Tag: statistics

Niger J Clin Pract. 2022 Oct;25(10):1771-1777. doi: 10.4103/njcp.njcp_82_22.

ABSTRACT

CONTEXT: Ameloblastoma is a benign epithelial odontogenic tumor with a tendency for recurrence. Some recurrent tumors could behave unpredictably with atypical microscopic changes.

AIM: To study the clinicopathologic features and diagnoses of recurrent tumors of ameloblastoma.

SETTINGS AND DESIGN: This is a 5-year (2012-2017) retrospective study of 17 consecutive patients with recurrent tumors of ameloblastoma in a Teaching Hospital in Enugu.

METHODS AND MATERIAL: The relevant clinicopathologic information, histology slides, and blocks were retrieved and reviewed. Descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test was used to determine the statistical significance.

RESULT: Recurrent tumors constituted 33.3% (17/51) of all confirmed diagnoses of ameloblastoma. The histopathologic diagnosis of the recurrent tumors includes conventional ameloblastoma 58.8% (10/17), unicystic ameloblastoma 5.9% (1/17), and ameloblastic carcinoma 35.3% (6/17). There was bilateral mandibular involvement in 60.0%, pain 58.8%, ulceration 29.4%, and matted lymph nodes 5.9%. Tumors with positive fluid aspirates 82.4% (14/17) yielded dark-brown fluids in 90.0% (9/10) of recurrent ameloblastomas and in 66.7% (2/3) of ameloblastic carcinomas.

CONCLUSION: There was a high recurrence rate of recurrent tumors of ameloblastoma demonstrated in the present study, with a malignant presentation in some cases.

PMID:36308255 | DOI:10.4103/njcp.njcp_82_22

Niger J Clin Pract. 2022 Oct;25(10):1725-1730. doi: 10.4103/njcp.njcp_206_22.

ABSTRACT

BACKGROUND: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction involving nasal mucosa characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness, and eyes itching. Tympanometry is a simple, rapid, and objective test that can be easily carried out. The use of tympanometry in clinical setting can improve detection of middle ear effusion and other middle ear abnormalities. AR has been found to be one of the predisposing factors to developing Otitis Media with Effusion (OME) in children.

PATIENTS AND METHODS: A case-control study was used to determine the prevalence of OME among children with AR as cases and those without allergy as controls. The study participants were children aged 4-12 years with clinical diagnosis of AR attending ENT clinics of Aminu Kano Teaching Hospital, whereas controls were children age 4-12 years without history of AR, ear diseases, or other respiratory system related ailments attending general outpatient clinics in Aminu Kano Teaching Hospital. An interviewer-administered score for AR (SFAR) questionnaire was filled out for all the participants, those with score of 6 and above were selected as cases. The two groups had complete ENT examination and tympanometry done, findings were recorded, and analyzed using SPSS version 21.

RESULTS: The mean age of the cases was 6.8 ± 2.1 years, whereas it was 7.5 ± 2.6 years for the controls. The mean difference was 0.7 and was not statistically significant (t = 2.35, df = 258, P value = 0.20). Type B tympanogram suggesting OME was found in 7.3% of subjects and in 2.8% of controls. Type C tympanogram suggesting negative middle ear pressure was found in 15.5% of subjects and in 4.6% of controls. Type A tympanogram suggesting normal middle ear pressure was found in 75% of subjects and in 90% of controls. Acoustic reflex was found to be absent in 29.6% of subjects and in 15.4% of controls and this found to be statistically significant (χ² = 7.77, df = 1, P value = 0.001). The difference between type A, B, and C tympanograms of subjects and that of controls was found to be statistically significant (Type A χ² = 14.62, df = 4, P value = 0.01, Type B χ² = 14.06, df = 4, P value = 0.01, Type C χ² = 17.01, df = 6, P value = 0.01). Type B tympanogram was used as an indicator to suggest OME for the purpose of this study.

CONCLUSION: Participants with AR were found to have more abnormalities of tympanometric parameters and higher prevalence of type B tympanogram suggesting OME than controls.

