LIP LACERATION ASSESSMENT AMONG STUDENTS OF DELTA STATE UNIVERSITY IN ABRAKA, NIGERIA

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INTRODUCTION
According to Moore et al., (2014), Lip can be defined as a mobile sphincter with its muscular movements controlled by the maxilla and mandible. Embryologically, upper lip is developed from the joining of the lateral maxillary processes and midline frontonasal process with the lower lip formed from a fusion between both mandibular processes at the midline (Moore et al., 2014). The lip musculature comprises levator group of muscles, orbicularis oris, depressor angulioris, depressor labii inferioris, mentalis, risorius, zygomaticus major and minor . Its neurovasculature structure comprises of the facial nerve (lip depressors and levators), mental nerve (lower lip), infraorbital nerve (upper lip), facial artery and vein for vascular supply and the submental and submandibular nodes for lymphatic drainage .
As stated by William et al. (1995), the lip is an anatomical feature that has been observed to be commonly associated with laceration which is also referred to as lip injury or lesion. With one of the lip functions been aesthetic balance, this condition has proven to be a major challenge. Infections, trauma, autoimmune disease and tumour have been observed to be associated with the lip, and have been classified as etiological factors in the development of lip laceration (Constantinidis et al., 2000). Other etiological factors for lip laceration include road traffic accident, human bite, home accidents, and interpersonal violence (Bansal et al., 2017). Adeyemo et al., 2018 stated that in every healthcare facility, accident and emergency room, traumatic injuries to the cranio-maxillofacial region soft tissue (lips) are the most commonly encountered pathological problems. Various studies have also shown environmental effects on the lips; such as sun, wind and extreme temperatures due to reduction in skin barrier function and its water retention capacity (Fomete et al., 2018). Treatment and management techniques have been improvised to help combat lip laceration and they include reconstructive operative surgeries, with pharmacological management techniques which are strictly dependent on the etiologic of the laceration (Nabili and Knott, 2008). For example, some authors have advised prophylactic antibiotics for management of lip laceration caused by human bites since pathogens such as Staphylococcus aureus and Eikenella corrodens are suspected to lead to lip laceration (Olaitan et al., 2007).

AIM OF THE STUDY
The purpose of this study is to assess and evaluate the prevalence level of lip laceration among Delta State University undergraduates in Abraka, Nigeria.

MATERIALS AND METHODS
A descriptive cross-sectional study design was adopted for this study. Data collection was carried out via a selfadministered questionnaire consisting of respondent's demographics (age and gender) and lip was observed physically for any presence of laceration. All activities pertaining to this study were carried out within the time frame of three a student population of about 36,000 students. Inclusion criteria for this study were respondents who were undergraduates in the Delta State University in Abraka, Participant's personal details and private interaction were kept in utmost secrecy with only the age and gender of participants been used in order to ensure confidentiality of respondent's information. Data analysis eventuated via the chi-square test tool for inferential statistics. Analysed data were presented in tables and charts and significance level was attributed to p< 0.05.     From figure 1 above it can be observed that most respondents in the study were within the age range of 15-20 years with a frequency of 210 (54.7%), which was closely followed by those aged 21-25 years (146, 38.0%) with the least age group been those 26-30 years with a frequency of 28 (7.3%).

RESULTS AND DISCUSSION
Evaluation from table 2 has shown the distribution of lip laceration among the observed respondents with the incidence level of this condition been n= 79/384 (19.8%), majority of the respondents without the lip laceration constituting a frequency of 305 (80.5%) of the observed respondents.
Results observed from table 3 showed gender and the prevalence of lip laceration depicting a significant association with a p-value of 0.037. In this study, age groups and the prevalence of lip laceration had a significant association with a p-value been 0.029 (table 4).
Lip laceration as a medical condition has posed a major challenge of aesthetic alongside digestive functions . Studies over the years have observed various etiological factors responsible for this condition which range from human bites, animal bites, developmental, inflammatory, potential malignant disorders, infection, allergic and immunological factors etc. (Olaitan et al., 2007). Despite the feature of this condition, several management techniques have been innovated over the years one of which is reconstructive surgery which has proven to be appropriate (Nabili and Knott, 2008). Other management techniques developed have been found to be accustomed to distinct causative factors of lip lesions (Olaitan et al., 2007).
On investigation of results from this study, similarity was observed on comparison of results obtained from a retrospective study conducted by Adeyemo et al., 2012, among Nigerians; it was observed that females were more with lip laceration compared to males. Sami et al., (2018), also showed similarity with findings from this study, Our finding is tandem with a study conducted by Osterne et al. (2011), among Brazilians who showed similar findings with those observed in the current study, prevalent age being those in late teens and early twenties. But these results varied from those obtained from studies conducted by Ntomouchtsis et al., 2010;Fomete et al., 2018 which both depicted the most affected age group as those in their 3 rd and 4 th decades respectively.
Finding from this study is in keeping with studies conducted by Adeyemo et al. (2012) et al. (2018), dissimilarity was observed (p=0.645). It was also observed from the submission of Fomete et al. (2018) who reported same results with our study that there exist a significant association between gender and lip laceration but these finding is in disparity with those by Sami et al. (2018) which depicted that gender had an insignificant association with lip laceration.

CONCLUSION
Conclusively, this study depicted the female gender 49 (62%) having a higher prevalence of lip laceration alongside individuals within the ages of 15-20 years 47 (59.5%) with the least affected age group been those aged 26-30 years with a frequency of 10 (12.7%). It was also observed that both gender and age depicted significant association with the prevalence level of lip laceration.