Nigerian Journal of Medical and Dental Education

The Effectiveness of Virtual Reality Distraction on Dental Anxiety During Local Anaesthesia among Adolescents – A Randomized Controlled Trial

OK Orhue — 2025-07-01

Objective: To determine the impact of the clinical use of virtual reality distraction in reducing anxiety levels in adolescents during local anaesthetic (LA) administration.

Methods: This was a randomized controlled study. Study participants comprised of adolescents aged 10 -17 years attending the Paediatric Dentistry outpatient Clinic of University of Benin Teaching Hospital, Benin City. One hundred and fifty-eight adolescents who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction and a study group with distraction using a Quest Oculus VR headset. Anxiety was assessed using subjective (MDAS) and physiologic (pulse rate, heart rate, oxygen saturation, respiratory rate and temperature) methods respectively, pre-treatment and post treatment. The IBM SPSS version 20 was used to analyze the data. The level of significance was set at p<0.05.

Results: A total of 156 participants with a mean age of 13.56±1.682 years were recruited in the study. The mean scores for MDAS after the administration of LA for the control and study group was 14.74 ± 3.35 and 10.09 ± 1.90 and this was statistically significant (P<0.001). PR had a mean value of 88.06 ± 11.19 and 93.56 ± 10.10 in the control and study group respectively before LA and was statistically significant (P= 0.002). However, after the administration of LA, the mean values were 97.08 ± 10.96 and 89.19 ± 10.17 showing a significant rise in the control group and decrease in the study group respectively (P <0.001). Temperature, systolic BP and SPo2 showed slight changes between the control and study groups before and after administration of LA but these were not statistically significant. The sociodemographic factors which played a role in anxiety levels (as recorded in PR variation) following linear regression analysis were position in family, study group and site of administration (P = 0.018; 0.003 and <0.001) respectively.

Conclusion: Virtual Reality distraction significantly reduced pain and anxiety during administration of local anaesthesia in adolescents undergoing dental treatment.

Spirometry at a Tertiary Hospital in South-South, Nigeria: Indications, Referral Patterns, and Ventilatory Function Outcomes

OT Ehondor — 2025-07-01

Background: Spirometry is an essential diagnostic tool in respiratory medicine, widely used for assessing lung function and diagnosing respiratory disorders. Despite its clinical significance, its utilization in low-resource settings remains suboptimal. Understanding the indications for spirometry and referral patterns can help optimize its use in patient management. The objective of the study was to evaluate indications, referral patterns, and ventilatory function outcomes among patients undergoing spirometry at a tertiary hospital in South-South Nigeria.

Methods: A cross-sectional study was conducted involving 90 patients who underwent spirometry. Data on demographic characteristics, referral sources, and ventilatory function outcomes were collected and analyzed using descriptive statistics.

Results: The most common indication for spirometry was asthma (46.7%), followed by chronic obstructive pulmonary disease (COPD) and chronic cough (25.6%). Other indications included post-chemotherapy pulmonary assessment (11.1%), pulmonary fibrosis (4.4%), bronchiectasis (4.4%), and pleural effusion (3.3%). The respiratory unit accounted for most referrals (68.9%), followed by cardiology (13.3%), cardiothoracic surgery (12.2%), and maxillofacial surgery (5.6%). Obstructive ventilatory impairment was the most frequently observed pattern (51.1%), followed by mixed (23.3%) and restrictive (17.8%) impairments, while 7.8% of patients had normal spirometry results.

Conclusion: This study highlights the high burden of chronic respiratory diseases and the critical role of spirometry in their assessment. Despite its diagnostic utility, limited access remains a challenge, emphasizing the need for improved availability, clinician awareness, and integration into routine clinical practice for better respiratory health outcomes.

