Department of Oral and Maxillofacial Surgery
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- ItemOpen AccessAcceptance and perception of Nigerian patients to medical photography(2013-12-13) Adeyemo, W.L.; Mofikoya, B.O.; Akadiri, O.A.; James, O.; Fashina, A.A.The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self‐administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non‐identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non‐identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital‐owned camera to personal camera/personal camera‐phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non‐identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera‐phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice.
- ItemOpen AccessAccidental Denture Ingestion in Two Teaching Hospitals in Lagos(Lagos University Medical Society, 2019-06-01) Oremosu, O.A.; Olubi, O.O.; Akinola, M.D.; Adeyemo, W.L.BACKGROUND Accidental foreign body ingestion is a common cause for emergency treatment. Dentures can be accidentally ingested. OBJECTIVE This study investigated accidental denture ingestion, and management outcome. MATERIALS AND METHODS A prospective study involving patients at 2 teaching hospitals in south-west Nigeria, who presented in the emergency room within a period of two years (2016-2018) with a previous history of wearing dentures were included. Information collected included patients’ demography, presenting complaints, investigations done, type of dentures/prostheses, surgical procedure performed and outcome. RESULTS A total of 20 cases were seen during the period of the study. The age range was from 28-75 years. More males 16 (80.0%) presented than females 4 (20.0%). Patients presented with pain on swallowing 9 (45.0%), while 11 (55.0%) gave a positive history of ingestion dentures. Dentures ingestion occurred more frequently while taking medications 12 (60.0%). Most patients (80.0%) presented with denture impaction in the upper oesophagus, while 3 (15.0%) were lodged in the hypopharynx. All dentures ingested were more often upper dentures 13 (65.0%) and made of acrylic with no metallic attachment. Most dentures were used for more than five years (76.5%). Radiographs showed widened prevertebral shadow in 13 (65.0%) patients, air trapping and widening of hypopharynx in 3 (15.0%). Seventeen of the 20 ingested dentures were successfully removed without complications. Complications included oesophageal perforation with secondary mediastinitis, and oesophageal mucosal tear without perforation. CONCLUSION Denture use after more than 5 years, with or without signs of lack of retention have a higher tendency to be ingested accidentally, leading to impaction in the upper oesophagus. The impacted denture can be successfully removed through oesophagoscopy.
- ItemOpen AccessAcutely inflamed socket: A post-extraction healing complication-clinical observation in 2 patients.(Pakistan Oral & Dent. Jr., 2004-12-01) Adeyemo, W.L.; Ogunlewe, M.O.; Ladeinde, A.L.Acutely inflamed socket as a complication of extraction socket wound healing is a very rare clinical entity worldwide. We report 2 patients with acutely inflamed socket following non-surgical extraction of permanent teeth. One of the patients had a positive history of hypertrophic I keloid scar.
- ItemOpen AccessAirway and respiratory complications in children undergoing cleft lip and palate repair(Ghana Med J, 2010-03-01) Desalu, I.; Adeyemo, W.L.; Akintimoye, M.; Adepoju, A.OBJECTIVES: Anatomical abnormalities associated with cleft lip and palate increase the risk of airway complications. The aim of this study was to determine the incidence of intra-operative airway and respiratory complications during cleft lip and palate repair and identify risk factors. DESIGN: Observational study in which fifty consecutive patients undergoing cleft lip or/ and palate repair (CL, CP, CLP) were prospectively studied in a teaching hospital in Nigeria. Anaesthesia was achieved by the inhalational or intravenous route. Tracheal intubation was performed under deep inhalational anaesthesia or muscle relaxation. All patients were ventilated. Demographic data, airway and respiratory complications were documented. RESULTS: The mean age of the patients was 26.62± 4.71(SEM) months (median 11.50). Nineteen airway complications occurred in 16 patients (incidence - 38%) as failed and difficult intubation (2% respectively) which only occurred in CP surgeries, Tube disconnection (6%), Tube compression (2%), Accidental extubation (2%) and Desaturation (14%). Laryngeal spasm (6%) and Bronchospasm (4%) occurred in surgeries for CP repair only. Some patients had more than one complication. Complications occurred in 38.4% of patients having CP repair, 15.8% having CL repair and 50% having CLP repair (p=0.185). This was not influenced by weight nor age group (p = 0.076 and 0.400 respectively). CONCLUSION: Cleft repair had a high incidence of airway/ respiratory complications. More complications occurred with CP surgery. There is a need to ensure adequately skilled personnel and appropriate monitoring to minimise morbidity.
