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Biomedical subjects

O Adejuyigbe

Publications and source records attributed to O Adejuyigbe.

34 records · Page 2Linked to original sources
PubMed1991

Childhood intussusception in Ile-Ife, Nigeria.

A retrospective review of 41 intussusceptions encountered in 39 children seen over an 8-year period in Ile-Ife, Nigeria is presented. Most cases (61.5%) occurred in infancy. This contrasts with previous reports from Nigeria where intussusception has been presented as being commoner in older children. Vomiting, abdominal pain, excessive crying and passage of bloodstained stools were the main presenting symptoms. An abdominal mass was palpable in only 28.2% of patients. Generally, patients presented late in hospital with only two (5.1%) arriving within 24 hours of the onset of illness. Hydrostatic reduction with barium enema was attempted in these two patients, and it successfully reduced the intussusception in one and caused partial reduction in the other. Nineteen patients (46.3%) required bowel resection. There were nine deaths, giving a mortality rate of 23.1%. The relatively high bowel resection and mortality rates were attributed to the delay in seeking medical treatment.

Adolescent↗
PubMed1991

Intra-abdominal abscesses in children.

Forty-one intra-abdominal abscesses in 30 Nigerian children seen over a 2-year period at the Obafemi Awolowo University Teaching Hospital were studied prospectively to determine their location, aetiology, microbiology and clinical course. Thirty-four abscesses (83%) were intraperitoneal with the subphrenic spaces and pelvis being the commonly involved intraperitoneal sites. Six abscesses (15%) were retroperitoneal while there was only one visceral abscess (2%). Diseases of the gastrointestinal tract occurring in 20 patients (67%) were responsible for the majority of intraperitoneal abscesses, while suppurating external iliac adenitis was the major cause of retroperitoneal abscesses. There were 62 microbiological isolates, with 52% being anaerobic bacteria and 47% aerobic bacteria. A fungus, Candida, was isolated once (2%). Escherichia coli and Staphylococcus aureus were the commonest aerobic bacteria, while Bacteroides and anaerobic streptococci were the commonest anaerobes. Sixteen patients (53%) had a mixed flora of aerobic and anaerobic bacteria, while in seven patients each (23%) only aerobic or anaerobic bacteria were isolated. The mortality rate in this series was 23%. Association of an intra-abdominal abscess with remote organ failure, postoperative anastomotic leakage, non-localization of the abscess within the peritoneal cavity and gastrointestinal perforation due to typhoid enteritis was found to portend poor prognosis.

Abscess↗
PubMed1990

Intrauterine intussusception causing intestinal atresia.

The patient presented at the age of 2 days with persistent bilious vomiting, failure to pass meconium and urine, and progressive abdominal distension dating from birth, and a clinical diagnosis of intestinal obstruction was made. This was confirmed by plain abdominal radiographs. At laparotomy atresia of the terminal ileum was found. The proximal and distal segments of the bowel ended blindly and there was a V-shaped defect in the adjoining mesentery. The blind ends were resected and an end-to-back anastomosis was performed. The lumen of the resected distal segment contained an intussusceptum.

Anastomosis, Surgical↗
PubMed1990

The bacteriology of intra-abdominal abscesses in Nigerian children.

The bacteriology of intra-abdominal abscess in 30 Nigerian children showed anaerobic bacteria constituted 52 per cent of total microflora with Bacteroides fragilis and anaerobic streptococci (19 per cent each) being predominant. E. coli and S. aureus were the predominant facultative bacteria isolated occurring in 24 and 11 per cent, respectively. The incidence of abscess was higher in males than in females and these predominant bacteria were relatively resistant to penicillins, suggesting caution in the use of penicillins in the treatment of intra-abdominal infections.

Abdomen↗
PubMed1990

The predictive value of bacterial contamination at operation in post-operative wound sepsis.

