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A comparative evaluation of outcome of cataract surgery at Ago-Iwoye, Ogun State
CO Bekibele
Nigerian Journal of Surgical Research , 2004,
Abstract: Objective: To compare the outcome of cataract surgery using intracapsular/ extracapsular extraction alone to surgery with lens implantation. Methods: A retrospective review of all patients who had cataract surgery by all methods between February 1998 and October 1999 at St Mary’s Catholic eye hospital Ago-Iwoye, Ogun state, for post operative visual acuity and surgery related complications. Results: Two hundred and forty nine eyes of 211 patients were reviewed. 128 (60.7 %) were males and 83(39.3) were females. The age range was from 9years to 90years. Post op vision of 6/18 or better was present in 71% of the posterior chamber intra ocular lens (PC-IOL) group; 50% of anterior chamber lens (AC-IOL) group, 62% of intracapsular cataract extraction (ICCE) group and 31.2% of the extracapsular cataract extraction group. Preventable causes of poor visual outcome were present in 14.9% 0f the cases reviewed especially the ECCE and ICCE groups and included: posterior capsule opacity, uveitis, cystoid macular oedema and endophthalmitis. Poor outcome was associated with pre-existing ocular disease in 10.8% of the eyes operated and were due to pre-existing glaucoma, macular degeneration, optic atrophy and diabetic retinopathy. Conclusion: Best functional visual results are obtained by modern techniques of ECCE with IOL, which ensures that the patient has adequate post op vision for his needs. Adequate case selection to exclude pre-existing ocular morbidity as well as prevention or proper management of surgery related complications when they occur are also essential for satisfactory results. Older techniques of ICCE or ECCE with out IOL are associated with less satisfactory functional visual acuity and should therefore be discouraged.
Chronic allergic Conjunctivitis: An evaluation of the role of family history and atopy
BA Olusanya, CO Bekibele
Annals of Ibadan Postgraduate Medicine , 2006,
Abstract: No Abstract.
Buphthalmos: a Twelve-year Review at Ibadan
CO Bekibele, BA Olusanya
Nigerian Journal of Paediatrics , 2004,
Abstract: Objective: To review the presentation, management, follow-up and outcome of management of children presenting with buphthalmos at the University College Hospital (UCH), Ibadan. Methods: This was a retrospective review of cases of buphthalmos seen at the UCH Ibadan, between 1991 and 2002. The case notes of patients seen in the Eye Clinic during the period were reviewed. All children diagnosed with buphthalmos or congenital glaucoma were identified, and their case notes studied in greater details. Results: Twenty seven eyes in 15 children with buphthalmos were reviewed. This represented 0.1 percent of all new patients, and 0.6 percent of new paediatric cases seen within the study period. Their ages ranged between 22 days and nine years (mean, 25.5 months). Sixty percent were aged 18 months or less, 80 percent were boys and the disease was bilateral in 80 percent of cases. Only one (6.7 percent) patient presented with the classical triad of epiphora, photophobia and blepharospasm, while four (26.7 percent) presented with both epiphora and photophobia. Two (13.3 percent) patients had associated cardiac abnormalities. Of the 27 buphthalmic eyes, 21 (77.8 percent) had trabeculectomy, with good intraocular pressure control (i.e. <21mmHg) after surgery in 14 eyes (66.7 percent). Of these, three (21.4 percent) required medication to achieve such control. The duration of follow-up from the time of initial presentation ranged between 2.5 months and 6.75 years (mean, 25.9 months). Six (40 percent) of the patients were followed up for more than a year, while 60 percent were lost to follow-up. Out of 10 eyes in which the visual acuity was objectively measured, two (20 percent) had good visual outcome (i.e. visual acuity 6/18 or better), while six had poor outcome due to complications associated with late presentation. Due to lack of appropriate facilities, visual acuity was not assessed objectively in 17 eyes. Conclusion: Buphthalmos is a rare disease in Ibadan and occurs predominantly in males. Majority of cases are bilateral. In this study, trabeculectomy achieved adequate pressure control in the majority of cases and as such, it appeared to be a good option in the management of buphthalmos in black patients. The main problems were late presentation and poor follow up. The public needs to be educated on making early use of available health services. There is also a need to introduce, equip and provide support for paediatric ophthalmology units. Nigerian Journal of Paediatrics Vol.31(2) 2004: 39-42