- ItemOpen AccessALVEOLAR OSTEOTOMY FOR CORRECTION OF ANTERIOR OPEN BITE.(Pakistan Oral & Dent. Jr., 2002-12-01) Obisesan, B.O.; Nwoku, A.L.; Adeyemo, W.L.; Ogunsanwo, S.O.; Oluyadi, B.A.Changes in the intimate relationship of the jawbones lead to dentofacial deformities. Orthognathic surgical interventions attempt to return the hard and soft tissues to normal relationship and thereby enhance facial appearance in addition to improving function. Skeletal open bite is characterized by a noticeable vertical disproportion of the face with changes in the soft tissue and bone. Several suggestions for its correction have been made in the past; the original operation being described by Wassmund in 19357. This procedure is recommended in patients with marked anterior open bite and sound anterior teeth. The surgery is carried out in the upper first premolar region after which the anterior segment is repositioned.
- ItemOpen AccessAmeloblastic carcinoma: a multicenter Nigerian study.(Elsevier, 2010-09-01) Ndukwe, K.C.; Adebiyi, E.K.; Ugboko, V.I.; Ladeinde, A.L.; Okojie, V.N.; Ajike, S.O.; Olasoji, H.O.PURPOSE: To obtain a national profile on the prevalence and management of ameloblastic carcinoma in Nigerians. MATERIALS AND METHODS: Data were collected from the case files of patients with a histologic diagnosis of ameloblastic carcinoma from 4 tertiary referral centers in Nigeria from January 1980 to December 2008. RESULTS: Twenty patients were seen within the study period. There were 11 male and 9 female patients, with a male-to-female ratio of 1.2:1. Their ages ranged from 16 to 85 years (mean +/- SD, 41.63 +/- 19.8 years). The duration of the lesion before presentation was 6 months to 4 years. Twelve cases occurred in the posterior mandible alone, 1 case occurred in the anterior mandible alone, and 4 cases involved the anterior and posterior mandible. The posterior part of the maxilla was involved in 3 cases. A majority of the cases (17) occurred de novo, and 3 patients presented with carcinoma ex-ameloblastoma. Treatment included surgical resection with or without neck dissection. Eight patients declined treatment after diagnosis. Surgery was planned for 12 patients, but 2 patients died of intractable bleeding episodes before surgery. Mandibulectomies and maxillectomies were performed for 10 patients. Follow-up was carried out for 5 patients. Recurrence ranged from 6 to 96 months after the first surgery. Overall deaths recorded involved 6 patients. Three patients died within 3 years after the initial surgery and 1 patient died about 8 years after the initial surgery. One patient is still alive and well 1 year after surgery. CONCLUSION: Ameloblastic carcinoma is an uncommon malignancy. Most cases occur in the mandible and arise de novo. Early diagnosis and radical local excision remain the mainstay of treatment.
- ItemOpen AccessAmeloblastoma: analysis of 207 cases in a Nigerian teaching hospital.(Quintessence Publishing, 2006-01-01) Ladeinde, A.L.; Ogunlewe, M.O.; Bamgbose, B.O.; Adeyemo, W.L.; Ajayi, O.F.; Arotiba, G.T.; Akinwande, J.A.OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature.
