Browsing by Author "Baiyeroju, A. M."

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5-flourouracil vs. beta-aiiadiation in the prevention of pterygium recurrence
(Blackwell Publishing Limited, 2004) Bekibele, C. O.; Baiyeroju, A. M.; Ajayi, B. G. K
Aim: The aim of this study was to compare 5-fluorouracil (5-FU) with beta-irradiation in the prevention of pterygium recurrence. Materials and methods: A retrospective non-randomised review of cases of fleshy pterygium treated with bare sclera excision and adjuvant 5-FU were compared with similar morphologically appearing ptervgia, marched for age and sex, treated with bare seleral excision and adjuvant beta-irradiation. All surgeries were carried out at the university college hospital and Ojulowo eye hospital, Ibadan, Nigeria. Results: Twenty-seven eyes of 24 patients who had pterygium excision with adjuvant treatment with 5-FU were compared with 31 eyes of 24 patients who were treated with excision and beta-irradiation. The mean age for the 5-FU group was 46.1 years while that for the beta-irradiation group was 46.9 years. Both sexes were equally represented, 12 males and 12 females. There were seven (25.9%) initial recurrences in the 5-FU group but four of these became atrophic, and therefore, cosmetically acceptable leaving three eyes (11 %) with unacceptable recurrent pterygium. The beta-irradiation group, however, had seven (22.5) initial recurrence but five of these became atrophic and fell short of the cornea, leaving two (6.5%) with clinically unacceptable recurrence. The difference was, however, nor statistically significant (Zc = 0.74 and p > 0.1). The associated complications were mostly mild in both groups and included cornea opacitv of 10 (37%) complications, conjunctivitis of three (11 %) complications, sclera granuloma of three (11%) complications and conjunctiva necrosis of one (3.7%) complication for the 5-FU group, and while the beta-irradiation group had corneal opacity of one(3.7%) complication and conjunctivitis of three (11%) complications. Conclusion: The non-statistical significance of a lower pterygium recurrence rate with use of beta-irradiation for the treatment of fleshy pterygium compared with 5-FU may have been partly due to the small number of patients studied. A randomised-controlled study using a larger sample size is therefore proposed. However, the fact that over half of those with initial recurrence in the 5-FU group became atrophic (and therefore cosmetically acceptable) over rime as well as less cost implication in the purchase of 5-FU relative to Strontium-90 association with few and mild complications makes it a desirable adjuvant therapy in depressed economics. However, beta-irradiation still has a place when cost issue is not an inhibiting factor in view of its clinically superior outcome
Blepharoptosis in Ibadan, Nigeria
(2003-09) Baiyeroju, A. M.; Oluwatosin, O. M.
Objective: To look into the cases of blepharoptosis in our environment as well as find out the causes and effects of the ptosis. Design: Prospective clinic study and prospective cluster sampling method of school children. Setting: University College Hospital, Ibadan and 3 schools in Ibadan, Nigeria. Subject: Over a 5 year period, all patients who presented with blepharoptosis at the University College Hospital were recruited for the study. During the same period, a school survey was also done to find out the prevalence of blepharoptosis among school children. Results: Twenty five cases of blepharoptosis were found during the 5 year period. Fifty two percent of the patients were found to be less than 16 years of age while only 8% were over 50 years of age. There was a 1:1 male to female ratio with majority of them (68%) having only one eye affected. The most common cause of blepharoptosis was found to be congenital, accounting for 56% of the patients. The prevalence in the school survey was found to be 1.2% higher than the incidence of 0.5% found in the eye clinic. Conclusion: Blepharoptosis is not an uncommon ocular problem. A detailed assessment of the cause, amount of ptosis and levator functions helps to determine the most appropriate surgical technique which would give the best functional and cosmetic result
Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria
(Springer, 2010) Bekibele, C. O.; Baiyeroju, A. M.; Ajaiyeoba, A.; Akang, E. E. U.; Ajayi, B. G. K.
Background: Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. Objective; To identify symptoms and surface abnormalities associated with dry eyes. Materials and methods: One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer's 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Results: Mean tear meniscus height, Schirmer's test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer's test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer's values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher's exact test) and 95.8% of dry right eyes compared to 61.1 % of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). Conclusion: A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.
Hunter syndrome: case report and review of literature
(2006-06) Ogunbiyi, A.; Adeyinka, A. O.; Ogah, S. O.; Baiyeroju, A. M.
