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Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management
Odutola Israel Odetunde,Oluwatoyin Arinola Odetunde,Adesoji Oludotun Ademuyiwa,Henrietta Uche Okafor,Uchenna Ekwochi,Jonathan Chukwuemeka Azubuike,Nene Elsie Obianyo
International Journal of Nephrology , 2012, DOI: 10.1155/2012/345298
Abstract: Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide. 1. Introduction Posterior urethral valves (PUV) are the commonest cause of lower urinary tract obstruction in male infants [1–3]. The incidence of this congenital anomaly in our setting is unknown, although reports from Unites States and Europe indicates that it occurs in about 1?:?8000 and 1?:?25,000 male live births [1, 3, 4]. Prolonged and unrelieved lower urinary tract obstruction leads to back pressure effects on the kidneys resulting in obstructive uropathy with renal impairment [5]. PUVs are also a common cause of chronic renal failure in children if treatment is delayed [6–8]. Late presentation in patients with PUV is associated with urosepsis, uremia, and anemia and these form the bulk of patients seen in our centre. Early diagnosis and prompt commencement of treatment is therefore germane to the overall outcome of these patients [9, 10]. This is particularly important in a resource—limited environment like ours where facilities for renal replacement therapy in children is not readily available. The aim of this study is to document the pattern of presentation in our centre and outcome of management. 2. Materials and Methods This is a retrospective descriptive study. Records of patients with PUV at the University of Nigeria Teaching Hospital (1997–2004) and Enugu State University of Technology Teaching
Seasonal Frequency in Esophageal Atresia/Tracheo-Esophageal Fistula: Is there an Environmental Etiology?  [PDF]
Christopher Bode, Adesoji Ademuyiwa, Sylvester Ikhisemojie
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.27084
Abstract: Background: Esophageal Atresia and Tracheo-Esophageal Fistula (EA/TEF) occurs sporadically and its eti-ology is poorly understood. We observed six cases of EA/TEF within three weeks of October 2007 at the Lagos University Teaching Hospital (LUTH), Nigeria. Aims: To analyze the monthly trends of presentation of EA/TEF at the LUTH from 2002-7, test the hypothesis that the October figures were not due to chance and correlate data with known local disease patterns. Setting: Lagos University Teaching Hospital, Nigeria. Patients, Materials, Method: A retrospective analysis of all EA/TEFs managed at the LUTH within stated period. Results: 25 babies with EA/TEF presented over the period. 10 (40%) were seen in the month of Oc-tober, 5 (20%) occurred in May while the rest were spread over the rest of the months. Chi-square analysis confirmed that the EA/TEF cases occurred significantly more frequently in October (P < 0.001) and this ob-servation was unlikely due to chance. Conclusions: There seems to be a seasonal variation in the occurrence of EA/TEF in Lagos, with a significantly higher frequency in the month of October. 96% of mothers of ba-bies with EA/TEF lived in low socioeconomic parts of Lagos. This study highlights the possibility of local viral etiology of EA/TEF.
HIV Seropositivity among Paediatric Surgical Patients at the Lagos University Teaching Hospital: What Risk to the Surgeon  [PDF]
Christopher Bode, Adesoji Ademuyiwa, Sylvester Ikhisemojie, Olumide Elebute
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.21006
Abstract: Background: Although much concern has been expressed about the occupational risk posed to surgeons by the HIV pandemic infection, the paediatric age group is often seen as less likely to harbor the disease. Aim: To determine the HIV infection rate among children presenting for surgical operations at the Lagos University Teaching Hospital (LUTH), Lagos. Materials, patients and method: Blood was taken from 1000 consecutive children referred to LUTH for surgical conditions and tested for HIV sero-positivity using the Western blot method. Consenting parents of sero-positive patients were also tested. Result: Five children tested positive for HIV, giving an overall infection rate of 0.5%. Four mothers and three consenting fathers were also positive. In one child, none of the parents was positive and he was suspected to have developed the disease from a previous blood transfusion prior to presentation in LUTH. This possibly resulted from transfusion of infected blood during its window period. Conclusion: Although the HIV infection rate of 0.5% in paediatric surgical group in Lagos is low, surgeons should vigilantly apply universal precautions to prevent needle-stick injuries while the rate of HIV infection should be periodically monitored to determine the trend.