- ItemOpen AccessAmeloblastoma: the most common odontogenic tumour?(Niger J Med, 2004-10-04) Adeyemo, W.L.Is Amelobalstoma the most common odontogenic tumour worldwide? This article examines the prevalence of ameloblastoma in different parts of the world, most especially in Africans and Americans
- ItemOpen AccessApplication of the research electronic data capture (REDCap) system in a low- and middle income country– experiences, lessons, and challenges.(Springer, 2021-09-25) Odukoya, O.; Nenrot, D.; Adelabu, H.; Katam, N.; Christian, E.; Holl, J.; Okonkwo, A.; Kocherginsky, M.; Kim, K.Y.; Akanmu, S.; Abdulkareem, F.B.; Anorlu, R.; Musa, J.; Lesi, O.; Hawkins, C.; Okeke, O.; Adeyemo, W.L.; Sagay, S.; Murphy, R.; Hou, L.; Ogunsola, F.T.; Wehbe, F.H.The challenges of reliably collecting, storing, organizing, and analyzing research data are critical in low- and middle-income countries (LMICs), particularly in Sub-Saharan Africa where several healthcare and biomedical research organizations have limited data infrastructure. The Research Electronic Data Capture (REDCap) System has been widely used by many institutions and hospitals in the USA for data collection, entry, and management and could help solve this problem. This study reports on the experiences, challenges, and lessons learned from establishing and applying REDCap for a large US-Nigeria research partnership that includes two sites in Nigeria, (the College of Medicine of the University of Lagos (CMUL) and Jos University Teaching Hospital (JUTH)) and Northwestern University (NU) in Chicago, Illinois in the United States. The largest challenges to this implementation were significant technical obstacles: the lack of REDCap-trained personnel, transient electrical power supply, and slow/ intermittent internet connectivity. However, asynchronous communication and on-site hands-on collaboration between the Nigerian sites and NU led to the successful installation and configuration of REDCap to meet the needs of the Nigerian sites. An example of one lesson learned is the use of Virtual Private Network (VPN) as a solution to poor internet connectivity at one of the sites, and its adoption is underway at the other. Virtual Private Servers (VPS) or shared online hosting were also evaluated and offer alternative solutions. Installing and using REDCap in LMIC institutions for research data management is feasible; however, planning for trained personnel and addressing electrical and internet infrastructural requirements are essential to optimize its use. Building this fundamental research capacity within LMICs across Africa could substantially enhance the potential for more cross-institutional and cross-country collaboration in future research endeavors.
- ItemOpen AccessAppropriateness of intra-operative blood transfusion in children at the Lagos University Teaching Hospital--an initial survey(Nig Q J Hosp Med, 2009-07-01) Desalu, I.; Kushimo, O.T.; Bode, C.O.; Adeyemo, W.L.BACKGROUND: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. OBJECTIVES: We sought therefore to determine the appropriateness of intra-operative blood transfusion in a sample of children METHODS: All children requiring intra-operative blood transfusion between May and June 2008 were prospectively studied. Neonates and children already on blood transfusion at induction were excluded. Transfusion was prescribed at the discretion of the attending anaesthetist. The Estimated blood volume (EBV) and estimated blood loss (EBL)were determined. Appropriate transfusion was defined as blood transfusion at EBL > 15% of EBV, maximum allowable blood loss to PCV of 27% and pre-transfusion Hb < 8g/dl. RESULTS: Twenty-five patients were studied with a mean age of 4.16 +/- 3.59 years (Range 0.33-11 years). The mean preoperative PCV was 31.14 +/- 3.53% (range 25-34%). Twelve patients (48%) were appropriately transfused when MABL was calculated to PCV of 27%. Nine patients (36%) had appropriate blood transfusion at an EBL greater or equal to 15% of the EBV. Of the 12 patients that had pre-transfusion Hb measured, 2 (16.6%) were appropriately transfused at Hb < 8 g/dl. CONCLUSION: The use of near patient monitoring devices should be encouraged as this will give an accurate assessment of Hb and appropriate indication for transfusion. Equipment should be made available to perform gravimetric estimation of blood loss as the visual method is notoriously unreliable.
