http://hdl.handle.net/123456789/8868 SMS 2026-03-12T04:53:50Z http://hdl.handle.net/123456789/10156 Wound dressing where there is limitation of choice Rahman, G. A.; Adigun, I. A.; Yusuf, I. F.; Ofoegbu, C. K. P. Background Many sophisticated dressings are available to the wound care practitioner in the developed countries. These materials are made from a wide range of products like polyurethane, salts of alginic acid and other gelable polysaccharides. The situation is different in the developing countries where what is commonly available to wound care provider are traditional agents such as sodium hypochlorite, hydrogen-peroxide, cetrimide solution, chlorhexidine and others. The aim of this study is to reappraise the problem of limitation of wound dressing selection in the developing countries and to sensitize the wound care practitioner on the use of the commonly available products based on the needs of a different wound or even the same wound throughout its healing course. Patients and methods Patients attending the General Outpatient Department (GOPD) of our hospital for wound dressing were used for the study. Five surgeons who are familiar with wound care management visited the dressing unit of the GOPD daily for one week in October 2005. A proforma was designed where information on each of the patient was recorded. Results Fifty-three patients attended the dressing unit of our GOPD during the study period. Twenty-six patients (49.1%) had their wounds dressed with hypochlorite solution (Eusol), seventeen patients (32.1%) had their wounds dressed with honey and two patients, wound were being dressed with hydrogen peroxide. Conclusion While we are still awaiting the availability of the newer products in the developing countries, we should make use of the traditional products that are readily available to us according to the need of a particular wound, by this, our choice of wound dressing will not be arbitrary, ineffective and wasteful both in terms of time and physical resources. 2006-01-01T00:00:00Z http://hdl.handle.net/123456789/10155 Vesicovaginal Fistula:AReview of Nigerian Experience Ijaiya, M. A.; Rahman, A. G.; Aboyeji, A. P.; Olatinwo, A. W. O.; Esuga, S. A.; Ogah, O. K.; Raji, H. O.; Adebara, I. O.; Akintobi, A. O.; Adeniran, A. S.; Adewole, A. A. A. BACKGROUND: Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. OBJECTIVE: To review the causes, complications, and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline), WHO website, Biolin, International, African Journal on Line, Google scholar, Yahoo, Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1%– 100% of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%–96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty, illiteracy, ignorance, restriction of women’s movement, non-permission from husband, and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%– 91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern. WAJM 2010; 29(5): 293–298. 2010-01-01T00:00:00Z http://hdl.handle.net/123456789/10154 Typhoid ileal perforation in Nigerian children: an analysis of 106 operative cases Rahman, G. A.; Abubakar, A. M.; Johnson, A-W.B.R.; Adeniran, J. O. Typhoid ileal perforation ¬TP) is a major problem in developing countries and carries a high mortality. The purpose of this retrospective study from Nigeria was to review the outcome in children less than 15 years of age who underwent surgery for TP from 1984 to 1999. Demographic data, clinical features, results of investigations, Findings at surgery, postoperative course, and complications were recorded. There were 55 boys and 51 girls. The median age at presentation was 10 years range 3±14). The surgically confirmed perforation rate was 11.0%. The clinical features in children older than 5 years were similar to already documented patterns in the literature. In children less than 5 years old the predominant symptoms were fever and vomiting only. Therefore, in the very young a high index of suspicion is required to avoid delay in diagnosis. Ninety eight patients ¬92.5%) had simple double-layer closure of the perforation. The mean hospital stay among survivors was 23.6 18.8 days. The commonest postoperative complications were wound infection and enterocutaneous fistula. The overall mortality was 23.8%, increasing to 50% in children aged less than 5 years, although the difference was not statistically significant ¬P > 0.05). To improve survival in TP, attention should be focused on perioperative resuscitation and early intervention. The provision of potable water, adequate sanitation, and active immunisation are means to eradicate the disease. 2001-01-01T00:00:00Z http://hdl.handle.net/123456789/10153 Traumatic Shoulder Girdle Injury: Relation to the Mechanism of Trauma, and the Age and Sex of Patients Abdulkadir, Adekunle Yisau; Rahman, Ganiyu A; Adesiyun, Olusola A.M.; Akande, Halimat J.; Babalola, Olasunkanmi M. Fractures and dislocations are common manifestations of shoulder girdle injuries (SGI) and are routinely diagnosed using radiography. SGI were investigated in relation to age and sex, and trauma. Furthermore, the number of diagnostic errors arising from evaluating SGI without the use of imaging tools was investigated. Two consultant radiologists retrospectively analyzed 572 shoulder radiographs from 293 patients for evidence of fractures and dislocations. The age and sex of patients, radiographic indications, etiology, clinical diagnoses, and cadres of the requesting physicians and the reporting radiologist were also recorded. Eighty-seven shoulder fractures were diagnosed and 44.4% were accounted for by road traffic injuries (RTI). Scapular fractures occurred predominantly in males aged 20-39 years (P = 0.031) after high-energy trauma, and the majority were associated with other shoulder girdle and extra-shoulder fractures. Falls and RTI accounted for 50% and 61.5% of fractures in patients less than 20 years of age and aged between 20-39 years, respectively (P=0.001). Clinical evaluation of SGI without using imaging tools resulted in 52 of 72 patients (72.2%) being diagnosed incorrectly. Falls are a common cause of SGI in females aged less than 10 years, and scapular fractures are more common than previously thought. This study demonstrates that radiography is invaluable for the evaluation and diagnosis of SGI 2011-01-01T00:00:00Z