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Article ; Online: Formal saline versus honey as escharotic in the conservative management of major omphaloceles

Christopher O Bode / Adesoji O Ademuyiwa / Olumide A Elebute

Nigerian Postgraduate Medical Journal, Vol 25, Iss 1, Pp 48-

2018 Volume 51

Abstract: Background: The use of honey as an escharotic agent in the conservative management of omphalocele major has not been widely explored in spite of its proven benefits in chronic wound management. We explored the use of local honey as an escharotic agent by ...

Abstract	Background: The use of honey as an escharotic agent in the conservative management of omphalocele major has not been widely explored in spite of its proven benefits in chronic wound management. We explored the use of local honey as an escharotic agent by comparing its use with 2.5% formal saline in the conservative management of major omphaloceles at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: From January 2006 to December 2009, 43 consecutive newborns with intact omphalocele major were alternately assigned into either Honey (H) or formal saline (FS) group. The membrane cover of each omphalocele was painted with the allotted group agent once every 48 h. The occurrence of faecal fistulas, rupture of eschar, intestinal obstruction as well as the mean duration of full wound healing, infection rates and overall mortality rates were compiled for the two groups. Results: Eighteen newborns were assigned to the FS group while 25 others were prospectively enrolled into the H group. The age, sex and weight of newborns in both groups at presentation were comparable. Three omphaloceles (16.7%) ruptured and eviscerated among the FS group during the study while 1 (4%) of these occurred in the H group. Four (22.2%) cases of faecal fistula occurred in the FS group while none was recorded in the H group. One (5.6%) patient in the FS group developed small bowel stricture. This was not recorded in the honey group. Overall, there were 8 (44.4%) complications in the FS group and 1 (4%) in the H group. There was no statistical difference between the two groups concerning the occurrence of fistulae, sac rupture or bowel stricture. However, overall number of complications was statistically more in the FS group when compared to the H group (P < 0.05). Wounds in the H group healed within a mean period of 34.4 ± 4.9 days while those in the FS group healed within a mean period of 45.7 ± 6.8 days P < 0.01). Conclusion: Honey is a good escharotics agent in the conservative management of major omphaloceles. Honey ...
Keywords	honey ; omphalocele ; paediatric ; Medicine ; R
Subject code	630
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of the effect of nutritive versus non-nutritive pacifiers as adjuncts to local anaesthesia in male neonatal circumcision using the plastibell technique – A prospective randomised controlled study

Chibuike George Ihediwa / Christopher O Bode / Felix M Alakaloko / Olumide A Elebute / Justina O Seyi-Olajide / Oluwaseun Abiola Ladipo-Ajayi / Adesoji O Ademuyiwa

Nigerian Postgraduate Medical Journal, Vol 29, Iss 4, Pp 310-

2022 Volume 316

Abstract: Background: Male circumcision is the most common surgical procedure worldwide and is often carried out for religious, cultural, medical and public health reasons. It is commonly performed during the neonatal period. Many studies have now shown that pain ... ...

Abstract	Background: Male circumcision is the most common surgical procedure worldwide and is often carried out for religious, cultural, medical and public health reasons. It is commonly performed during the neonatal period. Many studies have now shown that pain is a common intra- and post-operative complication. To ensure proper analgesia during the procedure, many surgeons opt for the use of pacifiers as an adjunct to anaesthesia during neonatal circumcision. The aim of this study is to compare nutritive pacifiers (NPs) versus non-NPs (NNPs) as adjuncts to local anaesthesia in male neonatal circumcision using the Plastibell technique. Methods: A prospective randomised controlled study was carried out between October 2019 and March 2020. A total of 100 neonates were circumcised using the Plastibell technique and randomised into NP (Group A, n = 33), NNP (Group B, n = 33) and controls (Group C, n = 34), respectively. The differences in pain scores using the Neonatal Infant Pain Scale, total crying time and heart rate during circumcision were recorded and assessed. Results: The age of participants ranged from 5 to 28 days and the weight ranged from 2.5 to 5.0 kg. The overall mean age, birth weight and current weight of the participants were 15.5 ± 6.1 days, 3.4 ± 0.4 kg and 3.5 ± 0.6 kg, respectively. The control group had the highest average pain score of 5.5 (4.5–5.8) compared to the intervention groups with median pain score (NP: 3.3 [1.3–4.3] and (NNP: 4.3 [3.1–5.1], respectively). NPs had significantly lower pain scores (P = 0.023) and reduced total crying time (P = 0.019) at all stages of the circumcision compared to those given NNPs and controls. Conclusion: This study showed that NPs were superior to NNPs in providing additional pain control during male neonatal circumcision.
Keywords	anaesthesia ; circumcision ; nutritive ; pacifiers ; pain ; randomised controlled trial ; Medicine ; R
Subject code	796
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Impact of corona virus disease 2019 pandemic on paediatric surgery in a sub-saharan tertiary hospital