Hunter syndrome is one of the mucopolysaccharidosis, which are a rare group of genetic diseases, It is due to a deficiency in the enzyme Iduronate 2-sulphatase. This in turn leads to the accumulation of glycosaminoglycans, dermatan and heparan sulphate. The intra and extracellular accumulation of this substances lead to multisystemic organ abnormality. We present a patient with Hunter syndrome who presented with involvement of the skin, cardiovascular system, the eyes and musculoskeletal system. We have also included a literature review. As far as we know, it is the first case reported in a Nigerian.
Non-cardiac surgery and anaesthesia in children with congenital heart disease
(1996-06) Soyannwo, O. A.; Baiyeroju, A. M.
Children with Congenital Heart Disease (CHD) presenting for non-cardiac surgery have various physiological and functional abnormalities and thus pose great challenges to the anaesthetist. This one year prospective study was undertaken to determine the incidence of CHD in children presenting for noncardiac surgery, the type of lesions and anaesthetic course. Five patients (1.5%) out of a total of 324 children aged from birth to twelve years who had surgery during the study period were found to have CHD, ventricular septal defect (VSD) being the commonest cardiac lesion. Surgery was for cataract extraction and herniorrhaphy. Although all the children had been previously treated or were on current treatment for additional medical problems, surgery under closely monitored balanced general anaesthetic technique was found to be safe.
Patients' perception of the quality of eye care at the University College Hospital, Ibadan
(2005-06) Awobem, F. J.; Bekibele, C. O.; Baiyeroju, A. M.
Objective: To determine patients' perceptions about the quality of care and possible factors that may prevent adequate utilization of services at the study centre and therefore make recommendations for improvement in service utilization. Materials and methods: A cross sectional survey of patients from the Eye Clinic and Eye Ward of the University College Hospital, Ibadan, was carried out using a standardized questionnaire between May and June 2001. Results: A total of fifty respondents were interviewed: 33 (66%.) were male, while 17 (34%) were female. Their ages ranged from less than 10 years to more than 80 years, with a mean age of 46.5 years. The majority of the patients (78%) lived within Ibadan, while 22% lived outside Ibadan. Over half of the respondents (56%) were gainfully employed. Others included retirees (20%) and students (20%). Thirty-eight of the respondents (88%) experienced some obstacles before and/or on presentation at the hospital. Notable obstacles to the optimal use of facilities include: frequent strikes embarked on by hospital workers (66% of respondents), long wait before seeing the eye doctor as reported by 36% of respondents; high cost of services 8%, fear of the outcome of surgery reported by 12% of those who had surgery; and the unfriendly attitude of some staff. Recommendations by respondents for improving the quality of health service delivery include: provision of more equipment in the eye clinic (68%) and the employment of more eye doctors (64%). Other suggestions include reduction in the cost of surgery and other services (12%), and the need for records staff and nurses to be more humane and show understanding to patients, especially those from out of town (4%).
Pattern of ophthalmic consult from the ear, nose and throat ward of a tertiary hospital
(2009) Komolafe, O. O.; Adeosun, A. A.; Baiyeroju, A. M.
Objective: To study the pattern and indications for ophthalmic referral of patients with otorhinolaryngology problems. Method: A retrospective study of patients who were admitted into the Ear, Nose and Throat (ENT) ward of the University College Hospital, lbadan and had ophthalmic referral between July 2000 and June 2004. The parameters evaluated were the demography of the patient, indication for ophthalmic consult, and the contribution of the ophthalmologist towards the management of the patient. Results: Reports on 26 patients on whom ophthalmic consults were sent were available for review. This accounted for 3% of the patients admitted during the period under review. Fourteen (53.8% ) of the consults were sent on account of proptosis and 7 (26.9%) for complaints of poor vision. In 12 (46.2%) of these patients, the otorhinotarfngological diagnosis was sinonasal tumour. The ophthalmologist made positive contributions to the management of 20 (76.9%) of the patients. These included the use of lubricants/protective shield (6 [23.1%]), tarsorrhaphy (3 [11.5%]), antiglaucoma medication (2{7.7%}) and cataract extraction (2[7.7%]). Conclusion: Proptosis milked highest for ophthalmic consult from the ENT ward in this review. Close collaboration between subspecialties should be encouraged when managing visllally-threatening conditions. There is also the need for a standard referral protocol.
Service uptake in UCH, Ibandan: a tme flow study
(2005-12) Bekibele, C. O.; Baiyeroju, A. M.
