Background: Dental caries is painful, expensive to treat and can harm nutrition and overall health. Good oral hygiene, regular utilization of dental health facilities, dietary habits and knowledge of determinants of dental caries play important role in the prevalence of dental caries among school children. Tooth loss, sequelae to untreated dental caries is higher among urban school children than their rural counterparts. Aim: To compare and determine the oral health status and investigate dental clinic attendance and knowledge of students in rural and urban secondary schools in Lagos on the aetiology of dental caries. Methods: Using stratified and proportionate to size sampling techniques, a random sample of 598 students aged 12-26years from rural and urban local government areas were examined for dental caries and gingivitis. Questionnaires were administered to elicit information on frequency of consumption of refined sugar, parents' educational status, knowledge of dental caries aetiology and dental clinic attendance. The decayed, missing and filled tooth index (DMFT) was measured according to the WHO caries diagnostic criteria for epidemiological studies and the clinical oral hygiene status measured with the gingival index (GI) of Loe and Silness, Plague index and the Simplified Oral Hygiene Index. Results: There was a statistically significant difference between urban and rural students in caries experience in permanent teeth (mean DMFT = 0.26 in urban areas; 0.11 in rural areas), More of the parents of students in the urban schools are educated than those in rural schools. The decayed (D) and missing (M) components were higher in the rural area, indicating a high level of restorative treatment need among the students in rural area. The urban participants had better oral hygiene and the gingival index was higher among rural students. Dental clinic attendance was higher among the urban participants than the rural participants. Conclusion: The students in urban secondary schools had better oral health status and make use of dental facilities more than their rural counterparts. The knowledge of aetiology of dental caries is poor among both the rural and urban school students.

Background: The Beck's Depression Inventory (BDI) and Alcohol Use Disorder Identification Test (AUDIT) have been validated for use in the study of alcohol related psychiatric disorders in the developed world as well as in Western Nigeria, but not in the Niger Delta Region. Aim: To ascertain the psychometric properties of BDI and AUDIT for use in this part of the world using psychiatric out-patients at the University of Port Harcourt Teaching Hospital. Methods: Four hundred and seventy (470) subjects were enlisted into the study using systematic sampling technique. The BDI and AUDIT were administered to each of them. One hundred and eighty five (185) subjects met the criteria for the second stage viz; a score of 18 and above on the BDI and/or a score of 5 and above on the AUDIT. Diagnoses of Depression and Alcohol Use Disorder were made using the Composite International Diagnostic Interview (CIDI). The data were analyzed using the statistical package for social sciences (SPSS) version 16.0 Results: The sensitivity and specificity of the BDI were 96.3% and 58.8% respectively. The positive and negative predictive values of BDI were 86% and 85.7% respectively. Also, the sensitivity and specificity of the AUDIT were 100% and 92.1%. Furthermore, the positive and negative predictive values of the AUDIT were 85.5% and 100% respectively. Conclusion: The BDI and AUDIT have excellent psychometric properties; hence they are valid for carrying out studies on alcohol related psychiatric disorders.

Background: The incessant crude oil spillage into the water bodies of the Niger delta region of Nigeria has raised fears that the fish caught in the water bodies would be heavily contaminated with heavy metals. This study tested five commonly consumed local fish species for their lead, cadmium, mercury, and arsenic content. Methods: Samples of dark tilapia (Sarothendon gallelacus), light tilapia (Oreochronis niloticus), two-fin catfish (Clarias gariepinus), "Zeghe" (Hydrocynus forskahlii) and three-fin catfish (Auchenoglanis occidentalis) bought from three fish markets (Creek Road, Mile One and Iwofe) were used for the study. The levels of the heavy metals in the fish samples were assessed in an accredited laboratory, while the human health implications of the contaminants were determined using the relevant international regulatory standards. Results: The fish samples contained detectable levels of the assessed metals. The mean concentration of cadmium in the fish samples was 0.29mg/kg; while the mean concentration of arsenic was of 1.85mg/kg. The average concentrations of lead and mercury in the fish samples were below the regulatory limits, whereas the mean concentration of cadmium was three times the WHO permissible limit of 0.1mg/kg. The concentrations of cadmium were highest in the light tilapia, and in the fish bought from the Mile One market, and lowest in the three-fin catfish, bought from the Creek Road market. Conclusion: The levels of the assessed heavy metals were significantly less than expectation. The levels of cadmium in the samples were however high enough to cause severe adverse health effects, hence the need for a more comprehensive public health response in managing crude oil spills.

