FACULTY OF CLINICAL SCIENCES

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Start date: 1990End date: 1999

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    Socio-economic implications of the surgical treatment of hydrocephalus
    (1993) Afolabi, A. O.; Shokunb1, M. T.
    Between July 1987 and June 1991, 38 patients presented to our service for the surgical treatment of hydrocephalus. The average age at presentation was nine months and the sex ratio was M:F = 1:2: 1. Majority of the patients presented at advanced stage of the disease with gross head enlargement, psychomotor retardation and optic atrophy. Despite the willingness of the parents to have surgical treatment, there was an average delay of six weeks between confirmation of diagnosis and treatment, because of socioeconomic reasons.
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    The efficacy of non-drug therapy in cancer pain management
    (1999-08) Onibokun, A.
    This study sort to examine the effects of cognitive-behavioural therapy (CBT) on pain intensity (PI), occurrence and control of negative thoughts in response to pain (OCNT) and quality of life (QOL) in breast cancer patients who were experiencing physical pain. A pretest post-test control group quasi- experimental research design was utilised. Ninety patients with breast cancer who were; experiencing physical pain were randomly assigned to three groups. Experimental group I received training in relaxation and guided imagery, white experimental group II had training in cognitive restructuring, in addition to relaxation and guided imagery. The control group received no CBT. The effects of CBT were tested on PI, OCNT and QOL, both among the three groups an between the two experimental groups, using Analysis of Variance and T-test, respectively. Subjects who received CBT experienced low PI than the control group. They perceived significantly fewer OCNT, and their health related QOL were better enhanced as compared with those who received no CBT. .The subjects in experimental group II who had an additional benefit of cognitive restructuring training experienced fewer OCNT than those in experimental group I. There was no significant difference in PI and QOL between experimental groups I and II. The results indicated that CBT plays a significant role in the control of cancer pain
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    Commonly reported gynecological morbidities and health-seeking behaviours among reproductive age women in urban Nigeria
    (1998-08) Uwnkwe, C. B. U.; Adoyomi, O. A.; Palayo, J.; Moronkola, O. A.; Onibokun, A.; Ogundiran, A.
    The present study investigated the commonly reported gynecological morbidities by reproductive age women in some/urban areas of south western Nigeria. Specifically the study attempted to determine the proportion of the reproductive age women surveyed reported the symptoms associated with obstetrics and gynecological morbidity, the perceived causes of such obstetrics and gynecological morbidity in the women, whether such women sought treatment or consultation for specific symptoms, and in what kind of health facilities., The Ex post facto research design was adopted in the study. The subjects used for the study were randomly selected from four health facilities located in the Ibadan metropolis, south western Nigeria. The findings from the study revealed that 91% of the respondents have had cause to report their problem to either government hospital, primary health center, private hospital, a sub-center or traditional hospital. Also, 55% of the respondents had their medium of information about health programmes through the radio, while the remaining 45% had been adequately informed about health programmes through the other media like television, magazines, workshops or seminars. About 80% claimed that they had menstrual disorders of heavy or light irregular bleeding, painful menstruation or spotting between periods, while79.6% claimed to have anaemia indicated by feeling excessively weak, tired or breathless during household activities. Some 60.4% of the respondents claimed to have lower reproductive tract infections while 30.7% stated that they have acute pelvic inflammatory disease, which is the lower abdomen pain or vagina discharge with fever. Also, about 58.4% was the percentage of women who sought or consultation for specific symptoms in the private hospital while the rest used the network of health centers and sub-centers available in their areas under the primary health care system. The implication of this findings were highlighted and discussed
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    Psychotherapy in Africa: experience of the group psycho-educational support programme at Ibadan - a preliminary report
    (1995-11) Onibokun, A. C.; Ohaeri, J. U.; Campbell, O. B.; Adenipekun, A. A
