Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.

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Objective: The objective of this study was to determine the prevalence and pattern of amblyopia in primary school pupils in Kosofe town of Lagos State with a view to providing baseline data that may facilitate the establishment of routine school eye screening programs in primary schools in Lagos State. Materials and Methods: A descriptive, cross-sectional study was conducted among pupils from public and private primary schools in Kosofe town. The pupils underwent visual acuity assessment with the HOTV charts, detailed ocular examinations and cycloplegic refractions. Data obtained were analysed using the Statistical Package for Social Sciences version 20.0. Results: A total of 1702 pupils participated in the study, out of which 899 (52.8%) were males. The age range was 4-16 years with 1630 (95.8%) pupils within the ages of 4 and 10. Amblyopia was detected in 24 (1.4%) of the screened pupils (95% confidence interval = 0.610-0.914). There was no significant sex predilection (P = 0.367) or age trend (P = 0.158) in this study although amblyopia occurred more in boys (54.2%). Refractive amblyopia (58.4%) was the most common type of amblyopia out of which anisometropic amblyopia accounted for 78.6%. Unilateral amblyopia was observed in 87.5% of the amblyopic pupils, and the left eye was more commonly affected than the right eye. All the types of amblyopia were more common within the age group of 4-10 years and in public school children (P = 0.039 and P = 0.015, respectively). Conclusion: The prevalence of amblyopia in this study was low and it falls within the general prevalence range for amblyopia in Nigeria.

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Aims: The aims of this study were to describe the pattern of presentation of halitosis and to evaluate the success rate following routine dental intervention irrespective of the type of halitosis. Patients and Methods: This cross-sectional study was conducted among sixty consecutive patients who presented in our Oral Diagnosis and Oral Medicine Clinic, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, on account of halitosis from May 2015 to April 2016. Diagnosis of halitosis was made using the organoleptic method from a whole mouth breath test as described by Miyazaki et al., 1999. Halitosis was assessed before treatment, 2 and 6 weeks after treatment. The results were analysed with STATA statistical software version 11. Results: Sixty out of 305 patients seen in the clinics during the study period had halitosis, with a prevalence of 19.5%. Fourteen (23%) patients had pseudohalitosis while 46 (77%) had genuine halitosis; no case of halitophobia was seen. Majority (71.6%) brush their teeth once daily. The predominant extra-oral etiologic factors were respiratory 2 (3.3%) and ear, nose and throat disorders 1 (1.6%). Twenty-nine (63%) patients with genuine halitosis who had organoleptic scores of ≥4 had no perceivable odour, following routine dental interventions (P < 0.001); the remaining 17 (37%) patients only had slight malodour. Similarly, all the 14 (100%) patients with pseudohalitosis had complete remission after the treatment. Conclusions: The prevalence of halitosis was 19.5%, with male predilection. Routine dental interventions achieved >90% success rate. Preventive oral care is recommended for all halitosis patients.

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A horseshoe kidney (HSK) is the most common congenital renal fusion anomaly. HSKs are more likely than normal kidneys to have associated problems of stones, ureteropelvic junction obstruction, stasis and infection. However, they do not have an increased incidence of renal cell carcinoma when compared to normal kidneys. Due to its rarity, accurate diagnosis may be difficult. Of similar significance is the fact that problems may arise during surgery on these kidneys due to altered anatomy and aberrant blood supply. We report a case of HSK with a renal tumour in a 69-year-old woman and highlight our challenges in the management of the case. To the best of our knowledge, this is the first reported case of a tumour in an HSK in West Africa

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Aims and Objectives: The study was designed with the broad objective of determining the safety profile of artemisinin-based combination therapies amongst Nigerian population. Patients and Methods: This was a cohort event monitoring (CEM) programme involving monitoring adverse events (AEs) in malaria patients treated with either artemether-lumefantrine (AL) or artesunate-amodiaquine (AA) in healthcare facilities in Nigeria. The study involved continuous enrolment of patients with malaria and treated with either AL or AA at the various sites until a total cohort of 600 patients were enrolled at each site. Patients were monitored from the onset of therapy, and on days 3 and 7 from the first day of treatment to identify AEs that may occur. Results: A total of 6102 AEs were recorded in 10,259 patients monitored during the programme. Of 4896 patients who received AA, 4233 (86.5%) patients reported at least one AE while 1869 (34.8%) AEs out of 5363 patients who received AL were reported (P = 0.010). The predominant incidence of each specific AE reported in each group among the patients who received AA and AL includes body weakness 30.8%/7.5%, dizziness 10.3%/3.9%, restlessness 5.02/1.12%, vomiting 3.5/1.03% and drowsiness 3.1/1.5% for AA and AL, respectively. There were more AEs among patients with co-morbid conditions and patients in the younger age groups (9-<15 years), P = 0.000. Conclusions: Various types of AEs were seen and documented during the CEM programme. The findings suggested that the AA/AL monitored during this programme was generally safe and remarkably well tolerated among the Nigerian populations.