PMID:36308246 | DOI:10.4103/njcp.njcp_206_22

Niger J Clin Pract. 2022 Oct;25(10):1704-1709. doi: 10.4103/njcp.njcp_187_22.

ABSTRACT

BACKGROUND: Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent changes in the diapers may vary according to their absorbent capacity and may not be in parallel with the amount of bleeding. Before significant visual difference occurs, the patient’s hemodynamics may be impaired.

AIM: Aim of the study is to evaluate better circumcision bleeding.

PATIENTS AND METHODS: Patients were divided into groups according to 12 different brand diapers of the same size, containing super-absorbent material. The study started by 15/01/2022, and finished by end of 01/03/2022. Diapers with concealed brands were soaked with blood with equal hematocrit value in 100 ml with increments of 5 ml. 252 images were obtained by taking 21 images of each diaper with the same method. The diapers were evaluated colorimetrically, and numerical values were obtained showing the color differences in red, green, and blue and saturation and lightness. Working groups were formed according to 12 different brands of diapers of the same size, containing super-absorbent material. Standard statistical tests were performed using obtained values.

RESULT: : Dry diapers had different weights, volumes, and specific gravities; the diapers with the lowest unit weight were ranked ninth in terms of volume; the diapers with the highest specific gravity were ranked third in terms of thinness. There were significant differences in the blood on the diaper, and significant differences between some groups (p < 0.005); on the other hand, there was not any difference between some other groups (p > 0.05). There was a significant relationship in terms of Analysis of Variance (ANOVA) (P < 0.05 and P < 0.01). Visual graphic examination showed that linear but non-parallel color changes occurred. As the blood load increased, the visual and statistical differences between the diapers became more pronounced, and the curves diverged.

CONCLUSION: Visual evaluation of the color change of the diapers may not give accurate results for bleeding follow-up. If necessary to use diapers after circumcision, it is more appropriate to prefer those with low absorbency capacity. Using fabric or cotton products in cases with bleeding risk may be recommended. If bleeding is suspected, hemogram control is the most appropriate option. Diaper manufacturers should warn consumers of the risk. In conclusion, we should be on the safe side for mortality and morbidity.

PMID:36308243 | DOI:10.4103/njcp.njcp_187_22

Niger J Clin Pract. 2022 Oct;25(10):1699-1703. doi: 10.4103/njcp.njcp_177_22.

ABSTRACT

BACKGROUND: Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities.

AIMS: The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement.

MATERIALS AND METHODS: Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant.

RESULTS: We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05).

CONCLUSIONS: Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.

PMID:36308242 | DOI:10.4103/njcp.njcp_177_22

Niger J Clin Pract. 2022 Oct;25(10):1693-1698. doi: 10.4103/njcp.njcp_173_22.

ABSTRACT

BACKGROUND: The optimal treatment for distal tibial fractures remains a matter of debate. Nonetheless, plate osteosynthesis produces favorable results to intramedullary stabilization in aspects of alignment restoration.

AIM: The aim of the study was to compare the radiologic and clinical outcomes of distal metadiaphyseal tibial fracture between a simple/wedge fracture (SWF) and a comminuted fracture (CF) using minimally invasive plate osteosynthesis (MIPO).

PATIENTS AND METHODS: This retrospective study analyzed patients with SWF or CF of the distal tibial metadiaphysis that was surgically treated with a locking compression plate. Postoperative radiographic assessments and the time to radiologic union were noted. Clinical assessments were evaluated using both the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the foot function index (FFI). Postoperative complications were documented.

RESULTS: Seventy-one cases were analyzed over a mean follow-up period of 20.9 months. Thirty-six patients had SWF and 35 patients presented with CF. The mean time to radiologic union, amounts of postoperative coronal angulation, and incidence of malunion showed no statistical differences. Fibular fixation was more applied in the CF group (P < 0.001). Moreover, the clinical scores revealed no differences. Nonetheless, in the valgus union group, the AOFAS ankle-hindfoot score was 90.9 compared to 84.1 in the varus union group (P = 0.042) and the FFI was 9.2% compared to 20.2% in the varus union group (P = 0.017).