    Africa stem from the lack of an appropriate psychodynamic theory ori which to base the technique used. He suggested and experimented with the use of cosmologies (world view) native to the culture (e.g. - the Yoruba Ayanmo myth) in psychodynamic elaborations in therapy. Ohaeri (1989) believed that work along the lines suggested by Morakinyo (1982) be encouraged, but opined that the current socio-economic and cultural changes in Nigeria make it imperative to examine the need for formalized psychotherapy in the contemporary Nigeria. In view of the above coupled with the felt needs of the teaming number of oncology patients at the Cancer Registry of the University College Hospital (U.C.H.), Ibadan, the Lola Marinho Psycho-oncology Counselling Clinic (LMPOC2) was established in July 1992. The clinic now runs a formal psychotherapy programme. With the increased availability of modern methods for diagnosis and the treatment of cancer, our experience has shown that many more cases of cancer now report in hospitals in Nigeria, in particular, at the Radio-therapy Centre of the University College Hospital (U.C.H.), Ibadan, which is the only functioning radio-therapy centre in West Africa sub-region for now. This has offered us the opportunity to enquire into aspects of psycho-oncology. Our goals in this clinic are: 1. to assist the patients and heir family members in becoming more knowledgeable about the disease by providing them with all necessary information. 2. to give support by providing continuity of care. 3. to teach the patients and their family members the necessary skills to cope with the stress of living with cancer. It is an eight session progressive course, which we have developed and used for hundreds of patients at the Lola Marinho Psycho-oncology Counselling Clinic (LMPOC2). The programme is intended for people living with cancer who want to help themselves cope with and combat their disease. It is also meant for those who wish to conduct group teaching skills for people living with cancer and their family members. The paper deals with the efficacy of psychotherapy in improving the quality of life of oncology patients in Nigeria, judging from our experience with our clients at the Lola Marinho Psycho-oncology Counselling Clinic (LMPOC2) of the University College Hospital, Ibadan, Nigeria. The findings pose great challenges to all categories of health care providers, especially Nigerian psychologists
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    POST-TRAINING ASSESSMENT OF DIARRHOEA MANAGEMENT WITH SALT SUGAR SOLUTION BY COMMUNITY-BASED DISTRIBUTION WORKERS IN AKINYELE LOCAL GOVERNMENT AREA, OYO STATE
    (1995) ADEKOLA, O.
    Studies in a number of pilot Community Based Distribution (CBD) programmes have shown that CBD workers can deliver modern contraceptives and safe maternal and child health services (including treatment or management of common childhood diseases such as diarrhoea) in their communities (Weiss, 1985). CBD workers have been active in Akinyele Local Government Area (LGA) and a high number of diarrhoea episodes have been managed by them. Most efforts have been on the general assessment of service delivery and also certain issues such as increasing availability of contraceptives have been addressed by CBD workers. One major problem is lack of specific post-training assessment of CBD workers' skill in preparing and use of some of the innovative training packages especially the use of salt sugar solution (SSS) in the management of children diarrhoea diseases. A descriptive study was carried out in five CBD centres of Akinyele LGA between June 1990 and October 1990. All the CBD workers identified were 91 but after four visits to each home, a sample of 77 was found and was interviewed and observed. Baseline information on CBD workers who had managed diarrhoea cases were obtained from records at CBD office. The ammended final draft of the questionnaire after pretest at Ajia in Afijio Local Government Area was administered to the 77 workers. In addition observation with a checklist was used to assess workers' ability to prepare SSS. The respondents were similar in age, occupation (other than CBD work) religion. Though while all Traditional Birth Attendants (TBAs) were female and aged above 45 years, Village Health Workers (VHWs) included both male and female and some aged less than 45 years. All the workers, irrespective of either VHWs or TBAs recognised diarrhoea as a servere case and could relate the causes and management but only 9.1% (2 TBAs, 5 BHWs) could assert the correct preventive measures. All the categories of workers asserted that they have heard of SSS but 14.3% (6 VHWs, 5 TBAs) of the workers could state the correct measurements of SSS though 72.7% used it in diarrhoea management, however 27.3% workers have never used it. More than one third (36.7%) of the workers stated that SSS stops diarrhoea rather than preventing dehydration which was mentioned by only 16.3%. All the workers (100%) mentioned that the ingredients - salt and sugar are expensive though they will continue to use it in future unless there is a new technological breakthrough. However, the workers (97.4%) do not teach mothers who utilize their services. Results from observation study revealed that all the workers (100%) did not have SSS corner and sugar was readily accessible in 48.1% of the homes. The workers' preparation of SSS revealed inadequacy in the skills. The study has demonstrated that operation research can reveal hidden facts which could have been overlooked if research was on a general scope. Based on findings, the researcher recommends that workers undergo refresher training which will emphasise measurements of SSS ingredients, SSS use and preparation. Workers should also have SSS corner in their homes where they can teach mothers and should be compensated financially or in kind as this will motivate workers to be dedicated. Specifically, future study should focus on the diarrhoea occurrence among under five children in the five CBD centres of Akinyele Local Government.
