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Genetic Relationships and Population Structure among Nigerian Ethnic Groups (Ibibio, Igbo, Hausa, Tiv and Yoruba) Based on Nine DNA Loci

Abstract Context: Population-specific attributes typically determine the behavior of human genotypes and traits in individuals. Examining the genetic relationships between populations presents an opportunity to observe patterns of genetic changes over time. By comparing populations, it is possible to see factors that may have sparked the evolution of a trait or genotype as well as the genetic diversity of the populations. Genetic diversity in the groups in Nigeria is still largely undefined. This can be achieved with the use of genetic markers. Aims: To determine the genetic relationships between Igbo, Ibibio, Yoruba, Tiv, and Hausa ethnic groups using nine short tandem repeat DNA markers. Settings and Design: Observational studies of 250 consenting participants. Methods and Material: Individuals of Igbo, Yoruba, Hausa, Ibibio, and Tiv were randomly sampled from their ethnic homes in Nigeria at participating institutions. DNA was extracted from blood samples using commercial DNA kits, and tested for nine autosomal short tandem repeat loci alleles using PCR and electrophoresis. The allele types and sizes were read and recorded for each locus for every individual. Statistical Analysis Used: Allelic frequencies, population pairwise genetic distances (FST and RST, analysis of molecular variance (AMOVA), and principal component analysis (PCA) were calculated using GenAlEx v6.502. Results: The fixation index (FST) was between 0.001 and 0.500 in the five populations. The estimated variation was 99.98% within individuals and 0.10% among populations. Four heterogeneous clusters were observed with three axes accounting for 32.86% variation. Conclusions: The genetic relationships closely mirrored linguistic groupings showing that language may have shaped early interaction and ultimately gene transfer between these groups.

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Open Access
Evaluation of Right Ventricular Diastolic Function among HIV-1-Infected Patients on Highly Active Antiretroviral Therapy and its Relationship with CD4 Cell Count and Viral Load

Abstract Context: With the introduction of highly active antiretroviral therapy, human immunodeficiency virus (HIV) patients live longer and therefore develop complications such as cardiovascular diseases. The prevalence of left ventricular diastolic dysfunction among HIV-infected patients ranges from 2.7% to 64%. Data on right ventricular diastolic function among HIV-infected patients in our region of northeastern Nigeria are lacking. Aims: We therefore assessed right ventricular diastolic function among HIV-infected patients on highly active antiretroviral therapy (HAART). Materials and Methods: This cross-sectional study was conducted among HIV-infected patients receiving HAART at the Federal Medical Centre Nguru, Yobe State, Northeastern Nigeria. Tricuspid flow E/A ratio, right ventricular deceleration time, and tissue Doppler E/e’ waves were used to assess the right ventricular diastolic function. Results: One hundred and seven subjects were recruited into the study comprising 70 (65.4%) females and 37 (34.6%) males. The prevalence of right ventricular diastolic dysfunction is 12.15%. CD4 cell count correlated positively with right ventricular deceleration time and negatively with tricuspid E/A ratio. Viral load correlated positively with the tricuspid E/A ratio and negatively with the tricuspid E/e ratio and right ventricular deceleration time. Conclusion: Right ventricular diastolic dysfunction is not uncommon among HIV-infected patients in northeastern Nigeria; its prevalence was found to be 12.15%, and there was a significant positive correlation between right ventricular deceleration time and CD4 cell count and a significant negative correlation between right ventricular deceleration time and viral load, suggesting that lower CD4 cell count and higher viral load are associated with worsening right ventricular diastolic function.

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Open Access
Does Pederson Difficulty Index Accurately Predict the Difficulty of Mandibular Third Molar Extraction?

