D O Akinola

Obafemi Awolowo University Teaching Hospital, Eshogbo, Osun, Nigeria

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Publications (19)6.4 Total impact

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    ABSTRACT: Background:Different complications may occur at laparoscopic port sites. The incidence of these varies with the size of the ports and the types of procedure performed through them.Objectives:The aim was to observe the rate and types of complications attending laparoscopic port wounds and to identify risk factors for their occurrence.Patients and Methods:This is a prospective descriptive study of all patients who had laparoscopic operations in one general surgery unit of a University Teaching Hospital in Nigeria between January 2009 and December 2012.Results:A total of 236 (155 female and 81 male) patients were included. The laparoscopic procedures include 63 cholecystectomies, 49 appendectomies, 62 diagnostic, biopsy and staging procedures, 22 adhesiolyses, six colonic surgeries, eight hernia repairs and 22 others. Port site complications occurred in 18 (2.8%) ports on 16 (6.8%) patients including port site infections in 12 (5.1%) and hypertrophic scars in 4 (1.7%) patients, while one patient each had port site bleeding and port site metastasis. Nine of 11 infections were superficial, while eight involved the umbilical port wound.Conclusion:Port site complications are few following laparoscopic surgeries in our setting. We advocate increased adoption of laparoscopic surgeries in Nigeria to reduce wound complications that commonly follow conventional open surgeries.
    No preview · Article · Jul 2014
  • AO Adisa · O O Lawal · OA Arowolo · D O Akinola
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    ABSTRACT: Laparoscopic cholecystectomy is not yet routinely performed in most public tertiary hospitals in Nigeria. To assess the feasibility and early outcoe of laparoscopic cholecystectoy in Ile-ife, Nigeria. Consecutive patients who were selected for the procedure from June 2009 through December 2010 at the Ife State Hospital of the ObafemiAwolowo University Teaching Hospitals Complex, Ile-Ife were prospectively studied. Eighteen female (75%) and six male patients had laparoscopic cholecystectomy within the study period. They were aged 19-83 years with a mean age of 33.4 years. Six (25%) patients had acute calculous cholecystitis while the rest presented with chronic calculous cholecystitis. Their Body Mass Indices ranged from 21 to 32kg/m2. Operation time ranged from 65 to 105 minutes. One procedure (4%) was converted to open due to bleeding from the gallbladder bed. Another patient who had a minor common bile duct injury presented with generalized dull abdominal pain on the sixth postoperative day. She had open repair of the injury over a T-tube. Three patients (12.5%) were discharged on the first postoperative day while 15 (62.5%) others were discharged on the second postoperative day. No mortality was recorded. Laparoscopic cholecystectomy is feasible in our setting with outcome comparable to previous pioneering experiences in other African countries centre in spite of resource limitations.
    No preview · Article · Sep 2011 · African journal of medicine and medical sciences
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    ABSTRACT: Injection sclerotherapy has a prominent role in the treatment of bleeding hemorrhoids. The commonly used sclerosants are not available or very expensive in Nigeria. We prospectively evaluated 50% dextrose water, used as a nonallergenic sclerosant, in the treatment of bleeding internal hemorrhoids. Forty consenting adult patients (median age 50 years [range 35-67]; 22 women) with bleeding hemorrhoids, seen over a 2-year period, were offered injection sclerotherapy with 50% dextrose water. They were assessed for response, tolerance and complications. The duration of symptoms before presentation was 3 months to 15 years. The bleeding stopped after the injection in all patients. No patient needed a repeat procedure. No complication was recorded during follow up which ranged from 2 months to 12 months. We conclude that endoscopic hemorrhoidal sclerotherapy using 50% dextrose water offers a simple, safe and effective modality of treatment if properly utilized.
    Full-text · Article · Jan 2009 · Indian Journal of Gastroenterology