- ItemOpen AccessAppropriateness of removal of impacted lower third molars. A 2- year audit at the Lagos University Teaching Hospital.(Nig Q J Hosp Med, 2003-01-01) Ladeinde, A.L.; Ogunlewe, M.O.; Adeyemo, W.L.; Bamgbose, B.O.Prophylactic removal of impacted third molars in the absence of specific medical and surgical conditions has generated a lot of controversy among oral and maxillofacial surgeons. The first attempt to create simple but effective guidelines to aid decision-making about removal of impacted third molars was made at a National Institute of Health Conference in the USA in 1979. In 1997, the Faculty of Dental Surgery of the Royal College of Surgeons of England published guidelines for the management of patients with impacted wisdom teeth and these guidelines were endorsed by the National Institute for Clinical Excellence (NICE) of England in March 2000. The purpose of this study was to assess whether these approved guidelines were being followed in considering impacted lower third molars for surgical extraction at the Oral and Maxillofacial Clinic of the Lagos University Teaching Hospital. A retrospective study of the 156 patients who had 160 impacted lower third molars surgically extracted between November 2000 and November 2002 was done. Patients’ records were reviewed for age, sex, and site, type and angulation of impaction, as well as reasons for surgical extraction. Most patients (66%) were in their third decade of life. Distoangular impaction was the most common (40.6%). The commonest reason for extraction was recurrent pericoronitis (62.5%). Only three (2%) extractions (one episode of pericoronitis and two asymptomatic lower impacted third molars) were considered unjustifiable based on the guidelines. Based on the result of this study, unjustifiable and prophylactic removal of impacted lower third molars was not a common practice in our clinic.
- ItemOpen AccessAre sterile gloves necessary in nonsurgical dental extractions?(Elsevier, 2005-07-01) Adeyemo, W.L.; Ogunlewe, M.O.; Ladeinde, A.L.; Bamgbose, B.O.PURPOSE: The aim of the study was to compare the incidence of healing complications of extraction socket with the use of sterile or clean nonsterile gloves during nonsurgical dental extractions. MATERIAL AND METHODS: This was a randomized prospective study conducted at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (Nigeria), between October 2002 and January 2003. Patients who were referred for nonsurgical extractions of permanent teeth and who satisfied the inclusion criteria into the study were randomly allocated into 2 groups. One group had their extractions performed with the surgeon wearing a pair of sterile gloves and the second group had their extractions performed with the surgeon wearing a pair of clean nonsterile gloves. Two hundred sixty-nine patients who had 301 teeth extracted and satisfied the inclusion criteria for socket healing assessment were assessed for postoperative socket healing. RESULTS: Three different types of socket healing complications were identified (dry socket, acutely inflamed socket, and acutely infected socket). A total of 32 patients (11.9%) developed socket healing complications. Nineteen of 122 patients in the sterile glove group and 13 of 147 patients in the clean nonsterile glove group developed socket healing complications (P = .09). CONCLUSION: The study confirmed that the use of sterile surgical gloves offers no advantage over clean nonsterile gloves in minimizing extraction socket healing complications following dental extraction. Therefore, nonsurgical dental extraction can be safely performed with the surgeon wearing clean nonsterile gloves.
