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  1. Article ; Online: Clinicopathological Features, Management and Outcome of Paediatric Solid Renal Tumours in Southeast Nigeria

    Okechukwu Hyginus Ekwunife / Jideofor Okechukwu Ugwu / Victor Ifeanyichukwu Modekwe / Chijioke Elias Ezeudu / Thomas Obiajulu Ulasi / Cornelius Ozobia Ukah

    Journal of Clinical and Diagnostic Research, Vol 15, Iss 4, Pp PC15-PC

    The Need for Protocol and Multidisciplinary Collaboration

    2021  Volume 19

    Abstract: Introduction: Renal malignancies are common in children and they constitute 6-7% of all childhood tumours and nephroblastoma is the most common solid renal tumour in children. Currently, standardised institutional protocols in management of renal tumours ...

    Abstract Introduction: Renal malignancies are common in children and they constitute 6-7% of all childhood tumours and nephroblastoma is the most common solid renal tumour in children. Currently, standardised institutional protocols in management of renal tumours in children are the norm. Large scale collaborative studies have started emerging, yet not much has been documented on the clinical presentation, pathology and outcome of solid renal tumours particularly in Africa. Aim: To review the presentations, pathology and the management-outcome of solid renal tumour in the centre in the absence of a coordinated protocol and multi disciplinary collaboration. Materials and Methods: This was a nine and a half year longitudinal retrospective audit study of consecutive patients with solid renal tumours managed in a single tertiary centre: Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeast Nigeria. It took place from January 2009-June 2018. Relevant data on demography, clinical features, management and outcome were extracted from records. Results were analysed using Statistical Package for Social Sciences (SPSS) version 22. Categorical data were tested for independence using Chi-square test and significant p-value set at <0.05. Results: Twenty two paediatric cases (15 males and 7 females) were included in the study. The mean age at presentation was 50.10±45.18 months. The mean duration of symptoms was 5.5 months; 21 (95.5%) presented with abdominal masses while 6 (27.3%) had gross haematuria and 13 (59.1%) were emaciated. Tumours involved left kidney in 15 (68%). Histological reports were available in 9 cases with nephroblastoma being the most common 6 (27.3%). The most common stage was stage 3, 10 (45.5%) and most common procedure was nephroureterectomy, 11 (50%). Neo-adjuvant and adjuvant therapies were inconsistent. Conclusion: Late presentation, discordant treatment protocol, non completion of treatment and poor collaboration, were found to contribute largely to poor outcome of solid renal tumours in children in our setting. It is strongly believed that adoption of standard protocol and a multidisciplinary collaboration in management will improve records keeping and outcome.
    Keywords nephroblastoma ; nephroureterectomy ; neo-adjuvant therapy ; renal malignancies ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher JCDR Research and Publications Private Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: A Randomised Controlled Trial on the Efficacy and Safety of Oral Ketamine in Neonatal Circumcision

    Victor Ifeanyichukwu Modekwe / Jideofor Okechukwu Ugwu / Okechukwu Hyginus Ekwunife / Andrew Nwankwo Osuigwe / Jideofor Chukwuma Orakwe / Dubem Stephen Awachie / Elizabeth Onuwa Ogboli-Nwasor

    Journal of Clinical and Diagnostic Research, Vol 15, Iss 1, Pp PC01-PC

    2021  Volume 04

    Abstract: Introduction: Procedural analgesia use in neonatal circumcision is not widespread in the developing world. An easy-to-administer, adequate and safe analgesia will encourage usage in neonatal circumcision. Orally administered ketamine may prove effective ... ...

    Abstract Introduction: Procedural analgesia use in neonatal circumcision is not widespread in the developing world. An easy-to-administer, adequate and safe analgesia will encourage usage in neonatal circumcision. Orally administered ketamine may prove effective and safe, and may encourage procedural analgesia use in neonatal circumcision. Aim: To determine the analgesic efficacy of oral ketamine in Plastibell® neonatal circumcision. Materials and Methods: A hospital based randomised double blind controlled study was conducted at the paediatric surgery unit of the hospital, from March 2015 to December 2015. Total 121 neonates were sequentially recruited, and randomised into two groups. Group A received oral ketamine, and Group B received plain syrup (placebo) as procedural analgesia. Continuous pulse oximeter monitoring was done before, during and immediately after the procedure. The pre-procedural and intra-procedural peripheral oxygen saturation (SpO2 ) and Pulse Rate (PR) were determined at the various stages. Also, the Neonatal Infant Pain Scale (NIPS) scores were assessed during the stages of the procedure. Differences in mean scores were analysed. Mann-Whitney U test and Independent t-test were used to compare means of continuous variable, while Fisher’s exact test was used to compare categorical variables. Significance was set at p<0.05. Results: Sixty-one neonates received oral ketamine, while 60 received placebo. The intraoperative mean SpO2 were lower in the placebo group and significant at the tying stage with p=0.022. The mean intraoperative PR was higher in the placebo group and significant at dorsal-slit, tying and excision stages (p<0.05). The mean intraoperative NIPS scores were significantly higher in the placebo group. Conclusion: Oral ketamine provides effective and safe analgesia for neonatal Plastibell® circumcision in comparison to placebo.
    Keywords analgesia ; pain ; plastibell ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher JCDR Research and Publications Private Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Spontaneous rupture of an umbilical hernia