  • No preview · Article · Jun 2008
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    ABSTRACT: Delayed graft function (DGF), a term employed when a newly transplanted organ does not function efficiently is commonly observed following cadaveric renal transplantation but is very rare after living related transplants. We present a 31-year-old female recipient of a related donor kidney (mother) who had DGF following trans-plantation due to acute tubular necrosis, probably caused by partial allograft arterial thrombosis, which recovered function after 60 days. Appropriate use of allograft biopsy should be encouraged even in resource-limited settings lest the allograft be assumed to have failed irreversibly.
    No preview · Article · Feb 2008 · Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
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    ABSTRACT: Diagnosis of upper gastrointestinal (UGI) diseases is often made on clinical grounds alone in Nigeria due to lack of endoscopic facilities. The validity of using such diagnosis is presently unknown. The study aimed to determine: age and sex distribution of patients presenting for UGI endoscopy; pattern of clinical and endoscopic diagnoses in patients with UGI diseases; and, the validity of clinic-based diagnosis. Medical records of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria for UGI endoscopy between September 1999 and August 2003 were reviewed. Data was analysed for sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis using endoscopic diagnosis as "gold" standard. Males constituted 53.4% of subjects and mean age was 45 years (+/- 1.69 SD). Peptic ulcer disease (PUD) constituted 67.6% of referral diagnosis but 33.9% of endoscopic diagnosis. PUD had the highest sensitivity value (0.72) while gastritis had the least (0.04). Specificity ranged from 0.40 for PUD to 1.00 for corrosive oesophagitis. Positive predictive value ranged from 0.29 (oesophageal cancer) to 0.67 (corrosive oesophagitis) and negative predictive value ranged from 0.66 for gastritis to 0.99 for corrosive oesophagitis. The validity of clinical diagnosis in UGI conditions varied widely, and in general, there is poor agreement between clinical and endoscopic diagnoses.
    Full-text · Article · Jul 2006 · African health sciences
  • E A Agbakwuru · C M Asaleye · A B Ogunrombi · D O Akinola
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    ABSTRACT: Pancreatic pseudocyst is a major health problem in the developed countries and its incidence is noted to be getting higher among the Caucasians as a result of better diagnostic techniques. This retrospective study was done to review the cases of pancreatic pseudocyst seen between 1991 and 1999 at the Obafemi Awolowo University Teaching Hospitals, Ile-Ife, Nigeria. The 5 cases seen over this period of study were used to illustrate its rarity. The case notes of the patients managed for pancreatic pseudocyst during the period under review were studied and analysed to evaluate the different modes of presentation, investigations done and the modes of treatment. The age range of the patients varied between 23 and 70 years with three of them being male while two were female. The most common presenting symptom and sign were abdominal pain and abdominal mass. Abdominal ultrasonography, chest X-ray, upper gastrointestinal endoscopy and laboratory blood tests were the investigative procedures carried out. The treatment modalities were either conservative or surgical (operative). One patient had spontaneous resolution of the pseudocyst, 2 had external drainage while the remaining 2 had cystogastrostomy. Two of the patients responded well to treatment and were being followed up in the Surgical Out Patient Clinic, one died within 24 hours of surgery while the other developed diabetes mellitus 3 months post surgery and was referred to the physicians for follow-up. Though pancreatic pseudocyst remains uncommon in Nigeria, ultrasonography can play an essential role in assisting diagnosis while successful management of this condition is still possible in the absence of current endoscopic techniques of drainage.
    No preview · Article · Jan 2005 · Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria
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    H S Aghanwa · A Akinsola · D O Akinola · R O A Makanjuola
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    ABSTRACT: The Renal Unit of Obafemi Awolowo University Teaching Hospital Ile-Ife in Southwest Nigeria intends commencing a kidney transplantation program. This cross-sectional study aimed at examining the willingness of Nigerians to be living-related kidney donors. Three hundred and sixteen Nigerians (96 first-degree relatives of end-stage renal disease patients, 69 rural dwellers and 151 health workers) were interviewed regarding their willingness to donate kidneys using an interview schedule designed to elicit socio-demographic information, knowledge about kidney transplantation and attitude toward kidney donation. Sixty-two percent of health workers, 52.1% of the patients' relatives and 27.1% of rural dwellers expressed willingness to donate. Higher proportions of health workers and patients' relatives--compared with the rural dwellers--were willing to donate a kidney to their children, full-siblings and parents (P<0.05). The level of awareness about kidney transplantation was highest among health workers and least among rural dwellers (P<0.001). Altruism was the primary motivation for those willing to donate a kidney. The most important reason for refusal to donate was fear of adverse health consequences. Among the rural dwellers, never-married persons were more willing than the married to donate (P<0.05). Programs aimed at increasing awareness about the safety of kidney donation, reducing adverse beliefs about kidney donation, and encouraging altruistic tendencies will increase the availability of kidney donors.
    Preview · Article · Aug 2003 · Journal of the National Medical Association
  • D A Ndububa · G E Erhabor · D O Akinola
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    ABSTRACT: Sixty-eight proved cases of typhoid and paratyphoid fever were reviewed in a retrospective study covering 5 years (1986-1990). Patients within the age range of 10 to 39 years constituted 82.3 per cent of cases and there was equal incidence in both sexes. The mean duration of illness before presentation was 9.67 days. The major clinical features were fever (97%), abdominal tenderness (-9.4%), headache and abdominal pain (70.58%) each). Intestinal perforation was the commonest complication (27.9%) with a male preponderance (M:F-3:1). Perforation occurred after the first week of illness in 73.7 per cent of cases. Fourteen out of the nineteen patients who perforated were not on therapy at the time of perforation and they constituted 80 per cent of those cases of mortality in which perforation played a role. Surgical management of perforation gave better results than conservative management (mortality rates of 16.7% and 40% respectively). Salmonella was sensitive to Chloramphenicol in all the cases where the organism was grown. There were 10 recorded deaths (14.9%) of whom 60 per cent (i. e. 6 patients) presented after two weeks of illness.
    No preview · Article · Apr 1992 · Tropical gastroenterology: official journal of the Digestive Diseases Foundation
  • D O Akinola · EA Agbakwuru
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    ABSTRACT: Complete rectal prolapse is uncommon in adults. Out of 129,525 patients treated at our teaching hospital over a five-year period, only 29 patients were managed with complete rectal prolapse. The total mean-age was 52 years with an approximate 1:2 male-female ratio. Two of the patients had their prolapse for 16 years before presentation. Major clinical features included constipation, diarrhoea, soiling and rectal bleeding. 51.72% of the cases had partial to complete incontinence of faeces. 22 patients were treated with the simple technique posterior fixation of both rectum and sigmoid colon. Follow-up was from 6 months to 4 years, mortality was 3.44%. There had been no recurrences of the complete rectal prolapse to date.
    No preview · Article · Nov 1991 · East African medical journal
  • O Adejuyigbe · O O Lawal · D O Akinola · S O Nwosu
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    ABSTRACT: Omental and mesenteric cysts are rare intra-abdominal lesions which may be congenital, traumatic, neoplastic or infectious in origin. They give rise to non-specific clinical features and may be a cause of the surgical acute abdomen, especially in children. Correct preoperative diagnosis is infrequent but a high index of suspicion and use of ultrasonography when available would improve clinical diagnosis. Six omental and mesenteric cysts encountered in five children over a 10-year period (1978-87) are reported. All the cysts were congenital. Three patients presented with non-specific symptoms and two presented with acute abdomen. Correct preoperative diagnosis was made in two patients. All five patients had surgery. Two had enucleation of the cysts, two had excision of the cysts with adjacent bowel segment and one patient with two cysts had partial excision of the wall of the cysts with free internal drainage into the peritoneal cavity. All patients survived.
    No preview · Article · Jul 1990 · Journal of the Royal College of Surgeons of Edinburgh
  • E O Fashakin · D O Akinola · W O Odesanmi