CONCLUSION: Plate osteosynthesis for SWF or CF of the distal tibial metadiaphysis led to high union rates and good clinical outcomes. There was no significant difference in the radiologic and clinical results according to the presence of fracture comminution. Nonetheless, the valgus union group showed better clinical outcomes than the varus union group. Clinically, it would be preferred to avoid intraoperative varus reduction.

PMID:36308241 | DOI:10.4103/njcp.njcp_173_22

Niger J Clin Pract. 2022 Oct;25(10):1681-1686. doi: 10.4103/njcp.njcp_71_22.

ABSTRACT

BACKGROUND: In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments.

AIMS: The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars.

MATERIALS AND METHODS: This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III.

RESULTS: Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation.

CONCLUSION: Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

PMID:36308239 | DOI:10.4103/njcp.njcp_71_22

Niger J Clin Pract. 2022 Oct;25(10):1674-1680. doi: 10.4103/njcp.njcp_2050_21.

ABSTRACT

BACKGROUND: The hyperdense middle cerebral artery sign (HMCAS) on admission non-contrast computed tomography (NCCT) is a well-characterized phenomenon in acute ischemic stroke.

AIM: The purpose of this study is to determine the impact of HMCAS on the outcome of patients who underwent endovascular thrombectomy.

MATERIALS AND METHODS: A retrospective analysis of a prospectively collective database included 136 consecutive patients with anterior circulation acute ischemic stroke who underwent endovascular thrombectomy. We collected the demographics, and clinical and brain imaging as well as functional and imaging outcomes data at baseline. Patients were divided into two groups with hyperdense artery sign and those without the sign. The difference between the two groups in terms of mortality and prognosis was analyzed.

RESULTS: There were 136 patients, 50.7% of them were women. The mean age was 59.1 years. The subgroup with HMCAS present consisted of 93 patients. There were no differences in demographics and clinical characteristics between the two groups; however, tobacco use is more common in patients with HMCAS. No significant difference was observed in clinical outcomes and mortality between the two groups at 3 months. Patients with HMCAS had statistically more new territory emboli during the procedure (9.7%) compared to patients without HMCAS.

CONCLUSION: We showed that the presence of HMCAS in initial CT was not helpful in predicting good clinical outcomes in patients undergoing endovascular therapy patients. However, the presence of HMCAS is related to more new territory embolism during the procedure. Different endovascular strategies may be applied to these patients.

PMID:36308238 | DOI:10.4103/njcp.njcp_2050_21

Niger J Clin Pract. 2022 Oct;25(10):1666-1673. doi: 10.4103/njcp.njcp_2047_21.

ABSTRACT

BACKGROUND: The tooth movements were generally analyzed in two dimensions on cephalometric radiographs. Nowaday, 3D digital model analysis, which does not have any harmful effects on patients, can be used to evaluate the palatal morphology and coronal tooth movements in a very comfortable and easy way.

AIMS: To investigate the effect of palatal morphology on anchorage reinforcement during intraoral molar distalization with pendulum appliance using 3D model analysis.

MATERIALS AND METHODS: The material consisted of before (T0) and after (T1) dental plaster models of Class II malocclusion patients (17 females, 3 males) treated with pendulum appliance for molar distalization and Nance appliance for anchorage. T0 and T1 digital models were superimposed using the palatal area as a reference via three points and surface-matching software, and the changes in teeth movement were calculated for left and right central incisors, first premolars, and first and second molars. Palatal morphology was evaluated at T0 on digital models as palatal inclination, palatal depth angles, and anterior hard palate area. Wilcoxon test was used to evaluate the treatment results and Spearman’s correlation analysis was performed to evaluate the relationship between palatal morphology and dental movement. The upper limit for the level of significance was taken as 0.05.

RESULTS: Mesial movement of first premolars and distal movement of first and second molars were found to be statistically significant (P < 0.001). A weak negative correlation was found between the palatal inclination and the movement of first premolars (P < 0.045 and P < 0.003). Palatal depth angles and anterior hard palate area had no correlation with dental movements.

