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  1. Article ; Online: A probabilistic decision support tool for prediction and management of rainfall-related poor water quality events for a drinking water treatment plant.

    Bertone, Edoardo / Rousso, Benny Zuse / Kufeji, Dapo

    Journal of environmental management

    2023  Volume 332, Page(s) 117209

    Abstract: A data-driven Bayesian Network (BN) model was developed for a large Australian drinking water treatment plant, whose raw water comes from a river into which a number of upstream dams outflow water and smaller tributaries flow. During wet weather events, ... ...

    Abstract A data-driven Bayesian Network (BN) model was developed for a large Australian drinking water treatment plant, whose raw water comes from a river into which a number of upstream dams outflow water and smaller tributaries flow. During wet weather events, the spatial distribution of rainfall has a crucial role on the incoming raw water quality, as runoff from specific sub-catchments usually causes significant turbidity and conductivity issues, as opposed to larger dam outflows which have typically better water quality. The BN relies on a conceptual model developed following expert consultation, as well as a combination of different types (e.g. water quality, flow, rainfall) and amount (e.g. high-frequency, daily, scarce depending on variable) of historical data. The validated model proved to have acceptable accuracy in predicting the probability of different incoming raw water quality ranges, and can be used to assess different scenarios (e.g. timing, flow) of dam water releases, for the purpose of achieving dilution of the tributary's poor-quality water and mitigate related drinking water treatment challenges.
    MeSH term(s) Water Quality ; Drinking Water ; Bayes Theorem ; Australia ; Water Purification ; Environmental Monitoring
    Chemical Substances Drinking Water
    Language English
    Publishing date 2023-01-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 184882-3
    ISSN 1095-8630 ; 0301-4797
    ISSN (online) 1095-8630
    ISSN 0301-4797
    DOI 10.1016/j.jenvman.2022.117209
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  2. Article ; Online: Management of Paediatric Testicular Torsion - Are we adhering to Royal College of Surgeons (RCS) recommendations.

    Thakkar, H S / Yardley, I / Kufeji, D

    Annals of the Royal College of Surgeons of England

    2018  Volume 100, Issue 5, Page(s) 397–400

    Abstract: Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery ... ...

    Abstract Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Materials and methods Retrospective data were collected for all paediatric scrotal explorations performed within our centre between January 2014 and July 2016. Patient demographics, sources of referral, transfer times, time to surgery and operative findings were obtained. Results A total of 100 patients underwent a scrotal exploration. Median age at presentation was 11 years (range 4 months to 15 years). Fifty-three per cent of referrals were from network hospitals. The median duration of symptoms was 25 hours (range 1-210 hours). The median transfer time from local centres was 120 minutes (range 45-540 minutes). The median time to theatre from the decision being made to operate was 60 minutes (range 30-600 minutes). Eighty-seven per cent of cases were explored within three hours. There were 13 cases of torsion with one orchidectomy. When taking into account the transfer time for external patients aged over five years without precluding comorbidities, exploration within three hours dropped to 18 of 46 (39%). Conclusion The RCS guidelines recognise the need for specialist input in very young patients. A large proportion of explorations are, however, currently taking place in older patients with unacceptably long transfer times. We propose an extension of this review nationally to work towards the local provision of care for suitable patients.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Delayed Diagnosis/statistics & numerical data ; Guideline Adherence/statistics & numerical data ; Humans ; Infant ; Male ; Patient Transfer/statistics & numerical data ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/statistics & numerical data ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; Spermatic Cord Torsion/diagnosis ; Spermatic Cord Torsion/surgery ; United Kingdom
    Language English
    Publishing date 2018-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 80044-2
    ISSN 1478-7083 ; 0035-8843
    ISSN (online) 1478-7083
    ISSN 0035-8843
    DOI 10.1308/rcsann.2018.0041
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  3. Article: Primary Umbilical Endometriosis in an Adolescent Girl: Unsuspected Pathology.

    Nellihela, Leel / Al-Adnani, Mudher / Kufeji, Dorothy

    European journal of pediatric surgery reports

    2020  Volume 8, Issue 1, Page(s) e10–e13

    Abstract: Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature. A 16-year-old girl of African ... ...

