Torsion of wandering spleen, an unusual cause of acute abdomen; a report of two cases.

BACKGROUND: Wandering spleen is an uncommon entity that is rarely considered in the evaluation of patients with acute abdominal conditions. OBJECTIVE: To report two cases of wandering spleen presenting with acute abdominal pain. METHODS: The clinical records of the patients including preoperative evaluation, intra-operative findings and postoperative care were reviewed RESULT: A 6 year old boy presented with right lumbar pain which worsened over a 36 hour period with findings of a tender right lumbar mass. Abdominal ultrasound showed a mass with echogenicity consistent with that of the spleen with no blood flow and an empty splenic bed. The pre-operative diagnosis was torsion of a wandering spleen. The second case was that of a 42 year old woman who presented with severe colicky lower abdominal pain which worsened over three days with a background history of progressively increasing lower abdominal mass which was tender and about 26 week gestational size at presentation. The initial diagnosis was torsion of an ovarian cyst. Abdomino-pelvic Ultrasound scan showed a heterogeneously hypo-echoic mass overlying the uterus and the left ovary with no blood flow. The presence of wandering spleen with torsion of the vascular pedicle was confirmed at laparotomy in both instances. Splenectomy was performed in both cases with good recovery. CONCLUSION: Torsion of a wandering spleen poses a diagnostic challenge. A high level of suspicion is required to make a diagnosis and institute appropriate treatment.

Transferability of clinical skills acquired on simulator to real life clinical practice.

AIM: The aims of this study were to determine the relationship between performances of students in clinical skills laboratory and real life clinical practice and to determine the experiences and views of instructors as it relates to teaching in skills laboratory. METHODS: The performances of two randomly selected sets of graduates in the operative examinations conducted in skills laboratory were compared with the performances of the same sets of graduates in the operative examinations conducted on life patients two years later using Spearman's rank test. Experiences and views of two teachers from each of the six dental schools in southern Nigeria as it relates to teaching in clinical skills laboratory were obtained using a structured questionnaire. RESULTS: There was an insignificant correlation between the outcomes at both examinations (p value was 0.18). Most of the respondents (62.5%) agreed that teaching in skills laboratory was tiresome and most (75.0%) strongly agreed that the number of students constitutes a serious challenge to learning. Most of the respondents regarded their role in skills laboratory as that of an expert as against that of a facilitator. CONCLUSION: There was a weak correlation between performances in skills laboratory and real life environment. Students' number appears to make teaching in skills laboratory unpleasant and teachers had a wrong perception of their role.

Randomized clinical study comparing metallic and glass fiber post in restoration of endodontically treated teeth.

BACKGROUND: Post-retained crowns are indicated for endodontically treated teeth (ETT) with severely damaged coronal tissue. Metallic custom and prefabricated posts have been used over the years, however, due to unacceptable color, extreme rigidity and corrosion, fiber posts, which are flexible, aesthetically pleasing and have modulus of elasticity comparable with dentin were introduced. AIM: To compare clinical performance of metallic and glass fiber posts in restoration of ETT. MATERIALS AND METHODS: 40 ETT requiring post retained restorations were included. These teeth were randomly allocated into 2 groups. Twenty teeth were restored using a glass fiber-reinforced post (FRP) and 20 others received stainless steel parapost (PP), each in combination with composite core buildups. Patients were observed at 1 and 6 months after post placement and cementation of porcelain fused to metal (PFM) crown. Marginal gap consideration, post retention, post fracture, root fracture, crown fracture, crown decementation and loss of restoration were part of the data recorded. All teeth were assessed clinically and radiographically. Fisher's exact test was used for categorical values while log-rank test was used for descriptive statistical analysis. RESULTS: One tooth in the PP group failed, secondary to decementation of the PFM crown giving a 2.5% overall failure while none in the FRP group failed. The survival rate of FRP was thus 100% while it was 97.5% in the PP group. This however was not statistically significant (log-rank test, P = 0.32). CONCLUSION: Glass FRPs performed better than the metallic post based on short-term clinical performance.

Depo-provera effects on Wistar rat performance in the Y-maze.

Medroxyprogesterone acetate is the most commonly used progestin component of hormone therapy. The goal of the present study was to determine whether Medroxyprogesterone affects rat behavior using a Y-maze test. Twenty-four female Wistar rats were randomly selected into three groups; control group, a low dose (13 mg/ml MPA) group and a high dose (33 mg/1 ml MPA) group. Doses of Medroxyprogesterone were delivered by intramuscular injection for a period of 3 weeks. Medroxyprogesterone administration resulted in a decrease in memory and locomotion activity of rats (p < 0.05). Despite Medroxyprogesterone being effective in modulating hormonal interaction to prevent conception in actively reproducing females, cognitive impairment could be one of its adverse effects.

Comparison of the haemodynamic effects of pyrethroid insecticide and amodiaquine in rats.

Malaria infection is a common cause of morbidity and mortality especially in the tropics and subtropics. This has led to the increased prophylactic use ofpyrethroid insecticides and/or Amodiaquine (Aq) to combat the parasitic protozoan infection. The aim of this study was to investigate the comparative haemodynamic effects of pyrethroid insecticide and amodiaquine in rats. Experimental rats were randomly allocated into seven groups of five rats in each. Groups 1, 2 and 3 were exposed to pyrethroid by inhalation for 1, 2 and 3 min, respectively, while groups 4, 5 and 6 were administered Aqper oral at 5, 10 and 15 mg kg(-1) b.wt., respectively. Control rats were neither exposed to pyrethroid nor administered Aq. Pyrethroid insecticide led to reduced systolic, diastolic and mean arterial pressures, but increased pulse pressure. Aq treatment did not cause any significant variation in haemodynamic variables. Heart rate was comparable in all groups. Results from the study provide extended safety/toxicity profile for pyrethroid use and Aq treatment. Aq showed no cardiotoxic potential, while pyrethroids have hypotensive effect. It is thus recommended that exposure to pyrethroids should be minimized.

Comparing the knowledge and attitude about HIV/AIDS and the sexual behaviour of secondary school students of a missionary school and a public school.

BACKGROUND: A study of high school students attending a missionary school and a public school in Lagos was carried out to determine their knowledge and attitude about HIV/AIDS and to compare their sexual behaviour. METHODS: Self administered questionnaires, were used for the respondents, selected by multistage sampling and a response rate of 98% was obtained. The average age of the population was 13.6 years. There was no significant difference in the knowledge of students from both schools about HIV/AIDS. 90% of all the respondents knew the exact meaning of HIV/AIDS. Most of the students got their information from the mass media (66%) and the school (57%). Only 5% and 0.3% of missionary and public school students respectively were informed by their parents. RESULTS: There was no significant statistical association between the type of school and the occurrence of sexual intercourse. However, only 4% of sexually active missionary students used condoms compared to the 37% of the public school students. Condom usage was associated with the type of school (X2 = 1830; P-value = 0.0000189). There was also a statistically significant relationship between condom use and the age, sex and class of sexually active students (P-value = 0.00000006; 0.00000032; 0.00497073 respectively). 25% of the sexually public students had multiple sexual partners, compared to 2% for the missionary school students. There was a statistically significant relationship between the type of school and the number of sexual partners (X2 = 11.37; P-value = 0.003390). CONCLUSION: The study recommends that age-appropriate comprehensive sexuality education (including condom use) should be made available to students from both schools.