CONCLUSION: Presented results supported that the mesial movement of premolar teeth decreased as the inclination of the palate increased.

PMID:36308237 | DOI:10.4103/njcp.njcp_2047_21

Niger J Clin Pract. 2022 Oct;25(10):1647-1653. doi: 10.4103/njcp.njcp_1684_21.

ABSTRACT

BACKGROUND: Most educational institutions in Nigeria were shut down for a long while at the onset of the COVID-19 pandemic as a preventive measure, and this affected dental students’ academic and clinical training.

AIM: To determine the influence of the pandemic on the academic, clinical training, and psychosocial well-being of dental students in Nigeria.

SUBJECTS AND METHODS: This cross-sectional survey was conducted among undergraduate dental students in clinical years in Nigerian dental schools. Participants received the questionnaire through an online platform, it had four sections; socio-demographics, impact on academic training, psychosocial well-being, and an open-ended segment for participants’ suggestions to challenges. A mixed method was utilized to analyze the data. The statistical significance level was P < 0.05.

RESULTS: One hundred two dental students from nine dental schools participated, with a mean age of 25.3 ± 2.4 years. There were 56 (54.9%) males. Most students, 80 (78.4%) reported that their stay-at-home had not been rewarding academically. The majority, 90 (88.2%) were worried about contracting COVID-19 on school resumption. Participants’ psychosocial well-being had significant associations with gender (P = 0.001) and self-directed learning during their stay-at-home (P = 0.001). More female students, 33 (71.7%) were severely worried compared to males 20 (35.7%). Their major suggestions were to commence online teaching and examinations (40.1%) and be provided with adequate personal protective equipment (18.6%).

CONCLUSION: Most undergraduate students in Nigeria were anxious about COVID-19, and females were more affected. This negatively impacted their academic and clinical training. This underscores the importance of adequate psychological support for undergraduate dental students by school authorities.

PMID:36308234 | DOI:10.4103/njcp.njcp_1684_21

Niger J Clin Pract. 2022 Oct;25(10):1635-1640. doi: 10.4103/njcp.njcp_1371_21.

ABSTRACT

BACKGROUND: Congenital diaphragmatic hernia (CDH) is an anomaly with significant morbidity in neonates. It has been traditionally managed by an open approach with a recent trend toward a minimally invasive approach.

AIM: This is a retrospective study of our institutional experience with neonatal thoracoscopic management of CDH, with the impact of few technical nuances.

PATIENTS AND METHODS: The data was collected on neonatal thoracoscopic CDH repair between January 2015 and December 2018, in terms of the demographics, intra-operative parameters, post-operative status, recurrence, and mortality. While analyzing data, we found few technical modifications adopted by the surgeon such as trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch at some point, and continuation for further cases. An internal comparison was made to analyze the technical modifications influencing the outcomes, by dividing them into two groups, those with (group A) and without modifications (group B). The data was analyzed using SPSS software (IBM, Version 23). A P value of <0.05 was considered statistically significant.

RESULTS: Out of 45 newborns 64.4% were males with an average birth weight of 2.6 kg. Baseline variables were comparable between the groups. The operating time significantly reduced after a higher-level camera port was used (P-value: 0.0001). The mean follow-up was 30.8 months. There were totally seven recurrences (6 in group A and 1 in group B), all within 12 months. Seven parents gave the overall post-treatment feedback as “unsatisfied”. The operating time, recurrence rate, and parental satisfaction feedback were significantly less in group B (P-value: 0.001).

CONCLUSION: We recommend trimming the margin of the defect, use of prosthetic mesh overlay reinforcement for repairs under tension, and to prefer extra-corporeal knotting along with higher placement of trocar, temporary increase in CO₂, maximal use of muscle relaxant, extra-corporeal corner hitch stitch to reduce the operating time, and recurrence after thoracoscopic CDH repair.

PMID:36308232 | DOI:10.4103/njcp.njcp_1371_21