Survey of teaching, research and conference experiences of paediatric surgical trainees in Nigeria
Ademuyiwa Adesoji,Ameh Emmanuel,Bode Chris,Adejuyigbe Olusanya
African Journal of Paediatric Surgery , 2011,
Abstract: Aim : To determine the teaching methods used by residents in paediatric surgery in Nigeria and their exposure to research and conferences. Materials and Methods : A structured questionnaire was administered to trainees in paediatric surgery in Nigeria seeking information regarding different teaching methods used, frequency of use, involvement in research and participation in conferences. Results : There were 11 respondents (91.6%) of 12 questionnaires that were distributed. All of them were training in accredited teaching hospitals in Nigeria. All of them had been involved in teaching medical students. Ten residents were involved in teaching in wards/bedside two times or more in a week and all were involved in teaching at the clinics. Only one resident used audiovisual aid at least once a week to teach students. Eight trainees used tutorial or seminar group discussion as a teaching tool once a week. Four trainees had not used written essay as a way of teaching students while five had never given students lectures in a classroom before. All the respondents had participated in retrospective research while nine had been involved in prospective research. Nine residents had attended conferences nationally while two had attended international conferences. Six trainees presented a paper or more at national conferences while one presented at an international conference. Conclusion : Trainees in paediatric surgery in Nigeria are significantly involved in the teaching of undergraduate medical students and clinical research. This should be encouraged and further enhanced by motivating the trainees to attend international conferences.
Level of HIV/AIDS Information Consciousness among Secondary School Students in Ekiti State, Nigeria
FF Adesoji
African Research Review , 2010,
Abstract: This paper highlights the result of an investigation into the level of information consciousness of the Human Immunodeficiency Virus or Acquired Immune Deficiency Syndrome HIV/AIDS among secondary school students in Ado-Ekiti and Ekiti East Local Government Areas of Ekiti State in Nigeria. They respectively represent urban and rural settings in the state. Three research questions and three hypotheses guided the study. 165 copies of the questionnaire were distributed while 150 copies were utilized for the study in both urban and rural areas. Mean scores and standard deviations were used to answer the three research questions while t-test statistic was used for the three hypotheses. The major findings of the study were that secondary school students in both urban and rural areas of Ekiti State. Nigeria did not know all the possible causes, signs and symptoms of HIV/AIDS or the protection against contracting the infections. Based on the above findings, the researcher made some recommendations.
The Boko Haram Uprising and Islamic Revivalism in Nigeria Die Boko-Haram-Unruhen und die Wiederbelebung des Islam in Nigeria
Abimbola Adesoji
Africa Spectrum , 2010,
Abstract: From the 1980 Maitatsine uprising to the 2009 Boko Haram uprising, Nigeria was bedevilled by ethno-religious conflicts with devastating human and material losses. But the Boko Haram uprising of July 2009 was significant in that it not only set a precedent, but also reinforced the attempts by Islamic conservative elements at imposing a variant of Islamic religious ideology on a secular state. Whereas the religious sensitivity of Nigerians provided fertile ground for the breeding of the Boko Haram sect, the sect’s blossoming was also aided by the prevailing economic dislocation in Nigerian society, the advent of party politics (and the associated desperation of politicians for political power), and the ambivalence of some vocal Islamic leaders, who, though they did not actively embark on insurrection, either did nothing to stop it from fomenting, or only feebly condemned it. These internal factors coupled with growing Islamic fundamentalism around the world make a highly volatile Nigerian society prone to violence, as evidenced by the Boko Haram uprising. Given the approach of the Nigerian state to religious conflict, this violence may remain a recurring problem. This paper documents and analyses the Boko Haram uprising, as well as its links with the promotion of Islamic revivalism and the challenges it poses to the secularity of the Nigerian state. Vom Maitatsine-Aufstand 1980 bis zu den Boko-Haram-Unruhen 2009 hat die nigerianische Bev lkerung unter den verheerenden menschlichen und materiellen Kosten ethnisch-religi ser Konflikte gelitten. Die Boko-Haram-Unruhen (Juli 2009) markierten allerdings eine qualitative Ver nderung, denn sie stellten einen Pr zedenzfall dar und verst rkten Versuche konservativer Anh nger des Islam, im s kularen nigerianischen Staat