Browsing by Author "Ademola S.A"

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Ambulatory cleft lip surgery in a developing country
(2015) Olawoye O.A; Olusanya A.A; Ademola S.A; Iyun A.O; Michael A.I; Akinmoladun V.I.
Background: Ambulatory cleft lip surgery has been practiced extensively in many developed countries, however cleft lip repair in most developing countries involve patient hospitalization of varying duration. Driven bythe recent acute shortage of pediatric bed space in our hospital, an increasing number of cleft lip surgeries are being performed on out-patient basis. The aim of this study was to report our experience with ambulatory cleft lip surgery at the University College Hospital, Ibadan. Methods: A retrospective review of Cleft lip Surgeries performed between February 2007 and January 2010 was done. Data of patients who had cleft lip surgery was retrieved from our Smile Train data base, the operating room surgery records and the Nurses' admission/discharge records on ail the wards on which the patients were either received or admitted. Information obtained included the demographic characteristics of the patients, complications reported, length of stay (LOS) for in-patients and the need for re-admission before the first follow-up clinic appointment among the two groups. Results: Eighty three patients were identified but complete data was obtained for forty patients. (Retrieval rate of 48%) The ambulatory group comprised of 15 patients while- the in-patient group had 25 patients. The mean patient age was 5.7years in the ambulatory and 9.7 years in the in-patient group. Both groups were homogenous for other parameters. None of the patients in the ambulatory group was re-admitted for any post-operative complication while only one patient in the in-patient group had a post-operative complication necessitating prolonged hospitalization. Conclusion: Ambulatory cleft lip surgery was found to be safe in our practice with comparable patient outcome to the in-patient group. It is anticipated that this may assume increasing prominence in the scope of cleft lip management in many more centers in the developing world.
Awareness and attitude of doctors and nurses at a crossmark teaching hospital to skin donation and banking
(2014) Michael A.I; Ademola S.A; Olawoye O.A; Iyun A.O; Oluwatosin O.M.
Introduction: This study sought to determine the awareness and attitude of doctors and nurses in a teaching hospital to skin donation and banking, and to identify needs for personnel educational programmes. Methods: A cross sectional survey on doctors and nurses was carried out using a 44-item questionnaire that included a Likert scale on attitudes. Predictors of favourable attitudes were determined. Results: Eighty (49.7%) doctors and 81 (50.3%) nurses participated in the study. Many participants, 126 (78.3%), knew that skin could be donated, but only 96 (59.6%) participants were aware of skin banking. The main source of information was during professional training (17.4%). Only 41 (25.5%) participants were willing to donate skin after death. Body disfigurement was the major reason (20.5%) against skin donation. Participants who were doctors, were aware of skin banking, and who were previous blood donors had higher attitudes scores (p < 0.001, p = 0.004, p = 0.007 respectively). Being a doctor and having heard of skin banking were predictors of favourable attitudes to skin donation and banking. Conclusion: Knowledge transfer during health professional training on the usefulness of banked skin in patients with major burns may lead to improved attitude of health professionals and acceptance of this modality of burn management.
Changing epidemiology of skin cancers in southwestern Nigeria.
(2006) Ademola S.A; Gana J.; Oluwatosin O; Ogundoyin O.
Introduction: The incidence of some skin cancers is on the rise in Caucasians1. There is also an observed increase in the diagnosis of Basal Cell Carcinoma in blacks. This study evaluated the Pattern of Skin Cancers in Southwestern Nigeria and compared the trends with what obtained three decades earlier. Methods: A review of 494 cases of skin malignancies recorded at the National cancer registry, Ibadan, Nigeria between January 1981 and December 2000 was carried out. The proportion observed was compared with a similar study carried out thirty years earlier. Results: The commonest lesion recorded was squamous cell carcinoma 40.5%. Malignant Melanoma was 25.1%, Dermatofibrosarcoma Protuberance 9.5%, Kaposi’s Sarcoma 8.3% and Basal Cell Carcinoma 6.7%. There was an observed decline in the proportion of Squamous Cell Carcinoma and an increase in the proportion of Basal Cell Carcinoma. Conclusion: There is a change in the incidence of skin cancers in Southwestern Nigeria.
Clefts of primary and secondary palate: a review of history and of cases seen from 2001 to 2005
(2006) Adekolujo; Dr lyun; Ademola S.A; Oluwatosin O.M.