Visual Outcome Of Traumatic Cataract Surgery In Ibadan, Nigeria
CO Bekibele, O Fasina
Nigerian Journal of Clinical Practice , 2008,
Abstract: To review the visual outcome of traumatic cataracts operated at the University College Hospital, Ibadanwith the view to making recommendations for improved outcome. All patients operated at the University College Hospital Ibadan, Nigeria between May 1999 and April 2004with traumatic cataractwere reviewed retrospectively to determine visual outcome andmain causes of poor visual outcome <6/18, using a structured data entry form and information obtained from the operation register and case notes of patients 32 patients, age range 2 to 71years, mean age 25.6 SD 16.1years were reviewed. 22 (68.8%) were maleswhile 10(31.2%)were females.Causes of traumatic cataract includedwood /stick splinters in 7 (21.9%), cane/ whiplash injury 6(18.8%), and propelled missile injuries, 5(15.6%). Less important cause of injuries were gun shot, road traffic accident and fist injuries. 11 (35.6%) of the patients had best corrected post operative visual acuity of >6/18, 10 (32.2%) < 6/18-3/60,while 32.2%of the cases reviewed remained blind or had vision <3/60 in the affected eye. Cause of poor post operative visual acuity (less than 6/18) in 64.4% of the subjects included cornea opacity 12.5%, posterior capsule opacity 12.5%, retinal detachment 9.4%, and glaucoma 6.9% Useful vision can be restored in a proportion of traumatic cataracts through surgery, although sight-limiting complications, which may be related to the severity of the trauma or prolonged post op inflammation may be present, many are potentially treatable with further intervention. The need for adequate health education to prevent ocular injuries and preoperative diagnosis of associated posterior segment complications thatmay prevent optimal post-operative visual acuity is also noted.
Hydro-dissection and posterior capsule opacifi
CO Bekibele, AL Musoro
Nigerian Journal of Surgical Research , 2005,
Abstract: Objective: to determine the efficacy of hydrodissection in the reduction of posterior capsule opacity. Methods: A non-randomised controlled comparative study carried out at the University College Hospital Ibadan between November 1999 and July 2004. 23 subjects with uncomplicated cataract who had cataract surgery using Extracapsular cataract surgery with out hydrodissection were compared to 33 subjects with similar cataracts who had surgery using hydrodissection. Results: A total of 56 subjects were included in the study comprising 33 subjects in the hydrodissection group (22 males, 11 females, age range 8-88, mean 59.7years). No-hydrodissection group (8 males and 15 females, age range 29-73, mean 60.8years). Early post op complications consisted of cornea striate (hydrodissection group 3%, non-hydrodissection group 34.7%), microcystic epithelial oedema (hydrodissection group78.8%, non-hydrodissection group 39.1%), iritis and irregular pupil. Late post operative complications consisted of cornea oedema 1 in each group, irregular pupil (16.3% more common in the hydrodissection group), and posterior capsule opacity (hydrodissection group 6.1%, and no-hydrodissection group 8.7%). The difference in posterior capsule opacity between the 2 groups was not statistically significant (P>0.05). Conclusion: Hydrodissection is associated with a marginal reduction in post-operative posterior capsule opacity formation following ECCE-IOL surgery. It may however be associated with early post operative complications presumably due to increased manipulation during the procedure. Its use is therefore encouraged but with generous use of viscoelastic material to reduce effect of manipulation on the eye.
