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Search Results: 1 - 10 of 4228 matches for " SI Omokhodion "
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Childhood heart failure in Ibadan
IA Lagunju, SI Omokhodion
West African Journal of Medicine , 2003,
Abstract: One hundred consecutive admissions of children with a diagnosis of congestive cardiac failure to the paediatric department of the University College Hospital, Ibadan were evaluated during a 10-month period. They were aged 8 days to 12 years. They constituted 5.8% of the total paediatric admissions during the study period. The most frequent underlying causes of heart failure were acute lower respiratory tract infections (36%), intrinsic heart disease (31%) and severe anaemia (28%). Other less common causes of heart failure were renal disorders (3%) and septiceamia (2%). Heart failure remains a common problem encountered in emergency paediatric practice in Nigeria, with the majority of cases resulting from preventable causes.
Prognostic indices in childhood heart failure
SI Omokhodion, IA Lagunju
West African Journal of Medicine , 2005,
Abstract: Objectives: To evaluate the short term prognosis of childhood heart failure and highlight the factors that affect outcome among cases of heart failure admitted into the paediatric wards, University College Hospital, Ibadan. Background: Childhood heart failure remains a major cause of morbidity and mortality in the developing world. The advent of open heart surgery, use of better myocardial preservative techniques, and the introduction of newer, more effective drugs in the treatment of heart failure have greatly improved the outcome of children with heart failure in the developed world but the outlook of such children in the developing world however remains poor. Methods: One hundred consecutive cases of heart failure admitted into the Paediatric wards of the University College Hospital, Ibadan with a diagnosis of heart failure over a 10-month period were studied prospectively. Diagnosis of heart failure was based on the presence of at least three of the four cardinal signs of heart failure: tachypnoea, tachycardia, tender hepatomegaly and cardiomegaly. All cases were followed up daily till a definite outcome was determined. Results: The predominant underlying causes of heart failure were acute respiratory infections (36%), severe anaemia (28%), and congenital heart disease (25%). There was a case-fatality rate of 24% among the study population. Poor prognostic indices identified were age below one year or above 5years, presence of underlying acute respiratory infections, rheumatic heart disease and renal disorders. Conclusion: Heart failure in Nigerian children though mostly due to preventable causes, are associated with an unacceptably high mortality.
Standard 12 Lead and 24 hour holter electrocardiographic observation in a biracial group of perinatally asphyxiated newborns
SI Omokhodion, F Jaiyesimi, TG Losekoot
West African Journal of Medicine , 2003,
Abstract: Aim: To compare the cardiovascular responses to perinatal stress between two ethnic groups of newborns. Study population: 23 Nigerians and 14 Dutch perinally asphyxiated newborns together with their respective control of 12 healthy Nigerian and 16 Dutch newborns. Method: The study subjects and their controls were evaluated with standard 12-lead and 24-hour Holter electrocardiographic recordings within 36 hours of postnatal life. Results: Rhythm, rate, P-wave, P-R interval and QRS duration were normal in study subjects and their respective controls on standard ECG. The prevalence of ST-segment depression in the mid-precordial lead V4 was significantly higher in the asphyxiated Nigerian infants (78%) than in the controls (42%); p < 0.05. Similarly, its prevalence in the Dutch infants (50%) was significanly different from the zero prevalence in the Dutch controls; p <0.05. Long duration ECG recordings showed a ‘fixed heart rate' phenomenon in the asphyxiated infants but not in their controls. Conclusion: ST-segment depression may imply myocardial ischaemia in asphyxiated Dutch newborns but such may not be inferred in asphydiated Nigerian newborns. ‘Fixed heart rate' phenomenon or loss of sinus arrhythmia appears to be causally related to hypoxaemia which results from perinatal asphyxia.
Case Report: Camptomelic Dysplasia in One of Twins
IA Lagunju, SI Omokhodion, BJ Brown, OF Adeniyi
Nigerian Journal of Paediatrics , 2002,
Abstract: Camptomelic dysplasia, a very rare and lethal form of skeletal dysplasia is reported in one of a set of twins. He presented on the second day of life with short, deformed lower limbs and respiratory distress from birth and died on the fifth day of life. This report highlights the features of camptomelic dysplasia and draws attention to its occurrence in a Nigerian child. With advances in neonatal life support, there is need to proffer solutions to the problems that presently make the prognosis of camptomelic dysplasia, poor. Nigerian Journal of Paediatrics 2002; 29:122-124.