The management of the cleft of the primary and secondary palate is interdisciplinary. It is complex endeavor requiring coordinated expertise of several specialists in various disciplines. We reviewed 62 patients with cleft of the primary and or the secondary palate managed between January 2001 and September 2005. The mean age at presentation was 25 months. There were 34 females (54.8%) and 28 males (45.2%). Isolated cleft of the primary palate was the most frequent accounting for 44.3%, of the patients while cleft of the primary and secondary palate was seen in 41.0%, and isolated cleft of the secondary pedate in 13.1 %. The male to female ratio in patients with isolated cleft of the primary palate (unilateral and bilateral) was 1.1 to 1, for unilateral cleft of the of the primary palate was 1.56 to 1 but all the patients with isolated bilateral cleft of the primary palate were females. The male to female ratio for patients with cleft of the primary and secondary pedate was 1 to 1 but all the patients with isolated cleft of the secondary palate were females. In cleft of the primary palate, the cleft was most frequently on the left and was complete in 63.8%. Associated malformations were seen in 11.3% of the patients, the most common being cardiac malformations We conclude that there is a need for a formation of a formal cleft team in our center to facilitate the optimum management of these patients.
Demographic characteristics and prognostic indicators of childhood burn in a developing country
(2014) Olawoye O.A; Iyun A.O; Ademola S.A; Michael A.I; Oluwatosin O.M.
Children constitute a significant proportion of burn victims in most studies from the developing countries. While there has been a progressive improvement in the outcome from childhood burn in many developed nations, the morbidity and mortality remains high in many low and middle income countries. The aim of our study is to evaluate the demographic characteristics and prognostic indicators of childhood burn in a major referral teaching hospital in a developing country. A review of the records of 638 patients with acute burns managed over a 10-year period from January 2001 to December 2010 at the University College Hospital, Ibadan Nigeria was done. The clinical and epidemiological data were retrieved from computerized data base using the ISBI proforma. Information obtained includes Biodata, Etiology, location, TBSA, presence of Inhalation injury and the treatment outcome. Data of patients aged 16 years and below were analyzed using the SPSS version 16. The main outcome measure was the patient’s survival. 289 children representing 45.3% of the total number of burn patients were managed over the period. The M:F ratio was 1.1:1. The median age of the cohort was 4.0 years while the median TBSA was 21.0%. Nonintentional causes were responsible for 89.6% cases. Most of the injuries (88.6%) occurred at home. Eighty-three patients had inhalation injury out of which 57 (68.7%) deaths were recorded. The overall mortality rate in the cohort was 39.5% with an LA50 of burn size of 45%. The TBSA was also found to be a determinant of outcome. Majority of childhood burns are from preventable causes with attendant dismal mortality figures. Effective burn prevention strategies and improved quality of care remain pivotal in reducing childhood burn morbidity and mortality in the developing countries.
Diabetes and surgery
(2007) Ademola S.A
Distribution and morphological pattern of clefts in the craniofacial region seen in a sub-saharan tertiary hospital
(2015) Olusanya A.A; Michael A.I; Olawoye O.A; Akinmoladun V.I; Ademola S.A; Iyun A.O; Oluwatosin O.M.
Aim: Clefts in the craniofacial region are one of the commonest congenital anomalies recorded in literature. The incidence varies globally with racial differences observed. In Nigeria, the evaluation of the absolute incidence of oral clefts is a challenge as births and deaths are not adequately registered. Especially lacking is the relative prevalence of rare craniofacial clefts to the more common cleft lip and palate anomaly. This study aims to document the pattern of distribution of craniofacial clefts, including cleft lip and palate anomaly, rare craniofacial clefts, unusual presentation of some of these anomalies, as well as other abnormalities noted in affected cleft patients seen at our centre. Material and methods: Information on age, gender, weight at presentation, type of cleft anomaly, other abnormalities, as well as affected relatives were extracted from the clinic records of the Cleft Clinic of the University College Hospital, Ibadan, Oyo, Nigeria, from April 2010 to September 2012. Results: One hundred and forty-two cases were seen within the 30-month period, consisting of 58 men and 84 women with a mean age of 43.54 months and a median of 2.0 months. Eighty-eight per cent of the cases were cleft lip and palate anomalies, while 12.0% were craniofacial clefts. Thirteen per cent had other abnormalities, while 3.5% were considered to be unusual cleft anomalies. Conclusion: The pattern of distribution of clefts in the craniofacial region in our centre has been documented. Cleft of the primary palate was the commonest while rare craniofacial clefts constituted about one-eighth of all the craniofacial clefts.