    Okechukwu Hyginus Ekwunife / A N Osuigwe

    African Journal of Paediatric Surgery, Vol 8, Iss 2, Pp 257-

    2011  Volume 258

    Keywords Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

    Okechukwu Hyginus Ekwunife / Jideofor Okechukwu Ugwu / Chinedu C Okoli / Victor Ifeanyichukwu Modekwe / Andrew N Osuigwe

    African Journal of Paediatric Surgery, Vol 12, Iss 4, Pp 251-

    2015  Volume 256

    Abstract: Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and ...

    Abstract Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. Patients and Methods: This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. Results: A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3%) and 122 (36.2%), respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9%) preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3%) patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Conclusion: Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.
    Keywords Complications ; infants ; neonates ; Nigeria ; plastibell circumcisions ; preferences ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
    Subject code 390
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Comparison of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study and conventional contrast radiographic colostography in children with anorectal malformation

    Okechukwu Hyginus Ekwunife / Eric Okechukwu Umeh / Jideofor Okechukwu Ugwu / Uzoamaka Rufina Ebubedike / Chinedu Christian Okoli / Victor Ifeanyichukwu Modekwe / Kelechi Collins Elendu

    African Journal of Paediatric Surgery, Vol 13, Iss 1, Pp 26-

    2016  Volume 31

    Abstract: Background: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the ...

    Abstract Background: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries. This study compared the accuracy of trans-perineal ultrasound-guided pressure augmented saline colostomy distension study (SCDS) with conventional contrast distal colostography (CCDC) in the determination of the precise location of the distal rectal pouch and in detecting the presence and site of fistulous communication between the rectum and the urogenital tract was studied. Materials and Methods: Trans-perineal ultrasound-guided pressure augmented SCDS, CCDC and intra-operative measurements were done sequentially for qualified infants with anorectal malformation and colostomy. Pouch skin distance and presence or absence of recto urinary or genital fistula was measured prospectively in each case. Statistical significance was inferred at P-value of <0.01. Results: There were thirteen infants, 9 males and 4 females. The age at onset of investigation ranged from 2 to 12 months with a median value of 9 months. Using paired t-test at a confidence interval of 95%, the P value when SCDS values are compared with CCDC is 0.19; and 0.06 when SCDS was compared with intra-operative measurements. Hence, there is no statistical difference as P > 0.01. On its ability to detect presence or absence of a fistula: SCDS had a sensitivity of 50.0%, specificity of 100.0%, accuracy of 69.2%, negative predictive value of fistulas of 55.6% and a positive predictive value of fistulas of 100.0%. Conclusion: Ultrasound-guided pressure augmented SCDS can safely and reliably be used to assess the distal colonic anatomy and the presence of fistula in infants with Anorectal malformation who are on colostomy.
    Keywords Anorectal ; colostography ; colostomy ; congenital ; loopogram ; malformation ; saline disten ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Paediatric surgical outcomes in sub-Saharan Africa

