FACULTY OF CLINICAL SCIENCES
Permanent URI for this communityhttps://repository.ui.edu.ng/handle/123456789/265
Browse
6 results
Search Results
Item Congenital aniridia: clinical profile of children seen at the University College Hospital, Ibadan, South-West Nigeria(SAGE Publishing, 2021) Ugalahi, M. O.; Ibukun, F. A.; Olusanya, B. A.; Baiyeroju, A. M.Purpose: To describe the clinical features of patients younger than 16 years with aniridia presenting to the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital, Ibadan, Nigeria. Methods: The is a retrospective review of children with aniridia seen between May 2015 and April 2019 at the Paediatric Ophthalmology unit of the Eye Clinic, University College Hospital in Ibadan. Data on demographic characteristics, presenting complaints, ocular and systemic examination findings, and interventions were collected and descriptively summarised. Results: A total of 28 eyes of 14 patients were studied. The mean age was 6.37 ± 4.98 years. Seven (50%) patients were male. Aniridia was diagnosed in first-degree relatives of nine patients. The most common complaint at presentation was poor vision in 11 (78.6%) patients. Objective visual acuity assessment was obtained in 22 (78.6%) eyes. Presenting visual acuity was worse than 20/60 in all 22 eyes and worse than 20/400 in 8 (36.4%) eyes. Refraction was performed in 17 (60.7%) eyes and revealed a mean spherical equivalent of −3.93 ± 5.99 diopters. Twenty (71.4%) eyes had corneal opacities, and lenticular opacities were seen in 15 (62.5%) of 24 eyes. Mean intraocular pressure (IOP) at presentation was 21.62 ± 10.4 mmHg; 12 (41.4%) eyes had elevated IOP at presentation. Ten (35.7%) eyes had cataract surgery and six (21.4%) eyes had glaucoma surgery. Conclusion: Familial aniridia was common in this study, and most of the patients presented with moderate to severe visual impairment. The common ocular associations were refractive error, cataract, corneal opacity and glaucoma.Item Age at detection and age at presentation of childhood cataract at a tertiary facility in Ibadan, Southwest Nigeria(2020) Olusanya, B. A.; Ugalahi, M. O.; Adeyemo, A. O.; Baiyeroju, A. M.Background: To describe factors which influence the age at detection and age at presentation of patients with childhood cataract at a tertiary eye care facility in Southwest Nigeria. Methods: A retrospective review of children who presented with cataract between 2011 and 2015. Case notes were reviewed and data on age at detection and presentation as well as other clinical information was collected and analyzed using Stata 12 statistical software. Results: A total of 164 cases were reviewed, 52.4% of them were boys. Median age at presentation was 48 months while the median age at detection was 13.5 months. Seventy-four (45.1%) children had congenital cataract, 31.1% had developmental cataract, and 21.3% had traumatic cataract. The child’s mother detected the cataract in 116 (70.7%) of the patients. Median age at presentation for patients with congenital cataract was 18 months and 84 months for developmental cataract. The median age at presentation for congenital cataracts that were noticed by the mother was 17 months compared with 72 months for those noticed by other caregivers (p = 0.0085). The median age at presentation for developmental cataracts that were noticed by the mother was 72 months compared with 114 months for those noticed by other caregivers (p = 0.0065). Gender of the child did not significantly influence the age at detection or presentation. The source of referral and the location of domicile did not significantly affect the time interval between detection of the cataract and presentation to hospital. Conclusion: The average age of children presenting with cataracts in our setting is older than in high income countries. Detection of the cataract by the mother increases the likelihood of early presentation; thus, focused maternal education may promote earlier detection and presentation. Keywords: Childhood, Cataract surgery, Access, Nigeria, Sub-Saharan AfricaItem 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 Acute kidney injury among patients undergoing major surgery in a tertiary hospital in Nigeria .