The Relationship Between Dental Malocclusions, Fingerprints and Blood Group in Patients attending Orthodontic Clinic in Benin City

C Osemwegie — 2025-07-01

Background: Literature evidence suggests a relationship between dermatoglyphic patterns, blood group system and the development of dental malocclusion. The wide variations observed have been suggested to be due to genetic and environmental influences. More research to ascertain the relationship between malocclusion with fingerprints and blood group in Nigerians is essential. The objective of the study was to assess the relationship between dental malocclusion with fingerprints and blood group in a Nigerian population.

Methods: A total of 205 patients, aged 13-40 years, attending the Orthodontic clinic of the University of Benin Teaching Hospital, Benin City who met the inclusion criteria were selected. Their dental malocclusion was determined using Angle’s classification, Fingerprints of both hands were taken using a Bio scanner, while blood samples were collected to determine their ABO blood group. Fingerprint patterns of arches, loops and whorls were assessed and grouped.

Results: More than half of the patients (62.0%) had Angle’s Class I malocclusion. The fingerprint patterns of left thumb, right thumb and right index finger had significant relationship with the different classes of dental malocclusion (P= <0.001, 0.009 and 0.0410) respectively. However, there was no significant association between blood group and dental malocclusion.

Conclusion: There is a relationship between dermatoglyphic pattern and dental malocclusion. No significant relationship was found between dental malocclusion and blood group. Dermatoglyphic patterns of some digits show predictive values when compared to others.

Bronchodilator Responsiveness in Different Ventilatory Patterns

OT Ehondor — 2025-07-01

Background: Bronchodilator response varies across ventilatory impairments, influencing diagnosis and treatment decisions. While obstructive lung diseases like asthma and COPD often show reversibility, the response in restrictive and mixed impairments remains unclear. In resource-limited settings, spirometry with bronchodilator testing is a valuable tool for distinguishing these conditions. The objective of the study was to evaluate bronchodilator response in obstructive, restrictive, and mixed ventilatory impairments and its clinical implications.

Methods: This study analyzed spirometric parameters (FEV₁% and PEF%) before and after bronchodilator administration in individuals with different ventilatory patterns. Reversibility was assessed by comparing pre- and post-bronchodilator values, identifying significant changes within each impairment group.

Results: The obstructive group exhibited significant improvements in FEV₁% and PEF%, confirming bronchodilator reversibility in asthma and mild COPD. In contrast, restrictive and mixed impairments showed minimal or negative responses, suggesting limited therapeutic benefit. The restrictive group’s decline in PEF% and FEV₁% likely reflects parenchymal or chest wall limitations rather than reversible airway obstruction. The mixed pattern demonstrated the least response, highlighting its complex interplay between obstruction and restriction. Normal and obstructive groups had the highest reversibility, while restrictive cases showed the lowest.

Conclusion: Spirometry with bronchodilator testing is an effective, low-cost diagnostic tool for distinguishing ventilatory impairments, particularly in resource-limited settings. The findings reinforce the limited role of bronchodilators in restrictive lung diseases and emphasize the need for alternative treatment strategies. Future research should explore long-term bronchodilator responsiveness in restrictive and mixed impairments, incorporating biomarkers such as eosinophil counts or FeNO to improve personalized treatment approaches.

Pre-Hospital Use of Antimalarial Drug and Associated Factors among Children with Febrile Illnesses Presenting to a Tertiary Health Facility

SO Akodu — 2025-07-01

Background: Malaria is still a major public health problem in Nigeria and it is a leading cause of infant and childhood mortality. The initiation of treatment with antimalarial drug within 24 hours of fever onset at home and before presentation to the hospital is one of the recommended strategies to reduce mortality from malaria in sub-Saharan Africa.

Objective: To determine the pattern of use of antimalarial drug prior to hospital presentation among febrile children presenting to a tertiary health facility in southwestern Nigeria.

Methods: This was a cross-sectional, descriptive study. All consecutive febrile children who presented in the Children Emergency Room of Olabisi Onabanjo University Teaching Hospital during the study period were recruited. Data on socio-demographics, treatments given at home, history of present illness and outcome of blood smear testing for malaria parasite were collected and analysed.

