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Welcome to UISpace, The University of Ibadan Institutional Repository. A collection of theses, articles, books, videos, images, lectures, papers, data sets and all types of digital content originating from the University of Ibadan Nigeria. This repository is managed by the Kenneth Dike Library University of Ibadan, Nigeria.
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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.
Diagnosing renal failure due to diethylene glycol in children in a resource-constrained setting
(Springer International Publishing, 2012) "Akuse, R. M.; Anyiam, J.; Eke, F. U.; Ademola, A. D.; Fajolu, I. B.; Gbelee, H. O.; Ihejiahi, U.; Bugaje, M. A.; Anochie, I. C.; Asinobi, A. O.; Okafor, H. U.; Adeleke, S. I.; Audu, L. I.; Otuneye, A.; Disu, E.; Idris, H.; Aikhonbare, H.; Yakubu, A.; Ogala, W.; Ogunrinde, O.; Wammanda, R.; Orogade, A.; Eseigbe, E.; Umar, L.; Musa, H.; Onalo, R.; West, B.; Paul, N.; Lesi, F.; Ladapo, T.; Boyede, O.; Okeowo, R.; Mustapha, A.; Akinola, I.; Chima-Oduko, O.; Awobusuyi O.
Background In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource constrained countries, this study investigated whether AKI associated with DEG could be identified by other means.
Methods: This was a multicenter study. Information was obtained from hospital records. Clinicopathological features of all children withAKI over a 6-month period were reviewed.
Results Sixty (50.4%) of 119 children ingested “My pikin” teething syrup. Compared to children who had not ingested it, they were significantly (p<0.05) younger (11.95 vs. 31 months), more were anuric (98.3 vs. 74.6%), hypertensive (84 vs. 52%), had severe metabolic acidosis (46.7 vs. 20.5%), and died (96.6 vs. 71.2%). They developed increasing metabolic acidosis and multiorgan dysfunction despite peritoneal dialysis. Late presentation, financial difficulties, inadequate facilities for toxicology, and hemodialysis complicated management.
Conclusions Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices,
field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.
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.
Minimal change nephrotic syndrome and Graves’ disease in a Nigerian child
(Nigerian Association of Nephrology, 2008) Ademola A. D; Asinobi A. O.; Ayoola O. O.; Ogunkunle O. O.; Olusola O. A.
We report a 12 year old Nigerian boy with steroid sensitive nephrotic syndrome who developed Graves’ disease 12 months after the diagnosis of nephrotic syndrome. He had two relapses of the nephrotic syndrome with early response to steroids on both occasions. Renal biopsy showed normal findings on light microscopy. Graves’ disease is rare among black African children, minimal change nephrotic syndrome is also not commonly reported among them. The coexistence of these two disorders in our patient underscores possible similar immunologic mechanisms in the aetiology of both diseases.
Effects of drought stress on grain yield, agronomic performance, and heterosis of marker-based improved provitamin-A maize synthetics and their hybrids
(Taylor&Francis, 2021) Iseghohi, I.; Abe, A.; Meseka, S.; Mengesha, W.; Gedil, M.; Menkir, A.
Provitamin A-enriched maize (Zea mays L.) is an important complementary food staple for combating vitamin A deficiency (VAD) in high maize-producing and maize-consuming countries of sub- Saharan Africa (SSA). However, frequent drought is a major abiotic factor that retards maize growth, resulting in yearly fluctuations in grain yield. Development of provitamin A-enriched maize varieties resilient to recurrent drought stress could enhance and stabilize maize grain yield. This study was conducted to assess the effects of managed drought stress (MDS) on the performance and heterosis of some marker-based improved provitamin A maize synthetics and their varietal-cross hybrids. The maize synthetics and their varietal-cross hybrids, along with a drought-tolerant check (PVASYN13), were evaluated under MDS and well-watered (WW) conditions at Ikenne, Nigeria, for two years. Genotype and year effects were significant for grain yield and some agronomic traits under MDS and WW conditions. Grain yield was reduced by 56% under MDS. Grain yield was significantly correlated with days to anthesis, days to silking and anthesis-silking-interval under MDS but not under WW condition. Under MDS, three varietal-cross hybrids (PVASYNHGBC0/PVASYNHGAC0, PVASYNHGBC2/ PVASYNHGAC0, PVASYNHGBC0/ PVASYNHGAC1) had similar grain yields and tolerance indices as the drought-tolerant check, whereas PVASYNHGBC1/PVASYNHGAC2 produced 12.5% more grain yield than the check. Three of the varietal-cross hybrids (PVASYNHGBC0/PVASYNHGAC0, PVASYNHGBC0/PVASYNHGAC1 and PVASYNHGBC1/PVASYNHGAC2) had significant mid-parent heterosis for grain yield under the two test conditions, and were recommended for developing drought-tolerant varieties to com-bat VAD in drought-prone environments of SSA