Relationship of age, anthropometry and haemoglobin concentration with echocardiographic findings in Nigerian children with sickle cell anaemia
BA Animasahun, OF Njokanma, UP Nwodo, SI Omokhodion
Nigerian Journal of Paediatrics , 2013,
Abstract: Background: Assessment of the structural and functional effects of sickle cell anaemia (SCA) on the heart can be done using echocardiography. There has been no agreement on which indicator of body size (weight, height, and body surface area (BSA)) or age in children should be used to relate to and correct echocardiographic measurements. Aim: To correlate the echocardiographic findings of children with SCA aged one to fifteen years in steady state with their age, anthropometry and haemoglobin concentration. Methods: A prospective study carried out at the Lagos University Teaching Hospital (LUTH), between May and October 2005. The subjects were 60 paediatric patients attending the LUTH SCA outpatient clinic and 60 age, sex and socioeconomic matched controls. Their height, weight, and echocardiographic parameters were measured and their BSA and haemoglobin level were determined. Results: The direct echocardiographic measurement (AO, LA, LVPW, EDD, ESD, IVS) and LVM each increased progressively with body weight, height, body surface area and age in both subjects and controls (r > 0.3, p < 0.001 in each case). Multivariate analysis showed that height correlated significantly with AO, ESD, EDD and LVPW in the subjects. All the parameters except age were significantly correlated with LVM both in univariate and multivariate analysis. Conclusion: Echocardiographic parameters in SCA patients are significantly correlated with anthropometric indices and age. Our data suggest best correlation with height in these subjects.
Palliation for transposition of great arteries
VO Adegboye, SI Omokhodion, O Ogunkunle, AI Brimmo, OA Adepo
Nigerian Journal of Surgical Research , 2003,
Abstract: Background: At the University College Hospital Ibadan we have no facility for total surgical correction of transportation of the great arteries (TGA). This prospective study reviews the palliative procedures we have used in the management of TGA. Method: Patients with the diagnosis of TGA were evaluated for morphological type. The choice of palliative procedure was made in some of the patients with morphological type in mind. No fixed criteria were used for allocating patients to Blalock-Hanlon (B-H), atrial septectomy while pulmonary banding (PB) and Blalock-Taussig (B-T) shunt have definite indications. Results: Fourteen consecutive patients with TGA were palliated. The ages of these patients ranged between 3 to 11 months (6.8 ± 2.4 months), there were 8 males to 6 females (1.3:1). Six patients had B-H atrial septectomy and 2(33.3%) died within 48 hours, 4 patients had B-T shunt and there were no mortality, 4 patients had PB and 2 (50.0%) died within 72 hours. The overall operative mortality was 28.6%. All the 10 survivors had improvement of their clinical features and fall in packed cell volume during the period of follow-up, which lasted 5 to 13 months (mean 9.3 ± 1.2 months). All patients had delayed wound healing. Conclusion: Appropriate and timely palliative surgery has a place in patients with TGA as an interim care. Key Words: Palliative surgery, transposition, great arteries Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 129-133
Low plasma bicarbonate predicts poor outcome of cerebral malaria in Nigerian children
S Oguche, SI Omokhodion, AA Adeyemo, PE Olumese
West African Journal of Medicine , 2002,
Abstract: Malaria remains a major cause of morbidity and mortality in many sub Saharan countries and cerebral malaria is widely recognised as one of its most fatal forms. We studied the predictive value of routine biochemical laboratory indices in predicting the outcome of cerebral malaria in 50 Nigerian children ages 9 months to 6 years with cerebral malaria at the University College Hospital, Ibadan, Nigeria. Of the 50 children studied, 43 (68%) made a full recovery, 5 (105) developed neurological sequelae while 11(22%) died. Biochemical derangements observed among the children included azotaemia (29%), elevated plasma creatinine (20%), metabolic acidiosis (22%) and hyponatraemia (16%). Metabolic acidosis and elevated plasma creatinine on admission were significantly associated with a poor outcome (p<0.05). Hyponatraemia and hypokalaemia were not significantly associated with outcome. On multivariated analysis, metabolic acidosis and elevated plasma creatinine on admission to hospital remained independent predictors of poor outcome after adjusting for other known risk factors. Patients with these findings require prompt referral for adequate treatment in centres equipped to manage such critically ill patients.