    No preview · Article · Dec 1989 · The Central African journal of medicine
  • D O Akinola · O Adejuyigbe · W O Odesanmi
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    ABSTRACT: Tubercolous mastitis is an uncommon lesion even in countries where the incidence of pulmonary and extrapulmonary tuberculosis is still very high. At the Ife University Teaching Hospital only one case of tuberculous mastitis has been seen over a ten-year period during which 671 breast biopsies were examined. This was in a 36-year old Nigerian woman who developed a left breast mass during pregnancy. She was seen after her delivery and was initially diagnosed as a case of carcinoma of the breast. Subsequent excisional biopsy and pathological examination of the mass confirmed tuberculosis of the breast. She has responded favourably to anti-tuberculous therapy.
    No preview · Article · Jul 1989 · West African journal of medicine
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    ABSTRACT: Background: Despite recent advances in anaesthetic, perinatal and preoperative care, surgical intervention during pregnancy may still result in fetal loss from either spontaneous abortion (especially in the first trimester) or premature labor (especially in the third trimester). This study was aimed at determining the factors that affect fetal and maternal outcome following emergency non-obstetric abdominal surgery in pregnancy. Methods: We reviewed all cases of emergency non-obstetric abdominal surgery performed on pregnant women at Obafemi Awolowo University Teaching Hospital complex from January 1991 and December 2006. The socio-demographic characteristics, obstetric history, diagnosis and outcome of management were documented and analyzed. Results: A total of 46 pregnant patients presented with various conditions necessitating emergency non-obstetric abdominal surgery during the study period. Their ages ranged from 23 to 39 years with a mean age of 29.33 +/-4.904. Six (13%) of the patients presented during the first trimester, 32 (69.6%) patients during the second trimester and 8 (17.4%) were seen in the third trimester. Thirty-two (69.6%) patients presented with features of acute appendicitis out of 12 had ruptured appendicitis and 8 had appendicular abscess. Eight (17.4%) had intestinal obstruction, 5 (10.8%) had haemoperitonueum from abdominal injury and 1 (6.7%) had an ectopic foetus in bladder. Four (8.8%) mothers and 20(43.5%) babies died. Factors affecting maternal outcome included parity (P=0.010), duration of symptoms (P<0.0001) and delay in surgery (P<0.0001) while the factors affecting fetal outcome include maternal age (P<0.0001), booking status (P<0.0001), educational status (P<0.010), parity (P<0.040), gestational age (P=0.048) and delay in surgery (P=0.016). Conclusion: Complicated appendicitis is the most common indication for abdominal surgery in pregnancy in our center. High foetal loss seen in this study can be reduced by early presentation of the patients, early booking and high index of suspicion and prompt treatment by the attending surgeon.
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