Background: While many countries of the world have incorporated the teaching of cardiopulmonary resuscitation (CPR) into their schools curricula, there has been little or no effort made towards this in Nigeria. The aim of this study was to find out whether exposure of some Nigerian secondary school children to the conventional CPR would result in significant change in their CPR skills immediately after the training. Methods: It was a quasi-experimental study design carried out in 2012 with participants drawn from both private and public secondary schools in Obio / Akpor Local Government Area in Port Harcourt City, Rivers State, Nigeria. The initial cohort (stage I) involved 400 participants from senior secondary school 1 and 2 (SS1) and SS2) when their baseline CPR skills were assessed and immediately after the CPR training (stage II) when the participants dropped to 347 [189 (54.5%) females; 158 (45.5%) males]. They were exposed to both class room teachings and the practical hands-on sessions using manikins in line with the American Heart Association (AHA) guidelines. The data was analyzed using ANOVA and t-test. Results: Although the participants had virtually no CPR skills at the beginning, they gained very substantially immediately after the training which was found statistically significant (P < 0.05). They showed much enthusiasm in the training with high percentage of them indicating willingness not only to provide bystander CPR to their relatives but to strangers and trauma victims. Over 98% of them wanted CPR to be formally taught in Nigerian secondary schools. Conclusions: The CPR skills of the Nigerian students improved statistically with many ready to offer bystander CPR. It was recommended that CPR training programme should be incorporated into the curriculum of secondary school education in Nigeria.

Background: Endophthalmitis is a rare but dreaded complication of cataract surgery. It is, therefore, imperative for cataract surgeons to know about its prevalence and how to prevent it in their institutions. Aim: The aim of this study was to determine the prevalence of postcataract surgery endophthalmitis in a private health facility in Port Harcourt. Methods: A retrospective analysis of the case files and theater records of 92 eyes of all 83 patients who had cataract surgery at the DDS Eye Centre and Surgery, Port Harcourt, Nigeria, between August 2006 and November 2012 was done. This included pre-, intra-, and post-operative care and features of endophthalmitis. Statistical software package SPSS version 17 was used to analyze the data (P < 0.005) with the prevalence of endophthalmitis between extracapsular cataract extraction and small incision cataract surgery. Results: A total of 2484 (1490 males and 994 females) patients were seen in the private eye hospital in the period under review and 92 eyes of 83 (3.34%) patients (59 males and 24 females) were included in the study. Sixty-seven (73%) eyes had extracapsular cataract extraction with intra-ocular lens (ECCE + IOL) whereas twenty-five (27%) had small incision cataract surgery with intra-ocular lens (SICS + IOL). Among those who had ECCE, one (1.49%) developed endophthalmitis while two (8%) developed endophthalmitis following SICS, and they were all males which was statistically significant for surgery type. The prevalence of endophthalmitis in this study was 3.23%. Conclusion: The high prevalence of endophthalmitis in this study may be due to inadequate management of comorbid conditions such as corneal ulcer and diabetes. The incisions were temporally placed and sutures were not used which may have compromised the integrity of the wound in SICS, causing a higher prevalence of endophthalmitis with this method.

Background: An appendix mass is a complication of acute appendicitis with an adherent covering of bowel and omentum enclosing a pocket of pus. A carcinoma may masquerade as an appendix mass in the middle-aged and elderly patients. The clinical findings may not be specific, hence the need for a high index of suspicion when managing the elderly with a suspected appendix mass. Aim: The aim of this study was to highlight the clinicopathological findings in elderly patients with appendix mass. Methods: This is a retrospective study of patients aged 60 and older diagnosed with appendix masses and managed surgically. The study was carried out from January 2002 to December 2005. The hospital records of all patients within the study period were obtained and analyzed. A literature review was done using the PubMed search engine. Data analysis was done using SPSS software version 17. Results: Fifty-eight patients presented with appendix masses and were operated upon during the period with a female:male ratio of 1.5:1. The modal age range was 60-69 years. Most of the patients presented within 5 days of the onset of symptoms. Abdominal pain (89.7%) was the most common symptom. Constitutional symptoms (any of fever, malaise, and anorexia) (27.5%), weight loss (15.5%), and constipation (12.5%) were the other symptoms observed. Acutely inflamed appendix was the most common pathological finding (39.7%). Perforated appendix (17.3%), adenocarcinoma of cecum (15.5%), ameboma (8.6%), benign appendix tumor (5.2%), ascaris-perforated cecum (5.2%), endometriosis (3.4%), and pedunculated fibroid (1.7%) were the other pathological findings. Conclusion: The appendix mass in the elderly should be treated by surgical exploration as soon as the patient is fit because tumors may masquerade in the mass.