Elemente islamischer Ideologie einzuführen. Angesichts der Empf nglichkeit der Nigerianer für religi ses Denken konnte sich die Boko-Haram-Sekte schnell ausbreiten, erleichtert durch die nach wie vor bestehende konomische Polarisierung der nigerianischen Gesellschaft, die erneut heftig aufgebrochene Konkurrenz der Parteien um die politische Macht und die Ambivalenz einiger lautstarker islamischer Führer, die zwar nicht explizit zum Aufstand aufriefen, aber auch nichts zur Beendigung der Hetze beitrugen und diese nur vorsichtig verurteilten. Diese internen Faktoren und der gleichzeitige weltweite Aufschwung des islamischen Fundamentalismus führten in der hoch volatilen nigerianischen Gesellschaft zu den gewaltsam ausgetragenen Boko-Haram-Unruhen. Die im nigerianischen Staat strukturell angelegte Gef
Complications of neonatal circumcision: Avoiding common pitfalls in a common procedure
Ademuyiwa A,Bode C
African Journal of Paediatric Surgery , 2009,
Differential effect of honey on selected variables in alloxan-induced and fructose- induced diabetic rats
F Adesoji, A Oluwakemi
African Journal of Biomedical Research , 2008,
Abstract: Honey contains a high concentration of fructose, a monosaccharide, capable of raising blood sugar level after oral ingestion. It is thus a paradox that nutritional experts have advocated its use as a nutrition supplement in patients with diabetes mellitus. It has also been used, over the years, as a sweetener by those who wish to avoid the use of sugar. The effective use of sugar in diabetes may be due to its other constituents, especially the various antioxidants that are abundant in honey. Glycemic effect of honey on alloxaninduced diabetes and with concomitant administration of fructose was studied in male rats of the Wistar strain. Alloxan was injected into the rats through a tail artery and three days later, a confirmation of successful induction of diabetes was made by demonstration of hyperglycemia in the rats. Another group of rats received daily oral ingestion of fructose. At the end of three weeks it was found that daily ingestion of honey for three weeks progressively and effectively reduced blood glucose level in rats with alloxaninduced diabetes. Honey also caused a reduction in hyperglycemia induced by long-term ingestion of fructose, albeit to a lesser degree than its effect on alloxan-induced hyperglycemia. Honey could not reduce blood glucose in controlled rats that received neither alloxan treatment nor fructose ingestion, even though it caused an increase in body weight, irrespective of other substances concomitantly administered to the rats. It is thus apparent that honey may be a useful adjunct in the management of diabetes, while serving as a sweetener, especially if taken in moderate quantities. (Afr. J. Biomed. Res. 11: 191 - 196) Key Words: Honey, Alloxan-induced diabetes, Fructose-induced diabetes, Rats
Students Perception of Cult Activity on United States Colleges and University Campuses
Adesoji A. Oni
Pakistan Journal of Social Sciences , 2012,
Abstract: The study investigated students perceptions of cult activity on United State Colleges and University campuses. Three hundred students from 6 Colleges and University campuses in US were involved. The students were randomly selected from the school population. The instrument used was a validated self-developed questionnaire. Five research questions were raised and answered. Chi-square and t-test statistics were utilized to analyze the research questions. Findings revealed that United States Colleges and University students perceived male dominance in cult membership and identified broken home as a potent factor to cult membership, while significant difference in the effect of cult activity on social order on the campuses were perceived by the respondents.
The Relationship Between Levels of Education and Perception of Democratic Governance Among Nigerian School Leavers
Adesoji A. ONI
The Turkish Online Journal of Distance Education , 2006,
Abstract: The study investigated the views and perception of school leavers about the democratic government in Nigeria. A self-designed questionnaire was used for collection of their views. The participants of the study comprised 500 school leavers selected across different working places in the six states of Southwest Nigeria. Results clearly revealed that majority of the respondents are not satisfied with the current performance of the present democratic Government in Nigeria. Most of the respondents suggested participation of everyone in the act of governance that favor rule of law, equality, and freedom and that this should be adopted by the government. The researcher therefore recommended a democratic system of government that will incorporate all the basic principles of democracy into the system of government, while marginalization and neglect of the poor, women, youth, and rural dwellers should be avoided.
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