Justina O Seyi-Olajide / Christopher O Bode / George C Ihediwa / Olumide A Elebute / Felix M Alakaloko / Oluwaseun A Ladipo-Ajayi / Adesoji O Ademuyiwa

Nigerian Postgraduate Medical Journal, Vol 29, Iss 2, Pp 102-

An observational study

2022 Volume 109

Abstract: Background: The impact of the corona virus disease 2019 (COVID-19) pandemic on global health, has reached far beyond that caused by the disease itself. With ongoing mutations and the emergence of new strains of the virus alongside repeated waves of the ... ...

Abstract	Background: The impact of the corona virus disease 2019 (COVID-19) pandemic on global health, has reached far beyond that caused by the disease itself. With ongoing mutations and the emergence of new strains of the virus alongside repeated waves of the pandemic, the full impact of the pandemic is still evolving and remains difficult to predict or evaluate. In paediatric surgery, it has led to significant disruptions in patient care, the extent and consequence of which are not fully documented in Nigeria. Aim: This study aims to evaluate the impact of COVID-19 on services, training and research in a busy paediatric surgery unit during the initial 3-month period of the COVID-19 pandemic lockdown. Methods: This study was an ambispective evaluation of the preceding 3 months before lockdown and the initial 3 months of lockdown. Clinic cancellations, elective and emergency surgeries, delays in access, extra cost of care to patients, impact on training and research, and the psychologic impact of the pandemic on staff and guardians were evaluated. Results: During the 3-month lockdown period, an estimated 78 new cases and 637 follow-up cases could not access care. Ninety-seven elective surgeries in 91 patients were postponed. Two (2.2%) patients' symptoms progressed. All emergency patients received care. Out-of-pocket expenditure increased averagely by $124. The pandemic contributed to delays in seeking (13%), reaching (20%) and receiving care (6%). Trainee participation in surgeries was reduced and academic programmes were suspended. Five staff were exposed to the virus and 3 infected. Conclusion: Paediatric surgery has been negatively impacted by COVID-19. Efforts must focus on planning and implementing interventions to mitigate the long-term impact.
Keywords	access ; corona virus disease 2019 ; impact ; paediatric surgery ; Medicine ; R
Subject code	306
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Intestinal malrotation in the older child

Oluwafunmilayo Funke Adeniyi / Elizabeth O Ajayi / Olumide A Elebute / Mary A Lawal

Journal of Clinical Sciences, Vol 14, Iss 4, Pp 200-

A call for vigilance

2017 Volume 203

Abstract: Context: Most cases of gut malrotation are diagnosed in the 1st year of life, but in minority of cases, the patient becomes symptomatic only in adolescence or adulthood. Aims: The aim of this study was to remind physicians to include intestinal ... ...

Abstract	Context: Most cases of gut malrotation are diagnosed in the 1st year of life, but in minority of cases, the patient becomes symptomatic only in adolescence or adulthood. Aims: The aim of this study was to remind physicians to include intestinal malrotation in the differential diagnosis of children who present with recurrent abdominal pain, especially when it is associated with vomiting and other gastrointestinal symptoms. Settings and Design: This was an audit of the older children with gut Malrotation who presented to the Lagos University Teaching Hospital (LUTH). Subjects and Methods: The clinical records of children above the age of 1 year who presented with recurrent abdominal pain and/or vomiting between January 2013 and October 2015 at the LUTH were reviewed. Clinical features, radiological findings, and operation findings were documented. Statistical Analysis: Data were analyzed using the SPSS version 21 (SPSS Statistics for Windows, version 21.0, IBM Corp., USA). Data were presented in frequency and percentages. Results: Five patients with gut malrotation were seen during the study period. The median age was 7.0 years (range: 15 months–10 years). The most common complaint was intermittent colicky abdominal pain and recurrent vomiting in 5 (100%). Preoperative diagnosis was possible in 3 patients, with the use of abdominal computerized tomography scan. Operative findings included obstructing bands of Ladd, volvulus with situs inversus. Symptoms were relieved satisfactorily with surgical intervention. Conclusions: There is a need for a high index of suspicion for intestinal malrotation in children who present with a prolonged history of recurrent abdominal pain and vomiting irrespective of the age. Imaging enables accurate diagnosis and most effective treatment is surgical.
Keywords	Intestinal malrotation ; older child ; recurrent abdominal pain ; vomiting ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Research experience of resident doctors who attended research methodology courses of the National Postgraduate Medical College of Nigeria

Emmanuel A Jeje / Olumide A Elebute / Bolaji O Mofikoya / Michael A Ogunjimi / Taiwo O Alabi / Oyenike O Ekekezie

Nigerian Postgraduate Medical Journal, Vol 24, Iss 1, Pp 31-

2017 Volume 36

Abstract: Introduction: For over three decades, the National Postgraduate Medical College of Nigeria (NPMCN) has been vested with the responsibility of overseeing postgraduate medical training. The main objective of this study was to assess the residents’ ... ...

