Pilot study of new statistical models for prognostic factors in short term survival of oral cancer.

Background: Survival times of oral cancer are poorly documented in Nigeria. This is partly due to poor documentation and limited investigations to elicit sufficient prognostic factors. In this study, we applied a new statistical model for survival times of oral cancer patients considering limited prognostic factors. Methods: A total of 29 cases of Oral cancer patients with stage I to IV invasive primary oral cancer treated at the University of Port Harcourt, Nigeria between 2008 and 2015 were used to generate prognostic models. Profiled prognostic factors include age, stage of tumor development, habitus, and treatment modalities. The baseline statistical distributions considered were Exponential, Weibull, Lognormal and Log-logistic distributions. The Chi-Square test was considered for the suitability of the model chosen. A comparison of the model performance was done using the Akaike Information Criterion (AIC). Results: Seventeen (58.6%) of the oral cancer patients were males and 12(41.4%) were females within the age range of 19 and 73 years. Sixteen (55.2%) of the patients were censored while 13(44.8%) were not censored. The estimated median survival time (MST) for the males was 29.50 months while that of the female was 7 months. Four parametric statistical models were tested and all identified tumor stage [cTNM stage (p= 0.000)] and treatment modality (p= 0.000) as more important predictors of survival. The models were then compared, using the Akaike Information Criterion (AIC) to determine the model best fit for the data. The model with the lowest AIC and so considered the best was the Weibull Statistical Model (WSM) with AIC= 100.76. Conclusions: This study suggests that the Weibull survival model is the best fit for estimating oral cancer survival times especially where only limited prognostic factors are available. Larger studies are required to validate the findings of this pilot.

COVID-19 outbreak and dental health care provision in Nigeria: a national survey.

BACKGROUND: The impact of the COVID-19 pandemic on the world is unprecedented, posing greater threats to vulnerable healthcare systems, especially in developing countries. This study aimed to assess the knowledge of dental healthcare providers in Nigeria about the disease and evaluate their responses to the preventive measures necessitated by COVID-19. METHODS: This was an online self-administered questionnaire-based study conducted among dentists practicing in Nigeria. A message containing the link to the survey was sent widely via social medial platforms and electronic mails to dentists practicing in Nigeria. The data collection was done between the 2nd of June and 3rd of July 2020. RESULTS: A total of 314 responses was recorded. Fever was the most specified generalized symptom (97.5%), while the use of masks (100%), hand hygiene (99.7%), social distancing (97.7%) and surface cleaning (99.4%) were the most commonly employed general preventive methods. The main identified risk of transmission in the clinic was aerosol generating procedures (98.7%). CONCLUSION: The general knowledge of dental personnel in our study population appears to be adequate on the common clinical features of COVID-19 but less adequate regarding the less common features. The COVID-19 pandemic has also modified some aspects of dental service delivery but more needs to be done in this regard. Preventive measures against the transmission of COVID-19 in dental practice settings include proper utilization of teledentistry, clinical triage, preprocedural 1% hydrogen peroxide oral rinses, and the use of appropriate Personal Protective Equipment (PPE) which should always be encouraged.

Evidence-based dentistry in a developing economy - the Nigerian example.

BACKGROUND: Evidence-based dentistry (EBD) is becoming popular all over the world with the increasing global involvement of dental practitioners in the debates on the relevance or otherwise of EBD. However, very little has been known on the evolutionary trend of EBD in the developing countries of the world. AIMS AND OBJECTIVES: This pilot study was designed to assess the state of EBD in the accredited dental schools in Nigeria as an example of a developing economy. METHODOLOGY: An electronic search was conducted for articles on the subject of EBD emanating into the world dental literature from Nigeria as a measure of activities in the field of EBD in the country. Further investigation was done by way of interviews of faculty members and resident doctors in the four fully accredited dental schools in Nigeria. The subject of the interview was premised around the evaluation of activities in the field of EBD. RESULTS: Only 6 relevant articles were found in the search. The interviews however revealed an increasing awareness but low level of knowledge of the principles of EBD in the dental schools. Major obstacles were infrastructural limitations and lack of personal motivations. The enthusiasm of the younger faculties and resident doctors was notable. CONCLUSION: It was obvious that EBD is yet to assume the desired momentum in the 21(st) century in Nigeria. It is however gladdening that there is a promising future for EBD with the rising enthusiasm noted among the younger generation of clinicians.