Wounds of 53 surgical patients were studied prospectively both clinically and bacteriologically. There were 26 males and 27 females with a mean age of 38.3 yr. Culture of fascia-deep wound swabs at closure of wound at the end of operation was related to culture if postoperative wound infection occurred. Overall wound infection rate was 15.1% with an infection rate for clean wounds of 3.7% being lowest and the dirty wound infection rate of 60% being highest. Pathogenic organisms in seven of eight infected wounds had been isolated at wound closure while in one instance they were different from organisms in the wound at closure. Risk of development of subsequent infection was significant if enteric organisms rather than Staphylococcus were isolated from the wound at closure. Wounds that had negative culture at the end of operation had no post-operative infection. The study underlines the importance of bacteriological analysis of wounds at the end of operation in identifying those at risk of post-operative infection and the probable causative pathogenic organisms. This will be useful in the choice of prophylactic antibodies for treatment of high-risk patients.

Adolescent↗
PubMed1990

Omental and mesenteric cysts in Nigerian children.

Omental and mesenteric cysts are rare intra-abdominal lesions which may be congenital, traumatic, neoplastic or infectious in origin. They give rise to non-specific clinical features and may be a cause of the surgical acute abdomen, especially in children. Correct preoperative diagnosis is infrequent but a high index of suspicion and use of ultrasonography when available would improve clinical diagnosis. Six omental and mesenteric cysts encountered in five children over a 10-year period (1978-87) are reported. All the cysts were congenital. Three patients presented with non-specific symptoms and two presented with acute abdomen. Correct preoperative diagnosis was made in two patients. All five patients had surgery. Two had enucleation of the cysts, two had excision of the cysts with adjacent bowel segment and one patient with two cysts had partial excision of the wall of the cysts with free internal drainage into the peritoneal cavity. All patients survived.

Adolescent↗
PubMed1989

Pattern of acute appendicitis in Nigerian children.

A review of 47 cases of acute appendicitis in children seen at the Ife University Teaching Hospital over a 7-year period (1980-86) is presented. Over this period the disease was responsible for 0.43% of all paediatric admissions and 18% of all paediatric abdominal emergencies. The clinical features were similar to those in other populations, but in this series there was a tendency towards late presentation with complications which caused significant post-operative morbidity. However, there was only one death.

Acute Disease↗
PubMed1989

Mesenteric cysts in Nigerians.

Mesenteric cysts are uncommon and are said to be rarer among blacks than in caucasians. We report six mesenteric cysts seen in five patients over a 9 1/2 year period with an incidence of one in 48,497 hospital admissions. there were three males and two females. Ultrasonography was carried out in three of our five cases. There is need to include mesenteric cyst in the differential diagnosis of an abdominal mass. Surgery was the mainstay of treatment. At laparotomy, five of the cysts were found in the mesentery of the small bowel. Simple enucleation was done in one patient while cyst resection with adjacent bowel was carried out in three patients. There were two cysts in the youngest patient and these were internally drained. All the patients did well with uneventful post-operative period with no mortality. Follow up had been from 14 months to 6 years.

Adult↗
PubMed1985

Nephrotoxicity of aminoglycosides in young and adult rats.

The nephrotoxicity of gentamicin and amikacin was evaluated comparatively in young and adult rats. The aminoglycosides were administered once daily for 14 days, gentamicin in a dose of either 20 or 60 mg/kg, and amikacin in a dose of either 60 or 180 mg/kg. Renal function was measured during and after treatment. In adult rats there was a dose dependent fall in the glomerular filtration rate which was preceded by histopathological changes in the proximal tubules. The nephrotoxicity of gentamicin was more severe than that of amikacin. The nephrotoxicity of either aminoglycoside was less severe in young rats than in adult rats. In the proximal tubules there were less histopathological changes in young rats than in the adult rats. The mechanism underlying this difference in nephrotoxicity was investigated by measuring the renal accumulation of gentamicin and amikacin. The renal uptake after the first dose of either aminoglycoside was similar in young and adult rats. Expressed as a percentage of the injected amount, the uptake decreased as the aminoglycoside dosage increased. The uptake of gentamicin was somewhat greater than that of amikacin. In young rats, the aminoglycoside concentration in total kidney as well as in renal cortex, was significantly less than in adult rats. This difference was due to the larger wet kidney weight relative to body weight in the young rats. The lower renal aminoglycoside levels in the young rats provide an explanation for the difference observed in aminoglycoside nephrotoxicity when comparing young and adult rats.

Age Factors↗
PubMed1984

Determination of aminoglycosides in rat renal tissue by enzyme immunoassay.