Patency of the Ductus Arteriosus in Newborns: Experience in a Special Care Baby Unit
SI Omokhodion, AM Baiyeroju-Agbeja, VO Adegboye, A Adeyemo, IA Lagunju
Nigerian Journal of Paediatrics , 2001,
Abstract: A prospective cohort study of infants admitted into the Special Care Baby Unit, University College Hospital, Ibadan, has revealed a 24.5 per cent prevalence of patency of the ductus arteriosus (PDA) among 97 infants, who were admitted over a six-month period. The major factor predisposing to PDA was prematurity (p=0.014). A higher incidence of PDA (35 per cent) was found among the preterm infants, and of these preterm infants, the very low birth weight (VLBW) infants were found to be more highly susceptible to PDA (p = 0.028). The mean birth weight of the preterm infants who developed PDA in the study was 1447g, while that of those preterm infants without PDA was 1835g. There was no relationship between the sex of the infants and the development of PDA. A strong association was however, found between respiratory distress and PDA (p<0.001). Nine of the hospital mortalities recorded occurred in the preterm infants and more than half of them (55.5 per cent) had PDA. Thus, prematurity is a risk factor for PDA and the presence of a PDA appears to increase the risk for mortality for such infants. Evidence for PDA should be sought in all premature infants and prompt and aggressive management of those infants who show signs of decompensation from PDA is recommended to reduce mortality from this disease. Nigerian Journal of Paediatrics 2001; 29:61. pp. 61-67
Experience with the Management of Congenital Diaphragmatic Hernia at the University College Hospital, Ibadan
VO Adegboye, SI Omokhodion, O Ogunkunle, MO Obajimi, AI Brimmo, OA Adebo
Nigerian Journal of Paediatrics , 2002,
Abstract: A retrospective review of 44 cases of congenital diaphragmatic hernia (CDH) treated at the Cardiothoracic Surgical Unit, University College Hospital (UCH), Ibadan, between August 1976 and May 1999, was carried out. Thirty (68.2 per cent) of the 44 were males and 14 (13.8 per cent) were females. The patients were analysed in three groups: 31 patients who underwent surgery were analysed as two groups: inborn (born within UCH), 10 patients, and outborn (born elsewhere), 21 patients; the third group consisted of 13 patients who were not operated upon. All the inborn patients and 18 (85.7 per cent) of the outborn had left-sided defects; the remaining three of the outborn had right-sided defects. Eleven (84.6 per cent) of those who didn't undergo surgery, had left-sided defects while the remaining 15.4 per cent had bilateral defects. The three groups had comparable gestational ages (inborn vs outborn, p> 0.05; inborn vs unoperated, p> 0.05; outborn vs unoperated, p>0.05) and birth weights ( inborn vs outborn, p>0.05; inborn vs unoperated, p>0.05; outborn vs unoperated, p> 0.05). Those who did not undergo surgery had lower Apgar scores and higher incidence of associated congenital malformations than the patients who underwent surgical repairs. The differences in the mean of 5 minute Apgar scores among the three groups were not statistically significant (p> 0.05). Age at surgery was higher in the outborn (mean 55.5 ± 42.2 hours) than the inborn (mean 9.2 ± 3.9 hours) patients. The difference between the mean age at surgery was statistically significant (p< 0.05). Majority of those requiring operation (24 patients, 77.4 per cent) had repair by thoracotomy, while the remaining seven (22.6 per cent) had repair by the abdominal approach. Most of the patients had primary repair while two required diaphragmatic patches with dacron. Sixty per cent of the inborn patients required post-operative ventilation compared with only 23.8 per cent of the outborn. Survival was 71.4 per cent for the outborn and 40 per cent for the inborn. It is concluded that CDH is a disease with a range of severity. The higher survival rate among the more mature outborns suggest a natural selection of those with minimum respiratory impairment.
Coarctation of the Aorta: Experience at the University College Hospital, Ibadan
VO Adegboye, O Ogunkunle, SI Omokhodion, AI Brimmo, OA Adebo, OO Ogunseyinde, MO Obajimi
Nigerian Journal of Paediatrics , 2002,
Abstract: Between May 1977 and June 1998, 697 patients with congenital heart diseases were admitted to the cardiothoracic surgical unit (CTSU) at the University College Hospital, Ibadan. Eighteen (2.6 per cent) of the patients with 19 coarctations of the aorta (CoA) were retrospectively studied. The age range of all the patients with CoA was 18 days to 30 years (mean 7.2±8.2 years), but for the 15 patients who underwent surgery, it was one month to 30 years (mean 8.6±8.3 years). Three patients died preoperatively of congenital cardiac anomalies associated with infantile CoA. There were 16 thoracic and two abdominal CoA, while one patient had recurrent CoA. Resection and end-to-end anastomosis was performed in four patients, dacron tube interposition graft in three, and dacron patch graft in four patients. Other procedures were employed in five patients. Operative mortality was 25 per cent. Operative deaths occurred in two infants with isolated CoA, a neonate who had associated pulmonary hypertension and a 17-year old who had surgery for re-coarctation. Complications of surgery included post-operative haemorrhage in two patients, intra-operative hemorrhage in one and hoarseness of the voice in four patients. Paradoxical hypertension occurred in three patients, graft occlusion and wound dehiscence occurred together in one patient and two patients had chylothorax. It is concluded that CoA is a surgically correctable congenital anomaly which is probably less frequently diagnosed locally. Nigerian Journal of Paediatrics 2002;29:27-33.
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