    Abstract Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature. A 16-year-old girl of African origin presented with painful umbilical lump for 2 to 3 months duration with background history of precocious puberty, cyclical vomiting, and menorrhagia. Clinical examination showed dark-colored, tender, irreducible umbilical lump. A provisional diagnosis of incarcerated umbilical hernia was made. Abdominal X-ray showed no features of intestinal obstruction. Ultrasound scan of the abdomen showed lump containing heterogeneous echogenic material measuring 2.0 × 1.5cm within the umbilicus with no visible bowel loops or peristalsis. This was reported as consistent with an umbilical hernia with narrow neck possibly containing mesentery or intra-abdominal fat. The patient underwent urgent exploration of umbilicus under general anesthetic. At operation, a dark-colored, firm mass was excised and sent for histology. The underlying fascia and peritoneum were repaired. Histological examination confirmed the excised tissue was endometriosis. Follow-up continues in the endometriosis clinic. Umbilical endometriosis should be considered in differential diagnoses of painful umbilical lesion in adolescent girls and women of reproductive age. Complete excision and histology are highly recommended for obtaining a definitive diagnosis, to exclude malignancy and to prevent recurrence.
    Language English
    Publishing date 2020-02-08
    Publishing country Germany
    Document type Case Reports
    ZDB-ID 2674016-3
    ISSN 2194-7627 ; 2194-7619
    ISSN (online) 2194-7627
    ISSN 2194-7619
    DOI 10.1055/s-0039-1700987
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  4. Article: Primary Umbilical Endometriosis in an Adolescent Girl: Unsuspected Pathology

    Nellihela, Leel / Al-Adnani, Mudher / Kufeji, Dorothy

    European Journal of Pediatric Surgery Reports

    2020  Volume 08, Issue 01, Page(s) e10–e13

    Abstract: Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature. A 16-year-old girl of African ... ...

    Abstract Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature. A 16-year-old girl of African origin presented with painful umbilical lump for 2 to 3 months duration with background history of precocious puberty, cyclical vomiting, and menorrhagia. Clinical examination showed dark-colored, tender, irreducible umbilical lump. A provisional diagnosis of incarcerated umbilical hernia was made. Abdominal X-ray showed no features of intestinal obstruction. Ultrasound scan of the abdomen showed lump containing heterogeneous echogenic material measuring 2.0 × 1.5cm within the umbilicus with no visible bowel loops or peristalsis. This was reported as consistent with an umbilical hernia with narrow neck possibly containing mesentery or intra-abdominal fat. The patient underwent urgent exploration of umbilicus under general anesthetic. At operation, a dark-colored, firm mass was excised and sent for histology. The underlying fascia and peritoneum were repaired. Histological examination confirmed the excised tissue was endometriosis. Follow-up continues in the endometriosis clinic. Umbilical endometriosis should be considered in differential diagnoses of painful umbilical lesion in adolescent girls and women of reproductive age. Complete excision and histology are highly recommended for obtaining a definitive diagnosis, to exclude malignancy and to prevent recurrence.
    Keywords endometriosis ; umbilical ; primary ; adolescent
    Language English
    Publishing date 2020-01-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2674016-3
    ISSN 2194-7627 ; 2194-7619
    ISSN (online) 2194-7627
    ISSN 2194-7619
    DOI 10.1055/s-0039-1700987
    Database Thieme publisher's database

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    Zs.A 6998: Show issues Location:
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  5. Article ; Online: Anorectal manometry with and without ketamine for evaluation of defecation disorders in children.

    Keshtgar, A S / Choudhry, M S / Kufeji, D / Ward, H C / Clayden, G S

    Journal of pediatric surgery

    2015  Volume 50, Issue 3, Page(s) 438–443

    Abstract: Introduction: Anorectal manometry (ARCM) provides valuable information in children with chronic constipation and fecal incontinence but may not be tolerated in the awake child. This study aimed to evaluate the effect of ketamine anesthesia on the ... ...

