Biomedical subjects

L I Okeke

Publications and source records attributed to L I Okeke.

11 recordsLinked to original sources

PubMed2006

Female urethral and bladder neck injury after rape: an appraisal of the surgical management.

The aim of this study was to discuss the surgical management of urethral and bladder neck injury after urethral coitus during rape. A 21-year-old lady presented with total urinary incontinence of 1-year duration after being raped. On examination, she had urethral laceration and a patulous urethra and bladder neck suggesting urethral coitus during the rape. Her introitus and vagina were however normal. She had repair of her urethral laceration and plication of her urethra and bladder neck via a vaginal approach. She regained her continence and voids without any residual urine. Urethral coitus is rare. Urethral coitus in the presence of a normal introitus and vagina is very rare. The urethral and bladder neck injury resulting from this can be satisfactorily corrected by urethral and bladder neck plication via a vaginal approach with the vaginal incisions positioned to forestall suture line apposition, which may lead to wound failure.

Adult↗

PubMed2003

Delayed primary realignment of posterior urethral rupture.

The treatment of acute posterior urethral rupture is controversial. Twelve patients who presented with acute posterior urethral rupture over a five-year period were treated by delayed primary realignment of the injury. The technique of this procedure and the outcome are the subject of this presentation. Eight patients had successful realignment without strictures. Two patients with strictures responded to simple dilatations with bougies and the other two had formal urethroplasty.

Acute Disease↗

PubMed1996

Experience with 5-fluoro-uracil and levamisole in the management of advanced rectal carcinoma.

Eleven cases of bulky rectal carcinoma occupying the whole of the pelvis are presented. We refer to this advanced rectal carcinoma as "frozen" pelvis. Management of these cases includes performing a divided stoma colostomy, intravenous administration of 5-fluoro-uracil, intraperitoneal instillation of 5-fluoro-uracil when ascites is present, intra-rectal perfusion with 5-fluoro-uracil, administration of levamisole, and radiotherapy. We think this regimen improves, to some extent, the quality of life and probably prolongs survival period, although disturbing tenesmus does not disappear completely. This will buttress the argument that abdomino-perineal resection is justified when possible, even if only as a palliative measure to prevent disturbing tenesmus.

Adjuvants, Immunologic↗

PubMed1993

Crush injuries of the hand.

A retrospective review of 58 patients presenting with crush injuries of the hand within the 6 year period April 1984 to March 1990 was undertaken. The male-female ratio was 3:1, with a mean age of 25.13 +/- 15.1 years. The peak incidence was in the 3rd decade of life. Machines (55.17%) were the commonest cause with the pepper grinder featuring most prominently. The dorsum (60.3%), little (55.1%) and ring (53.5%) fingers of the right hand were the most commonly involved. Most of the injuries were multiple. Management was mainly conservative and entailed initial limited debridement, thorough washing with soap and water under adequate anaesthesia, bulky boxing glove dressing, elevation, antibiotics and early hand physiotherapy with late reconstruction. Results were excellent in 13 (22.41%), good in 19 (32.76%) poor in 23 (39.66%) and unknown in 3 (5.17%) who were lost to follow-up. Our poor result is perhaps the warning signal that we should abandon our extreme conservative stance and be more aggressive in our attitude to these injuries.

Adolescent↗

PubMed1993

The retained urinary catheter.

Retention of urinary catheters is an increasing complication in our practice. We have reported 18 patients seen over a 6-month period during which 528 catheterizations were done, representing an incidence of 3.4%. Various forms of management were offered and blind percutaneous suprapubic puncture (BPSP) was found to be simple and effective. One out of 13 patients, however, undergoing BPSP developed transient haematuria. The high incidence of malfunctioning catheter balloon mechanisms may be due to poor quality equipment or lack of appropriate storage facilities.

Cystostomy↗

PubMed1992

Grinding machine injury of the hand: a preliminary report.

Case notes of 20 patients who presented with grinding machine injury to the hand from April 1984 to March 1990 were analysed for pattern of injury, method of management and outcome of treatment. Thirteen cases were seen in the last three years of this period (the SAP era) compared to seven cases in first three years of the period (the pre-SAP era). Children from low socio-economic class were the commonest victims. The right hand was commonly involved alone. Most injuries were multiple but the skin of the dorsum of the hand and ring finger were most commonly injured. Associated fractures of the metacarpals, carpals, joint dislocations in the hand and injuries to other parts of the body were uncommon. Thorough washing of the wound with soap and water, careful, limited initial debridement, elevation of the hand, antibiotics, antitetanus prophylaxis and early intensive hand physiotherapy yielded good to excellent results in seventeen patients. Eventhough the viability of the crushed skin on the dorsum of the hand may be questionable at initial presentation most of it will 'take' and we advocate that as much of this skin as is possible should be spared.

