Effect of Chronic Kidney Disease on Taste Function: A Case Control Study among Nigerian.

Taste dysfunction has been associated with chronic kidney disease (CKD) especially end stage kidney disease (ESKD) and also implicated as one of the predisposing factors for the prevalent malnutrition, muscle wasting and impaired quality of life among patients with CKD. To assess the taste function and determine the pattern of taste dysfunction in patients with CKD attending the University College Hospital, Ibadan. This was a cross sectional, hospital-based case-control study of adult patients with CKD. The control group were age and sex matched without CKD. Interviewer-assisted questionnaires were administered on all participants to obtain clinical information concerning demographics, clinical data on kidney disease and taste dysfunction. The four basic taste modalities namely; sweet, sour, bitter and salt taste senses of the participants were tested with validated "taste strips". There were 100 patients with CKD and 100 healthy controls, age ranges between 19 and 86 years (mean ± SD = 46.3 ± 13.9 years) and 20 and 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution (p = 0.57). Hypogeusia was found in 27.0% of CKD patients with specific taste modalities dysfunction for salt, sour, sweet and bitter taste of 13.0, 24.0, 13.0 and 17.0%, respectively. The controls only had specific taste modalities dysfunction for salt, sour and bitter taste of 1.0% for each of the taste modalities. The mean total taste scores in the cases and controls were - 9.8 ± 3.2 and 13.4 ± 1.5 (p = 0.001), respectively. The mean taste scores were significantly lower among the cases than controls, salt taste-2.82 ± 1.1 and 3.7 ± 0.7 (p = 0.001), sour taste - 2.2 ± 1.0 and 3.2 ± 0.7 (p = 0.001), sweet taste-, 2.9 ± 1.8 and 3.8 ± 0.5 (p = 0.001), bitter taste - 1.9 ± 1.2 and 2.8 ± 0.9 (p = 0.001). Taste dysfunction is prevalent among patients with CKD and the affectation involves all taste modalities.

Pattern of Oral Health Among a Population of Pregnant Women in Southwestern Nigeria.

Oral health in pregnancy is important to the health of the pregnant woman; and good oral health plays a role in the outcome of pregnancy. However, many pregnant women and healthcare providers are either unaware of this or accord this less attention. The study was designed to describe pattern of oral health among a cohort of pregnant women. Seventy-seven pregnant women attending antenatal care at a secondary healthcare facility were evaluated in third trimester following written informed consent. Each participant had a structured data collection form administered and clinical examination conducted. Information on socio-demographic characteristics, dental and obstetric history and examination were obtained. Dental assessment involved the use of the oral hygiene, gingival, periodontal and caries indices. The data collected was entered and analysed using IBM SPSS Statistics version 20. The mean age of the participants was 29.90 (± 4.38) years and all women were in the third trimester of pregnancy. Only 6.5% of the participants had dental complaints, 26% indicated brushing twice a day and 96.1% never had dental health check in the past. A good oral hygiene score was found in 40% of participants; 6.5% and 10.4% had a healthy periodontal and gingival status respectively and only 8 (10.4%) had caries. Less than half of the pregnant women had good oral health status. The antenatal care period may be an opportunity to identify oral diseases; counsel and introduce positive oral health behaviours and enhance improved personal oral hygiene.

Salivary Electrolytes, Total Protein and Immunoglobulin A in Patients with Chronic Kidney Disease: A Case Control Study.

The objectives of this study were to compare levels salivary electrolytes, total protein and immunoglobulin A(IgA) in patients with chronic kidney disease (CKD) and healthy individuals; and to determine the relationship between thesalivary and blood levels of these factors between the two groups. Ninety-eight participants consisting of 48 patients withCKD and 50 healthy individuals (age and gender matched) were included. Whole saliva and blood samples were collectedand analyzed for concentrations of electrolytes (K+, Na+, Ca2+, Cl-, and HCO32-), total protein and IgA. Data were analyzedusing Independent-Samples t-test and Pearson correlation test. Concentrations of salivary K+, Ca2+, Cl-, and total proteinwere higher; while concentrations of salivary Na+, HCO32- were lower in patients with CKD compared with healthyindividuals. There was no difference in the salivary IgA levels in patients with CKD compared with healthy individuals.Salivary calcium level showed linear correlation with the plasma calcium level while salivary chloride level showed negativecorrelation with plasma chloride level among patients with CKD. These findings indicate that saliva and plasma from patientswith CKD are characterized by higher potassium, chloride, and lower sodium concentrations than their levels in healthyindividuals; thus, suggesting a possible increased adrenal-cortical activity in patients with CKD.