    Abstract Introduction: Anorectal manometry (ARCM) provides valuable information in children with chronic constipation and fecal incontinence but may not be tolerated in the awake child. This study aimed to evaluate the effect of ketamine anesthesia on the assessment of anorectal function by manometry and to evaluate defecation dynamics and anal sphincter resting pressure in the context of pathophysiology of chronic functional (idiopathic) constipation and soiling in children.
    Methods: This was a prospective study of children who were investigated for symptoms of chronic constipation and soiling between April 2001 and April 2004. We studied 52 consecutive children who had awake ARCM, biofeedback training and endosonography (awake group) and 64 children who had ketamine anesthesia for ARCM and endosonography (ketamine group). We age matched 31 children who had awake anorectal studies with 27 who had ketamine anesthesia.
    Results: The children in awake and ketamine groups were comparable for age, duration of bowel symptoms and duration of laxative treatments. ARCM profile was comparable between the awake and the ketamine groups with regard to anal sphincter resting pressure, rectal capacity, amplitude of rectal contractions, frequency of rectal and IAS contractions and functional length of anal canal. Of 52 children who had awake ARCM, dyssynergia of the EAS muscles was observed in 22 (42%) and median squeeze pressure was 87mm Hg (range 25-134). The anal sphincter resting pressure was non-obstructive and comparable to healthy normal children. Rectoanal inhibitory reflex was seen in all children excluding diagnosis of Hirschsprung disease.
    Conclusions: Ketamine anesthesia does not affect quantitative or qualitative measurements of autonomic anorectal function and can be used reliably in children who will not tolerate the manometry while awake. Paradoxical contraction of the EAS can only be evaluated in the awake children and should be investigated further as the underlying cause of obstructive defecation in patients with chronic functional constipation and soiling.
    MeSH term(s) Adolescent ; Anal Canal/physiopathology ; Analgesics ; Biofeedback, Psychology ; Child ; Child, Preschool ; Constipation/physiopathology ; Defecation/physiology ; Endosonography ; Fecal Incontinence/physiopathology ; Female ; Hirschsprung Disease ; Humans ; Ketamine ; Laxatives/administration & dosage ; Male ; Manometry/methods ; Muscle Contraction ; Pressure ; Prospective Studies
    Chemical Substances Analgesics ; Laxatives ; Ketamine (690G0D6V8H)
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2014.08.016
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    Zs.A 607: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  6. Article ; Online: Application of the Clavien-Dindo classification to a pediatric surgical network.

    Thompson, Hannah / Jones, Ceri / Pardy, Caroline / Kufeji, Dorothy / Nichols, Eric / Murphy, Felim / Davenport, Mark

    Journal of pediatric surgery

    2019  Volume 55, Issue 2, Page(s) 312–315

    Abstract: Introduction: A comprehensive validated system to evaluate surgical complications is required in our specialty to facilitate comparison and audit. The Clavien-Dindo (CD) classification of post-surgical complications was originally described in an adult ... ...

    Abstract Introduction: A comprehensive validated system to evaluate surgical complications is required in our specialty to facilitate comparison and audit. The Clavien-Dindo (CD) classification of post-surgical complications was originally described in an adult general surgical setting in 1992 and has become widely used. We aimed to apply this to a pediatric surgical setting.
    Methods: Data were collected on emergency and elective surgical activity together with complications in a prospective audit over a recent 4-month period in three geographical conjoined regional pediatric surgical units (including two major trauma centres). Briefly the CD classification codes complications according to degree of harm and magnitude of intervention required [I - V (death) with III and IV sub-divided according to whether general anesthesia was needed]. Length of stay and mode of admission were recorded. Data are given as median (range). Non-parametric comparison was used, and a p value of <0.05 was regarded as significant.
    Results: During the period JULY - OCT 2018 (inclusive), there were 1822 admissions (elective, n = 1186: emergency, n = 636) and 1556 operations (elective, n = 1189, and of these 393 were urological). There were 69 patient complications: CDI (n = 7), CD-II (n = 19), CD-IIIa (n = 4), CD-IIIb (n = 28), CD-IV (n = 4), CD-V (n = 7). Deaths were principally in neonates and due to NEC (n = 6) at 2.5 (1-140) days post-operatively. There was a single post-traumatic death in an adolescent. LOS was 9 (0-217) days in CD I-IV. The incidence of any complication was 4.4%, of serious complication (defined as ≥CD III) 2.6% (A = 2.1%, B = 2.0%, and C = 3.2%: p = 0.16), and of death 0.45%. The most frequent complications were wound infection (n = 12) and post-appendicectomy collections/abscess (n = 10).
    Conclusions: This appears to be the 1st report of the C-D classification in a general pediatric surgery network and can be considered a benchmark. The risk of death or serious harm is very low in such a practice.
    Type of study: Prospective Cohort Study.
    Level of evidence: IIb.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Postoperative Complications/classification ; Postoperative Complications/epidemiology ; Postoperative Complications/mortality ; Risk ; Severity of Illness Index
    Language English
    Publishing date 2019-11-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2019.10.032
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    Zs.A 607: Show issues Location:
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  7. Article ; Online: Differential diagnosis of double site intussusception in childhood: a 15-year-old girl presenting with bowel obstruction.