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    CONTRACEPTION AMONGST SENIOR SECONDARY SCHOOL STUDENTS IN IBADAN NORTH-EAST LOCAL GOVERNMENT AREA OF OYO STATE
    (1995-02) ADEGBENRO, C. A
    Over the recent years, sexual activities among students in Secondary Schools in Nigeria, particularly those in urban areas, are thought to be high and increasing. The resultant unwanted pregnancies and illegal abortions among these young unmarried population are creating social and health problems (Nichols, et al, 1986). According to previous research findings, included in the causative factors responsible for this unfortunate situation, cure the problems of poor knowledge of Family Life (Sex Education) and Reproductive Health Education and Contraception, negative attitude towards contraceptive services, low and ineffective use of contraceptives due to low accessibility to family planning services. Therefore, the present Knowledge, Attitude and Practices (KAP) study was carried out in order to assess the level of contraceptive awareness and utilization amongst Students in Secondary Schools in- Ibadan North-East- Local Government Area of Oyo State. After the pretesting, a total number of 766 questionnaires were finally administered to students in the Senior Classes in four (4) Secondary Schools in the Local Government Area using a combination of proportional stratified and systematic random sampling techniques. The selected four (4) schools consists of one Boys' only, Girls' only and two mixed schools. Out of this number, a total of 744 duly completed questionnaires were subsequently analysed. The result showed that 484(65.1%) respondents had the correct knowledge of some modern methods of contraception, and out of this figure, 183(37.8%) mentioned condom as a popular method of contraception among them. Although, attitudinal disposition of the respondents towards contraceptive use was as high as 76.0%, however, the results showed a very low level of contraceptive utilization among them (15.7%), Based on these findings, it is suggested that Family Life and Reproductive Health Education including contraceptive counselling services should be introduced in the secondary schools in the L.G.A.
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    BREAST SELF-EXAMINATION (BSE) PRACTICES AMONG FEMALE STUDENTS IN HIGHER INSTITUTIONS IN IBADAN: IMPLICATIONS FOR CANCER EDUCATION
    (1992-01) ADEGOKE, F. R.
    This study assessed the knowledge, attitude and existing breast self-examination practices among six hundred and ninety female students of the University of Ibadan and the Ibadan Polytechnic, Oyo State, Nigeria; using a set of questionnaire. Results showed that 66.1% had ever practiced breast self-examination. However, only 77% reportedly carried out monthly examination of their breasts in the last six (6) months, although 84.6% were aware of it and 33.3% knew that it should be carried out monthly. Knowledge of the correct sequence of breast self-examination and the symptoms to look for was low. The major source of information on breast self- examination was through the mass media. There was a generally positive attitude toward the behaviour. In light of these findings, some breast self- examination information packages and progammes are proposed for the students. In addition, suggestion regarding the examination of breast, self-examination materials for completeness, accuracy and appropriateness before dissemination to the public were made.
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    Squamous cell carcinoma of the cervix simulating an advanced malignancy of the ovaries
    (College of Medicine, University of Ibadan, Ibadan, 1998) Obisesan, K. A.; Adeyemo, A. A.; Fawole, A. O.; Adesina, O. A.
    A 40-year-old woman was diagnosed as having stage II squamous cell cervical carcinoma and managed with radiotherapy. Three months after treatment, she presented with features suggestive of an advanced ovarian tumour including gross abdominal swelling, bilateral ovarian tumours, multiple tumour seedlings in the abdominal cavity and ascites. There was also pleural effusion. Operative findings revealed widespread intra-abdominal metastases whose histology, contrary to expectations, showed squamous cell carcinoma of cervical origin. Distant metastases from squamous cell carcinoma of the cervix are rare. A high index of suspicion is necessary to detect this unusual mode of presentation.
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    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.
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    Ocular complications of head injury in children
    (Springer-Verlag, 1991) Shokunbi, T.; Agbeja, A.
    Ocular complications occurred in 28%, of children with head injury. Neuro-ophthalmological lesions made up one-third or these complications, mostly involved the optic nerve, and were associated with other focal neurological signs more frequently than non-neural ocular complications. Lesions or the posterior visual pathways were rare but tended to be permanent.