- ItemOpen AccessAre systemic antibiotics necessary in the prevention of wound healing complications after intra-alveolar dental extraction?(Int J Oral Maxillofac Surg., 2016) Gbotolorun, O M; Dipo-Fagbemi, I M; Olojede, A O; Ebigwe, S; Adetoye, J OThis double-blind, randomized controlled study was done to assess the necessity of systemic antibiotics in the prevention of wound healing complications after intra-alveolar dental extraction. A consecutive recruitment method was used to allocate participants to two treatment groups. Subjects in group A (antibiotics group, n = 75) received amoxicillin and metronidazole for 5 days postoperatively, while those in group B (placebo group, n = 75) were given identical-looking placebo drugs in place of the antibiotics. Postoperative socket healing complications, pain, and compliance with postoperative instructions were assessed postoperatively. Healing was uneventful in 129 patients (86%). Twenty-one patients (14%) developed wound healing complications. Dry socket was the most common complication in the antibiotics group (six subjects), while acutely inflamed sockets was the most common in the placebo group (five subjects). Non-adherence to postoperative instructions and postoperative pain were found to be significantly associated with the development of wound healing complications. The prescription of antibiotics after routine intra-alveolar dental extraction in healthy patients may not play any significant role in preventing wound healing complications. However, non-compliance with postoperative instructions might be associated with increased wound healing complication
- ItemOpen AccessAssault relted Maxillofacial injuries in Nigeria: A review of literature(2020) Oluwarotimi, A.C.O; Emeka, C.I; Gbotolorun, O.M.Texts attached
- ItemOpen AccessAssessment of predictors of treatment outcome among patient with bacteria odontogenic infection(Unilag Press, 2018-08-28) Adamson, O.O.; Gbotolorun, O.M.; Odeniyi, O.; Oduyebo, O.O.; Adeyemo, W.L.Despite the increasing availability of antimicrobial therapy and healthcare services, odontogenic orofacial infections remain a cause of admission and mortality of patients. Subjects who presented with bacterial odontogenic orofacial space infection and satisfied inclusion criteria were included. Incision and drainage/decompression was performed for all anatomic fascial spaces that were involved. All subjects received empirical antibiotics and MCS samples collected were cultured for aerobic and anaerobic organisms. There were 30 males and 25 females with a male-to-female ratio of 1.2:1. Of the 55 cases seen, majority (39) presented with abscess, 7 with Ludwig’s angina and 5 with necrotising fasciitis. Forty-two (76.4%) of specimen sent for MCS yielded positive culture for bacteria. Gram negative aerobes (25) were the most common bacteria and the least isolated were anaerobes (8). Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics. Subjects with clinical diagnosis of abscess or cellulitis were more likely to have a successful outcome without complications. The only significant predictors of outcome were haemoglobin level and number of spaces involved. Organisms involved in odontogenic infections were more sensitive to Ceftriaxone making it a better empirical antibiotic to Amoxicillin-clavulanate for severe odontogenic infections. Subjects with clinical diagnosis of abscess or cellulitis were more likely to have a successful outcome than those with necrotising fasciitis or Ludwig’s angina. Haemoglobin level and number of spaces involved were the only significant predictors of outcome. KEYWORDS: Bacterial, Odontogenic, Orofacial space, Infections, Sensitivity, Outcome
- ItemOpen AccessAssociation of Dickkopf-1 (DKK1) Mutations with Non-syndromic Orofacial Clefts in African Populations(Pan Arab Human Genetics Conference 2018, 2018-01-18) Adeyemo, W.L.; Lo, C.; James, O.; Busch, T.; Butali, A.Background and Purpose: Orofacial cleft (OFC) has both genetic and environmental. In studies with mice, when the TGFβ gene was knocked out, orofacial clefts resulted because the absence of the TGFβ gene led to upregulation of DKK1. However, the role of DKK1 in human orofacial clefts remains unclear. The purpose of this study was to identify certain loci in the DKK1 gene associated with non-syndromic OFCs in humans in order to further research about the genetic aetiology