(2018) Raji, Y.R.; Ajayi, S.O.; Ademola, A.F.; Lawal, T.A.; Ayandipo, O.O.; Adigun, T.A.Background. Acute kidney injury (AKI) is an underreported but major cause of morbidity and mortality among patients undergoing major surgical interventions in sub-Saharan Africa (SSA). Whereas AKI is often seen following major cardiac surgery in high-income countries, a similar spectrum of surgical diseases and interventions is not seen in developing countries. The impacts on surgical outcomes have also not been well characterized in SSA. This study aimed at identifying risk factors, incidence and determinants and short-term outcomes of AKI among patients undergoing major surgery. Methods. This was a cohort study of adult patients undergoing major surgery at the University College Hospital, Ibadan, Nigeria. Data obtained were sociodemographic details, risk factors for AKI, details of surgery, anaesthesia and intraoperative events and short-term outcomes. Blood samples were obtained for pre-operative (pre-op) full blood count, serum electrolytes, blood urea and creatinine (SCr). Post-operatively (Post-op) SCr was determined at 24 h, Day 7 post-op and weekly until each patient was discharged. Results. A total of 219 subjects who had major surgery (86.3% elective) were enrolled. The median age of the patients was 46 (range 18–73) years and 72.6% were females. The surgeries performed were mostly simple mastectomies (37.4%), exploratory laparotomies (22.8%) and total thyroidectomies (16.4%). The incidences of AKI were 18.7% at 24 h and 17.4% at Day 7 post-op, while cumulative AKI incidence was 22.5% at 1-week post-op. Pre-op elevated SCr [odds ratio (OR) 3.86], sepsis (OR 2.69), anaemia (OR 2.91) and duration of surgery >120 min (OR 1.75) were independently associated with AKI. In patient mortality was 20.4% in individuals with AKI and 5.3% in those without AKI (P < 0.01) Conclusion. Peri-operative risk factors for AKI are common among patients undergoing major surgery in SSA hospitals. The cumulative incidence of AKI was high and independently associated with pre-op sepsis, anaemia, pre-existing kidney dysfunction and duration of surgery >120 minItem Pattern of prescription of anti-hypertensive medications in a tertiary health care facility in Abuja, Nigeria.(2013) Ojji D.B.; Ajayi S.O.; Mamven M.H.; Alfa J.; Albertino D.Introduction: Marked changes have been made in the pharmacotherapy of hypertension over the years. In sub-Saharan Africa, hypertension pharmacotherapy is often thought to include only thiazide diuretics, beta blockers and centrally acting medications and, it is unclear if and how often calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are used. Objective: To examine the anti-hypertensive prescription pattern in a tertiary health centre in Nigeria to determine how it conforms to current guidelines. Method: 590 newly diagnosed hypertensive patients presenting at the Cardiology Unit of University of Abuja Teaching Hospital over a three-year period were studied. Result: Calcium channel blockers were the most frequently prescribed anti-hypertensive medications (66.9% of all cases) and centrally acting medications were prescribed in only 5.01% of cases. Single-pill combination either alone or in combination with other antihypertensive medications were prescribed in 17.3% cases. Of these, calcium channel blocker-based combinations constituted the most frequently used multiple drug combinations. 94.6% of the patients required more than one medication for blood pressure control. Conclusion: Anti-hypertensive pharmacotherapy in Abuja, Nigeria, compares favorably with the current recommendations in the prescription pattern of anti-hypertensive medications. (Ethn Dis. 2013;23[4]:480–483)Item Pediatric head and neck malignancies in sub-Saharan Africa(2012) Adeyemo, A. A.; Okolo, C. A.Introduction: Cancers are relatively rare in children however recent reports suggest that malignancies are becoming a major source of pediatric deaths. Method: Using the database of the cancer registry of the University College Hospital, Ibadan we reviewed all newly diagnosed cases of head and neck cancers in children under 19years old at the hospital between 1981 and 2008. Results: A total of 1,021 cases of Head and Neck cancers were seen in children. The hospital based incidence of pediatric head and neck cancers is 36 cases per year. There were 627 males and 394 females [M:F ratio of 1.6:1] with mean ages of 8.21 and 7.70 years respectively. Boys were more affected than girls in all years of life while the peak age of onset for both sexes is the third year of life. The commonest anatomical site involved is the eye/orbit; other common sites were the nasopharynx, paranasal sinuses, nasal cavity and thyroid gland. Neural malignancies constitute the commonest malignancies seen (35.3%), other are lymphomas (33.1%), squamous cell carcinoma (9.1%) and soft tissue sarcoma (8.6%). Retinoblastoma is the commonest lesion seen among the patients with a slight male preponderance [M:F ratio of 1.2:1] Burkitt lymphoma (BL) is seen in all age groups but there is greater frequency in the older ages. The incidence of carcinomas is higher in the older age groups, relatively rare lesions like Hodgkins lymphoma and thyroid malignancies are almost exclusive to older children. Conclusion: The pattern of head and neck malignancies in children in sub-Saharan Africa is changing; dominant lesions like lymphomas are being gradually replaced by other malignancies such as neural malignancies, soft tissue sarcomas and squamous cell carcinoma