Results: A total of 50 children aged one month to 13 years who had documented fever were studied. Three-quarters of the febrile children had duration of fever of more than one day (77.5%) and four-fifths had negative blood smear for malaria parasite (82.2%). Only four (8.0%) of the febrile children received antimalarial drug prior to hospital presentation. Twelve of the febrile children (24.0%) had a presenting temperature of ≥38.50C. All the four febrile children who received anti-malarial drug prior to hospital presentation had a negative blood smear for malaria parasite and duration of fever of greater than two days.

Conclusion: This study showed that pre-hospital home treatment with antimalarial drug was inappropriate among the enrollees. Health education on appropriate antimalarial drug use for febrile children should be intensified.

Factors Affecting Medication Adherence Between Health Workers and Non health Worker of National Obstetric Fistula Centre, Ningi, Bauchi State.

D Azaki — 2025-07-01

Background: The study was motivated by the need to understand the factors impacting medication adherence among both healthcare workers and non-healthcare workers. It sought to address problems of non-adherence to medication regimes which can negatively affect health outcomes by focusing on behavioural, occupational and regimen related obstacles. The objective of the study was to determine whether healthcare professionals exhibit better adherence than non-health workers and to identify the factors that affect adherence behaviour in both groups.

Methods: The study was conducted at the National Obstetric Fistula Centre, Ningi, Bauchi State, Nigeria, using a cross-sectional analytic technique. Participants consisting of both health workers and non-health workers were both surveyed through structured questionnaires and the Morisky Morisky Medication Adherence Scale (MMAS-8).

Results: There were strong negative correlations between adherence and issues such as forgetfulness, and perceived annoyance. Both health workers and non-health workers experienced declines in adherence as the complexity and number of prescriptions increased. Health workers did not consistently show better adherence despite their medical expertise, and non-health workers improved adherence despite side effects.

Conclusion: Employment in the health sector does not significantly impact overall medication adherence. Targeted interventions, such as simple treatment regimens and medication reminders are needed to address behavioural barriers like forgetfulness, and complex regimens, especially for non-health workers. The research highlighted the importance of tailored strategies to improve adherence across all professions for better health outcomes

Workplace Violence: The Perception of Healthcare Workers

JO Omo — 2025-07-01

Objective: To analyse the perception of healthcare workers on workplace violence

Methods: This descriptive study investigated healthcare providers in Edo State, Nigeria, using a self-administered questionnaire with two sections. Section A collected demographic data, while Section B explored the research topic in-depth. Responses were measured on a Likert scale with four options: Strongly Disagree, Disagree, Agree, and Strongly Agree. The study focused on healthcare workers in the Accident and Emergency units of three hospitals in Edo State, selected to represent distinct senatorial districts. Participants were randomly distributed across the hospitals. Data analysis employed simple percentages and Chi-square tests, with results presented in tabular form.

Results: The profession of the respondents comprised medical doctors 72(18), nurses 196 (49%), pharmacists 64(16%), physiotherapists 32 (8%) and laboratory scientists/Technician 36 (9%). In terms of age, 8 respondents (2%) were below the age of 20years, 68 respondents (17%) are between the ages of 21-30 years, 54 respondents (88% are between the ages of 31-40years while 236 respondents (59%) are 41 years and above.

Twenty-nine of the respondents (7.25%) strongly agreed that workplace violence exists among health workers either by staff or patients/relatives, 338 respondents (84.5%) agree, 21 respondents (5.25%) disagreed while the remaining 12 respondents (3%) strongly disagree.

Sixteen of the respondents (4%) strongly agree that violence in workplaces among health workers is caused by non-staff only, 68 respondents (17%) agree, 204 respondents (51%) disagree while the remaining 112 respondents (28%) strongly disagreed

Conclusion: Workplace violence is a harsh reality for healthcare workers, particularly those in emergency departments, and poses a significant threat to their well-being. Therefore, it is imperative to provide healthcare workers with training on violence prevention and management to ensure a safer working environment.