Objective: To determine the time flow of service uptake as assessed by patients in the eye clinic of UCH with the view of identifying delays in service uptake, the reasons for such delays and ways to improve services. Materials and methods: patients attending the eye clinic of the University College Hospital (UCH) were selected consecutively and interviewed using a semi-structured questionnaire on the amount of time spent waiting for the various services at the eye clinic and reasons for any perceived delays in receiving the services. For under-aged children, their guardians were interviewed. Results: A total of 42 patients we're interviewed, out of which 22 (52.4%) were male. The age range was 5 to 75 years. All the patients were referred, with 78.1 % coming from the general outpatient departrnent of the hospital. They spent between 30 minutes and 2 hours waiting to get their referral letters. Delay was believed to be due to the large number of patients relative to the small number of doctors. Services with extended time flow in the eye clinic include delayed first consultation due to long appointrnent dates (1 to 6 months in 45% of patients studied), need for repeated visits before doctor is seen (2 visits by 78.6% of patients), prolong waiting for nursing procedures (1 to 3 hours by 11 .9%), waiting for doctor's consultation (1 to 3 hours by 21.4%), waiting to pay to the cashier (10 minutes to 1 hour). Reasons for delay include: insufficient number of doctors, few functioning equipment and the poor attitude of some staff. Other services with extended time flow include prolonged surgical bookings of between 1 week and 6 months, mainly due to industrial action by staff, lack of sterile linen due to broken down boiler, unsatisfactory laboratory results, unresolved medical problems or financial constraints. Conclusion: Services in the eye clinic of UCH are perceived by patients to be associated with extended time flow due mostly to the insufficient number of trained staff and functioning equipment, recurrent industrial action and the poor attitude of some staff, which gives rise to patient dissatisfaction and complaints. There is the need to employ more eye doctors to provide functioning equiprnent to re-educate, re-orientate all staff in the eye clinic and in UCH, and in fact, in all public health institutions, to provide a more patient friendly environment through attitudinal change, and to ensure accessible, affordable and acceptable health care.
A sino-orbital scissors foreign body
(2005) Bekibele, C. O.; Ogunleye, A. O. A.; Ashaye, A. O.; Baiyeroju, A. M.; Fasina, O.; Sandabe, M. B.; Aluko, A. A.
The case of a sino orbital foreign body from the broken tips of a pair of scissors transversing the floor of the left orbit, left maxillary sinus and left nasal cavity, and which had been left in place for two years because of financial constrains, before its surgical removal without much sequel, is presented. The need for adequate radiological investigations in all cases of head and neck trauma as well as the institution of health insurance in developing / low income economies to cater for indigent patients especially in emergency situations is highlighted.
Tear function and abnormalities of ocular surface: relationship with subjective symptoms of dry eye in lbadan, Nigeria
(2008-03) Bekibele, C.O.; Baiyeroju, A. M.; Ajaiyeoba, A. I.; Akang, E. E. U.; Ajayi, B. G. K.
Objective: To determine the relationship between tear function and ocular surface abnormalities with subjective symptoms of dry eye. Methods: Patients with various ocular irritation symptoms suggestive of dry eye were examined for tear break up time (TBUT), Schirmer's test 1, and Rose Bengal staining pattern. They were compared with a group of asymptomatic healthy subjects. Results: There were 63 subjects, mean age 43.8 years (+/-14.7 years) with various complaints of dryness presenting as having irritation or foreign body sensation. A group of 17 asymptomatic subjects, mean age 42.1 years (+/-12.7 years) were studied as controls. There were 22 (34:.9 %) males and 41(65.1%) females in the symptomatic group while the control group had 4 (23.5%) males and 13(76.5%) females. Ocular irritations included itching 38(60.3%), pricking and itching 10 (15.9%). Mean Shirmer's test value were lower for symptomatic, subjects (mean 14.5mm +/-12.3 right eye; 14.9mm+/-12.4 left eye), compared to the controls (23.0mm +/-13.4 right eye; 17. 9mm +/-13.4 Ieft eye) P=0.02, for right eye and 0.4 for left. The mean TBUTwere also lower amongst the symptomatic subjects (10.5 seconds, right eye and 10.1 seconds left eye), while for controls mean TBUT was 12.7.,seconds right eye and 12.1 seconds left eye (P=0.2). Fifty -six out of 126 (46.8%) eyes of all symptomatic subjects compared to 7 out of 34 (20.6%) eyes of asymptomatic subjects had positive staining of conjunctiva with rose Bengal (p=0.06). For subjects with itching as the primary symptom 44.7% of them as opposed to 23.5% of the controls were likely to stain positive with rose Bengal, (sensitivity of itching as screening tool for dry eye was 81%, specificity 38.2%). Itching and pricking sensation together (sensitivity 46.2% and specificity improved to 65%). Rose Bengal grades were also inversely correlated with mean Schirmers values (Pearson correlation -0.429; P = 0.001) and TBUT (Pearson correlation -0.316, P=0.005). Conclusion: Itching and other ocular irritation symptoms may be indicative of underlying abnormal tear function and ocular surface damage, their presence calls for further examination for tear deficiency and prompt institution of treatment for dry eye
Visual Impairment from fibrous dysplasia in a middle-aged African man: a case report
(2009-01) Bekibele, C. O.; Fasola, O. A.; Okojie, V. N.; Komolafe, O. O.; Oluwasola, O. A.; Emejulu, J. K.; Ajaiyeoba, A. I.; Baiyeroju, A. M.