Abstract	Introduction: For over three decades, the National Postgraduate Medical College of Nigeria (NPMCN) has been vested with the responsibility of overseeing postgraduate medical training. The main objective of this study was to assess the residents’ perception of research as well as challenges faced in pursing seamless research during their training. Materials and Methods: This study was a cross-sectional descriptive survey in 2013. Self-administered questionnaires were distributed to the participants of the annual research methodology workshop in all the 15 faculties of the NPMCN. The questionnaires assessed the residents’ previous exposure to research, their publication history and their trainers’ input to their own research. Statistical analysis was performed using the Statistical Package for the Social Sciences version 20 software. Results: Four hundred and one resident doctors, out of a total of 415 who attended the course, completed the questionnaires during the study period (96.6% response rate). There were 269 (67.0%) males and 132 (33.0%) females, giving a male-to-female ratio of 2:1. About three-quarters of them admitted that their exposure to research during training was grossly inadequate. Twenty-five percent of them were involved in a previous research before residency training, and a further 70% of respondents were involved in their trainers’ research work. Ninety-four percent in our study identified a lack of dedicated time to be spared for research as a major obstacle to research. Conclusion: Contribution and exposure to research among postgraduate trainees in Nigeria are low. Lack of dedicated time for research was viewed as the major obstacle to research by most residents.
Keywords	postgraduate ; research ; resident doctor ; Medicine ; R
Subject code	001
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: An audit of parental satisfaction of pediatric day case surgery at the Lagos University Teaching Hospital

Olumide A Elebute / Adesoji O Ademuyiwa / Justina O Seyi-olajide / Christopher O Bode

Journal of Clinical Sciences, Vol 11, Iss 2, Pp 44-

2014 Volume 46

Abstract: Background: In recent past, there has been a gradual increase in the volume of patients treated on a day case basis in our center. However, no study has been conducted to audit pediatric day case surgery practice at the Lagos University Teaching Hospital. ...

Abstract	Background: In recent past, there has been a gradual increase in the volume of patients treated on a day case basis in our center. However, no study has been conducted to audit pediatric day case surgery practice at the Lagos University Teaching Hospital. Objectives: To determine the level of parental satisfaction with pediatric day case surgery at the Lagos University Teaching Hospital. Patients and Methods: A total of 101 parents or the patient′s caretakers whose wards had day case surgery were administered a self-completed questionnaire on the first postoperative day visit at the surgical outpatient clinic. The questions assessed parental satisfaction with the following: (a) Communication with doctors (surgeons and anesthesiologists), (b) Physical conditions of the theatre environment, (c) Staff′s care, (d) Need to care for the child at home, and (e) Postoperative complication. Result: There were 101 respondents with an age range of 22-56 years (mean 35.05 ± 6.85). Eighty-seven (86%) of the respondents were satisfied with the amount of information they obtained from their doctors before the operation; 43 (42.6%) were satisfied with the waiting time, whereas 47 (46.5%) were satisfied with the fasting time. However, 26 (25.7%) of the respondents were dissatisfied with the waiting room environment and 87 parents (87.1%) were dissatisfied with the nursing care. Conclusion: Most parents are satisfied with pediatric day case surgery care. Some adjustments, however, need to be made on reducing the waiting and fasting time of the patients and improving both the waiting room environment and the nursing care in order to increase its acceptance.
Keywords	Day case surgery ; parental satisfaction ; pediatric ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors influencing waiting time in hypospadias repair surgery

Hestia O Idiodi-Thomas / Adesoji O Ademuyiwa / Olumide A Elebute / Felix M Alakaloko / Christopher O Bode

Nigerian Postgraduate Medical Journal, Vol 23, Iss 1, Pp 21-

2016 Volume 24

Abstract: Aims: Hypospadias is a common congenital anomaly of the urethra and phallus, which is not life threatening. It is thus less prioritised in a resource-limited setting. The aim of this study was to evaluate the management of hypospadias by our paediatric ... ...