Abstract Context: To determine the relationship between the Pederson difficulty index and the modified Parant scale and to assess the effectiveness of the Pederson difficulty index in predicting the difficulty of mandibular third molar extractions. Settings and Design: This cross-sectional study recruited participants with indications for third molar extractions. Pederson’s difficulty index was used to evaluate the anticipated difficulty of preoperative mandibular third molar extraction. Surgical extraction of impacted third molars was done under local anesthesia and patients were then assessed postoperatively with the Modified Parant Scale. Methods: In this study, 85 participants indicated for surgical extraction of mandibular third molars under local anesthesia were enrolled between February 2018 and July 2018. The relationship between Pederson’s difficulty index modified Parant scale and duration of extraction was evaluated. Statistical Analysis Used: Sociodemographic variables of study participants were summarized with descriptive statistics. Student’s T-test was utilized for mean differences between groups and correlations were computed between Pederson and modified Parant scale. Results: This study comprised 85 participants with a mean age of 25.8 years ± 4.6, showing no significant difference across genders (P = 0.87). Pederson difficulty index demonstrated a sensitivity of 46.4% and a specificity of 89.5% and a moderate correlation (0.35, P < 0.001) was observed between Pederson difficulty index and surgery duration, ditto, between Pederson and modified Parant scores (0.36, P < 0.001). Conclusion: In conclusion, our study underscores the importance of pre-operative assessment for mandibular third molar extraction, highlighting the Pederson Difficulty Index’s moderate predictive value but emphasizing concerns about its sensitivity.

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Open Access
Sociodemographic and Clinical Correlates of Uncontrolled Hypertension in Patients on Treatment for Hypertension in a Family Practice in Southwest Nigeria

Abstract Context: Hypertension causes cardiovascular morbidities globally, particularly in Africa. Hypertension is a disease that is difficult to manage, and there are reports of suboptimal control in hypertensive patients despite clinic attendance. This study sought to characterize the profile of outpatients with uncontrolled hypertension while on treatment. Materials and Methods: There was a purposive consecutive sampling of 78 registered hypertensive patients diagnosed at least six months before recruitment and having clinic blood pressures at ≥ 140/90 mmHg in at least two previous consecutive clinic visits in an outpatient clinic. Their sociodemographic and clinical variables were collected using a semi-structured questionnaire, which incorporated the Hillbone Compliance to High Blood Pressure Scale. Results: There were 52 (66.7%) females and 26 (33.3%) males. The mean age was 54.3 years ± 11.48. The mean blood Pressure (BP) at initial contact was 143.92/89 mmHg. About 40.3% of participants were obese. Most 71.4% of the patients were adherent to prescribed medications. There were no significant socio-demographic factors associated with uncontrolled hypertension after multiple linear regression analysis. There was a significant positive linear correlation between poorer medication adherence and higher diastolic blood pressure r = 2.57, P = 0.024. Conclusion: Physicians ought to recognize the pattern of uncontrolled blood pressure in patients despite treatment and institute an appropriate intervention.

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Open Access
Enteric Adenovirus Gastroenteritis in Under-Five Children, Kano-Nigeria

Abstract Context: Adenoviruses have been implicated in many outbreaks and sporadic cases of pediatric gastroenteritis. Aim: This study aimed to determine the prevalence and circulating serotype(s) of enteric adenoviruses among under-five children with diarrheal diseases in Kano, Nigeria. Settings and Designs: This was a multicentered hospital-based cross-sectional study involving 250 under-five children recruited from Murtala Muhammad Specialist Hospital, Muhammad Abdullahi Wase Teaching Hospital and Hasiya Bayero Paediatric Hospital. Materials and Methods: Enteric adenovirus F40/F41 were checked in the stools of children exhibiting symptoms of gastroenteritis, diarrhea, and/or vomiting by nested PCR amplification of the adenovirus Hexa/E1B regions and positive samples characterized by sequencing and phylogenetic analysis. Statistical Analysis Used: Data generated were analyzed using descriptive statistics, and the association between the variables was checked by the Chi-square test. A P value <0.05 was considered statistically significant. Results: The nested PCR result shows that 7 (2.8%) out of the 250 stools were positive for enteric adenovirus (group F), with only serotype F41 detected within the cohort examined. The isolates were more closely related to KJ425126 from Gabon. The results highlighted that fever and vomiting are prominent features of adenovirus F41 gastroenteritis and children 1–2 years especially males were mostly affected. Conclusion: The study improved our knowledge and understanding of the role of enteric adenovirus in under-five gastroenteritis and suggests that EAdeV-F41 is an important cause of gastrointestinal infections, particularly in infants and young children in Kano, Nigeria. This may call for routine screening of the stools of children with diarrhea for future management guidelines.