CLINICO-PATHOLOGIC REVIEW OF BIOPSIED TONGUE LESIONS IN A NIGERIAN TERTIARY HOSPITAL.

BACKGROUND: Varying pathologic conditions can affect the tongue for which the pattern of occurrence may differ. The aim of this study was to review the clinico-pathologic features of histologically diagnosed cases of tongue lesions that presented in our hospital over a 21 years period. MATERIALS AND METHODS: Data on habits, class of lesion, histological diagnosis, age, gender, and site distributions were analyzed using descriptive frequencies, ranges and means ± SD. Variables were compared using Chi square and ANOVA tests as appropriate. Sites of lesions were coded using the WHO ICD-O code on topography. RESULTS: Tongue lesions were seen in 43 males and 31 females. There was a bimodal peak age of occurrence at 40-49 and 60-69 years of age. Smoking and alcohol intake habits were recorded in 8 cases only. Neoplastic lesions constituted 78.4% of the cases. Using the WHO ICD-O code for topography of lesions, the tongue dorsum (ICD-O-2.0) was the most commonly affected site. Malignant lesions constituted 47.3% of the cases seen. Also, 8.6% of the malignant lesions were seen in younger patients (< 40 years). CONCLUSION: Tongue lesions showed a bimodal age of occurrence with neoplastic lesions as the most histologically diagnosed lesions in our study.

Effects of induced-kwashiorkor on salivary parameters in Wistar rats.

BACKGROUND: This study was undertaken to determine changes induced by protein malnutrition (kwashiorkor). in the secretory functions of salivary glands and biochemical parameters of salivary fluid using rats. METHODS: Eighteen male Wistar rats were randomly divided into two groups (control and kwarshiorkor) of 9 rats each. The rats were fed with normal diet and low protein diet (2% protein) respectively for a period of 6 weeks. Stimulated saliva samples using pilocarpine (10 mg/kg body weight i.p.) were collected and salivary glands (parotid and submandibular) were surgically removed. Biochemical analysis of salivary secretion using salivary lag time, flow rate, pH, total protein and concentrations of electrolytes (Na+, K+, Ca++, Cl-, HCO(2-)3 PO4) were conducted and compared. Morphological assessment of the salivary glands was done using heamatoxyline-eosin and Alcian blue stains. RESULTS: Body weights decreased in the kwashiorkor group. Weights of submandibular and parotid glands (right and left) were lower in the kwashiorkor group compared to the normal diet group. The mean salivary lag time was increased while the salivary flow rate was reduced in the kwashiorkor group compared to normal diet group. Salivary electrolytes and total protein analysis showed reduced concentration of sodium while potassium and bicarbonate concentrations were increased in the kwashiorkor group compared to the normal diet group. Histological analysis of the H-E and alcian blue stained salivary glands in the kwashiorkor group exhibited moderate to severe acinar cell atrophy, periductal fibrosis and reduced mucin content. CONCLUSION: These findings suggest the role of functional and biochemical changes in salivary secretion in the pathophysiology of oral diseases associated with protein malnutrition.

Pregnancy related changes in human salivary secretion and composition in a Nigerian population.

