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Search Results: 1 - 10 of 6806 matches for " LO Abdur-Rahman "
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Should Omphaloceles be Re-classified?
JO Adeniran, LO Abdur-Rahman, AA Nasir
East and Central African Journal of Surgery , 2011,
Abstract: Background: Omphaloceles are presently classified into ‘minor’ and ‘major’ categories depending on the diameter of the umbilical defect. In developed countries most ‘major’ cases are treated with silo, parenteral nutrition and progressive compression. In developing countries most cases are managed conservatively with honey dressing. This may take 1-2 months for proper eschar to form. Even when successful, most patients don’t come for secondary repair. The objective of this review was to re-classify omphaloceles into ‘minor’, ‘intermediate’ and ‘major’ anomalies. Methods: Cases of omphaloceles treated from 2002-2007 were retrospectively reviewed. Patients whose diameter of defects were more than 5cm, but closed primarily were separated and analyzed. Results: Forty four (44) patients with anterior abdominal wall defects were seen during the study period. There were 37 cases of omphalocele, 4 bladder extrophy and 3 gastroschisis. Of the 37 omphaloceles, 12 were ‘minor’ and 25 ‘major’. Twelve of the ‘major’ cases were closed primarily. The mean size of the defect was 7.5 cm by 6.3cm. There were 5 boys and 7 girls. Three of them were operated within 48 hours, but all died. The other 9 were properly resuscitated and operated between 3 and 15 days. Only 2 died. Conclusion: More than half of cases originally classified as ‘major’ have plenty of skin and fascia to be closed primarily if properly selected. This classification into a new‘intermediate’ category helps to isolate this group for primary closure.
Pediatric day case surgery: Experience from a tertiary health institution in Nigeria
LO Abdur-Rahman, IK Kolawole, JO Kolawole, AA Nasir, JO Taiwo, T Odi
Annals of African Medicine , 2009,
Abstract: Background : The general observation that children achieve better convalescence in the home environment supports the need for adoption of day case surgery, which is gaining considerable acceptance in developing countries. Pediatric surgical service is in great demand in developing countries, and in-patient beds and surgical supplies are insufficient. Method : A prospective collection of data on all pediatric day surgeries (PDSs) by the pediatric surgical unit University of Ilorin Teaching Hospital (UITH, Ilorin, was done. Parents had pre-operative outpatient briefing and postoperative interviews on the second and ninth days for consultation regarding post-operative complications and events at home. Study period was between April 2005 and September 2007 (2 years). Results : Of the 660 elective cases, 449 (68.02%) children were recruited as day cases. The male-to-female ratio was 14.3:1. Age ranged between 20 days and 15 years with a mean of 37.6 months and standard deviation (SD) of 34.4 months. Congenital hernias/ hydroceles were the highest indications (71.2%), followed by lump/ masses (12.9%), undescended testes (8.7%), umbilical hernias (4.8%) and thyroglossal duct cyst (2.5%). In 98.9% of cases, the parents resided within 20 km radius of the hospital, and 91.5% of them could reach the hospital within 1 hour. Fathers and mothers of 80.1% and 77.1% of children, respectively, had above-primary education. More than half of the fathers (55%) were civil servants, while 30% were self-employed. The mothers were civil servants in 37.3% of cases, and 34% were self-employed. The average number of outpatient clinic visits before surgery was 2-3 visits (41.2%) with mean interval to surgery of 4-5 weeks (60.3%). Logistics (investigations and availability of operation list) and patient's fitness for surgery were statistically significant delay factors (P= 0.001). Conclusion : Parents reported 14 children to be irritable at home due to pain, while the others reported satisfactory day case experience. No unplanned admission or mortality was recorded, and only 3 (0.8%) parents would not recommend day case surgery to other people. Conclusion: Pediatric day case surgery is feasible for well-selected and monitored cases in our environment. Term neonates with informed parents are suitable for pediatric day case surgery. There is a need for a day case center to reduce waiting list at UITH.
