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   Table of Contents - Current issue
Coverpage
July-September 2017
Volume 14 | Issue 3
Page Nos. 37-60

Online since Monday, March 19, 2018

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ORIGINAL ARTICLES  

Oral and maxillofacial tumours in children and adolescents: Clinicopathologic audit of 75 cases in an academic medical centre, Sokoto, Northwest Nigeria p. 37
Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah, Adebayo Aremu Ibikunle, Mutiat Feyisetan Obileye, Nma Muhammed Jiya, Saddiku Malami Sahabi, Idris Kabiru Jaja
DOI:10.4103/ajps.AJPS_81_16  PMID:29557349
Background: Maxillofacial tumours in children and adolescents have been documented worldwide; however, few studies were reported from Africa, especially sub-Saharan Africa. In Nigeria, most of the studies emanated from the Southwest region. Aim: To present an audit of clinicopathologic features and treatment of orofacial tumours in children and adolescents in Sokoto, Northwest Nigeria. Patients and Methods: Clinicopathologic records of the Departments of Dental and Maxillofacial Surgery, Paediatrics and Histopathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, were reviewed for all the oral and maxillofacial tumours managed in children <19 years from January 2011 to December 2015. Results: Two hundred and twenty-two tumours were noted in all age groups during the study duration and 75 (33.8%) of these occurred in children and adolescents. A total of 45 (60%) males and thirty (40%) females constitute the patient population with a male to female ratio of 1.5:1. There are 32 (42.7%) benign tumours and 43 (57.3%) malignant tumours. Burkitt's lymphoma was the most common malignant tumour in 24 cases (55.8%), whereas pleomorphic adenoma was the most common benign soft tissue tumour in 4 cases (30.8%) and fibro-osseous lesions were the most common benign jaw tumours in 10 cases (52.6%). Chemotherapy alone was the treatment modality in 24 cases of malignant tumour whereas 13 cases had combination chemotherapy and irradiation. Conclusions: Our findings established that oral and maxillofacial tumours in children and adolescents are quite common in Sokoto, Northwest region of Nigeria, particularly the malignant types. There is a need for improved universal healthcare insurance for all citizens to adequately manage these children effectively.
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Acute presentation of koch's abdomen in children: Our experience p. 43
Basant Kumar, Vijai Dutta Upadhyaya, Sandeep Kumar Rahul, Laxmi Kant Bharti, Ram Nawal Rao, Sheo Kumar
DOI:10.4103/ajps.AJPS_91_16  PMID:29557350
Background: To analyse our experience with acute presentations of abdominal tuberculosis (TB) in children for early diagnosis and management. Materials and Methods: From December 2010 to April 2016, available electronic and operation theatre (OT) records of 17 patients with confirmed diagnosis of abdominal TB were analysed retrospectively. Parameters reviewed were age, sex, presentations, diagnostic investigations, surgery/intervention performed, final outcome and follow-up. Results: Out of 17 patients, 6 (35.3%) were already operated elsewhere. The duration of symptoms ranged from 4 to 58 weeks. Abdominal pain was present in all cases whereas 11 (64.7%) had abdominal distension, 16 (94.1%) fever, 14 (82.3%) ascites, 9 (52.9%) vomiting, 14 (82.3%) weight loss, 6 (35.3%) anorexia and 4 (23.5%) night sweat. All patients needed surgical intervention for definitive diagnosis. Thirteen (76.5%) out of 17 patients managed by staged surgery and primary anastomosis/repair/adhesiolysis were done in 4 (23.5%) patients. The main post-operative problems were wound infections (8; 47.1%), subacute bowel obstruction (6; 35.3%) and chest infections (12; 70.6%). Follow-up period ranged from 3 months to 5.5 years. Conclusion: Abdominal TB should always be considered in differential diagnosis in children presenting with abdominal pain/distension, fever and ascites or with abdominopelvic mass. Recurrent bowel obstruction or anastomotic disruptions also give clues of its diagnosis. A careful history of illness, high index of suspicion, ascitic fluid adenosine deaminase or polymerase chain reaction for Mycobacterium needed for early diagnosis. Prompt minimal surgical interventions, preferred diversion over primary anastomosis, algorithmic vigilant post-operative care and early antitubercular treatment required for success in acute crisis.
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Acute mechanical intestinal obstruction in children at zinder national hospital, Niger: Aetiologies and prognosis p. 49
Harissou Adamou, Ibrahim Amadou Magagi, Oumarou Habou, Ousseini Adakal, Kabirou Ganiou, Magagi Amadou
DOI:10.4103/ajps.AJPS_96_16  PMID:29557351
Background: To describe the aetiological and prognostic aspects of acute mechanical intestinal obstruction (AMIO) in children at Zinder National Hospital (Niger). Materials and Methods: This was a cross-sectional study on a period to January 2013–June 2015. The database included all children under 15 years of age with a surgical diagnosis of mechanical intestinal obstruction. P < 0.05 was considered statistically significant for analysis. Results: AMIOs represent 21.78% (n = 78) of child digestive surgical emergencies (n = 358). Median age was 12 months (range: 1 day–15 years). Fifteen (19.23%) were neonates and sixty children (76.92%) had ≤60 months. The sex ratio (male/female) was 2.8. The mean time from onset to presentation was 39.96 ± 36.22 h. Intussusception and strangulated hernias were the main causes of AMIO with, respectively, 43.59% (n = 34) and 29.48% (n = 23). Anorectal malformations represent 17.95% (n = 14) of cases of AMIO. Intestinal resection was made in 22.08% and colostomy in 19.23% of patients. The average length of hospital stay was 6.44 ± 4.30 days. The post-operative complications were recorded in 26 patients (33.33%), mostly surgical site infections. Overall mortality of AMIO was 15.38% (n = 12). It was higher in the neonates (33.33%) (P = 0.032). Deaths were associated with delay of admission (P = 0.0005) and waiting time for surgery (P = 0.019). Conclusion: Intussusception and strangulated hernia are the most common cause of AMIO in children. Diagnostic and therapeutic delays, lack of paediatric intensive care and post-operative complications are prognostic factors.
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CASE REPORTS Top