Adolescent↗

PubMedDate not supplied

Experience with caudal block regional anesthesia for transurethral resection of the prostate gland.

Ninety five consecutive patients with obstructing prostatic enlargement requiring surgery underwent caudal anesthesia for transurethral resection of the prostate gland (TURP). Their mean age was 73 +/- 7.8 years, the mean preoperative volume of the prostate gland was 160cc and the mean resection time was 97.3 +/- 30 minutes. The anesthesia was satisfactory with a mean pain score of 0.3 +/- 0.6 on the 0-10 pain rating scale. No complication of the anesthetic procedure occurred. Ten patients were discharged free of catheter on the same day while all the remaining 85 patients were discharged within 48 hours of surgery. It is concluded that caudal anesthesia with 2% xylocaine with 1 in 80,000 adrenaline gives adequate anesthesia for transurethral resection of the prostate gland.

Aged↗

PubMedDate not supplied

Soap induced urethral pain in boys.

OBJECTIVE: To describe the cause, possible pathogenesis and management of "idiopathic" urethral pain in boys. PATIENTS AND METHOD: Eighteen boys presenting with distal urethral pains over a period of 12 years were reviewed and their responses to the application of bland petroleum jelly to the external urethral meatus before each soap bath was noted. RESULTS: The symptoms started suddenly while bathing with soap. Penile erections at onset occurred in 14 (78%). Two (11%) had purulent urethral discharge and 1 (5.5%) had meatal stenosis. Application of bland petroleum jelly to the external urethral meatus before each soap bath satisfactorily controlled the urethral pains. CONCLUSION: "Idiopathic urethral pain in boys" may be due to soap induced chemical urethritis and responds well to application of bland petroleum jelly to the external urethral meatus before each soap bath with appropriate antibiotics when there is associated purulent urethral discharge.

Baths↗

PubMedDate not supplied

Day case transurethral prostatectomy in Nigeria.

BACKGROUND: Caudal block regional anaesthesia has been used over the years for out-patient procedures, and in transurethral resection of the prostate gland in Nigeria since 1995. In a preliminary study involving 10 selected patients undergoing TURP, spontaneous voiding resumed on the operative day, and their discharge on the same day did not in any way lead to any adverse events. This larger series further confirms the safety of transurethral resection of the prostate gland as a day case procedure. METHOD: One hundred and eighty patients with obstructing benign prostatic enlargement on urethral catheter drainage with prostate glands weighing 60g or less on ultrasound assessment, were subjected to transurethral resection of the prostate gland (TURP) as day-cases under caudal block regional anesthesia using 2% xylocaine with 1 in 80,000 adrenaline. Hemostasis was secured until effluent of the irrigation fluid from the bladder was totally free of any visible trace of blood. A catheter was not inserted postoperatively. The patients were discharged on the same day after they had satisfactorily voided. RESULTS: These patients resumed spontaneous voiding postoperatively before discharge on the operative day. Their discharge on the same day did not in any way lead to any adverse events. CONCLUSIONS: With a better understanding of the anatomy of the innervations and blood supply of the prostate gland, and proper patient selection, this larger series has confirmed that day-case TURP without postoperative catheterization can now be safely added to the list of day case procedures.

Aged↗

PubMedDate not supplied

Surgery of toxic goitre in non-euthyroid patients: a preliminary report.

In recent years, the cost of medical care has skyrocketed and since medical treatment is not free, some drugs are now beyond the reach of some patients. One of such drugs is the antithyroid drug, carbimazole, which has been priced beyond the reach of our thyrotoxic patients. We have therefore been forced to operate on these patients whenever they present, even while thyrotoxic. The principle of our management is to anticipate the development of thyroid crises and to prevent its occurrence post-operatively by using saturated solution of potassium iodide (SSKI) or Lugol's iodine, propranolol, diazepam, and hydrocortisone. This is a preliminary report of the first twelve consecutive patients so treated.

Adult↗

PubMedDate not supplied

Fournier's gangrene in Ibadan.

Twenty six patients with Fourniers gangrene seen over an 8 year period at the University College Hospital Ibadan are presented. Their ages ranged from 34 years to 70 years with a mean of 52.5 years. Possible predisposing conditions were present in 17 (65%) patients. The anterior scrotal skin alone was most commonly involved. They were treated with systemic antibiotics, wound debridement and sitz baths. While the wound healed spontaneously on this regimen in 6 (23%) patients, 19 (73%) patients required suture closure of their clean granulating wounds. None required rotational skin flap scrotoplasty and no deaths occured. It is stressed that because of the independent arterial supply and venous drainage of the testes, even when the entire scrotum has sloughed, orchidectomy should never be considered a management option.

Adult↗