Visual outcome of pressurised bottled drinks related eye injuries in Ibadan
(2003) Bekibele, C. O.; Ajayi, B. G. K.; Baiyeroju, A. M.; Ayeni, E. A.
Records of 15 patients presenting with pressurised bottled drinks related eye injuries between January 1996 and 2001 were reviewed to identify factors contributing to accidental eye injuries from pressurised bottled drinks, reason for poor outcome and to make recommendations. In all, 16 eyes of 15 patients were studied out of which 7 were males (M:F, ratio I :1.1). Age range, 3 years-49 years, mean 23.6 years. The majority of those affected were students 46.7%, and traders 26.7%. The commonest activity leading to injury was explosion during the process of arranging the bottles or crates of drinks (43.8%) and accidental fall of bottle from hand or height (37.5%). Drinks implicated include, Coca-cola 50%, beer 25%, others (Fanta, Legend stout, Mirinda, Grape juice) 25%. Complications arising from the injury included, hyphema 43.8%, vitreous haemorrhage 12.5%, and retinal detachment 12.5%. The globes were retained in 12 (75%) cases, 3 defaulted and one eye became phthisical. The final visual acuity was 6/18 or better in 25%, between 6/24 and 6/60 in 12.5% and less than 6/60 in 31.3 %. The final visual acuities of three patients who were lost to follow up were unknown. Reason for poor visual outcome include severity of injury with resultant serious complications, and delay with instituting surgical treatment. Eye injuries resulting from exploding bottled drinks are potentially very serious and therefore best prevented. It is recommended that conversion of bottled drinks to canned or plastic containers be considered by the manufacturers. Greater care should be taken with the handling of bottled drinks by the sellers, factory workers and consumers. High risk occupations such as bottled drink sellers and factory workers may need to wear protective goggles during handling. Public health education on need to seek prompt and proper treatment as well as need for Government to institute the National health insurance scheme to cater for indigent patients.
Visual recovery after cataract surgery in children
(2006-12) Olusanya, B. A.; Baiyeroju, A. M.; Fajola, A. O.
Objective: To evaluate the visual outcome of cataract surgery in children aged 16 years and below at the University College Hospital (UCH), Ibadan. Methods: A retrospective review of the case records of patients aged 0-16 years who had cataract surgery at the UCH Ibadan between January 1995 and June 2006. Results: One hundred and fifty-one eyes of 101 patients were studied. Eighty-four eyes (55.6%) had congenital cataracts, 25.2% were developmental, while 13.9% were secondary to trauma. Seventy-one (70.3%) patients had bilateral cataracts. Eighty-nine (58.9%) of the eyes had an associated ocular pathology. Ninety-eight eyes (64.9%) had extracapsular cataract extraction without intraocular lens implant (ECCE), while 50 eyes (33.1 %) had extracapsular cataract extraction with posterior chamber intraocular lens implant (ECCE+PCIOL). Primary capsulotomy was performed on 34 eyes (22.5%). Postoperative complications were observed in 119 eyes (78.8%); with posterior capsule opacity occurring in 41.1%. Thirty-five eyes (38.9%) of those with objective visual acuity had a visual outcome ≥ 6/18. A visual outcome of 6/18 Dr better was significantly associated with increasing age (p =0.007) and the use of PCIOL implants (p =0.005), while poor visual outcome (≥ 6/24) was significantly associated with onset of cataract at birth (p =0.001); the presence of other ocular pathology (p =0.03); and a long delay between presentation and surgery (p= 0.02). Conclusion: The visual recovery of children who underwent cataract surgery in Ibadan is encouraging and the surgical results are likely to improve with increased proficiency in IOL implant surgery. The establishment of well-equipped and well-staffed paediatric ophthalmology centres would be beneficial in improving outcomes and would therefore help in achieving the goals of Vision 2020: The Right to Sight' .