FACULTY OF CLINICAL SCIENCES
Permanent URI for this communityhttps://repository.ui.edu.ng/handle/123456789/265
Browse
379 results
Search Results
Item 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.Item 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.Item Otitis media with effusion and hearing loss in childen with orofactial clefts.(2019) Olije, T.; Fasunla, A.J.; Onakoya, P.A.; Ademola, S.A.; Adeosun, A.A.Background: Little or no attention is given to hearing health of children with orofacial cleft. This study was carried out to determine the prevalence of otitis media with effusion (OME) and evaluate hearing thresholds of children with orofacial cleft in Nigeria. Methodology: Eighty-three consecutive children with orofacial cleft comprising, 12 (14.5%) cleft lip alone, 32 (38.5%) cleft lip and palate and 39 (47.0%) cleft palate alone, and 83 healthy controls participated in the study. Structured questionnaire was used to collect socio-demographic and relevant medical information. Participants had ear, nose and throat examinations, visual reinforcement or condition play audiometry and tympanometry tests done. Statistical analysis was done with appropriate statistical tools, level of significance was set at p<0.05. Results: Mean age of cases was 22.83 ± 2.71 months and controls was 23.34 ± 2.54 months. Hearing loss was found in 28 (16.9%) ears of cases and 14 (8.5%) ears of controls (p=0.021). There was a significant difference between mean hearing thresholds of cleft palate ± lip and control (p<0.05). OME was present in 80 (48.2%) ears of cases and 17 (10.2%) ears of the controls (p=0.001). There was a statistically significant association between cleft palate ± lip and OME (p=0.0001, OR = 4.520 [2.353-8.681]). Conclusion: Otitis media with effusion and hearing loss were more prevalent among children with orofacial cleft palate than non-cleft children. Hence, routine early hearing and middle ear evaluations are recommended for inclusion in their management plan.Item 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.Item 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.Item Management of hypospadias in a resource-poor setting: the Ibadan experience(Wolters Kluwer, 2018) Ogundoyin, O.O.; Olulana, D.I.; Lawal, T.A.; Ademola, S.A.Background: Penile anomalies especially hypospadias are one of the most common genitourinary anomalies seen in newborns, and they pose a great deal of psychological stress to their mothers. This study examined our experience in the management of hypospadias. Patients: and Methods A retrospective study of all patients (Group A) managed for hypospadias from 2004 to 2013 was conducted. Data obtained included patients’ demography, their clinical presentation and management. These were analysed and compared with a similar study (Group B) conducted in this hospital four decades earlier between 1966 and 1977. Results: Forty-eight patients belonging to Group A had repair of hypospadias in comparison to the 42 patients in Group B. The mean age at presentation in Group A was 2.7 ± 4 years, and the anomaly was discovered at birth in all the patients. In contrary, Group B had 32 (76.2%) patients who presented immediately after birth and 10 (23.8%) patients who were either adolescents or adults (12-36 years) with a mean age of 18.9 years. Anterior hypospadias occurred more commonly in both groups; 10 (20.8%) patients were circumcised in Group A and 4 (9.5%) patients in Group B. Surgical site infection was the most common post-operative complication observed in both groups. The type of surgical repair was observed to have significantly influenced the outcome of surgical repair in patients in Group A (j2 = 14.13, P = 0.05). Conclusion: Proper and successful management of hypospadias can be enhanced in this environment with adequate media advocacy directed at prompt recognition of this anomaly and avoidance of circumcision when hypospadias has been identified.Item Management of cleft lip and palate in Nigeria: a survey(Wolters Kluwer, 2018) Akinmoladun, V.; Ademola, S.; Olusanya, A.Background: Clefts of the lip and/or palate are the most common congenital craniofacial defects and second only to club foot among all congenital anomalies. The management of this condition is resource intensive due to the multidimensional needs. This survey was carried out to ascertain the current state of cleft management in Nigeria with emphasis on training, scope of management, and assessment of treatment outcome. Materials and Methods: Structured questionnaires were administered to cleft surgeons based on professional and practitioners’ register and the result of literature search for cleft surgeons whose names may not appear in the registers. Results: A total of 69 returned questionnaires were analyzed. The highest number of surgeons was from southwest geopolitical region while the northeast had the least. Fifty-eight (84.1%) were specialists with the fellowships. Forty-seven had been cleft surgeons for <10 years. Majority undertook lip repair between 3 and 4 months while 50% did cleft palate at or more than 9 months. Millard rotation and advancement was used for lip repair by 91.2% and 44 employed the von Langenbeck technique for palatal repair. Forty-six respondents carried out nasal repair at the time of lip surgery with 44 doing this as closed rhinoplasty. Adhesive tapes were usually employed by 44 (63.7%) for managing the protruding premaxilla. Orthodontic evaluation was not usually part of the treatment plan of 34 respondents. Otology assessment and assessment of velopharyngeal competence were rarely done. Revision surgeries, alveolar bone grafting, rhinoplasties, and maxillary osteotomies were uncommon. Interdisciplinary team care approach was practiced by 54 (78.2%) respondents. Conclusion: Findings suggest an increase in the number of surgeons, but the training, scope, and standard of care remain relatively limited. Audit and assessment of the practice should also become points of emphasis.Item Identification of ASAH1 as a susceptibility gene for familial keloids(Macmillan Publishers, 2017) Santos-Cortez R.P.; Ying Hu; Fanyue Sun; Benahmed-Miniuk F.; Jian Tao; Kanaujiya J.K.; Ademola S.; Fadiora S.; Odesina V.; Nickerson D.A.; Bamshad M.J.; Olaitan P.B.; Oluwatosin O.M.; Leal S.M.; Reichenberger E.J.Item Management of split skin graft donor site in the west african sub region: survey of plastic surgeons’ practice.(2017) Olawoye O.A.; Ademola S.A.; lyun A.O.; Michael A.I.; Oluwatosin O.M.Split skin graft (SSG) is one of the most commonly performed operations on any Plastic Surgery service. Rate of donor site healing is affected by various factors including the type of dressing applied. The aim of this study was to survey the practice of plastic surgeons in the sub region with respect to management of SSG donor site and see how it conforms to international standards. Structured questionnaires on various aspects of the harvest and management of SSG donor sites were administered to plastic surgeons during the 53rd annual conference of the West African College of Surgeons (WACS) at Lome, Togo in March 2013. The data were analyzed using descriptive statistics. There were 47 respondents out of 55 plastic surgeons from four West African countries, which represented 85.4% of registered participants at the plastic surgery section of the conference. All the respondents performed SSG regularly, and the thigh was the most commonly used donor site. Different types of paraffin gauze remained the most commonly used primary donor site dressing. Only 17% of the respondents apply a topical local anaesthetic agent on the donor site. The choice of SSG donor site dressing in the sub region was driven mainly by availability. Concerted efforts must be made to access newer wound care products for optimum management of this commonly performed operation.Item Association between Perfluoroalkyl substance exposure and renal function in children with CKD enrolled in H3Africa kidney disease research network.(2019) Sood, S.; Ojo, A.O.; Adu, D.; Kannan, K.; Ghassabian, A.; Koshy, T.; Vento, S.M.; Pehrson, L.J.; Gilbert, J.F.; Arogundade, F.A.; Ademola, A.D.; Salako, B.O.; Raji, Y.; Osafo, C.; Antwi, S.; Trachtman, H.; Trasande, L.