of clefts. Method: Two hundred and eighty-eight cleft lip and palate (CLP) samples and 192 cleft palate only (CPO) saliva samples were collected from Ghana, Ethiopia, and Nigeria and sequenced. Then, using the programs Primer 3, UCSC Genome Browser, and BLAT, primers were designed for the four DKK1 exons to be used for PCR. DNA was extracted from the collected saliva samples and underwent PCR to be amplified and used for sequencing. Using the computer program Consed, each individual’s nucleotide sequence acquired from Sanger Sequencing was compared to a reference sequence to identify variants. Once variants were identified, SIFT and Polyphen and HOPE were used to predict the degree of damage caused by the mutation. Results: One novel missense mutation was found on the fourth exon of DKK1 in an individual from the Ghana CLP population, and one known missense mutation (rs140471040) was found on the first exon of DKK1 in two individuals from the Ghana CLP population and four individuals from the Africa CPO population. The known missense mutation resulted in the amino acid change p. Met16Leu, and was predicted to be tolerated and benign. Conclusions: The novel variant found in one individual from the Ghana CLP population creates an association between DKK1 and non-syndromic orofacial clefts in humans, demonstrating the interactions between multiple signaling pathways in the aetiology of orofacial clefts. Keywords: DKK1; Orofacial clefts; Africans
- ItemOpen AccessAssociation Studies and Direct DNA Sequencing Implicate Genetic Susceptibility Loci in the Etiology of Nonsyndromic Orofacial Clefts in Sub-Saharan African Populations.(SAGE JOURNALS, 2016-10-01) Gowans, L.J.J.; Adeyemo, W.L.; Eshete, M.; Mossey, P.A.; Busch, T.; Aregbesola, B.; Donkor, P.; Arthur, F.K.; Bello, S.A.; Martinez, A.; Li, M.; Augustine-Akpan, E.A.; Deressa, W.; Twumasi, P.; James, O.; Deribew, M.; Agbenorku, P.; Oti, A.A.; Braimah, R.; Plange-Rhule, G.; Gesses, M.; Obiri-Yeboah, S.; Oseni, G.O.; Olaitan, P.B.; Abdur-Rahman, L.A.; Abate, F.; Hailu, T.; Gravem, P.; Ogunlewe, M.O.; Buxo, C.J.; Marazita, M.L.; Adeyemo, A.A.; Murray, J.C.; Butali, A.Orofacial clefts (OFCs) are congenital dysmorphologies of the human face and oral cavity, with a global incidence of 1 per 700 live births. These anomalies exhibit a multifactorial pattern of inheritance, with genetic and environmental factors both playing crucial roles. Many loci have been implicated in the etiology of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in populations of Asian and European ancestries, through genome-wide association studies and candidate gene studies. However, few populations of African descent have been studied to date. Here, the authors show evidence of an association of some loci with NSCL/P and nonsyndromic cleft palate only (NSCPO) in cohorts from Africa (Ghana, Ethiopia, and Nigeria). The authors genotyped 48 single-nucleotide polymorphisms that were selected from previous genome-wide association studies and candidate gene studies. These markers were successfully genotyped on 701 NSCL/P and 163 NSCPO cases, 1,070 unaffected relatives, and 1,078 unrelated controls. The authors also directly sequenced 7 genes in 184 nonsyndromic OFC (NSOFC) cases and 96 controls from Ghana. Population-specific associations were observed in the case-control analyses of the subpopulations, with West African subpopulations (Ghana and Nigeria) showing a similar pattern of associations. In meta-analyses of the case-control cohort, PAX7 (rs742071, P = 5.10 × 10(-3)), 8q24 (rs987525, P = 1.22 × 10(-3)), and VAX1 (rs7078160, P = 0.04) were nominally associated with NSCL/P, and MSX1 (rs115200552, P = 0.01), TULP4 (rs651333, P = 0.04), CRISPLD2 (rs4783099, P = 0.02), and NOG1 (rs17760296, P = 0.04) were nominally associated with NSCPO. Moreover, 7 loci exhibited evidence of threshold overtransmission in NSOFC cases through the transmission disequilibrium test and through analyses of the family-based association for disease traits. Through DNA sequencing, the authors also identified 2 novel, rare, potentially pathogenic variants (p.Asn323Asp and p.Lys426IlefsTer6) in ARHGAP29 In conclusion, the authors have shown evidence for the association of many loci with NSCL/P and NSCPO. To the best of this knowledge, this study is the first to demonstrate any of these association signals in any African population.