Childhood motorcycle-related injuries in a Nigerian city – prevalence, spectrum and strategies for control
AA Nasir, JO Bello, CKP Ofoegbu, LO Abdur-Rahman, S Yakub, BA Solagberu
South African Journal of Child Health , 2011,
Abstract: The use of motorcycles is becoming increasingly popular in Nigeria because of poor public and private transportation systems. Motorcycle crashes account for a disproportionate share of the deaths and disabilities that result from road traffic accidents. We undertook a prospective descriptive study of all children aged 15 years or under with motorcycle-related injuries (MCRIs) who presented at the emergency room of the University of Ilorin Teaching Hospital over a period of 3 years. Children with ophthalmic injuries and those who died before reaching the hospital were excluded. Over the study period, 40 of a total of 440 patients admitted with MCRIs were children (9.0%). Twenty-seven children (67.5%) were injured as pedestrians, 11 (27.5%) as passengers and 2 (5%, young adolescents) as riders. One 3-year-old child was admitted to the intensive care unit with severe head injury and died. Prevention of MCRIs in children should be a priority in our setting. Public campaigns should clearly highlight the risk of injury to this age group, and poor safety practices with regard to children should be specifically targeted. With the motorcycle gaining popularity as a mode of transportation in our cities and communities, the importance of teaching our youth about correct safety behaviour such as helmet use, and parents on the danger of letting their children cross roads alone, cannot be over-emphasised.
Pre-hospital care in Nigeria: A country without emergency medical services
BA Solagberu, CKP Ofoegbu, LO Abdur-Rahman, AO Adekanye, US Udoffa, J Taiwo
Nigerian Journal of Clinical Practice , 2009,
Abstract:
Fetus -in -fetu in a 6-month-old
Abdur-Rahman L,Abdul-Kadir A,Rahman A
African Journal of Paediatric Surgery , 2008,
Abstract: Fetus-in-fetu is a malformed parasitic monozygotic diamniotic twin found inside the body of the living child or adult. We report a case of lumbar mass having superficial rudimentary phallus, labioscrotal fold, testes, pedunculated thumb-like digit and rudimentary pelvis in addition to bowel loops in a 6-month-old Nigerian girl. The mass was excised and the baby did well. We propose based on these that dizygotic parasitic foetiform twin could exist.
One-stage correction of intermediate imperforate anus in males: preliminary results
JO Adeniran, L Abdur-Rahman, BO Bolaji
Nigerian Journal of Surgical Research , 2004,
Abstract: Background: This prospective study was designed to assess the safety, cost effectiveness, and advantages of performing posterior sagittal anorectoplasty without colostomy on males with intermediate imperforate anus. Method: Five consecutive males with intermediate imperforate anus were entered into the study. Chest and abdominal x-rays, skeletal surveys, renal ultrasound scans, and invertograms were done. Patients were resuscitated, and Pena’s posterior sagittal anorectoplasty (PSARP) done in prone positions. Two-ml syringe vents were inserted into the new anus for 10 days. Cephalosporin and metronidazole were given as peri-operative antibiotics. Results: All patients had intermediate anomalies. There were no other major associated congenital anomalies. Urethral catheter could not be inserted in one patient. One patient presented with septicaemia and jaundice. He was deemed too ill to withstand a major operation. These 2 patients therefore had diverting colostomies. There were no problems with posterior sagittal anorectoplasty in the other 3 patients. The father of one patient discharged him against medical advice on the 5th postoperative day. The mother had post-partum haemorrhage and they went for traditional treatment because they could not provide blood donors. The skin wound of 2 patients healed completely at removal of stitches. Both are having monthly dilatations 9months and 1 year post-operatively. Conclusion: This preliminary study shows that it is feasible for males with intermediate imperforate anus to have safe posterior sagittal anorectoplasty without colostomy. The advantages of one, instead of 3 major operations, are many, especially in developing countries. If this result can be reproduced in high anomalies colostomy may be unnecessary in many cases of anorectal malformations with a lot of benefits to these unfortunate children and their poor families.