Goldenhar syndrome: a case report and literature review
(2005) Bekibele C.O || Ademola S.A || Amanor-Boadu S.D || Akang E.E.|| Ojemakinde K.O; Ademola S.A; Amanor-Boadu S.D; Akang E.E.; Ojemakinde K.O
Summary The case of a 24-year-old female Nigerian with features of Goldenhar syndrome is presented and the challenges of management especially with reference to reconstructive facial surgery and general anaesthesia are discussed.
Great saphenous vein stripping using nasogastric tub
(2012) Ademola S.A; Adekolujo O.S; lyun A.O; Yunusa-Kaltungo Z |; Nnadozie U.U; Michael A; Oluwatosin O.M.
Background; Crossectomy and Great Saphenous Vein (GSV) stripping remains the gold standard of treatment for great saphenous varicose vein. Many techniques of GSV stripping have been described. However, very few hospitals in developing countries are equipped with a vein stripper. Method and result: We describe the use of nasogastric tube in the stripping of GSV. This simple technique has been successfully applied in three patients. Conclusion: There is a need to carry out a prospective study regarding the application of this technique of GSV stripping.
Management of haemorrhoid in a tropical .country
(2004) Agbakwuru E.Aug.; Adesunkanmi A.R.K; Ujba A.F; Fadiora S.O.; Ademola S.A; Ogunrombi A.B.
To appraise the pattern of presentation and management of Haemorrhoids in Ile-Ife. Setting: State Hospital and Wesley Hospital, Ilesa 2 major units of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria. Design: Retrospective Study. January 1990 to December, 2001 Patients and Method. 70 patients who presented with prolapsed (second and third degrees), over 11 years period were studied. Results Age Range was 10-80 years (average 27.8 + 1.9) with a male preponderance. Sixty-seven percent had prolapsing pile; 61.4% had open .excisional haemorrhoidectomy. Conclusion: It is felt that the late presentation was mainly due to fears, false belief and quackery often associated with the disease and its treatment. It was therefore suggested that more effort be made towards education of population in other to reduce above problems and encourage early presentation so that less invasive costly techniques could be used.
Normal values for hand grip strength in healthy nigerian adults
(2013) Michael A.I || Ademola S.A || Olawoye O.A ||lyun A.O || Nnabuko R.E || Oluwatosin O.M.; Ademola S.A; Olawoye O.A; lyun A.O; Nnabuko R.E; Oluwatosin O.M.
Background: Assessment of hand grip strength is used in a wide range of clinical settings particularly during management of hand injuries and diseases affecting hand function. This study aimed to determine age and gender specific normal values of hand grip strength in healthy adults in Nigeria and compare values obtained with those in the Western population. Materials and methods: Hand grip strength was measured using the Baseline Hydraulic Dynamometer. Results were analyzed with SPSS version 15. Results: Two hundred and forty two participants comprising 163 males and 79 females were recruited. Mean values for hand grip strength on the right and left hands were 32.1 ±7.6kg and 30.7±7.7kg in males and 20.3±5.3kg and 18.7±5.3kg in females. Males showed significantly higher grip strength on the right and left hands (p=0.000, p=0.000) than in females. Grip strength peaked in the 30-39 year age group in males and females. In females a positive correlation was found between the grip strengths in both hands with weight, height and body mass index. Normal grip strength in the Western population is at least 1.6 times higher than in this study. Conclusion: The study has been able to establish normal values for handgrip strength among healthy adults in Nigeria, which differ from that in the Western population. There is the need for further studies in other regions of Nigeria in order to establish national values.
Pattern of Bacterial Pathogens In Burn Wound Infections In Ibadan, Nigeria
(2004) Kehinde A.O; Ademola S.A; Okesola A.O; Oluwatosin O.M; Bakare R.A.
A retrospective study of 85 patients with burn wound infections was carried out in University College Hospital, Ibadan, Nigeria, between April 1998 and March 2001. A total number of 85 specimens consisting of 35 wound swabs (41.2%) and 50 wound biopsies (58.8%) were processed during the period. Burn wound infections were significantly more frequent in children and adolescents (5-20 yr) than in adults (p < 0.05). Klebsiella species was the pathogen most commonly isolated, constituting 34.4%. This was closely followed by Pseudomonas aeruginosa (29.0%) and Staphylococcus aureus (26.8%). The rate of isolation of Gram-negative organisms was more than twice that of Gram-positive organisms. More than 75% of the Gram negative isolates were resistant to gentamicin, a commonly used antibiotic for Gram-negative infections, but sensitive to ceftazidime and pefloxacin. Gram-positive isolates were predominantly Staphylococcus aureus sensitive to azithromycin and pef- loxacin. This study highlights the predominant bacterial pathogens and their antimicrobial profile among infected burn wounds in our centre.