    Davidson, Joseph / Wright, Naomi Jane / Kufeji, Dorothy

    BMJ case reports

    2015  Volume 2015

    Abstract: Abdominal pain in a teenage girl is common; however, thorough history and examination can often distinguish a more rare or sinister diagnosis. We present a case of a 15-year-old girl presenting with abdominal pain, who was subsequently diagnosed with ... ...

    Abstract Abdominal pain in a teenage girl is common; however, thorough history and examination can often distinguish a more rare or sinister diagnosis. We present a case of a 15-year-old girl presenting with abdominal pain, who was subsequently diagnosed with double intussusception secondary to her previously unrecognised Peutz-Jeghers syndrome (PJS).
    MeSH term(s) Abdominal Pain/etiology ; Adolescent ; Female ; Humans ; Intussusception/diagnosis ; Intussusception/etiology ; Intussusception/surgery ; Peutz-Jeghers Syndrome/complications ; Peutz-Jeghers Syndrome/diagnosis ; Peutz-Jeghers Syndrome/surgery
    Language English
    Publishing date 2015-11-18
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2015-212337
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  8. Article ; Online: Current Practice and Outcomes in the Management of Intra-abdominal Testes.

    Stedman, Francesca / Bradshaw, Catherine J / Kufeji, Dorothy

    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie

    2015  Volume 25, Issue 5, Page(s) 409–413

    Abstract: Introduction: Fowler-Stephens orchidopexy is the most widely used technique for the surgical management of intra-abdominal testes with laparoscopy being the preferred approach. The aim of this study was to review all two-stage laparoscopic Fowler- ... ...

    Abstract Introduction: Fowler-Stephens orchidopexy is the most widely used technique for the surgical management of intra-abdominal testes with laparoscopy being the preferred approach. The aim of this study was to review all two-stage laparoscopic Fowler-Stephens orchidopexies performed in one pediatric surgical unit over a 7-year period.
    Methods: A retrospective case series of all patients undergoing two-stage laparoscopic Fowler-Stephens orchidopexy was performed. Primary outcome measure was testicular atrophy at follow-up. Secondary outcomes included testicular atrophy at second-stage operation and testicular ascent requiring redo surgery.
    Results: A total of 83 two-stage laparoscopic Fowler-Stephens orchidopexy were performed, with outcome data available for 67. Median age at first stage was 1 year 11 months. No testes had undergone atrophy at the second-stage laparoscopy. Median follow-up was 1 year. The overall success rate was 86.4%. Seven patients were noted to have an atrophic testis at the initial clinic review. Five patients required redo orchidopexy for testicular ascent. Of these, two patients had a successful result, two patients subsequently had testicular atrophy and one awaits redo surgery.
    Conclusion: We conclude that Fowler-Stephens orchidopexy has a relatively good outcome. The rates of reoperation after the two-stage Fowler-Stephens orchidopexy were low in this study. Overall success rate compares very favorably to published literature.
    MeSH term(s) Adolescent ; Atrophy ; Child ; Child, Preschool ; Cryptorchidism/pathology ; Cryptorchidism/surgery ; Humans ; Infant ; Laparoscopy/methods ; Male ; Orchiopexy/methods ; Recurrence ; Testis/pathology ; Testis/surgery ; Treatment Outcome
    Language English
    Publishing date 2015-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1065043-x
    ISSN 1439-359X ; 0939-7248 ; 0939-6764 ; 0930-7249
    ISSN (online) 1439-359X
    ISSN 0939-7248 ; 0939-6764 ; 0930-7249
    DOI 10.1055/s-0034-1383854
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    Zs.A 3140: Show issues Location:
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  9. Article ; Online: Out with the old and in with the new: a comparison of rectal suction biopsies with traditional and modern biopsy forceps.

