Background and objectives:The need to attain and maintain good oral hygiene among pregnant women cannot be over emphasized as periodontal diseases in pregnancy have been linked with poor pregnancy outcomes. This study assessed the variables that affect oral hygiene status among pregnant women in a south-western Nigerian locality.Methodology:Four hundred and five pregnant Nigerian women were assessed for their oral hygiene status using the Oral Hygiene Index-Simplified. Demographic and pregnancy statistics were also obtained and the relationships between these and oral hygiene status were determined.Results:The mean age was 25.35 ± 5.02 years. Most of the women (96.0%) had never visited a dentist or any other oral health care provider and only 12.5% of those who had been attended by dental care givers have ever had professional dental cleaning. The oral hygiene status appeared to worsen as parity increased (p=0.047) while the use of the toothbrush and paste was associated with good oral hygiene (p=0.007). Higher education was associated with use of the tooth brush and paste (p=0.046) and good oral hygiene (p= 0.001).Conclusion:The positive effect of education on oral hygiene practices is highlighted in this study. However there is still need for proper health enlightenment in this population with regards to use of the available oral health care facilities.

Background:Delay in surgical treatment is a source of distress to patients and an important reason for poor outcome. We studied the delay before carrying out scheduled operative orthopaedic procedures and the factors responsible for it.Materials and Methods:This prospective study was carried out between March 2011 and December 2012. Temporal details of the surgical procedures at our hospital were recorded in a proforma including the patients’ perception of the causes of the delay to surgery. Based on the urgency of the need for surgery, patients were classified into three groups using a modification of the method employed by Lankester et al. Data was analyzed using the Statistical Package for the Social Sciences, version 17.0. Predictors of surgical delay beyond 3 days were identified by logistic regression analysis.Results:Two hundred and forty-nine patients with a mean age 36.2 ± 19.2 years and M:F ratio 1.3 were recruited. 34.1% were modified Lankester group A, 45.4% group B and 20.5% group C. 47 patients (18.9%) had comorbidities, hypertension being the commonest (22 patients; 8.8%). Median delay to surgery was 4 days (mean = 17.6 days). Fifty percent of emergency room admissions were operated on within 3 days, the figure was 13% for other admissions. Lack of theatre slot was the commonest cause of delay. There was full concordance between doctors and patients in only 70.7% regarding the causes of the delay. In 15.7%, there was complete discordance. Logistic regression analysis confirmed modified Lankester groups B and C (P = 0.003) and weekend admission (P = 0.016) as significant predictors of delay to surgery of >3 days.Conclusion:Promptness to operative surgical care falls short of the ideal. Theatre inefficiency is a major cause of delay in treating surgical patients in our environment. Theatre facilities should be expanded and made more efficient. There is a need for better communication between surgeons and patients about delays in surgical treatment.

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Background: Hundreds of international projects are implemented all over the world. Sustainability of such projects is always questioned. The objective of this study was to analyze landmarks of successful collaboration in global surgical issues between Ukrainian and Canadian institutions from 2006 to 2013. Methods: We completed a descriptive analyses of 3 international projects. Results: In collaboration with Ukrainian obstetrics and gynaecology associations and the Society of Obstetricians and Gynecologists of Canada, an initiative seeking to improve emergency obstetrical care using the Advances in Labour and Risk Management International Program (AIP) was conducted in Ukraine. From 2006 to 2009, 912 providers participated in 18 AIP trainings. Since project termination, 10 AIP training with 435 participants were conducted by a national team. Training is now institutionalized into the Donetsk National Medical University (DNMU) curricula. Since 2010 in collaboration between the University of Toronto, and the DNMU, the Donetsk Telesimulation Satellite Center was established. A telesimulation program has been applied to introduce the Fundamentals of Laparoscopic Surgery course, with the objective to standardize the technical skills of Ukrainian professionals. In total, 137 participants from 11 sites have completed the course. Since 2011, a collaboration between the McGill University and the DNMU to improve disaster management and trauma care has been established. A risk assessment tool geared speci fically toward the European Football Championship Euro 2012 was developed. Trauma training has been conducted and the creation of a database of injury epidemiology. Conclusion: Sustainable partnerships is important to ensure long-term interest in an initiative either funded or not. Capacity building based on bottom-up approaches with the initiative coming from national professionals to ensure national ownership and leadership with long-term commitment is essential. 2. COSECSA, achievements and challenges in improving global surgery. P.G. Jani.

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