Abstract	Aims: Hypospadias is a common congenital anomaly of the urethra and phallus, which is not life threatening. It is thus less prioritised in a resource-limited setting. The aim of this study was to evaluate the management of hypospadias by our paediatric surgery unit and determine the factors affecting the delay between presentation and surgical repair while proffering possible solutions to such delay in hypospadias repair surgery. Patients and Methods: This was a retrospective review of all hypospadias repair surgeries carried out by our paediatric surgery unit over a 38-month period, evaluating the period between presentation and first surgery for each patient. Data were analysed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Released 2011, Armonk, NY, USA). Chi-square test was used to compare categorical variables and P ≤ 0.05 was considered significant. Results: In 38 months, 47 operations for hypospadias were carried out on 42 boys. Thirty-seven patients (88.1%) had >3 months delay to surgery. The most frequent contributory factor to delay was unavailable theatre space (13 patients, 31%). Surgical outcome was good in only 16 patients (44%). Of the 16 patients with good outcome, 10 (63%) were operated between the ages of 2-4 years (P > 0.05). Conclusions: Multiple factors are responsible for delays in carrying out hypospadias surgery in resource-limited environments, notably securing a functional operating theatre suite in the light of more urgent conditions. To combat these delays, we recommend having dedicated hypospadias repair sessions and surgeons dedicated to hypospadias repair. Hypospadias outreach camps are also proposed.
Keywords	hypospadias ; hypospadiology ; waiting times ; Medicine ; R
Subject code	616
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Duplication cyst of ascending colon presenting as an ileal volvulus in a child

Adesoji O Ademuyiwa / Christopher O Bode / Opeoluwa A Adesanya / Olumide A Elebute

African Journal of Paediatric Surgery, Vol 9, Iss 3, Pp 237-

A case report and review of literature

2012 Volume 239

Abstract: Alimentary tract duplications are uncommon congenital anomalies that may be found anywhere along the gastrointestinal tract. They have a diverse presentation and often times present with complications of intestinal obstruction and/or lower ... ...

Abstract	Alimentary tract duplications are uncommon congenital anomalies that may be found anywhere along the gastrointestinal tract. They have a diverse presentation and often times present with complications of intestinal obstruction and/or lower gastrointestinal haemorrhage. We report a very rare finding of a colonic duplication cyst which presented as an ileal volvulus in a young girl. While available investigations were non-specific, the child survived on account of an early decision to operate. She had resection of the duplication cyst and ileo-colic anastomosis. She made good recovery post-operatively. A high index of suspicion is necessary on the part of clinicians to recognise this condition. Early operative intervention is necessary in the developing world setting where state of the art investigations are not available for accurate pre-operative diagnosis.
Keywords	Congenital anomalies ; colonic duplication cysts ; complications ; ileo-colic anastomosis ; volvulus ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
Subject code	360
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Duplication cyst of ascending colon presenting as an ileal volvulus in a child

Adesoji O Ademuyiwa / Christopher O Bode / Opeoluwa A Adesanya / Olumide A Elebute

African Journal of Paediatric Surgery, Vol 9, Iss 3, Pp 237-

A case report and review of literature

2012 Volume 239

Abstract	Alimentary tract duplications are uncommon congenital anomalies that may be found anywhere along the gastrointestinal tract. They have a diverse presentation and often times present with complications of intestinal obstruction and/or lower gastrointestinal haemorrhage. We report a very rare finding of a colonic duplication cyst which presented as an ileal volvulus in a young girl. While available investigations were non-specific, the child survived on account of an early decision to operate. She had resection of the duplication cyst and ileo-colic anastomosis. She made good recovery post-operatively. A high index of suspicion is necessary on the part of clinicians to recognise this condition. Early operative intervention is necessary in the developing world setting where state of the art investigations are not available for accurate pre-operative diagnosis.
Keywords	Congenital anomalies ; colonic duplication cysts ; complications ; ileo-colic anastomosis ; volvulus ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
Subject code	360
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Duplication cyst of ascending colon presenting as an ileal volvulus in a child

Adesoji O Ademuyiwa / Christopher O Bode / Opeoluwa A Adesanya / Olumide A Elebute

African Journal of Paediatric Surgery, Vol 9, Iss 3, Pp 237-

A case report and review of literature

2012 Volume 239

Abstract	Alimentary tract duplications are uncommon congenital anomalies that may be found anywhere along the gastrointestinal tract. They have a diverse presentation and often times present with complications of intestinal obstruction and/or lower gastrointestinal haemorrhage. We report a very rare finding of a colonic duplication cyst which presented as an ileal volvulus in a young girl. While available investigations were non-specific, the child survived on account of an early decision to operate. She had resection of the duplication cyst and ileo-colic anastomosis. She made good recovery post-operatively. A high index of suspicion is necessary on the part of clinicians to recognise this condition. Early operative intervention is necessary in the developing world setting where state of the art investigations are not available for accurate pre-operative diagnosis.
Keywords	Congenital anomalies ; colonic duplication cysts ; complications ; ileo-colic anastomosis ; volvulus ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
Subject code	360
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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