Reconstruction of a complex anterior abdominal wall defect with autologous tissues - a case report
(2011) Odeyinde S.O; Ademola S.A; Oluwatosin O.M.
Background: The anterior abdominal wall is an important complex composite structure that poses a challenge to the reconstructive surgeon. Defects produced from infection, herniation, tumour extirpation or trauma, are often encountered. Different techniques of reconstruction have been described using autologous tissues and prosthetic materials with varying results, availability and cost implications. The use of totally autologous tissues presents a readily available reconstructive option that has been shown to be associated with a satisfactory outcome and low morbidity. In this report, we describe the use of autologous tissues for the reconstruction of a major abdominal wall defect. Method: This communication describes our experience of the use of purely autologous tissues for a full thickness anterior, abdominal wall defect, presented as a case report. Result: The initial result that was obtained confirms that this is a useful technique with a satisfactory outcome with minimal morbidity. Conclusion: Utilizing purely autologous tissues, avoids most of the complications of the other techniques, is readily available, relatively cost-effective (especially advantageous in the developing country) and is less technically demanding.
The reverse sural artery flap for the reconstruction of distal third of the leg and foot
(2012) Olawoye O.A |; Ademola S.A; lyun K; Michael A; Oluwatosin O.
Soft tissue defects around the distal third of the leg and the foot present a major reconstructive challenge. There is limited expertise with free tissue transfers in many developing countries, necessitating consideration of other options for the closure of such defects. The versatility and reliability of sural artery flap have made it an emerging popular option for the reconstruction of such defects. Twenty patients comprising of 13 males and 7 females with soft tissue defects of the lower third of the leg and foot requiring soft tissue cover were treated between January 2006 and December 2010. The age range was 7-58 years with a mean age of 30 years. Nineteen (95%) of the defects were post-traumatic while one (5%) was post-infective. All the defects were covered with reversed sural artery flaps, which were raised on the posterior aspect of the junction of the upper and middle third of the leg. The smallest flap was 4 x 4 cm2 while the largest measured 20 x 12 cm2. The donor defect was closed directly in 7 (35%) patients, while split skin graft was applied in the remaining 13 (65%) patients. There was satisfactory flap healing in 17 patients (85%), while 3 patients (15%) had complete flap necrosis. Two of these patients had significant comorbidities of haemoglobinopathy and poorly controlled diabetes mellitus. Sural artery flap remains a viable option for the reconstruction of soft tissue defects of the distal third of the leg and foot. Caution should, however, be exercised in patients with some significant systemic diseases.
valuation of the reliability of levine method of wound swab for microbiological studies in chronic wounds: a pilot study.
(2013-05) Ademola S.A; Fayemiwo S.A.
Background: All chronic wounds habour microorganisms which may stall spontaneous healing of the wounds or impair success of wound closure. Wound biopsy for microscopy, culture and sensitivity is the preferred method of isolating microorganisms present in a wound but the procedure is resource intensive and unpleasant to patients. The aim of this paper is to evaluate the reliability of Levine swab in accurate identification of microorganisms present in a wound and identify the necessity for further studies in this regard. Methods: A semi structured questionnaire was administered and physical examination was performed on patients with chronic wounds who meet the inclusion criteria for the study. Full thickness wound biopsy and wound swab using the Levine method were taken from the wound of each patient The data generated was analysed using Statistical Package for Social Sciences (SPSS) version 20. Results: There were 21 ulcers from 19 patients but only nineteen ulcers were suitable for analysis. The mean age of the patients was 42 years (range 13-69 years). There were nine males and 10 females. Most of the ulcers were posttraumatic (67%), were located on the right side of the body and the commonest site was the right leg (24%). More than half of the ulcers had at least moderate discharge. Only one species of microorganism was isolated per wound swab or wound biopsy specimen. Comparison of results from wound swabs with wound biopsy from each of the patients revealed that isolated microorganisms were similar in 60% of cases. Conclusion: Wound swab by the Levine method may be as reliable as wound biopsy specimens for microbiological studies in chronic wounds due to certain causes. Larger studies that evaluate wounds due to different causes separately will be required to validate this observation.