The enzyme-multiplied immunoassay technique for the determination of gentamicin or amikacin in serum was evaluated for use in rat renal tissue. After the addition of either gentamicin or amikacin to tissue homogenate, the assay of the supernatant showed a reduced recovery, depending on the amount of renal tissue present per milliliter of homogenate. The recovery was independent of the amount of aminoglycoside added. This reduction could be due to either protein binding or interference with the enzyme-multiplied immunoassay technique by substances released from the renal tissue. When the enzyme-multiplied immunoassay technique is used for aminoglycoside assay in renal tissue, care should be taken to minimize the amount of tissue present in the homogenate or to correct for the decreased recovery.

Amikacin↗
PubMedDate not supplied

Appraisal on fluid and electrolyte management in paediatric surgical patient.

Fluid and electrolyte disorders are common occurrences in Paediatric surgical practice. Despite this, the management of fluid and electrolyte imbalance in the paediatric surgical patients remains problematic. This is partly because authorities vary considerably in their recommendations for therapy, despite the great advances being attained in the understanding of the fluid and electrolyte homeostasis in the Paediatric age group. This has, in no doubt, resulted in a number of morbidity and mortality that could have been prevented based upon rational and acceptable recommendations for fluid and electrolyte therapy in children. In this review, the normal homeostasis, disorders and management of fluid and electrolyte and corrections of metabolic disorders in children are highlighted, with the aim to update the practice of fluid and electrolyte therapy in children.

Age Factors↗
PubMedDate not supplied

Surgical audit in the developing countries.

Audit assures provision of good quality health service at affordable cost. To be complete therefore, surgical practice in the young developing countries, as elsewhere, must incorporate auditing. Peculiarities of the developing countries and insufficient understanding of auditing may be, however, responsible for its been little practised. This article, therefore, reviews the objectives, the commonly evaluated aspects, and the method of audit, and includes a simple model of audit cycle. It is hoped that it will kindle the idea of regular practice of quality assurance by surgeons working in the young developing nations and engender a sustainable interest.

Developing Countries↗
PubMedDate not supplied

Primary tuberculous mastitis in a Nigerian woman.

Tubercolous mastitis is an uncommon lesion even in countries where the incidence of pulmonary and extrapulmonary tuberculosis is still very high. At the Ife University Teaching Hospital only one case of tuberculous mastitis has been seen over a ten-year period during which 671 breast biopsies were examined. This was in a 36-year old Nigerian woman who developed a left breast mass during pregnancy. She was seen after her delivery and was initially diagnosed as a case of carcinoma of the breast. Subsequent excisional biopsy and pathological examination of the mass confirmed tuberculosis of the breast. She has responded favourably to anti-tuberculous therapy.

Adult↗
PubMedDate not supplied

Cervical teratoma in Nigeria children.

Cervical teratomas are uncommon tumours. Over an eight-year period, four cases of cervical teratomas were seen in children at the University Teaching Hospital, Ile-Ife, Nigeria. The children ranged in age from two weeks to nine years. In two patients the tumours were noticed at birth but in only one was it symptomatic to be the cause of hospitalization at the age of two weeks. The other two had the tumours for three and six years respectively and presented because of cosmetic embarrassment. All the tumours were easily resected at surgery and two showed an anatomical relationship to the thyroid gland. The post-operative course was uneventful in the four patients. The histopathology of the tumours have shown tissues from the three germ layers with neurological elements predominating in two and thyroid tissue present in the other two. Over a follow-up period varying from one to four years none of the children have demonstrated any abnormality of thyroid functions.

Child↗
PubMedDate not supplied

Acute intestinal obstruction in Nigerian children.

Over a 7 year period, intestinal obstruction accounted for 41.7 per cent of abdominal emergencies and 1.03 per cent of all paediatric admissions at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Nigeria. Of the total 76 cases of acute intestinal obstruction, intussuception was seen in 34 (44.7%), peritoneal adhesions in 17 (22.4%), obstructed hernia in 14 (18.4%), roundworm impaction in 4 (5.3%), volvulus in 3 (4.0%) while faecal impaction and mesenteric cysts were encountered in 2 children each (2.6%). Generally the patients presented late to the hospital and this accounted for the high post-operative morbidity and prolonged hospital stay. Wound infection occurred in 21.1 per cent of patients and formed the commonest post-operative complication. The overall mortality was 21.1 per cent.

Acute Disease↗