    Hall, Nigel J / Kufeji, D / Keshtgar, A

    Journal of pediatric surgery

    2009  Volume 44, Issue 2, Page(s) 395–398

    Abstract: Aims: Rectal suction biopsy, the gold standard for the diagnosis of Hirschsprung disease, has been associated with a varying incidence of complications and inadequate biopsy. The rbi2 is a modern alternative to the 'Noblett' biopsy forceps and has ... ...

    Abstract Aims: Rectal suction biopsy, the gold standard for the diagnosis of Hirschsprung disease, has been associated with a varying incidence of complications and inadequate biopsy. The rbi2 is a modern alternative to the 'Noblett' biopsy forceps and has recently become available. The aim of this study was to compare the performance of this novel tool with the Noblett forceps.
    Methods: Single-center retrospective study of all infants (<1 year) undergoing rectal suction biopsy from January 2004 to December 2007. During the study period, 2 different biopsy forceps were used--the Noblett forceps (first 2.5 years) and the rbi2 (last 1.5 years). A specimen was defined as inadequate if it was too small or contained inadequate submucosa for histological diagnosis. Fisher's Exact test and Mann-Whitney U test were used as appropriate.
    Results: During the study period, 238 specimens were obtained from 88 infants in 102 biopsy episodes. Overall, 13 episodes were inadequate. There were no demographic differences between the 2 groups, and no serious complications (hemorrhage requiring transfusion, rectal perforation, pelvic sepsis) occurred in any infant. A significantly higher proportion of specimens taken with the Noblett forceps were inadequate compared with the rbi2 (Noblett 30/153 [20%] vs rbi2 6/85 [7%]; Relative risk (RR) = 2.8; 95% confidence interval, 1.2-6.3; P = .01). There was a nonsignificantly higher incidence of inadequate biopsy episode with the Noblett forceps compared with the rbi2 (Noblett 10/63 [16%] vs rbi2 3/40 [7%]; RR = 2.2; 95% confidence interval, 0.6-7.3; P = .24). The rbi2 carries a small cost premium for each biopsy episode compared with the Noblett forceps, but this is low when compared with the cost of repeat biopsy.
    Conclusions: Rectal suction biopsy is a safe procedure with a low incidence of complications. The rbi2 offers superior efficacy over the Noblett forceps, and its use is likely to be more cost-effective.
    MeSH term(s) Biopsy/instrumentation ; Biopsy/methods ; Female ; Hirschsprung Disease/pathology ; Humans ; Infant ; Infant, Newborn ; Male ; Rectum/pathology ; Retrospective Studies
    Language English
    Publishing date 2009-02
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2008.10.093
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  10. Article ; Online: Surgical management of severe chronic constipation.

    Clayden, G S / Adeyinka, T / Kufeji, D / Keshtgar, A S

    Archives of disease in childhood

    2010  Volume 95, Issue 11, Page(s) 859–860

    MeSH term(s) Child ; Chronic Disease ; Constipation/surgery ; Humans ; Proctocolectomy, Restorative
    Language English
    Publishing date 2010-11
    Publishing country England
    Document type Comment ; Editorial
    ZDB-ID 524-1
    ISSN 1468-2044 ; 0003-9888 ; 1359-2998
    ISSN (online) 1468-2044
    ISSN 0003-9888 ; 1359-2998
    DOI 10.1136/adc.2009.180802
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