BACKGROUND: A variety of physiological changes occurring during pregnancy has been shown to affect the oral health. Saliva is critical for preserving and maintaining the health of oral tissues and has been used as a source of non-invasive investigation of different conditions in human and animal studies. AIM: This study was designed to evaluate changes in secretion and composition of saliva in pregnant women in a Nigerian population. METHODS: This was a descriptive cross-sectional study using purposive sampling technique. Saliva samples were collected from 50 pregnant and age matched 50 non-pregnant women. Salivary flow rate, pH, total protein and concentrations of sodium, potassium, calcium, phosphate and bicarbonate were determined and compared using paired independent sample t test. RESULTS: Salivary pH,mean concentrations of potassium and bicarbonate were significantly reduced while mean concentrations of salivary sodium and phosphate were significantly elevated in pregnant women compared to non-pregnant women (P < 0.05). However, there was no significant difference in the salivary flow rate, concentrations of total protein and calcium. CONCLUSION: Salivary pH, bicarbonate and potassium concentrations were reduced while sodium and phosphate concentrations were elevated in pregnant women. These findings suggest that pregnant women may be predisposed to higher caries incidence.

Aging affects morphology but not stimulated secretion of saliva in rats.

BACKGROUND: The role of aging on the salivary gland function still remains controversial and inconclusive. This study was undertaken to determine the effects of aging on the morphology and secretion of salivary glands using male Wistar rats. METHOD: There were three age groups; group A (3 months old; n = 8), group B (6 months old; n = 8), and group C (9 months old; n = 8). Body weights, salivary gland weights, salivary flow rates, pH and salivary levels of sodium, potassium, calcium, chloride, bicarbonate, phosphate and total protein were measured and compared. Hematoxylin-eosin stained histological slides of the salivary glands were assessed for morphological changes. RESULTS: Body weights increased with age while mean parotid gland weight was significantly higher in group B than in groups A and C. Mean salivary flow rate was significantly higher in group B and C than in group A, and mean salivary pH was significantly higher in group B and C than group A. Analysis of salivary electrolytes and total protein showed that mean levels of sodium, potassium and bicarbonate increased with age significantly while mean levels of calcium, chloride, phosphate and total protein did not show significant change among the groups. CONCLUSION: These findings showed that varying changes were observed in the morphology of salivary glands of aging rats without impaired function.

Salivary flow and composition in diabetic and non-diabetic subjects.

The study investigated the effects of type 2 diabetes mellitus on salivary flow and composition in humans compared to healthy sex and age matched controls. Forty adult human subjects divided into 20 diabetic and 20 non-diabetic healthy subjects were included. Saliva samples were collected and analysed for glucose, total protein, calcium, sodium, potassium, chloride and bicarbonate. Salivary flow rate was also determined. The results showed that salivary glucose and potassium levels were significantly higher (p = 0.01 and 0.002 respectively) in diabetic patients compared with non-diabetic participants. It was also found that the diabetic patients had significant reduction in salivary flow rate when compared with non-diabetic individuals. In contrast, there was no significant difference in levels of total protein, Na+, Ca++, Cl- and HCO3- between the two groups. These results suggest that some oral diseases associated with diabetes mellitus may be due to altered levels of salivary glucose, potassium and flow.

Oro-facial squamous cell carcinoma--a twenty-year retrospective clinicopathological study.

BACKGROUND: Squamous cell carcinoma of the orofacial region is a potentially life-threatening malignant epithelial neoplasm. There have been few studies on the relationship between clinical variables and histological grade among patients with oro-facial carcinoma. We sought to find correlation (if any) between clinical profile, anatomical location and histological grade of these tumours. METHODOLOGY: A retrospective study of all histologically diagnosed oro-facial squamous cell carcinoma cases seen at the University College Hospital, Ibadan between 1990 and 2009. RESULTS: Squamous cell carcinomas constituted 176 (38%) of all oro-facial malignancies. They comprised 91 males and 85 females with mean age of 57 (+/- 16.4) years. The maxillary region was most frequently affected (25%) while the lip was least involved (3.4%). Well-differentiated squamous cell carcinomas constituted 49%, moderately differentiated carcinoma accounted for 36.8% while poorly-differentiated squamous cell carcinomas constituted 14.2%. Well-differentiated and moderately differentiated tumours were relatively more common among subjects older than 50 years of age and poorly-differentiated tumours were more common before 50 years of age (p= 0.001). Degree of tumour differentiation was not correlated with gender (p = 0.88), and anatomical location (p = 0.17). CONCLUSION: Further clinical studies may be required to determine whether oro-facial carcinoma in patients less than 50 years of age has a more aggressive behaviour than in older patients.