Background: Visual impairment and blindness pose different degrees of public health and social problem among the different age groups and sex. The problems are worse in the developing countries due to ignorance and lack of adequate eye care services. Public information systems, epidemiological data, and funding for blindness programs are often lacking and have hampered comprehensive blindness control programs in the rural communities, a fact that underscores the importance of this study. Aim: To estimate the burden of blindness and visual impairment according to age and gender in Emohua local government area (LGA), Nigeria. Methods: A population-based descriptive cross-sectional study conducted between October 11, and November 29, 2014, in Emohua LGA. Three hundred and fifty-three inhabitants were recruited in the study through a multistage sampling method. Demographic data, detailed ocular examinations were recorded and analyzed using SPSS version 20. Results: The study participants were 164 males and 189 females (male:female = 1:1.2). The prevalence of bilateral blindness is 1.4% (95% confidence interval [CI]: 0.78-2.5%) and unilateral blindness 2.5% (95% CI: 1.2-3.4%). Those who had various degrees of visual impairment in both eyes constituted 6.2% (95% CI: 5.7-8.5%) and 9.1% had unilateral visual impairment (95% CI: 8.7-9.7%). Cataract was the leading cause of bilateral blindness, accounting for 60% of cases, glaucoma (20%), and corneal opacity (20%). Conclusion: Blindness and visual impairment are more common in the older age groups and female gender in Emohua LGA. Government and nongovernmental organizations should step up comprehensive eye health care programs to realize the goals of Vision 2020.

Background: The risk of nosocomial infection is increasing due to the increasing number of patients with immune depression. Good ventilation is one of the methods used to reduce the ambient air levels of the causative agents, but this is rarely observed in Nigeria as hospital designs used to shut out the inclement weather in temperate countries are copied without many modifications, and without adequate provisions to constantly power the mechanical ventilation mechanisms. This study tested the microbiological air quality at different areas of the University of Port Harcourt Teaching Hospital to ascertain the levels of airborne bacteria and fungi in the ambient air. Methods: The study was carried out in July 2015 in randomly selected inpatient wards, outpatient clinics, and clinical laboratories of the hospital. The assessment was carried out by exposing Petri dishes containing the appropriate culture media for about 30 min at a convenient place in each of the nine study sites. Thereafter, the plates were covered and immediately transferred to the laboratory for incubation at 37°C, for 24-48 h, for bacteria; and at room temperature, for 5-7 days, for fungi. The number and types of bacteria and fungi in the cultures were determined at the end of the incubation period. Results: There were detectable bacteria and fungi in the ambient air of all the study sites. The mean bacterial count ranged from 9.5 colony forming unit per cubic meter (CFU/m ³ ) in the urology ward to 199.33 in the HIV clinic, with a mean of 80.0 CFU/m ³ , while the mean fungal count ranged from 10.5 CFU/m ³ in the surgery outpatient clinic (SOC) to 23.5 in the Anatomical Pathology Laboratory (APL), with a mean of 16.9 CFU/m ³ . Staphylococcus and Streptococcus were the most common bacteria in the SOC; Klebsiella was predominant in the immunization clinic; Escherichia coli were the most common in the APL, while bacillus was most frequently isolated in the gynecology ward. The fungi cultured from the study sites include Aspergillus, Penicillium, Fusarium, Trichophyton, Candida, and Rhizopus. Unlike the bacteria count, the fungal count increased in all the study sites at the end of the working day. Conclusion: The number and types of bacteria and fungi cultured from the study sites have the potential to cause ill health. Corrective actions are therefore needed.