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Background: Hypertension and diabetes are the two most important modifiable risk factors for cardiovascular disease (CVD) among Nigerian population. Because of the lifelong nature of the two diseases and the attendant long treatment regimen required, assessing the health-related quality of life (HRQoL) is an important outcome of these diseases. Objective: This study assessed the pattern and predictive factors of HRQoL among patients with hypertension, diabetes and concomitant hypertension and diabetes using the 36-item short-form version 2. Patients and Methods: A cross-sectional study of 1203 patients attending the outpatient clinics of the University of Ilorin Teaching Hospital, Ilorin; the patients were sampled using systematic random sampling methods. Patients were divided into those with hypertension, diabetes and both diseases. The predictors of physical and mental component summaries of HRQoL were analysed using Norm-based Scoring. The level of significance was set at P < 0.05 and 95% confidence interval. Results: The patients with both diseases have lowest physical HRQoL (45.6), while the diabetic patients have the worst mental HRQoL (39.5). Negative predictors of physical HRQoL across the three groups were: drug regimen (hypertension P < 0.001, diabetes P < 0.001, both P = 0.005), CVD complication (hypertension P < 0.001, diabetes P = 0.025) and accompanying persons (P < 0.001). The positive predictors of physical HRQoL across the three groups were medication adherence (hypertension P < 0.001, diabetes P < 0.001 and both P = 0.002). Similarly, medication adherence was the positive predictor for mental HRQoL across the three groups of patients (hypertension P < 0.001, diabetes P = 0.001 and both P < 0.001). Conclusion: This study provided evidence to show that HRQoL across the three categories of patients in Ilorin, Nigeria, is suboptimal. Drug regimen, medication adherence and support from accompanying persons were important predictive factors of HRQoL.

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Background: Gross examination of the placenta may provide useful insight into the aetiology of newborn and maternal complications. A review of literature revealed only a few epidemiological studies that determined the relationships between placental abnormalities, gestational age and occurrence of adverse outcome in babies of healthy pregnant women in our region. Patients and Methods: A prospective cross-sectional study was conducted at the Department of Obstetrics and Gynecology of University of Ilorin Teaching Hospital, between 1 ^st February and August 2013. Pregnant women in labour at ≥28 weeks' gestational age with singleton pregnancies were recruited. Gross examination of the placenta and umbilical cord after delivery were performed. Results: Four hundred and twenty-eight singleton deliveries were studied. The average placental weight was 580.8 ± 130.6 g (range = 125-1500 g). The mean values of the umbilical cord length and width were 52.7 ± 10.5 cm and 1.96 ± 1.11 cm, respectively. Placental abnormalities occurred in 1.2%. The umbilical cord was centrally inserted in 290 (67.8%), marginally in 31% of cases. There was significant but weak positive correlation between the placental weight, birth weight and gestational age at 40 weeks (P ≤ 0.001, r = 0.356). Placental weight was directly related to birth weight (P < 0.0001, r = 0.244) and greater in babies with congenital abnormalities (P = 0.002). Conclusions: There was an association between placental parameters and foetal outcome at birth. Placental weight was positively correlated with birth weight, gestational age and occurrence of congenital abnormalities.

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Background: Endodontic instruments including the nickel-titanium (NiTi) instruments produce debris and smear layer during instrumentation. The study was carried out to evaluate and compare the cleaning effectiveness of root canal preparation using three different rotary NiTi instrumentation systems - ProTaper Universal, K3 and Mtwo by means of scanning electron microscopy (SEM). Methods: Thirty-six freshly extracted permanent mandibular molars were randomly divided into four groups: ProTaper Universal, K3, Mtwo system and control group. The mesiobuccal canal was cleaned and shaped with rotary instruments. The intracanal irrigant used after each instrument was 3 mL of 3% sodium hypochlorite (NaOCl). After the cleaning and shaping was completed, a 1-min 17% ethylenediaminetetraacetic acid rinse was followed by a final NaOCl rinse. All samples were decoronated. Mesial roots were sectioned buccolingually and examined under SEM at 500× magnification in three areas of root canal. Canal walls were quantitatively evaluated using a five-score evaluation scale. Statistical analysis was done using Kruskal-Wallis test, Fisher's exact test and weighted kappa. Results: Completely clean canals were not found in any of the groups. The mean value of debris score for ProTaper, K3 and Mtwo was 2.35, 2.41 and 2.22 respectively. There was no statistically significant difference between the three tested groups (P = 0.237). The apical thirds of the canal was found to be significantly less clean than coronal and middle thirds irrespective of the system used. Conclusions: There was no statistically significant difference between the three tested groups - ProTaper, K3 and Mtwo in cleaning different regions of the canal - coronal, middle and apical.