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Open Access
Assessment of Patients’ Anxiety Levels and Their Decision-Making When Choosing Dental Care

Abstract Context: A comprehensive understanding of the patient’s decision-making process helps a dentist to successfully present a range of treatment possibilities. Aim: The purpose of this study was to examine how patients choose dental services and clinics and how they make decisions about those visits. Materials and Method: From April 2023 and September 2023, 584 participants who were seen in the Dental Outpatient Department participated in a cross-sectional survey. Willing participants were given a questionnaire with 15 questions addressing different facets of patient perception. Informed consent was obtained from the parents. Both English and local Tamil languages were used to structure the questions, which centered on patient viewpoints, expectations, decision-making, lowering anxiety, and recommendations for new dental procedures. Result: Important behavioral insights were collected from the study. The majority of participants stated that they will ask their opinion on dental care. They prefer to visit dental clinics when problems arise. They knew about dental clinics through the Internet and per group preference. The majority of participants reported that dental clinic preference is based on proximity and popularity. They prefer specialist and multispecialty dentistry. The majority of participants prefer brand and longevity for the purchase of dental procedures. Social media is a major factor in dental clinical search. The majority of participants preferred an explanation of procedure before and anxiety reduction if a complaint is addressed. The majority of participants prefer the quality of treatment and truthfulness of dentist recommendations. Conclusion: Dental professionals must comprehend the decision-making processes of their patients. Establishing patient satisfaction and trust requires open communication, high-quality care, and honesty. To properly meet patients’ expectations, dentists should be honest in addressing their worries and offering assurances on the course of treatment.

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Endoscopic-Assisted Balloon Dilatation of Eustachian Tube—Preliminary Report from a Tertiary Hospital in Northwestern Nigeria

Abstract Context: Eustachian tube dysfunction (ETD) results from failure of the Eustachian tube (ET) to ventilate the middle ear adequately. It is responsible for most cases of persistent middle ear disease. Management of ETD is classically conservative and limited to medical therapy. Surgery is usually reserved for cases that fail medical treatment. Recently, endoscopic balloon dilation of the cartilaginous ET has shown encouraging results and appears effective, safe, well tolerated, and affordable. Aims: To present a preliminary report of Endoscopic balloon dilatation of Chronic ETD in a tertiary hospital. Settings and Design: A retrospective study involving 5 patients with chronic ETD who had endoscopic-assisted balloon dilatation of the ET in a tertiary hospital. Materials and Methods: The patients’ records were retrieved, and relevant data were extracted. All patients had completed an otorhinolaryngological examination and tympanometry. Statistical Analysis: The data were analyzed using SPSS version 25.0. Results: There was a symptomatic improvement in four patients (7 ETs) at 2 weeks post-operative review. No improvement was seen in one patient (2 ETs). Similarly, the result of tympanometry at 6 weeks follow-up showed a change in tympanogram from type-C to type-A in two patients and from type-B to type-C in one patient. There was persistence of type-C in one patient and type-B in one patient. Conclusion: Although findings from our experience showed mixed results, endoscopic-assisted balloon dilatation of ET is feasible and can be used as an option in managing patients with ETD in our environment.

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Preventive and Therapeutic Adjunctive Roles of Immune Optimization on Inflammatory and Infectious Diseases: A Mini Review

