary school female adolescents are sexually active with an average age at initiation of 13.7 years. About 22.6% of them have more than one sexual partner. Most of them (51.2% ) learned about sexual intercourse from their peers. They go into sexual intercourse for fun, intimacy and friendship (84% ). Only 6.0% of the sexually active adolescents ever used family planning methods. This poor sexual behaviour in these adolescent girls is significantly influenced by the socio-economic status of parents and not by the type of school attended. About 18.4% of them have been pregnant at least once, 15.1% have had genital tract infection and 31.9% have sustained genital tract injury during sexual intercourse. CONCLUSION: Sexuality education both at home and in school is lacking in Calabar. There is need for adolescents in Calabar to be exposed to sexuality education both at home and in school. Schools with adolescent girls whose parents are of low socio-economic status should be targeted more than others. There is a call for the provision of youth care centres in schools where reproductive health matters are discussed and managed.

To determine the causes and frequencies of maternal deaths in the Lagos University Teaching Hospital (LUTH) as seen at autopsy; to find their age associated frequencies; and to compare these findings with previous studies done in this hospital as well as those from other parts of the world. MATERIALS AND METHODS: Those cases for which autopsies were requested and performed between January 1989 and December 1998 (inclusive) formed the material for this study. Excluded were patients who were dead on arrival, as well as badly autolysed cases. Records including autopsy protocols were retrieved from the Morbid Anatomy Department and relevant information was extracted and analysed from these records. RESULTS: About 81% of autopsy certified were due to direct causes. The three leading causes of maternal death were obstetric haemorrhage (25.61% ), genital sepsis (19.68% ) and pregnancy-induced hypertension (16.71% ). The most common indirect cause of death was anaemia (7.01% ) making it the fifth leading cause of death in this study. Majority of deaths (70% ) occurred in those between 11 and 30 years. Maternal mortality Ratio was 2,920/100,000 live births. CONCLUSION: Though maternal mortality figures from hospital-based studies are usually over-estimates of the true picture in the community they tend to provide a more thorough assessment of the underlying causes of death and their contributing factors, hence providing useful data for planning interventions.

OBJECTIVES: Regional lymph node metastases is found in about 6-85 per cent of all patient with carcinoma in the head and neck region. It is also widely accepted that lymph node metastases is the single most important predictor of survival in patient with squamous cell carcinoma of the oral cavity. The present review was undertaken to provide practitioners managing oral cancers in the sub-region an update on developments in the clinical significance and management of regional lymph node metastases in oral mucosa squamous cell carcinoma. SOURCE OF DATA: This review is primarily based on articles selected from MEDLINE concerning regional lymph nodes metastases of oral squamous cell carcinoma up to July 2001. RESULTS: Characteristics of metastatic lymph node such as number of positive nodes, histological features, extracapsular spread and location in the neck significantly affect the prognosis of oral squamous cell carcinoma in individual patient more that most other parameters that are usually considered in the surgical management of such lesion. CONCLUSION: Prognosis of oral mucosa squamous cell carcinoma to a large extent depend on the status of regional lymph nodes however, the management of such node varies in different center. Conservative approach such as supraomohyoid neck dissection is currently widely accepted as the method of management in No and some selected N1 neck in oral squamous cell carcinoma.

Cerebral malaria, one of the severe forms of malaria, carries a very high fatality rate even when managed in the best of centres. This underpins the need for a medical audit to review patient management steps or procedures to improve the standard of patient care of children with cerebral malaria in the Lagos University Teaching Hospital.METHODS: A retrospective audit of records of children with cerebral malaria who presented in the emergency room of the Lagos University Teaching Hospital in the last five years. Relevant clinical and patient management information of survivors were extracted from the records and analysed. RESULTS: The records show that critical information useful in the management of these children was lacking in 50 - 60% of the records reviewed. The appropriate anti-malarial drug (intravenous quinine) in adequate doses was used in 54(94.7% ) of cases. A total of 12 patients (21.1% ) still had either mannitol or dexamethasone given to them. Blood transfusion was ordered in 60% of the children despite severe anaemia being present in only 30% of them. CONCLUSION: This study highlights the sub-optimal level of knowledge and practice among doctors and the need for retraining of medical staff in maintaining proper records. The authors recommend the use of patient management guidelines.

