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Biomedical subjects

O Osinowo

Publications and source records attributed to O Osinowo.

At least 19 recordsLinked to original sources
PubMed2002

Trans-oral irrigation for the management of cervical esophagogastric anastomotic leak.

Over a period of 8 years, 15 of the 65 patients who had transhiatal esophagectomy (THE) for esophageal diseases and cervical esophagogastrostomy had cervical oesophagogastric anastomotic leak. Seven of the 18 patients (38.9%) with corrosive esophageal strictures (CES) due to acid burns had anastomotic leaks while 2 out of 6 patients (33.3%) and 6 out of 41 patients (14.6%) were the incidences of anastomotic leaks among alkali burnt and carcinoma of the esophagus. Anastomotic leaks were more commonly associated with surgery for CES. They were managed by trans-oral irrigation with water after ingestion of either soft/solid diet or high protein, high carbohydrate fluid diet along with adequate jejunostomy feeding. The age of the patients ranged between 5 to 65 years (mean 38.8 +/- 15.7 year). Anastomotic leaks were diagnosed between 3rd to 10th postoperative day (mean 7.1 +/- 2.6 day). The period of transoral irrigation before closure of leakage ranged from 2 to 14 days (mean 6.1 +/- 2.9). In 12 patients (80%) anastomotic leakage closed within 5 days, (mean 3.9 +/- 1.0). Two weeks after closure, all the patients had bouginage and every two weeks for another 3 dilation. Four of the 15 patients needed repeated two monthly dilation for 8 to 12 months. There were no other complications nor mortality in this study. There was psychological acceptance of this minimally invasive procedure.

Adolescent↗
PubMed2002

Gunshot injuries in adults in the Abha region of Saudi Arabia.

In the four-year period from 1996 to 1999, 42 adult patients (age 12 years and above) were admitted to the Assir Central Hospital, Abha, Saudi Arabia, following gunshot injuries. The mean annual admissions for gunshot injuries was 10.5 +/- 4.04 (range = 8-16 cases/annum). All the patients were males. The distribution of the patients' nationalities were: Saudis 66.7%, Yemenis 11.9%, Ethiopians 11.9%, Eritreans 7.1% and Sudanis 2.4%. In 38 cases, others shot the patient, while only one patient (2.4%) admitted to shooting himself accidentally. A pistol was used in 81% of cases while an air gun was used in 9.5% of the cases. Wound of entry analysis showed that gunshots were to the lower limbs in 20 cases (47.2%), the upper limbs in 22% and the chest in 13% of cases. Gunshots to the head and neck occurred in 7% and 2% of cases, respectively, while the abdomen was hit in 4% of cases. The injuries sustained included: superficial wounds (64.3%), haemothorax (9.5%), nerve injury (9.5%), lower limb fractures (9.5%), haematoma (7.1%), liver and kidney injuries (2.4%, respectively). Management included wound debridement and suturing (76.2%), thoracostomy tube drainage (14.3%), bullet removal (11.9%), internal fixation of fractures of long bones (9.5%), laparotomy and repair of gut (7.1%), nerve repair (4.8%), ulnar nerve graft (2.4%), and external fixation compound fracture of the tibia (2.4%). All the patients survived. The mean hospital stay was 15.45 +/- 23.06 days (range = 1-150 days). Although gunshot injuries are increasingly being reported from Saudi Arabia, the injuries are accidental and the morbidity appears to be low.

Accidents↗
PubMed2000

Carcinoid tumourlets associated with diffuse bronchiectasis and intralobar sequestration.

Innumerable carcinoid tumourlets may develop within pulmonary lobes should there be scarring from intralobar sequestration; these tumourlets may, in turn, be the cause of chronic lung disease. This report documents the incidental detection of multifocal carcinoid tumourlets in the lung of a 65-year-old man who had repeated episodes of lung infection, progressive dyspnea and haemoptysis; he lived at high altitude. The left lower lobe of the lung was resected surgically, during which procedure an aberrant systemic arterial supply was noticed. The patient had diffuse bronchiectasis and intralobar sequestration. The latter implies the development of abnormal lung tissue located within lobar tissue--but which does not communicate with the bronchial tree; it is supplied with arterial blood from a branch of the aorta--arising either above or below the diaphragm. There was loss of demarcation between the sequestered lung and the surrounding lower lobe lung parenchyma. The proliferation of pulmonary neuroendocrine cells in the form of tumourlets, had probably occurred as an adaptive response to the chronic hypoxia experienced. The combination of intralobar sequestration, bronchiectasis and carcinoid tumourlets, although uncommon, may arise when intralobar sequestration of the lung has not been resected at an incipient stage.

Aged↗
PubMed1996

Closed chest drainage without an underwater seal.

