Browsing by Author "Nasir, A.A"

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    Analysis of presentations and outcomes of care of children with disorders of sexual development in a Nigerian Hospital
    (Elsevier Inc, 2019) Nasir, A.A; Abdur-Rahaman, L.O; Omotayo, O.A; Bamigbola, K.I; Adegboye, M.B; Raji, H.O; Adesiyun, A.M; Adeniran, J.O
    Study Objective: To describe the presentation, diagnosis, management, and short-term outcome of children with disorders of sexual development (DSD) in the context of multidisciplinary team care. Design: Prospective descriptive study. Setting: University Teaching Hospital. Participants: All children who presented with genital ambiguity. Interventions and Main Outcome Measures: Records of all patients diagnosed and managed for DSD between January 2011 and December 2016 were reviewed. The care pathway included clinical, laboratory, internal genitalia evaluation, and panel (including parents) meeting. Results: Fifteen children presented with DSD at a median age of 20 months. Only 5/15 (33.3%) presented in the neonatal period. Ten of fifteen patients (66.7%) presented with genital ambiguity. Ovotesticular DSD was the most common diagnosis (9/15; 60%). Seven of the patients were genetically female (46, XX), 1 was genetically male (46, XY) and 1 without genetic diagnosis. Six patients were assigned male gender and they underwent male genitoplasty. Five of them had excision of M€ullerian structures with gonadectomy. Three of fifteen patients (20%) were diagnosed as 46, XX DSD, at a median age of 7 years. All of them were due to congenital adrenal hyperplasia and underwent female genitoplasty. Two patients were diagnosed as XY, DSD. They were both raised as female at presentation and were reassigned male sex. Both had urethroplasty done. Four patients had postoperative urethrocutaneous fistula and 1 had partial wound dehiscence. The median follow-up period was 21 months (interquartile range, 2-26 months). Conclusion: The frequency of ovotesticular DSD is high in our setting. The decision of sex assignment was finally made at a median age of 7.5 months in most of our patients with satisfactory short-term surgical outcome.
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    First successfully separated set of thoracic-omphalopagus twins in Ilorin, Nigeria
    (Faculty of Clinical Sciences, College of Medicine, University of Lagos., 2023) Abdur-Rahman, L.O; Raji, T.K; Lawal, A.O; Nasir, A.A; Adesiyun, O.A; Abdulkadir, M.B; Sayomi, O; Ayinmode, I; Oyinloye, O.; Bolaji, B.O; Adegboye, K.A; Adegboye, M.B.; Adeoye, P.O; Oyedepo, O.O; Olafimihan, B.M; Olatunbosun, L.O; Shittu, A; Arinpe, S.F; Deborah, A; Rufai, Z
    The birth of babies sharing body part(s) and surviving independently is indeed a scientific marvel. Conjoined twinning is a rare phenomenon with various presentations, having an estimated incidence of 1 per 200,000 live births. The successes recorded by experts in developed countries in the separation of conjoined twins in recent times, especially among those with complex unions are indeed fascinating. The management of conjoined twins presents a great challenge to medical and surgical teams in tropical African countries such as ours where we are faced with challenges of limited resources and facilities, even amidst the presence of well‑trained experts. The incidence of conjoined twins is difficult to report in our practice because of failures that accompanied previous cases that were managed and not reported. This is the first successful separation after two previous failed attempts at our center. We report a case of successful surgical separation of thoraco‑omphalopagus conjoined twins who were undiagnosed prenatally and delivered by emergency cesarean section following prolonged labor by a primiparous woman. Babies were joined from the lower chest and the upper abdomen and they shared a single umbilicus and omphalocele sac. No internal viscus was shared apart from the torso wall. They were cared for from 12 h of live until 127 days of live when they were successfully separated by a team of medical and surgical experts. This is a report of a successful separation of conjoined twins at the University of Ilorin Teaching Hospital in North Central Nigeria. Careful interdisciplinary conduct of expert activities will ensure the survival of rare congenital malformations such as conjoined twinning even in underdeveloped climes