- ItemOpen AccessBlood transfusion requirements in cleft lip surgery(Elsevier, 2011-06-01) Adeyemo, W.L.; Adeyemo, T.A.; Ogunlewe, M.O.; Desalu, I.; Ladeinde, A.L.; Mofikoya, B.O.; Adeyemi, M.O.; Akanmu, A.S.OBJECTIVE: Cleft lip surgery is a common procedure performed by surgeons worldwide. The aim of the study was to determine blood transfusion requirements and factors influencing blood transfusion in cleft lip surgery. METHODS: Transfusion rate in 100 consecutive patients who had cleft lip surgery was prospectively evaluated at the Lagos University Teaching Hospital, Nigeria. Data collected included age and sex of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Cardiovascular parameters at the point of transfusion were also recorded. Each patient was made to donate a unit of homologous blood prior to surgery. RESULTS: Mean estimated blood loss during surgery was 26.5 ± 47.1 ml. Most patients (92%) lost between 2 and 50 ml of blood. Mean estimated blood loss in unilateral cleft lip surgery was not significantly differently from that of bilateral cleft lip surgery (P=0.46). Only five patients (5%) required blood transfusion. The mean blood transfused was 50.0 ± 16.9 ml. All the patients transfused had a preoperative haematocrit of <30% (23-27%). The cross-match-to-transfusion ratio for cleft surgery was 20. The transfusion index was 0.05 and overall blood-ordering quotient was 20. CONCLUSION: Cleft lip surgery is a low volume blood loss surgery. Homologous blood donation prior to cleft lip surgery in patients with preoperative haematocrit of 30% or more is not necessary. For patients with preoperative haematocrit of less than 30%, type and screen of donated blood should be adequate.
- ItemOpen AccessBone grafts for jaw augmentation procedures: anterior versus posterior iliac crest.(Elsevier, 2004-12-01) Adeyemo, W.L.Cortico-cancellous bone graft is considered the material of choice for jaw augmentation because of its rich cellularity, its rapid revascularization, and its potential to induce new bone formation. Several donor sites have been advocated, but the iliac crest is still considered the golden standard for the procedure. However, the choice between the anterior and posterior iliac crest as the preferred site for harvesting has been a subject of debate. NKENKE et al. in a recent issue of the journal compared the morbidity of harvesting of bone grafts from anterior iliac crest with that of posterior iliac crest for preprosthetic augmentation procedures. The authors and others have reported that the posterior approach yields a larger graft volume and has a lower post operative morbidity rate. In addition, the authors reported that by post-operative day thirty, there was no statistically significant difference in pain and thermal sensitivity test (PATH test), and visual analogue scale (VAS) between the anterior or posterior approaches; and also no gait disturbance could be observed in both groups of patients. Based on these findings, they concluded that the posterior iliac crest should be taken into account even for less extensive augmentation procedures. I feel that these findings, however, do not justify their conclusion.
- ItemOpen AccessBreast feeding practices among mothers of children with oro-facial cleft in an African cohort.(Unilag Press, 2019, 2019-08-21) Adekunle, A.A.; Adamson, O.O.; James, O.; Adeyemo, W.L.; Ogunlewe, M.O.Background The challenge of breastfeeding in infants with cleft lip is achieving a seal around the nipple, but this can still be achieved with some effort, a cleft of the palate on the other hand makes it difficult to achieve the required intra oral negative pressure to suck, making feeding more challenging in this population which may result in inadequate nutrient intake (Chen et al. 1990; Ize-Iyamu and Saheeb 2011; Miller 2011).There is limited literature from our environmentabout breastfeeding practices among mothers of babies with oro-facial cleft. Objective:The study was carried out toassess the breastfeeding practices among mothers of children born with oro-facial cleft. Methodology: This was a cross sectional descriptive study using an interviewer administered questionnaire. Sample population was all mothers of babies aged between 1 and 18 months with non -syndromic oro-facial cleft attending the cleft clinic of the department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-araba, Lagos. Result: A total of 65 mothers participated in the study. Initiation of breastfeeding was reported by majority (83%, n=54) of the mothers, however, only 18.5%(n=10) of this proportion continued exclusive breastfeeding. Inability of the babies to suck was reported by 46% (n=30) of the mothers as being the most important challenge in breast feeding. There was a significant correlation between type of cleft and challenge in breastfeeding (fishers exact P = 0.001). Sixty three percent (n= 41) of the mothers reported they received no counselling on overcoming challenges associated with feeding their babies with a cleft at the facility where they delivered. Sixty nine percent (n=45) reported they first received nutritional information from the cleft clinic at presentation. The most commonly adopted substitute for breastfeeding was the use of regular feeding bottles (n=24, 43.6%). Conclusion:Rate of initiation of breastfeeding for children with oro-facial cleft in this African cohort is higher than reported in other populations despite the low level of nutritional counselling of the mothers after delivery.