Six hundred and eighty-five patients requiring pleural drainage were referred to and managed by the Cardiothoracic Unit of the University College Hospital, Ibadan between June 1985 and September 1992. Two hundred patients, in which Aldon's urobag (e.g. Simpla S4 type) was used for pleural drainage were studied. The indications for pleural drainage were pyothorax or pyopneumothorax (106 patients), malignant pleural effusion (53 patients), tuberculous effusions (23 patients) and chest trauma (18 patients). In seven of these patients, the Aldon's urobag was used for out-patient care pleural drainage. Some of the reasons for discontinuing its use were major tracheobronchial injuries (2 patients), clotted haemothorax (5 patients), chronic empyema thoracis (10 patients) and loculated malignant pleural effusions. The few easily surmountable complications encountered were obstruction of the tube by blood clot and fibrinous coagulate, stoma necrosis and periosteal reaction. The advantages observed from the use of Aldon's urobag for pleural drainage were reduction in cost of pleural drainage, availability of this drainage system and its use for out-patient care when indicated.

Drainage↗
PubMed1989

Spontaneous pneumothorax in adult Nigerians.

A 6-year study was carried out in our hospital practice to determine the prevalence of spontaneous pneumothorax. Thirty patients with 32 episodes of pneumothorax were diagnosed. Tuberculosis was encountered in 9(30%) patients while no specific cause was found in 12(40%) patients. This study indicates that spontaneous pneumothorax is uncommon in the Nigerian, while the tuberculosis aetiology may be a pointer to the overall high prevalence of the disease in the community.

Adolescent↗
PubMed1989

Surgical treatment of persistent ductus arteriosus at the University College Hospital, Ibadan.

Seventy-seven patients aged from 5 days to 30 years underwent surgical correction of persistent ductus arteriosus (PDA) between July 1975 and December 1985. Forty-seven percent presented before 5 years of age while 20% were aged above 15 years. The male:female ratio was 1:2. Additional cardiovascular anomaly was present in 14 patients, 8 of which were ventricular septal defect. Majority presented with congestive heart failure and or failure to thrive. Surgical closure was effected by ligation in 67 cases, division and suture in 5 and unspecified in 5 cases. Operative mortality was 2(2.1%) cases. Complications with superficial wound infections occurred in a minority of patients. We conclude that despite a large left to right shunt in most patients, attested to by their symptomatic status, and late presentation surgical closure can be accomplished with minimal morbidity and mortality in centres with limited facilities.

Adolescent↗
PubMed1988

Post-operative wound infection in thoracic patients: a preliminary report.

A retrospective study of 37 patients undergoing pulmonary resection, between 1975 and 1980, was performed to establish the incidence of wound infection and to determine contributory factors. Sixteen patients had suppurative lung disease while 11 had pulmonary tuberculosis. The majority of the patients received prophylactic antibiotic (Ampicillin and Cloxacillin) given intramuscularly or intravenously, prior to thoracotomy, and continued for several days post-operatively. Twenty of the 37 cases (54%) developed wound infection, defined as any purulent wound drainage in the post-operative period. The patients with infection (group A) did not differ from those without (group B) as regards presence of pyorrhoea or haemoptysis, the duration of operation or the quantity of blood infused during surgery. A significant difference in the duration of chest intubation was identified between group A (6 +/- 1.3 days) and group B (3 +/- 1.5 days) (P less than 0.001). The implication of the results towards the modification of post-operative management of patients is discussed.

Humans↗
PubMed1986

Pneumopericardium following blunt chest injury: report of three cases.

Three cases of pneumopericardium following blunt chest injury are presented. All three patients were victims of road traffic accidents and were managed at the University College Hospital, Ibadan, Nigeria. One of the patients had a tension pneumopericardium, which was relieved by pericardiocentesis. The other two patients had only small amounts of pericardial air, which was absorbed after about 1 week. All three patients had multiple chest and associated injuries. The suspected mechanism of the pneumopericardium in the three patients is pleuropericardial rupture in the presence of an intrathoracic air leak. This is the first report of pneumopericardium following blunt injury of the chest in Nigeria. Only 16 previous cases have been reported in the world literature.

Adult↗
PubMed1986

Osteomyelitis of the ribs in Ibadan.

Sixteen patients with pyogenic osteomyelitis of the ribs are reported; ages ranged from 3 months to 42 years and 10 were female. Right sided ribs were affected in 10 cases and single ribs in 12. Antecedent causes included empyema thoracis (56%) and blunt chest trauma (19%). Fourteen out of 16 patients presented with discharging chest wall sinuses and five patients had associated swellings on the chest wall. The duration of symptoms ranged from two to 36 months. The most common microorganism isolated was Staphylococcus aureus (50%). Rib excision (with drainage of the empyema in two cases) was curative in all 16 cases in this study.

Adult↗
PubMed1985

The use of glycerol-preserved homologous dura mater grafts in cardiac surgery: the Southampton experience.