Congenital absence of jejunum and ileum: A case report and literature review p. 53
Prasanta Kumar Tripathy, Banoj Kumar Ray, Hiranya Kishore Mohanty
DOI:10.4103/ajps.AJPS_63_16  PMID:29557352
We report an extremely rare finding 'congenital absence of jejunum and ileum' during explorative laparotomy of a 16-day-old female neonate. The dilated duodenum was terminating blindly, and the next segment of intestine was a peanut-sized cecum followed by microcolon. On an extensive survey of literature this type of intestinal atresia is not reported in living babies.
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Intraperitoneal cerebrospinal fluid pseudocyst with ventriculoperitoneal shunt p. 56
Mohammad Sadegh Masoudi, Marziye Rasafian, Zahra Naghmehsanj, Fariborz Ghaffarpasand
DOI:10.4103/ajps.AJPS_94_16  PMID:29557353
Ventriculoperitoneal (VP) shunting is mostly used in the treatment of hydrocephalus and many complications have been reported with this method. Abdominal Pseudocyst (APC) are relatively uncommon but important complications in patients with VP shunts. We herein report the case of a 9-year-old boy with VP shunt who presented with abdominal distension, abdominal pain, malaise, and decrease of appetite. Abdominal pelvic computed tomography confirmed a diagnosis of APC. Laparotomy was done and VP shunt was placed into the other side of peritoneal cavity again. Also here, etiology, presentation, diagnosis, and treatment of APC were reviewed.
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LETTERS TO THE EDITOR Top

Post-varicella necrotising fasciitis p. 59
Viroj Wiwanitkit
DOI:10.4103/ajps.AJPS_48_16  PMID:29557354
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Anti-smooth muscle antibodies and liver enzymes in differentiation of extrahepatic biliary atresia and idiopathic neonatal hepatitis: Concern in laboratory medicine view p. 60
Beuy Joob, Viroj Wiwanitkit
DOI:10.4103/ajps.AJPS_65_16  PMID:29557355
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