Risk factors for visually disabling age-related cataracts in Ibadan
CO Bekibele, AO Ashaye, BGK Ajayi
Annals of African Medicine , 2003,
Abstract: Objective: To assess the risk factors for visually disabling age related cataracts. Methods: A hospital based case-control study carried out at the university College Hospital Ibadan between May 1996 and March 1997. Three hundred and eighty three cases were matched for age and sex with five hundred and ninety nine controls. Subjects aged 50 years and above were examined for visual disabling central lens opacities, which were graded on a scale of 0-3, through undilated pupil with direct ophthalmoscope set at +2.00 Diopters, and held 1/3 meter away. Grades 2a or more with visual acuity less than 6/18 only were selected as cases. Both cases and controls were examined and the risk for development of cataract determined. Results: The analysis revealed a strong association between uncontrolled diabetes and cataracts (O.R 2.03, P < 0.021). A risk was seen to exist between visually disabling cataract and ultraviolet exposure (O.R 1.45; P <0.003), uncontrolled hypertension (O.R 1.3, p>0.05) and topical steroid use (O.R 1.57; p>0.05). Exposure to alcohol was found to be protective (O.R 0.66; P < 0.05) while no risk was observed with severe diarrhoea (O.R 0.85; P >0.05) and heavy smoking (O.R 0.81; P > 0.05). Conclusion: The study confirms an association between cataract and exposure to diabetes, ultraviolet irradiation, hypertension, corticosteroids, and cigarette smoking. There is therefore a need for introduction of intervention measures aimed at reducing exposure to these risk factors.
Visual outcome after cataract surgery at the University College Hospital, Ibadan
OO Olawoye, AO Ashaye, CO Bekibele, BGK Ajayi
Annals of Ibadan Postgraduate Medicine , 2011,
Abstract: Aim: The aim of this study was to determine the visual outcome of patients who had cataract surgery in the University College Hospital Ibadan. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at the University College Hospital conducted between May and October 2007. A total of 184 patients who presented to the hospital and met the inclusion criteria were recruited into the study. Patients were examined preoperatively, 1st day postoperatively and 8th week postoperatively. Results: The mean age was 66.5 years; and the male to female ratio was 1.2:1. Preoperatively, 137 patients (74.5%) were blind in the operated eye, while 39 patients (23.6%) were blind in both eyes at presentation. At 1st day postoperatively, 87 patients (47.3%) had pinhole visual acuity of 6/6-6/18. Best corrected vision after refraction eight weeks postoperatively showed that 127 patients out of 161 patients (78.8%) had good vision while 28 patients (17.4%) had borderline vision, and six patients (3.8%) had severe visual impairment after refraction. The number of bilaterally blind patients also reduced from 39 (23.6%) to one (0.6%). Uncorrected refractive error was the commonest cause of poor vision prior to refraction. Glaucoma was the commonest ocular co-morbidity accounting for poor vision in 9.1% of patients eight weeks after cataract surgery. Conclusion: This study demonstrates that good results can be obtained with cataract surgery and intraocular lens implantation in the developing world. More attention should be directed towards ensuring that successful outcomes are indeed being realized by continued monitoring of postoperative visual outcomes and prompt refraction for all patients.
Awareness and utilization of protective eye device among welders in a southwestern Nigeria community
IA Ajayi, AO Adeoye, CO Bekibele, OH Onakpoya, OJ Omotoye
Annals of African Medicine , 2011,
Abstract: Objective: To determine the level of awareness and practice of use of protective eye devices among welders in Ile-Ife. Methods: This is a cross-sectional descriptive study of 405 consenting welders. A pretested proforma was utilized to obtain information on sociodemographic characteristics, as well as awareness and use of protective eye device. Results: The age of the respondents ranged from 16 to 80 years. The mean age was 39 ± 13 years. A large proportion (315, 78%) of the welders was aged between 21 and 50 years. The youngest group aged ≤20 years accounted for 15 (4%) of all welders, while the oldest group aged >60 years accounted for 21 (5.2%). 402 were males (99.3%) and three were females (0.7%). Three hundred thirty-six (83%) of the welders had practiced for 6 years and above. There was a high level of awareness of protective eye devices among the welders (367, 90.6%), being higher among arc welders compared with gas welders (P<0.001). Less than half (186, 45.9%) of the welders possessed protective eye devices. Of these, only 39 (9.6%) made use of the devices always. Some of the reasons for not using the protective eye devices include discomfort and poor visibility (56, 13.6%) and inadequate appreciation of the necessity to wear it (49, 12.1%). Conclusion: The findings of this study suggest that a significant proportion of welders in Ile-Ife were not utilizing protective eye device. Health education and awareness campaigns about the importance and benefits of utilizing protective eye devices are recommended.