Dura mater obtained from human cadavers and preserved in glycerol was used as patch grafts in various positions in the repair of acquired and congenital cardiac defects in 107 patients over a four-year period. The ages of the recipients ranged from 2 days to 75 years. The mean duration of preservation of the dura mater before use was 25.2 +/- 8.1 weeks. The dural grafts were used as an aortic root gusset in 38 patients (35.5%) undergoing aortic valve replacement, for enlargement of the pulmonary artery or right ventricular outflow tract or both in 38 patients (35.5%), and for repair of coarctation of the aorta in 10 patients (9.4%). The grafts also were used for closure of atrial septal defects, for a variety of other congenital cardiac anomalies, and for replacement of segments of the aorta (2 patients). There were no complications attributable to the use of dura mater. Dura mater preserved in glycerol would seem to be a suitable material for repair of various cardiac defects because of its strength, low antigenicity, athrombogenicity, ease of handling, availability in large sizes, and rapid bonding to host tissue. However, long-term follow-up is important to assess the lasting properties of dura mater.

Adolescent↗
PubMed1985

Aortic root enlargement with glycerol-preserved homologous dura mater patch during aortic valve replacement.

Aortic root enlargement with a patch is sometimes indicated either to prevent aortic homograft valve distortion during implantation or to facilitate easy, tension-free closure of the aortotomy. Patches made of prosthetic material have been widely used for this purpose. The use of autogenous pericardium has recently been reported. Although dura mater has been shown to have great strength, low antigenicity, athrombogenicity, easy availability in large sizes and rapid bonding to most tissues, its use for patch enlargement of the aortic root has not been previously documented. From 1979 to 1983, 38 patients had dura mater aortic root gussets placed during aortic valve replacement at the Southampton General Hospital. In all cases, the patches were placed to facilitate aortic closure, or to prevent homograft valve distortion by enlarging the non-coronary sinus. Aortic homografts were implanted in 11 patients, Carpentier Edwards' Xenograft valves in 16, Björk-Shiley valves in 8 and Wessex Xenografts in 3 patients. All the patients survived and in a mean follow-up of 30 +/- 12.8 months (range 3 to 48 months) there has been no clinical evidence of patch failure due to leakage, rupture or aneurysm formation. These results suggest that glycerol-preserved dura mater is a satisfactory patch material for aortic root enlargement during aortic valve replacement.

Adolescent↗
PubMed1984

Developmental anomalies of the lung in Nigerian children.

Five cases of developmental lung anomalies occurring in Nigerian children are reported; three were congenital lobar emphysema while two were scimitar syndromes. The radiological features demonstrated in each case effectively excluded the common causes of pulmonary disorders. Three patients were treated surgically with successful results in two. We believe that an increased awareness in our tropical setting would result in improved detection of these treatable but rare conditions.

Female↗
PubMed1983

Congenital broncho-oesophageal fistula in the adult.

The case of a 46-year-old man with congenital broncho-oesophageal fistula is presented. The patient had had recurrent chest infections since childhood and a recent history of heartburn and flatulence. A barium-swallow examination showed a small sliding hiatal hernia and an oesophageal diverticulum communicating via a fistula with the apical and posterior segmental bronchi of the left lower lobe. Bronchography showed bronchiectasis in this lobe. At thoracotomy resection of the broncho-oesophageal fistula and left lower lobectomy were performed. The patient's recovery was uneventful. Twenty published cases are reviewed. The classification of congenital broncho-oesophageal fistulae should take account not only of the type of fistula but also of the type and size of the bronchus with which the fistula communicates, the age of the patient at the first appearance of symptoms, and the duration of symptoms.

Bronchial Fistula↗
PubMed1982

Suppurative diseases of the lung and pleura: a continuing challenge in developing countries.

A retrospective study of 1,150 consecutive patients with thoracic and cardiovascular diseases seen at the University College Hospital, Ibadan, Nigeria, over a five-year period (January, 1975, to December, 1979) showed that 42% (481 patients) were treated for suppurative diseases of the lung and pleura, notably empyema thoracis, lung abscess, and bronchiectasis. Of these, 336 or 70% were treated for empyema thoracis, most of whom were less than 2 years old. Seventy-five patients (16%) had lung abscess, 53 of whom were treated medically with 8 deaths, while 22 had emergency resection for massive hemoptysis with 9 deaths. Of the 70 patients with bronchiectasis, 37 were treated medically with 2 deaths, while 33 were treated surgically with 5 deaths. These data demonstrate that infectious diseases of the lung and pleura remain the greatest challenge to the thoracic surgeons in tropical, developing countries who are often handicapped by inadequate facilities, lack of drugs, illiteracy, poverty, superstitious beliefs, and poor environmental hygiene.

Adolescent↗
PubMed1981

Purulent pericarditis: a continuing surgical challenge.

This report presents a prospective series of 12 patients with a diagnosis of purulent pericarditis who were treated between April 1978 and September 1979 by the cardiothoracic surgical unit at the University College Hospital, Ibadan, Nigeria. These patients were studied to determine the adequacy of a therapeutic protocol consisting of systemic antibiotics and pericardiostomy tube drainage. All patients were in the pediatric age group with an average age of 6¾ years. Bronchopneumonia was the antecedent focus of sepsis in eight patients, with pyomyositis in four (33 percent). Two patients expired prior to surgery.No mortality or significant morbidity occurred in the ten patients who underwent pericardiostomy.The results of this series combined with the initial experience reported in 1978 by the same authors confirm the described protocol as the treatment of choice in their environment.

Anti-Bacterial Agents↗