To determine the frequency, age and sex patterns of non-Burkitt's non-Hodgkin's lymphoma among cases of lymphoma seen at the histopathology department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The records of patients with histologically diagnosed non-Burkitt's non-Hodgkin's lymphoma seen over a period of five years were studied. The classification was based on the Working Formulation. The sex and the age at diagnosis as well as the sites of the lesions were noted. Of the fifty three cases of non-Burkitt's non-Hodgkin's lymphoma seen during the study period 54.7% had intermediate grade tumours; 24.5% has low grade and 20.8% had high grade tumours. 92.5% of the cases occurred in adults over the age of 20 years. There was also a male predominance. Nodal as well as extranodal sites were involved and peripheral lymph node involvement most often affected the cervical group of lymph nodes. The results showed that non-Burkitt's non-Hodgkin's lymphoma is predominantly a disease of adults which more often affected males than females. The intermediate grade type with the possibility of cure is the type most often seen in this study. Therefore, early diagnosis and preventive measures against known risk factors in our environment, where possible, are strongly recommended.

Pregnancy-induced hypertension/pre-eclampsia and its sequelae eclampsia are major causes of maternal and perinatal morbidity and mortality in Nigeria. A retrospective review of 1200 deliveries in women who booked for antenatal care before the 20th week of gestation was done in a tertiary hospital. This was aimed at determining if a raised mid-trimester mean arterial blood pressure was predictive of subsequent development of pregnancy-induced hypertension/pre-eclampsia in Nigerian women, and if it is, to assess its sensitivity, specificity, positive predictive value and negative predictive value. There was a statistically significant higher incidence of Pregnancy-induced hypertension/pre-eclampsia in women with an elevated mid-trimester mean arterial blood pressure (P< 0.0001,OR=3.7). The sensitivity of the screening test was 22.9% , specificity 92.5% , positive predictive value 25.0% and negative predictive value 91.7% . The relative risk of developing Pregnancy-induced hypertension in women with elevated mid-trimester mean arterial blood pressure was 3 times that of those with a normal mid-trimester blood pressure. It is concluded that the test shows a high specificity and negative predictive value and allows apportioning of relative risks of developing the disease among booked antenatal patients. The calculation of the mid-trimester mean arterial blood pressure should become a routine part of antenatal care in Nigerian women.

Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. they include fibrovascular polyp, liposarcoma, harmatomas and lipomas. They may be asymptomatic for a long time and thus attain an enormous size. We present one of such cases of giant oesophageal polyp in a 28 year-old man with a history of difficulty in breathing and vocalisation, easy fatigability and cough. Dysphagia was late in the complaint and he also had lost 7 kg in the last six months before his presentation. A chest radiograph, barium swallow and oesophagoscopy gave the clinical diagnosis. The thoracic CT examination gave a better delineation of the site of the pedicle, the nature and extent of the tumour mass. The tumour was surgically removed and the final pathological diagnosis was afibro-lipoma of the oesophagus. The patient has since been discharged to follow-up in the Surgical out-patient.

This paper reports on the conservative management of five Nigerian edentulous patients who presented with shallow palatal vault, grossly resorbed and uneven alveolar ridges, flabby ridge forms, shallow sulci and loss of vertical face height as a result of tooth loss. There was associated loss of stability, retention and support of their complete dentures. Though the literature is replete with various problems in such patients, conservative treatment was employed in all the five cases, to achieve acceptable outcome. The paper recommends this treatment option and highlights the prosthetic techniques utilised in managing the patients including the factors that contributed to successful conservative treatment. In addition, the problems encountered when embarking on such treatments are enumerated and appropriate solutions proferred.