Browsing by Author "Michael, A.I."

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Management of lower extremity soft-tissue sarcoma in a sub-saharan african teaching hospital: case reports
(2019) Ayandipo, O.O.; Ademola, S.A.; Afuwape, O.O.; Michael, A.I.; Elemile, P.O.; Udonsak, N.S.
Background: Soft-tissue sarcomas are relatively rare tumors and can occur in many parts of the body. When they affect the body extremities, their management can be challenging, often leading to limb amputation. Recent advances in surgery, adjuvant therapy, and better collaboration among different surgical specialists, medical and radiation oncologists, coupled with management in specialized centers have led to an upsurge in limb preservation. However, this is not obtainable in many centers in the developing countries. We report cases of soft-tissue sarcoma of the lower limb in two patients managed in a tertiary center in sub-Saharan Africa and the challenges encountered in their management. Case Reports: Two patients presented to our hospital with progressive painless masses on the lower third of their legs. Evaluation suggested that the masses were malignant. They both had wide local excision. The first patient had reconstruction with island sural artery fasciocutaneous flap, whereas the second had reconstruction with freestyle propeller flap. The postoperative periods were uneventful, and timely adjuvant therapy was commenced. Limb function was preserved in the two patients. Conclusion: Treatment of soft-tissue sarcomas of the limbs could be tasking, but multispecialty surgical intervention and adequate adjuvant therapy could give favorable result and a functional limb postoperatively.
Pattern of congenital hand anomalies at a tertiary plastic surgery service in south-western Nigeria: a 10-year, cross-sectional retrospective review
(2020) Michael, A.I.; Ademola, S.A.; Olawoye, O.A.; Iyun, A.O.; Oluwatosin, O.M.
Context: Although congenital hand anomalies are among the more common musculoskeletal anomalies worldwide, we do not know its prevalence in our practice. Aims: The aim of the study was to determine the pattern of congenital hand anomalies presenting to our tertiary plastic surgery outpatient service in South-Western Nigeria. Materials and Methods: This is a cross-sectional retrospective analysis of outpatient cases of congenital hand anomalies presenting over a 10-year period. Descriptive and inferential statistics were performed using frequencies, Student’s t-test and Chi-square as appropriate. The data were analysed using IBM SPSS Statistics 23.0. The statistical significance value was set at P < 0.05. Results: One hundred and twenty-two cases were identified. The highest number of cases was seen in the year 2012, 23 patients (19.3%). There was a male preponderance of 66 patients (55.1%). Thirty-two patients (26.2%) presented as neonates and 36 (29.5%) as infants. Bilateral anomalies were seen in 67 patients (54.9%). The most common anomaly was failure of differentiation, 88 patients (72.1%) followed by duplication, 26 patients (21.3%). Syndactyly with 43 patients (35.2%) was the most common anomaly under failure of differentiation. No significant associations were found between the type of anomaly and gender or laterality. Conclusions: Syndactyly was the most common congenital hand anomaly in this study. There was a preponderance of bilateral involvement in both syndactyly and polydactyly.
Pediatric keloids: a 6-year retrospective review
(2017) Michael, A.I.; Ademola, S.A.; Olawoye, O.A.; Iyun, A.O.; Adebayo, W.; Oluwatosin, O.M.
Background/Objectives: Keloids are reportedly rare at the extremes of life. We sought to describe the epidemiology of pediatric keloids seen at the plastic surgery outpatient department of the University College Hospital, Ibadan. Methods: We retrospectively reviewed all children younger than 19 years who presented with nonburn keloids between 2008 and 2014. Data were obtained on age; duration, size, and location of the keloid; family history; mode of treatment; and outcome. Outcome variables were recurrence and wound complications. Data were analyzed using the Pearson chi-square test for discreet variables and the independent- sample t test for continuous variables. P < .05 was taken as statistically significant. Results: Within the review period, 304 patients presented with keloids, of whom 40 (13.1%) were younger than 19 years. There was a female preponderance (n = 23, 57.5%). The mean age at onset of the keloid was 9.3 years (range 3 months-18 years). Thirty (75%) patients had keloids in the head and neck region. Keloids were sporadic in 31 (77.5%) patients. Nineteen (47.5%) patients had multimodal treatment for keloid. The recurrence rate was 20%. Recurrence was significantly associated with the size of the lesion (P = .003). Conclusion: Keloids during childhood are not rare. More attention should be paid to the management of keloids in this age group.
State distribution of new patients presenting with cleft lip and palate to the university college hospital: a pilot study.
(2018) Michael, A.I.; Olusanya, A.A.; Olawoye, O.A.; Ademola, S.A.; Iyun, A.O.; Akinmoladun, V.L.; Oluwatosin, O.M.
Background: The UCH/Smile Train partnership, which offers free cleft surgeries to patients provides succor. Objective: The objective of the study was to determine the state distribution of new patients presenting with cleft lip and palate, to The UCH. Method: A retrospective review of all new cleft patients presenting to The UCH between January 2012 and June 2015. The data obtained were their local government area of residence, age of the patients, gender of the patients and the type of cleft. Descriptive statistics was used to analyze the distribution of patients seen while Chi square test was used to analyze the influence of gender and laterality on the type of cleft. Results .'Sixty-seven eligible patients were seen within the study period. Majority (83.6%) of patients seen were from 14 of the 33 Local Government Areas (LGA’s) in Oyo state. Patients were seen from LGA’s in proximity to UCH. A few (16.4%) of the patients came from outside the state. Iwajowa, the LGA with the least number of patients (1.8%) was furthest from UCH. Left sided clefts were significantly more than bilateral or right-sided clefts (p=0.001). Most of the patients from Oluyole LGA had CP while no patient with CP was seen from Lagelu and Akinyele LGA’s. Conclusion: There is the need to intensify cleft awareness programs. Further studies into the health habits, cultural beliefs and genetic profile of communities may explain some regional distribution of cleft types seen.
Time to return to school in child and adolescent burn for patients from a sub-saharan tertiary hospital
(Elsevier Ltd, 2019) Michael, A.I.; Ademola, S.A.; Olawoye, O.A.; Iyun, A.O.; Arowojolu, O.; Oluwatosin, O.M.
Background: Africa, with the largest number of paediatric burns needs to focus more attention on paediatric burn survivors. Burn injury truncates schooling in child and adolescent burn patients. The aim of this study was to determine the time to return to school and factors influencing this in child and adolescent burn patients. Methodology: A cross-sectional study of child and adolescent patients aged one to nineteen years that had been managed for bun injuries. Demographic variables were obtained from archived computerized data. Phone interviews were conducted to obtain time to return to school variables using a questionnaire. Descriptive statistics, students t test, fishers exact test and Chi square test were uses as appropriate for analysis on data on SPSS version 23. A p value <0.05 was considered statistically significant. Results: Thirty-one patients were recruited for the study. There was a female preponderance, 19 (61.3%). The mean age of the patients was 7.2 (±5.3) years. Scald injuries were the commonest [N = 14 (45.2%)] cause of burn. The mean Total Burn Surface Area (TBSA) was 14.1 (±12.0)%. The mean length of hospital stay was 30 (±59) days. The mean time to return to school after discharge from the hospital was 8.4 (±8.7) weeks. The occurrence of burns on the trunk was significantly (p = 0.048) associated with an earlier time to return to school. Conclusion: Time to return to school from burn injury and from discharge in child and adolescent burn survivors in this study are at least three times longer than previous studies. The burn care team needs to consider school re-entry programs for these children.