Abdominal Pain in Adult Sickle Cell Disease Patients: A Nigerian Experience

Background: Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence; diagnostic dilemma; and the need for an accurate; early diagnosis; abdominal pain in sickle cell disease has not been rigorously studied. Objective: We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. Methods: A prospective case series of 20 patients was done in which data was collected on demographic characteristics; hemoglobin electrophoresis patterns; a description of the abdominal pain including sites; severity; and type of pain; packed cell volume and the provisional and final diagnosis. Results: Haemoglobin S patients were 17 in number constituting eightyfive percent (85) of our study population whilst the rest 3 were Hb S+C. Most patients (70) had one site of abdominal pain. The pain was mainly colicky or tightening; moderate to severe in nature and; in some cases; associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67. Conclusion: Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving

The Role of Forensic Dentist Following Mass Disaster

This review article focuses on mass disaster situations that may arise from natural or manmade circumstances and the significant role of forensic dental personnel in human identification following such occurrences. The various forensic dental modalities of identification that include matching techniques; postmortem profiling; genetic fingerprinting; dental fossil assessment and dental biometrics with digital subtraction were considered. The varying extent of use of forensic dental techniques and the resulting positive impact on human identification were considered. The importance of preparation by way of special training for forensic dental personnel; mock disaster rehearsal; and use of modern day technology was stressed. The need for international standardization of identification through the use of Interpol Disaster Victim Identification (DVI) for ms was further emphasized. Recommendations for improved human identification in Nigerian situation include reform of the National Emergency Management Association (NEMA); incorporation of dental care in primary health care to facilitate proper ante mortem database of the populace and commencement of identification at site of disaster