Browsing by Author "Ogunkunle, O. O."

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Nephrotic syndrome complicating cyanotic congenital heart disease: A report of two cases
(West African College of Physicians/ West African College of Surgeons., 2008) Ogunkunle, O. O.; Asinobi, A. O.; Omokhodion, S. I.; Ademola, A. D.
BACKGROUND: Renal complications are said to be common in cyanotic congenital heart disease (CCHD), but have not been documented frequently in Nigerian children. Nephrotic syndrome (NS) is an uncommon complication of CCHD. OBJECTIVES: To report two cases of NS complicating CCHD who presented within months of each other, in order to draw attention to the problem. METHODS: The details of the clinical presentation, course and outcome of two children with CCHD, presenting with features of NS within months of each other, were reviewed. The patients were fully assessed clinically and were further investigated with chest X-ray, ECG ad echocardiography. RESULTS: A 12-year old girl with Fallot’s tetralogy underwent a Blalock-Taussig shunt at the age of 2 years, but subsequently defaulted from follow-up. She reappeared 10 years later with features of NS. Echocardiography revealed impaired myocardial function. Despite initial clinical improvement following three plasma exchanges and Enalapril therapy, she suddenly died on the 15th day of admission. The second patient was a 7-year old boy with tricuspid atresia, diagnosed at the age of 10 months, and similarly defaulted, reappearing six years later with features of NS. Oedema regressed with similar treatment, but his renal function deteriorated. He was stable enough to be discharged after six weeks on admission. CONCLUSION: Proteinuria is likely to be more common in Nigerian children with CCHD than has been previously appreciated. Early intervention in patients with CCHD is desirable in order to prevent development of complications which worsen the prognosis. Patients with CCHD should be screened regularly for proteinuria in order to detect and address renal complications early.
Ophthalmic congenital anomalies: spectrum and systemic associations in a Nigerian tertiary hospital
(2017) Olusanya, B. A.; Ayede, A. I.; Adeleye, A. O.; Olusanya, A. A.; Lawal, T. A.; Baiyeroju, A. M.; Ogunkunle, O. O.; Joel-Medewase, V. I.; Adebayo, B. E.; Akinrinoye, O. O.; Ashubu, O. F.; Omokhodion, S. I.
Background: To document the pattern of ophthalmic congenital anomalies and their associated systemic anomalies in Nigeria’s foremost university teaching hospital. Methods: Retrospective cross-sectional study conducted at the University College Hospital, Ibadan from January 2009 to December 2013. Clinic and ward registers of various departments and units in the hospital were reviewed to identify children with any structural abnormality, present at birth, which involved the eye and/or its adnexae. Results: Two hundred and forty eight children with 259 ophthalmic congenital anomalies were studied. The median age was 1.2 years with an interquartile range of 4.6 years. The male to female ratio was 1.27:1. Congenital cataract was found in 109 (44%) patients; 40 (15.4%) children had congenital glaucoma, and whole globe anomalies were observed in 18 (6.9%) children. Eighteen (7.9%) children had a family history of congenital anomalies. Associated systemic congenital anomalies were seen in 32 (12.9%) patients with the most common being cardiovascular anomalies in 13 (5.2%) patients. Children who had congenital cataracts were more likely to have multiple associated systemic anomalies (p<0.005). All the children who had associated cardiovascular anomalies had congenital cataracts (p= 0.001). Conclusion: The commonest ophthalmic congenital anomaly presenting for tertiary care in Ibadan is congenital cataract. Cardiovascular anomalies are the commonest systemic association of ophthalmic congenital anomalies. There is an urgent need for the establishment of a registry for congenital anomalies with effective screening and active surveillance within the Nigerian health system.
Ophthalmic congenital anomalies: spectrum and systemic associations in a Nigerian tertiary hospital
(2017) Olusanya, B. A.; Ayede, A. I.; Adeleye, A. O.; Olusanya, A. A.; Lawal, T. A.; Baiyeroju, A. M.; Ogunkunle, O. O.; Joel-Medewase, V. I.; Adebayo, B. E.; Akinrinoye, O. O.; Ashubu, O. F.; Omokhodion, S. I.
Background: To document the pattern of ophthalmic congenital anomalies and their associated systemic anomalies in Nigeria’s foremost university teaching hospital. Methods: Retrospective cross-sectional study conducted at the University College Hospital, Ibadan from January 2009 to December 2013. Clinic and ward registers of various departments and units in the hospital were reviewed to identify children with any structural abnormality, present at birth, which involved the eye and/or its adnexae. Results: Two hundred and forty eight children with 259 ophthalmic congenital anomalies were studied. The median age was 1.2 years with an interquartile range of 4.6 years. The male to female ratio was 1.27:1. Congenital cataract was found in 109 (44%) patients; 40 (15.4%) children had congenital glaucoma, and whole globe anomalies were observed in 18 (6.9%) children. Eighteen (7.9%) children had a family history of congenital anomalies. Associated systemic congenital anomalies were seen in 32 (12.9%) patients with the most common being cardiovascular anomalies in 13 (5.2%) patients. Children who had congenital cataracts were more likely to have multiple associated systemic anomalies (p<0.005). All the children who had associated cardiovascular anomalies had congenital cataracts (p= 0.001). Conclusion: The commonest ophthalmic congenital anomaly presenting for tertiary care in Ibadan is congenital cataract. Cardiovascular anomalies are the commonest systemic association of ophthalmic congenital anomalies. There is an urgent need for the establishment of a registry for congenital anomalies with effective screening and active surveillance within the Nigerian health system.