    Niyi Ade-Ajayi / Dan Poenaru / Damian Clarke / Stephen Tabiri / Larry Akoko / Sharon Cox / Toru Shimizu / Bassey Edem / Kokila Lakhoo / Zaitun M Bokhary / Adesoji Ademuyiwa / Felix Alakaloko / Emmanuel Ameh / Theophilus Teddy Kojo Anyomih / Rouma Bankole / Bruce Bvulani / Milind Chitnis / Miliard Derbew / Stella Eguma /
    Omolara Faboya / Jacques Fadhili Bake / Intisar Hisham / Nasser Kakembo / Bertille Ki / Phyllis Kisa / Rashmi Kumar / Jerome Loveland / Bothwell Mbuwayesango / Mulewa Mulenga / Emmanuel Owusu Abem / Yona Ringo / John Sekabira / Albert Wandaogo / Anne Wesonga / Ali Hamad / Naomi Jane Wright / Abdelbasit E Ali / Ainhoa Costas-Chavarri / Samuel Osei-Nketiah / William Appeadu-Mensah / Opeoluwa Adesanya / Olalekan Ajai / Aminu Mohammad / Stephanie Van Straten / Robert Jaich / Osman Imoro / Lawal Abdullahi / Roel Matos-Puig / Andrew JM Leather / Ademola Olusegun Talabi / Oludayo Adedapo Sowande / Christopher Bode / Taiwo Akeem Lawal / Samson Olori / Reitze Rodseth / Andre Theron / Emily Rose Smith / Alessandra Bisquera / Anyanwu Lofty John-Chukwuemeka / Justine Seyi-Olajide / Bernadette Béré / Luc Malemo / Elisee Bake / Nwokoro Collins / Aberibigbe M. O. Shonubi / Daniel Sidler / Houégban Romeo / Gbenou Antoine Seraphin / Eugene Zoumenou / Béré Bernadette / Bandré Emile / Tapsoba W. Toussaint / Kabre Yvette / Manuela Ehua / Agbara Kouame / Moulot Olivier / Nandiolo Rose / Mesay Hailemariam Asfaw / Gudeta Didi / Hanna Getachew / Woubedil Kiflu / Samuel Negash / Tihitiena Negussie / Amezene Tadesse / Fiseha Temesgen / Afua Hesse / Francis Atidana Abantanga / Adakudugu Ida / Martin Kyere / Anwar Sadat Seidu / Paul M. Wondoh / Thomas Kirengo / Michael Ganey / Michael Mwachiro / Robert K Parker / Sinkeet Ranketi / Bitiel Banda / Caroline Melhado / Biplab Nandi / Mohakhelha Nyamulani / Johannes Verweij / Moustapha Helle / Paschal Anyanwu / Matthias Igoche / Elizabeth Ogboli-Nwasor / Baba Suleiman / Sholadoye Tunde Talib / Mustapha Abdulazeez / Farinyaro Aliyu / Aliyu Mohammed / Terlumun Patrick / Charles Soo / Akinlabi Emmanuel Ajao / Olayemi Anthony Ajiboye / Michael Abel Alao / Odion-Obomhense Kesiena Helen / Adenike Odewabi / Anuoluwapo Aremo / Taiwo Jones Olaoluwa / Odi Temitope / Kayode Bamigbola / E Uduehe Enono / Abdulsalam Moruf / Roland I Osuoji / Omolara M. Williams / Fatuga Adedeji / Ihediwa Chibuike / Ibironke Desalu / Olumide Abiodun Elebute / Charles Ememonu / Oluwaseun Ladipo-Ajayi / Sola Kushimo / Kayode Olayade / Adebambo Olowu / Okechukwu Hyginus Ekwunife / Victor Ifeanyichukwu Modekwe / Obiechina Sylvester Okwuchukwu / Ngozi Chidinma Osuji / Ezidiegwu Ugochukwu Stanley / Jideofor Okechukwu Ugwu / Chuka Ifeanyichukwu Ugwunne / Collins Chijioke Adumah / Lukmon Amosu / Ibukunolu Ogundele / Aderibigbe M. O. Shonubi / Felix Kumolalo / Olakayode Ogundoyin / Dare Olulana / John Chinda / Osagie Olabisi / Akan Inyang / Ijeoma Esther Nwachukwu / Nurudeen Toyin Abdulraheem / Lukman O. Abdur-Rahman / James O. Adeniran / Muslimat A. Alada / Abdulrasheed A. Nasir / David C. Nwosu / Christopher C Amah / Sebastian Okwuchukwu Ekenze / Uchechukwu Obiora Ezomike / Emmanuel I. Nwangwu / Ijeoma C. Obianyo / Nene E Obianyo / Nwankwo Elochukwu Perpetua / Alfred T Aggo / Tobin Maxwell / Philemon Okoro / James A. Brown / Moses Kasumba / Steve Kyota / Joy Robinson / Seo-Hwa Chung / Savannah smit / Andrew Grieve / Charles Carapinha / Mie Elsen / Nayha Gautam / Shamaman Harilal / Sanele Madziba / Hansraj Mangray / Babalwa Nondela / Ria Naidoo / Arasha Thotharam / Kondjela Sara Hamunyela / Corne De Vos / Enas Musa Ismail / Robert Bahati / Peter Dattani / Ezekiel Kambona / Silas Msangi / Komla Gnassingbé / Hamza Doles Sama / Mary T Nabukenya / Emma Lillie / Rae Oranmore-Brown / Hope Phiri / Victoria Simiyu / Tungamirai Gwatirisa / Houessou Gandjehou / Ebassa Karl / Goutam Chowdhury / Alagie Manneh / Michael Amoah / Boateng Nimako / Allan Kochi / Connie Keung / Robert Kuremu / Heuric Rakotomalala / Habou Oumarou / Okafor David / Faruk A Suleiman / Faturoti Olubukola / Innocent Igwilo / Alwanlehi Eighemhenrio / Andrew Shitta / Musa Ibrahim Zarenawa / Iyekeoretin Evbuomwan / Wabada Samuel / Emmanuel Kayibanda / Joseph Lule / Riikka Valjakka

    BMJ Global Health, Vol 6, Iss

    a multicentre, international, prospective cohort study

    2021  Volume 9

    Keywords Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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