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Background: Statins are the most widely used agents for the treatment of dyslipidaemias in geriatric patients. Muscle-related adverse effects (MRAE) are one of the most common toxicities of statins. Female gender has been mentioned as the risk factor for the development of MRAE of statins; however, there are inconclusive data regarding the difference in the occurrence of MRAE among male and female geriatric users. Objectives: The main objective was to find the difference in the occurrence of MRAE of statins among male and female geriatric statin users. Methods: In this cross-sectional, observational, comparative study, relevant patient information and MRAE associated with statin use were noted. Creatine phosphokinase (CPK) levels were obtained for all patients as this is considered as the marker for statin-induced muscle damage. The parameters were compared among male and female geriatric statin users. Results: 172 geriatric patients (86 male and 86 female statin users) were enrolled in the study. 38 (22%) geriatric statin users were found to have MRAE and significantly more number of female patients had MRAE as compared to male patients (25 vs. 13 P = 0.02). Significantly more number of female patients had elevated CPK as compared to male patients (20 vs. 8, P = 0.01). No significant difference was observed in CPK levels among male and female statin users. Conclusions: Statin-induced MRAE tend to occur with more frequency in geriatric female patients as compared to male geriatric patients; however, further research in the form of prospective studies is warranted.

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Background: Viral hepatitis is a serious public health problem with hepatitis B virus (HBV) being one of its principle causes affecting billions of people globally. The laboratory diagnosis of HBV infection is made by detection of hepatitis B surface antigen (HBsAg) in serum. Objective: The present study was done to evaluate the seroprevalence of hepatitis B infection among patients attending a hospital at a semi-urban North India using rapid immunoassay test kit. Materials and Methods: A total of 1537 patients were included in the study whose venous blood samples were collected, and serum was tested for the presence of HBsAg using a rapid one-step immunoassay test kit. Results: Out of 1537 patients whose blood samples were tested, 61 were found to be reactive to HBsAg giving the prevalence to be 3.9%, with 49 males and 12 females. Out of 61 reactive patient's majority belonged to inpatient (82.0%) as compared to outpatient department (18.0%). The majority of the reactive patients belonged to age group 28-37 years (37.7%), belonged to rural areas (86.9%), were illiterate (67.2%), were skilled workers (63.9%) and belonged to socioeconomic Class 4 (50.8%). Among the reactive patients, the most frequent suspected risk factor for hepatitis B infection was found to be visiting a community barber (19.7%). Conclusion: HBV infection is a dreadful disease, and its accurate and timely diagnosis using rapid immunoassay test kit is useful as it gives an indication about its seroprevalence in a given geographical area even with limited resources.

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Background: The community-based dental outreach programs play a very crucial role in declining discovery-delivery disconnect by introducing awareness through health education and dental adumbrating services to the community members. However, the success of any oral health programme depends largely on how it meets the needs and expectations of the target community. Therefore, the present study was designed for the assessment of patient satisfaction at various rural outreach dental camps conducted over a period of 2 months. Materials and Methods: The present study was conducted on patients visiting weekly and monthly outreach dental programmes organised by the Department of Public Health Dentistry. Data were obtained from a total of 298 patients using a pre-tested questionnaire as a survey instrument. The questionnaire consisted of nine questions, measuring the patient satisfaction levels on a five-point Likert scale. Results: The highest mean satisfaction score (4.97 ± 0.59) was observed for the question on the overall performance of camp, whereas waiting time for treatment, quality of the treatment and explanation of need for referral exhibited lowest mean scores. The mean satisfaction scores for the monthly camp (4.55 ± 0.52) were significantly higher as compared to the weekly camps (4.38 ± 0.55) (P = 0.013). Conclusion: The results of the study showed that the patient satisfaction scores were satisfactory to good for various aspects of the weekly and monthly dental outreach programmes. Such programmes should be conducted on regular basis, and comprehensive oral care should be provided.

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