Squamous papillomas of the conjunctiva: A retrospective clinicopathological study
OA Ogun, GO Ogun, CO Bekibele, EE Akang
Nigerian Journal of Clinical Practice , 2012,
Abstract: Background: There is very limited literature on squamous papillomas of the conjunctiva from Nigeria and sub-Saharan Africa. In an attempt to contribute to the literature on the subject, we studied the clinicopathological characteristics of patients histologically diagnosed with squamous papilloma of the conjunctiva in Ibadan, Nigeria. Materials and Methods: Clinical and pathological records of patients with histological diagnosis of squamous papilloma of the conjunctiva made in the Department of Pathology, University College Hospital, Ibadan, between January 1985 and December 2004, were reviewed. Results: There were totally 26 cases. Patients’ ages ranged from 2 to 58 years with a mean age of 32 years. Male to female ratio was 1.4:1. Size of tumors ranged from 2 to 10 mm. Duration of presenting complaints was from 2 months to 10 years. The lesions in 10 cases were located in the medial canthus, at or close to the limbus in another 10 cases, and in the tarsal conjunctiva in a single case. Five cases had no documentation of location. Sixteen cases (61.5%) had multiple papillomas. Four cases had a history of chemical injury (alkaline based – hair relaxer in a single case, acid based – wet cell car battery fluid in two cases, and unknown chemical in a single case) preceding the lesion by at least 6 weeks. Fourteen cases had koilocytosis on histology suggestive of Human Papilloma Virus (HPV) etiology. HIV screening test was negative in the three patients who had the screening done. Preoperative clinical diagnosis was squamous papilloma in 16 cases, pterygium in 6 cases and squamous cell carcinoma in 2 cases. Conclusion: In the environment where we practice, conjunctival squamous papilloma occurs most commonly in the fourth decade of life. Only very few cases are submitted for histological diagnosis. HPV infection and chemical injury are the main etiology. We strongly advocate that all excisions of the conjunctiva, irrespective of the clinical impression, should be submitted routinely for histological assessment.
Risk factors for road traffic accidents among drivers of public institutions in Ibadan, Nigeria
CO Bekibele, OI Fawole, AE Bamgboye, LV Adekunle, R Ajav, AM Baiyeroju
African Journal of Health Sciences , 2007,
Abstract: Recent studies have shown an increase in the rate of road traffic accident (RTA). Identifying the risk factors for this problem may provide a clue to possible effective intervention. This study aimed to determine the prevalence and risk factors for self reported RTA among drivers of educational institutions and make suggestions to promote safer driving. A cross sectional population study of motor vehicle drivers from the College of Medicine, University of Ibadan and University College Hospital (UCH) Ibadan was undertaken between December 2003 and January 2004. The study comprised of 99 motor vehicle drivers. 67 (67.7%) were from the College of Medicine, and 32 (32.3%) from the UCH. Response rate was 97.1%. All were males, aged 38 to 60 years, mean 50.1 + (SD= 4.8 years). The prevalence of self reported RTA was 16.2%. The cause of road traffic accidents included, mechanical fault (50%), bad road (12.5%). RTA prevalence was higher among older drivers (OR=1.7, 95%CI=0.5-5.9; P>0,05), drivers who had part time jobs (Odds ratio 2.6, 95% CI 1.1-6.3; X2 =4.5, P=0.03), and drivers with visual impairment (OR=1.6, 95% CI=0-9, X2 0.49, P > 0.05). The prevalence of RTA was lower amongst drivers who did not take alcohol, cola nut and other CNS stimulants while driving (OR 0.9, 95% CI=0.3-2.3, P >0.05). Regular maintenance of official vehicles and examination of drivers\' eyes are recommended. Drivers should be discouraged from drugs and part jobs so as to ensure that they have enough time to rest and therefore prevent fatigue related RTA. African Journal of Health Sciences Vol. 14 (3-4) 2007: pp. 137-142
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