Comparative analysis of salivary glucose and electrolytes in diabetic individuals with periodontitis.

BACKGROUND: A high incidence of periodontal disease has been reported among diabetics, however the role of saliva in the occurrence of this oral disease in these patients is yet to be understood. OBJECTIVE: To determine the effects of type-2 diabetes and periodontal disease on salivary flow rate and biochemical composition. DESIGN: A prospective study involving 40 adult human subjects divided equally into four groups of diabetics with periodontitis (group 1), diabetics without periodontitis (group 2), non diabetics with periodontitis (group 3) and non diabetics without periodontitis (group 4). METHODOLOGY: Saliva samples were collected and analyzed for salivary glucose, total protein, calcium, sodium, potassium, chloride and bicarbonate. Salivary flow rates were also determined. RESULTS: Salivary glucose and potassium levels were significantly higher (P = 0.002 and 0.04 respectively) in diabetic patients regardless of periodontal disease (mean = 100.7 ± 9.33 mg/dl; 111.5 ± 32.85 mg/dl and 23.79 ± 5.19 mg/dl; 22.9 ± 6.25 mg/dl respectively) compared with non diabetic participants (mean = 80.5 ± 30.85 mg/ dl; 62.5 ± 31.89 mg/dl and 19.23 ± 5.04 mg/dl; 17.74 ± 4.68 mg/dl respectively). In contrast, there was no significant difference in saliva flow rates and levels of total protein, Na(+), Ca(++), Cl(-) and HCO3 (-)between the groups. CONCLUSION: Salivary glucose and potassium levels were significantly higher among diabetics with or without periodontitis compared with non-diabetics with or without periodontitis. However, biochemical composition of saliva in diabetic individuals has probably little role in their susceptibility to periodontitis.

The role of plasma melatonin and vitamins C and B12 in the development of idiopathic tinnitus in the elderly.

BACKGROUND: To determine the correlation between plasma levels of melatonin, vitamin C and vitamin B12 and the presence of tinnitus among elderly subjects with unexplained subjective tinnitus. METHOD: Prospective involving apparently healthy elderly with subjective tinnitus and those without. Plasma levels of melatonin, vitamin C and vitamin B12 were determined using high performance liquid chromatography and correlation determined by comparing subjects with and without tinnitus. RESULT: There were 139 elderly subjects (78 females and 61males), the mean(SD) range of the age was 66.9years (0.77) 60-98 years. Of these 58.3% had tinnitus. The mean (SD) range of the plasma levels of melatoninn was 11.2 pg/mL(4.2) 5.1 pg/mL - 30.2 pg/mL while that of Vitamin C was 0.7 µmol/L (0.1) 0.3 µmol/L - 1.2 µmol/L, and vitamin B12 was 43.0pmol/L (3.1) 25.4 pmol/L - 71.6pmol/L. Comparing the plasma levels of the markers between elderly with and those without tinnitus, the plasma levels of melatonin (p=0.01) and vitamin B12 (p=0.03) were significantly lower among the elderly with tinnitus compared to those without, while the difference in the plasma level of vitamin C (p=0.6) was not. CONCLUSION: Low plasma melatonin and vitamin B12 have significant correlation with the development of subjective idiopathic tinnitus among the elderly. This finding suggests the need for the trial of correction of these markers in the reversal or control of tinnitus.

Florid cemento-osseous dysplasia: a report of two cases seen at the university college hospital ibadan.

SUMMARY: Florid cemento-osseous dysplasia (FCOD) is commonly seen in black women, but few cases have been reported in sub-Saharan Africa. This article presents two cases of FCOD seen at the University College Hospital Ibadan. Two women aged 70 and 60 years were initially diagnosed as chronic osteomyelitis but both were eventually diagnosed as florid cementoosseous dysplasia after radiological examination by orthopanthomogram. Diagnosis of florid cemento-osseous dysplasia is possible by clinical examination and the distinct radiological presentation, especially on orthopanthomogram and a biopsy may not be required.