Paediatric end-stage renal disease in a tertiary hospital in South West Nigeria
(Asian Pacific Society of Nephrology, 2014) Asinobi, A. O.; Ademola, A. D.; Ogunkunle, O. O.; Mott S. A.
Background: Children and adolescents with end-stage renal disease (ESRD) in sub-Saharan Africa may have the worst outcomes globally. Barriers to management include late presentation, poor socioeconomic conditions, absence of medical insurance, limited diagnostic facilities and non-availability of chronic renal replacement therapy (RRT). Our study was to determine the incidence, aetiology, management and outcomes of paediatric ESRD in a tertiary hospital in Nigeria. Methods: A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012. Results: 53 patients (56.6% male), median age 11 (inter quartile range 8.5-12) years were studied. Mean annual incidence of ESRD in Ibadan for children aged 14 years and below was 4 per million age related population (PMARP) while for those aged 5-14 years it was 6.0 PMARP. Glomerulonephritis was the cause in 41 (77.4%) patients amongst whom, 29 had chronic glomerulonephritis and 12 had nephrotic syndrome. Congenital anomalies of the kidneys and urinary tract (CAKUT) accounted for 11 (21.2%) cases, posterior urethral valves being the most common. Acute haemodialysis, acute peritoneal dialysis or a combination of these were performed in 33 (62.3%), 6 (11.3%) and 4 (7.5%) patients respectively. Median survival was 47 days and in-hospital mortality was 59%. Conclusions: Incidence of paediatric ESRD in Ibadan is higher than previous reports from sub-Saharan Africa. Glomerulonephritis, and then CAKUT are the most common causes. Mortality is high, primarily due to lack of resources. Preventive nephrology and chronic RRT programmes are urgently needed.
Peritoneal dialysis in childhood acute kidney injury: experience in Southwest Nigeria
(International Society for Peritoneal Dialysis, 2012) Ademola, A. D.; Asinobi, A. O.; Ogunkunle, O. O.; Yusuf, B. N.; Ojo, O. E.
Background: The choices for renal replacement therapy (RRT) in childhood acute kidney injury (AKI) are lim¬ited in low-resource settings. Peritoneal dialysis (PD) appears to be the most practical modality for RRT in young children with AKI in such settings. Data from sub-Saharan Africa on the use of PD in childhood AKI are few. Methods: We performed a retrospective study of chil¬dren who underwent PD for AKI at a tertiary-care hospital in southwest Nigeria from February 2004 to March 2011 (85 months). Results: The study included 27 children (55.6% female). Mean age was 3.1 ± 2.6years, with the youngest being 7 days, and the oldest, 9 years. The causes of AKI were in¬travascular hemolysis (n = 11), septicemia (n = 8), acute glomerulonephritis (n = 3), gastroenteritis (n = 3), and hemolytic uremic syndrome (n = 2). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. Duration of PD ranged from 6 hours to 12 days (mean: 5.0 ± 3.3 days). The main complications were peri¬tonitis (n = 10), pericatheter leakage (n = 9), and catheter outflow obstruction (n = 5). Of the 27 patients, 19 (70%) survived till discharge. Conclusions: In low-resource settings, PD can be suc¬cessfully performed for the management of childhood AKI. In our hospital, the use of adapted catheters may have contributed to the high complication rates. Peritoneal di¬alysis should be promoted for the management of childhood AKI in low-resource settings, and access to percutaneous or Tenckhoff catheters, dialysis fluid, and automated PD should be increased.
Trends in the epidemiology of severe pediatric non-surgical renal disorders in Ibadan Nigeria: A marked increase in the incidence of acute kidney injury
(Sciencedomain International, 2016) Asinobi, A. O.; Ademola, A. D.; Ogunkunle, O. O.; Yaria, J.
Background: Renal disorders are increasingly being recognized as major contributors to morbidity and mortality. Variability in their pattern in different populations and regions of the world and changes occurring with time have been demonstrated. We aimed to determine the current trends in the pattern of severe non-surgical childhood renal disorders at our Centre and compare the findings with previous studies. Methodology: A descriptive analytical study was carried out on consecutive incident cases of nonsurgical renal disorders aged 14 years and below, managed in the Pediatric Nephrology Unit of the University College Hospital, Ibadan, Nigeria. Two separate time periods were studied. Results: A total of 869 incident cases of severe non-surgical disorders were admitted during the study periods. There was an increase in the hospital incidence from 1.5 to 2.2 per 100 pediatric admissions and in the average yearly admission from 43 to 103. The crude annual incidence increased from 42 per million age-related population (PMARP) to 86 (PMARP) at the end of the two study periods. The most remarkable increase occurred with Acute Kidney Injury, which showed a 6.5-fold rise and was the most common cause of renal morbidity and mortality in children encountered in the study. Interventional measures resulted in early detection, prompt treatment and reduced mortality. Conclusion: The study has shown an increase in the incidence of severe childhood renal disorders in Ibadan, with Acute Kidney Injury being the leading non-surgical renal disorder. A significant decline in case fatality rates was demonstrated in recent years.