Abstract Inflammatory and infectious diseases encompass a wide array of pathologic processes underscored by inflammatory immune dysfunction and infections. They are commonly caused by immuno-toxic lifestyle habits (poor diet, inadequate sleep, lack of exercise) and infectious agents. Management of the disease spectrum is challenging. Immune dysfunction enhances their pathogenesis and clinical symptoms. Hence, immune optimization interventions are useful for their prevention and management. T-cell dysfunction disease mediating models describing inflammatory and infective disease processes underlying inflammatory and infectious diseases exist. However, they do not highlight inflammatory and infective dysfunctional processes underlying the diseases concerning toxin-mediated epigenetic T-cell dysfunction. Online searches were conducted on databases such as Google Scholar, PubMed, Biomed Central, and SciELO. Articles were reviewed using keywords such as Immune optimization/dysfunction, T lymphocyte activation/dysfunction, cytokines, inflammatory/infectious pathogenesis, therapeutic adjunct, and disease prevention. There is a putative T cell toxin-mediated dysfunction disease model for Immune-Mediated Inflammatory Diseases (IMIDs), which may apply to inflammatory and infectious diseases. The putative disease model may highlight the actual inflammatory/infective immune dysfunctional processes underlying T cell disease mediation in inflammatory and infectious diseases. We proposed putative inflammatory and infectious disease models that highlight inflammatory and infectious dysfunctional processes underlying T cell dysfunction disease mediation which may be validated by multi-omic studies. Validation of the putative disease models using inflammatory and infective heart diseases as classic examples should pave the way for a better understanding of the pathogenesis of inflammatory and infectious diseases. Insights from these putative disease models can guide effective interventions.

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Retrospective Analysis of Etiology, Pattern, and Determinants of Pediatric Maxillofacial Injuries

Abstract Context: Children sustain facial skeletal and soft-tissue injuries, which are often seen in the preschool age; however, severe facial injuries involving facial bones occur in ages above 11 years. There have been several postulated reasons for the reduction in the incidence of skeletal fractures in children. These include sutural pliability of pediatric facial bones, increased subcutaneous fat, and a greater ratio of cranial to facial bones. Aims: The study aimed to report our institutional experience of the pattern of presentation in pediatric maxillofacial trauma and report its main etiologies. Methods and Materials: Clinical and demographic information was retrieved from the maxillofacial registers, day clinics, and pathology registers. The etiology of the trauma and associated injuries were also noted. Statistical Analysis: Descriptive statistics were performed on demographic variables such as age, gender, and location of trauma. Categorical variables were analyzed in frequencies and proportions. Association analyses across variables were done using student t-test, ANOVA, and Pearson’s Chi-square after normality test had been conducted. Dunn’s test and Tukey’s post-hoc analysis were conducted after significant observations. Results: The mean age observed in the study was 7.3 years ± 5.3 SD (range: 2.6 months–16 years). There was a slight male predilection with 58.6%. Falls were the most common etiology in the ≤5-years group. RTC accounted for most injuries in children above 11 years. Soft-tissue-only injuries were observed in 51.4% of all cases. In facial bone fractures, mandibular fractures accounted for 40% of all cases. Conclusion: Male children experienced the greatest impact from maxillofacial trauma. The primary factor contributing to this was falls among preschool children. Soft-tissue injuries were found to be more prevalent among preschool children, whereas the incidence of facial fractures increased as age advanced.

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Renal Profile of Herbal Medicine Users and Nonusers: An Exploratory Cross-sectional Study in a Family Medicine Clinic in Nigeria

Abstract Context: A major risk of herbal medicine is the potential for toxicity and serious side effects. Unlike orthodox medicine, herbs are usually consumed without prior safety assessment via clinical studies. This means that the clinical effects of herbs may be detected only through an assessment of the health parameters of consumers. Aim: The study aimed to evaluate participants’ renal profiles, comparing that of herb users with nonusers, thereby identifying any differences between the two groups. Settings and Design: It is a cross-sectional, analytic study among adult patients attending the general outpatient unit of Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. Materials and Methods: The study assessed and compared estimated glomerular filtration rate, microalbuminuria, and proteinuria among patients who reported using herbs and those who did not report any use. Statistical Analysis: Data were analyzed using Epi Info 7.2. Results: Three hundred and forty-one participants were enrolled. The mean eGFR was 87.47 ± 25.44 ml/min/1.73 m2 for participants who used herbs and 84.76 ± 25.49 ml/min/1.73 m2 for those who never used herbs (P value 0.48). Among all participants, proteinuria ≥0.3 g/l was present in 29 (8.50%) and microalbuminuria ≥30 mg/l in 138 (40.47%). There was no statistically significant difference in the renal parameters of both groups. Conclusion: The study found no evidence of the harmful effect of the herbs reported on kidney function. This could be because that the study participants mainly reported using edible—and, therefore, presumably safe—herbs. Further studies in human subjects of the effect of herbal medicine on the kidney and other systems are suggested.

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