Improved Outcome of Fracture Treatment by Early Operative Reduction: Results of a Surgical Audit
B. A. Solagberu, L. O. Abdur-rahman
Nigerian Journal of Surgical Research , 2000,
Abstract: An audit is a useful means of examining improvements in the art and science of clinical practice. We applied this to surgery to determine improved outcomes of fracture treatment by early operative reduction. This was carried out at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, by comparing two years, 1997 when there was less emphasis and 1998 when there was a greater emphasis on operative reduction of fractures. Hospital records in the orthopaedic wards, operating rooms and the physiotherapy unit of all patients admitted were reviewed retrospectively. Two years, 1997 and 1998 were analysed for age, sex, type of treatment and quality of outcome. A total of 247 admissions into orthopaedic wards were made in 1997 leading to 79 major operations, 20 of which were operative reduction of fractures (25.3 %). In 1998, 239 patients were admitted out of which 174 major operations were performed, 72 of which were operative reductions (41.4 %, P = 0.014). Patients' stay in hospital was shorter in 1998 with 81% of patients staying 3 months and less compared to 40 % in 1997 (P = 0.000). Improved outcome of stiff knee joints from physiotherapy was judged good and excellent in 66.7 % and 20 % in 1998 compared to 28.3 % (P = 0.00005) and 1.9 % (P = 0.003) in 1997, respectively. These results suggest generally improved outcome when fractures are treated by early operative reduction because of shorter hospital stay, early return to work, improved nursing care and joint function. (Nig J Surg Res 2000; 2:114-122) KEY WORDS: Surgical Audit, Operative reduction, Fractures, Outcome
New method of hand anastomosis to complete the Duhamel operation for Hirschsprung′s disease
Adeniran J,Abdur-Rahman L,Odi T
African Journal of Paediatric Surgery , 2008,
Abstract: Objective/Purpose: This paper describes a new method of hand anastomosis to complete the Duhamel operation for Hirschsprung′s disease (HD). Methodology: All patients had diagnosis of Hirschsrung′s disease confirmed by rectal biopsy and had defunctioning colostomy. At the definitive operation, the ganglionic bowel was brought down in a retro-rectal position and anastomosed at the anal canal just above the dentate line. At this anastomosis, the sutures at 11 and 1 o′clock were left long as stay sutures. An incision was then made down the new bowel at the antimesenteric border from the pelvic brim. Another incision was made down the back of the native rectum. A long-curved artery forceps was then passed into the incision in the native rectum out of the anal canal. This forceps was now hooked round the anastomosis at 12 o′clock and further pushed in until the point appears through the colotomy in the ganglionic bowel. The two layers of bowel between the forceps were incised. The forceps was now inserted to grab the long sutures at 11 o′clock and 1 o′clock in turn, and delivered through the pelvis. Anastomosis between the edges of the native rectum and the neorectum was then done with interrupted PDS inside and silk outside. Results: Seven patients had the procedure done. Age ranged between 4 months and 4 years (mean 3.4 years). They were all males. One patient died early in the series from reaction to postoperative analgesia. Four older patients have bowel motions 2-3 times per day, do not soil at night, and are fully continent. Conclusion: This preliminary study shows that hand anastomosis could be used to complete Duhamel operation for patients with HD with satisfactory early results.
Bowel resection in Nigerian children
Abdur-Rahman L,Adeniran J,Taiwo J,Nasir A
African Journal of Paediatric Surgery , 2009,
Abstract: Background : Although bowel resections are commonly done for congenital malformations in children in developed countries, they usually follow neglected and preventable acquired diseases of the intestine in developing countries. Objectives : To determine the indications and outcome of bowel resections in children of a developing country in a university teaching hospital. Materials and Methods: Data of the patients operated (from birth to 15 years) was retrospectively collected over eight years (January 1999 to December 2006). The biodata of children included the following: Indications for operation, type of operations, duration of admission, and outcome of treatment including complications. Patients with Hirschsprung′s disease were excluded from the study because bowel resection forms part of their definitive surgical management. Results : There were 70 patients (38 boys and 32 girls). The age ranged between four hours to 15 years (median, five months). There were 16 (22.9%) neonates, 26 (37.1%) infants, and 28 (40%) grown children. The indications were congenital anomalies in the 16 neonates. Also, 23 (88.5%) infants had intussusception, 2 (7.7%) had midgut vovulusm and 1 (3.8%) had congenital small intestine band. Among the grown children, typhoid ileal perforation (TIP) was seen in 14 (50.0%), intussusception in 5 (17.9%), and other causes in nine patients. Overall, intussusception was the most common indication for bowel resection, followed by TIP. A total of 24 patients developed 33 complications. Complications included wound infection in 47.8% and anastomotic leak in 42.8%. The duration of admission ranged between 4-35 days (median, 15 days). The overall mortality was 17.1% -; which was highest among neonates (56.3%), followed by the infants (26.9% -). Conclusion : Bowel resections are mainly done for intussusception and complications of TIP at our centre. Late presentation, preexisting malnutrition, and nonavailability of parenteral nutrition contributed to unacceptable morbidity and mortality.
Persistent Mullerian duct syndrome: A case report and review of the literature
Odi Temitope,Abdur-Rahman Lukman,Nasir Abdulrasheed
African Journal of Paediatric Surgery , 2010,
Abstract: Persistent Mullerian duct syndrome is a rare form of internal male pseudohermaphroditism, in which Mullerian duct derivatives (uterus and fallopian tubes) are present in a genotypic (46XY) and phenotypic male. Over 150 cases have been reported, mainly from outside the African setting. This article presents an unexpected case encountered in an African setting. Handicaps in the management were unavailability of necessary diagnostic tools as well as lack of finance to assess those available. Although a diagnosis was eventually arrived at and the parents thoroughly counseled, the patient has not represented for definitive surgery.
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