Browsing by Author "Adeniran, James O"
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Item Post operative intensive care admissions of paediatric surgical patients in a Nigerian tertiary hospital: indications and evaluation of management outcome.(Journal of the Societies of Anaesthetists of West and East Africa., 2008) Bolaji, Benjamin olusomi; Nasir, AA; Adeniran, James O; Abdur-Rahman, Lukman O; Oyedepo, Olubukola OlanrewajuA retrospective study of all paediatric surgical patients aged 15 years and below, admitted into the Intensive Care Unit (ICU) of the University of Ilorin Teaching Hospital (UITH) following surgery was carried out, covering a period of 10 years. Demographic information, surgical procedures performed, indications for intensive care admission and outcome were obtained. Sixty-seven general paediatric surgical patients were admitted with a male to female ratio of 1.4:1. There were 32 (47.8%) infants, 6(9%) pre-school children and 29(43.3%) older children. There were 57(85.1%) emergency procedures. Of the 40 patients who had documented indications for admission, 25(62.5%) had respiratory insufficiency. Twenty (29.9%) of the 67 admitted patients died. Out of 25 patients that required ventilation for respiratory insufficiency, only five (20.0%) were ventilated. Primary diagnosis, American Society of Anesthesiologists’ (ASA) physical status score, emergency surgery and type of procedure significantly affected outcome. Conclusion: Availability of appropriate paediatric ventilatory facilities and personnel may reduce mortality in our ICU.Item Stage correction of intermediate imperforate anus in males: preliminary results.(The Surgical Sciences Research Society, Zaria and Association of Surgeons of Nigeria, Zaria, Nigeria., 2004) Adeniran, James O; Abdul-Rahman, Lukman O; Bolaji, Benjamin olusomiBACKGROUND: This prospective study was designed to assess the safety, cost-effectiveness, and advantages of performing posterior saggital 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 saggital anorectoplasty 9PSARP) done in prone position. Tow-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 saggital 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 9 months and 1 year post-operatively. CONCLUSION: This preliminary study shows that it is feasible for males with intermediate imperforate anus to have safe posterior saggital 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.