An Evaluation of School Oral Health Caries Prevention and Control Program for 5 And 12-Year-Old Children in Benin City, Nigeria

NM Chukwumah — 2025-07-01

Objective: To assess the effectiveness and impact of school oral health caries preventive and control program in 5- and 12-year-old children in Benin City.

Methods: This was an interventional study carried out in public and private primary and secondary schools in the Benin Metropolis, Edo State among 5 and 12-year-old children attending selected schools. Age-appropriate oral health education and oral hygiene tools were given every three months and participants followed up. Data was collected using a structured interviewer-administered questionnaire which generated information on the participant’s sociodemographic background (age, gender and socioeconomic status), oral examination was done, oral hygiene assessed using the Simplified Oral hygiene index (S-OHI). Caries risk was assessed using the Association for Pediatric Dentistry (AAPD) assessment form for 0-5-year-olds and >6 years to categorize participants into low, moderate and high risk for dental caries. This was done at baseline, 3 months and 6 months post intervention.

Results: A total of 226 children were recruited for the study, with 103 (45.6%) 5-year-olds and 123 (54.4%) 12-year-olds, all four Local Government Areas within the Benin metropolis were represented Egor (38.1%), Ikpoba-Okha (13.7%), Oredo (36.7%), Ovia North East (11.5%), while the public-school participants made up 54% of the study participants and 46% were private school participants. Prevalence of dental caries was 5.97% among 5-year-old and 5.29% among 12-year-old children. Mean oral hygiene scores differed slightly between baseline and 3 months post intervention assessment but was not statistically significant (P=0.834) however, there was a positive difference between baseline mean score and 6 months post intervention assessment as well as the difference between the 3 months and 6 months post intervention period mean scores were statistically significant (P<0.001) respectively. The oral hygiene status of participants at baseline was good (27.0%), fair (55.8%), and poor oral hygiene (17.3%) by the 3- and 6-months post intervention assessment the oral hygiene was good (40.7% and 58%); fair (52.2% and 42.0%) while poor was (7.1% and 0%) respectively. Caries risk assessment at baseline and 6 month post intervention assessment was low risk for caries (27% and 58%), moderate risk (55.8% and 42.0%) and high risk (17.3% and 0%) respectively.

Conclusion: The school oral health caries prevention and control program was very effective and had a positive impact on the oral health and caries risk of 5- and 12-year-old children in Benin City.

Prescription pattern of Antifungal medicines in a Tertiary Hospital General Practice Clinic, South-South, Nigeria

SA AYINBUOMWAN — 2025-07-01

Background: The increasing threat of antifungal resistance makes fungal diseases an emerging global health concern. Despite this, there is a notable lack of data on antifungal drug utilization in many low and middle-income countries like Nigeria. This study addresses this important gap by evaluating antifungal drug utilization in a tertiary hospital in South-South Nigeria. The objective: of the study was to describe the profile and prescribing trends of antifungal agents in a Tertiary Hospital General Outpatient Clinic South-South Nigeria

Methods: A cross-sectional and descriptive study conducted at the General Practice Clinic (GPC), of the University of Benin Teaching Hospital, Benin City, Edo state, Nigeria from January to December 2021. Dispensed prescription records from the GPC were manually reviewed. Patients who received antifungal agents were included in the study. Antifungal agents were identified using the World Health Organization Anatomical Chemical (ATC) system. The names, route of administration and use of multiple medications were noted. Data is presented descriptively.

Results: A total of 25,258 patients were dispensed prescriptions during the period, and of these, there were 538 (2.1%) patients with prescriptions of antifungal agents. The commonest antifungal monotherapies were fluconazole 284 (41.9%) and clotrimazole 183 (27.0%). Among the 128 patients prescribed multiple antifungal agents, Clotrimazole cream and fluconazole tablet was the commonest combination, 45 (35.2%). Oral formulations were mostly prescribed 350 (51.7%) followed by topical route 310 (45.8%).

Conclusion: This study found a low overall level of antifungal prescriptions. The urgent need for the development and implementation of antifungal stewardship programs cannot be overemphasized