Browsing by Author "Afuwape, O. O."

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A fifteen year experience of total thyroidectomy for the management of simple multinodular goitres in a low medium income country
(Association of Surgeons of South Africa, 2016) Afolabi, A. O.; Ayandipo, O. O.; Afuwape, O. O.; Ogundoyin, O. A.
Introduction: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. Methods: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. Results: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68.6%) with a male to female ratio of 1:6. Postoperative complications were hypocalcaemia in 22 (4.9%), unilateral recurrent laryngeal nerve palsy in 13 (2.8%) and haemorrhage in 2 patients. Others were seroma and cellulitis. Tracheostomy was required in 35 (5.8%) patients but none was permanent. Conclusion: Total thyroidectomy is a relatively safe treatment option for patients who have simple multinodular goitre. It provides a permanent cure with a low postoperative morbidity risk. The burden of replacement l-thyroxine needs to be discussed with the patients.
Experience with managing retrosternal goitres in ibadan, Nigeria
(Wolters Kluwer - Medknow, 2016) Ayandipo, O. O.; Afolabi, A. O.; Afuwape, O. O.; Bolaji, B. E.; Salami, M. A.
Background: There is no general consensus on the definition of retrosternal goitre however thyroidectomy remains the gold standard of treatment with or without a sternotomy Aim: To review the outcome of surgical management of retrosternal goitres. Methodology: Retrospective review of records of patients who had thyroidectomy for retrosternal goitre over a 15-year period. Results: Out of a total of 45 patients, 34(76%) were females and 11(24%) were males with a male/female ratio of 3:1; while their age ranged between 28 and 72years with a mean of 57+15SD. All the patients were euthyroid and a quarter did not have symptoms apart from a neck mass. In all, 15% of the patients had recurrent goitre. CT scan of neck and chest was done in 31 (72%) patients; while 44 (98%) patients had cervical retrosternal goitres, 1(2%) patient had ectopic retrosternal goitre. A cervical incision was sufficient in 28 (62%) patients while 17 (38%) patients required additional sternotomy. Total thyroidectomy was done in all the patients. There were post-operative complications in 19 (42%) patients. Histopathology showed that 3(6.6%) patients had papillary thyroid carcinoma while 42(93.4%) had benign pathology findings. Conclusion: Surgical removal is the treatment of choice. Most retrosternal goitres can be resected through a collar stud incision; however the possibility of a need for a sternotomy should always be planned. The simultaneous occurrence of cervical and ectopic retrosternal goitre should always be ruled out with a CT scan.
Geograpic information systems in determining road traffic crash analysis in Ibadan, Nigeria
(2014-09) Rukewe, A.; Taiwo, O. J.; Fatiregun, A. A.; Afuwape, O. O.; Alonge, T. O.
Background: Road traffic accidents are frequent in this environment, hence the need to determine the place of geographic information systems in the documentation of road traffic accidents. Aim & Objectives: To investigate and document the variations in crash frequencies by types and across different road types in Ibadan, Nigeria. Materials & Methods: Road traffic accident data between January and June 2011 were obtained from the University College Hospital Emergency Department's trauma registry. All the traffic accidents were categorized into motor vehicular, motorbike and pedestrian crashes. Georeferencing of accident locations mentioned by patients was done using a combination of Google Earth and ArcGIS software. Nearest neighbor statistic, Moran's-I, Getis-Ord statistics, Student T-test, and ANOVA were used in investigating the spatial dynamics in crashes. Results: Out of 600 locations recorded, 492 (82.0%) locations were correctly georeferenced. Crashes were clustered in space with motorbike crashes showing greatest clustering. There was significant difference in crashes between dual and non-dual carriage roads (P = 0.0001), but none between the inner city and the periphery (p = 0.115). However, significant variations also exist among the three categories analyzed (p = 0.004) and across the eleven Local Government Areas (P = 0.017). Conclusion: This study showed that the use of Geographic Information System can help in understanding variations in road traffic accident occurrence, while at the same time identifying locations and neighborhoods with unusually higher accidents frequency.