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  Citation statistics : Table of Contents
   2014| July-December  | Volume 10 | Issue 2  
    Online since April 15, 2015

 
 
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CASE REPORTS
Amniotic band syndrome in a Nigerian cleft patient: A case report
Oladimeji Adeniyi Akadiri, Joycelyn Odegua Eigbobo, Barbara Edewele Otaigbe
July-December 2014, 10(2):15-17
DOI:10.4103/0794-9316.155175  
Amniotic band syndrome is a set of congenital malformations ranging from minor constriction rings and lymphedema of the digits to complex, bizarre multiple congenital anomalies that are attributed to amniotic bands that stick, entangle, and disrupt fetal parts. The most commonly associated anomalies include amputations, constriction bands, syndactyly, craniofacial defects, and club feet. A case of amniotic band syndrome involving limb anomalies and orofacial cleft deformity in a Nigerian child is reported.
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Split-hand/Split-foot malformation
Namgwa J Kortor, Williams T Yongu, Itodo C Elachi, Daniel D Mue
July-December 2014, 10(2):18-20
DOI:10.4103/0794-9316.155181  
Split-hand/split-foot malformation (SHFM), also known as ectrodactyly or lobster claw hand deformity, is a rare congenital limb malformation characterized by a median cleft of hands and/or feet due to the absence of the central rays. SHFM has a reported incidence of 1 in 90,000 live births. It may occur either as an isolated anomaly or as part of a syndrome. We present a rare case of a 9-year-old boy with SHFM who underwent surgical correction of the cleft hand, with improved cosmetic and functional outcome.
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Experience with a two-stage nasal reconstruction with the paramedian forehead flap
Abdulrasheed Ibrahim, Ferdinand O Ijekeye, Malachy E Asuku
July-December 2014, 10(2):21-23
DOI:10.4103/0794-9316.155185  
The unique anatomy of the nose combined with its aesthetic and functional importance makes its reconstruction a challenging but rewarding undertaking. The authors of this study present their experience in a two-stage nasal reconstruction with a paramedian forehead flap. The patient underwent reconstruction with a narrow pedicle to resurface the dorsum, and its distal wings covered the alae. He had a significant amount of residual intranasal lining and this was used for a pedicle flap. The reconstructed dorsum and nasal tip appeared bulky, and the soft triangle needed better definition after the second stage. The patient underwent two revisions with improvement in the projection, outline, and contour of the nose.
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Van Der Woude syndrome and choanal atresia: Any association? A case report
Zainab Yunusa Kaltungo, Ahmed Ali, AbdulRasheed A Nasir
July-December 2014, 10(2):24-25
DOI:10.4103/0794-9316.155187  
Common features of Van der Woude syndrome include pits and or sinuses of the lower lip, cleft lip with or without cleft palate, isolated cleft palate, bifid uvula, and hypodontia. When associated with a web of the popliteal region, it is called popliteal pterygium syndrome. Here we present a case of popliteal pterygium syndrome with incidental finding of membranous type choanal atresia on attempt at nasotracheal intubation for general anesthesia.
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ORIGINAL ARTICLES
Impact of burn unit routine on outcome: A 5-year experience
Zainab Yunusa Kaltungo, Olabisi Shakir Olajide, Adamu Danladi Bojude
July-December 2014, 10(2):6-9
DOI:10.4103/0794-9316.155169  
Background: The burn unit, like any high dependency, unit is awash with multi-antibiotic resistant microbes, and the clinician is in a constant battle to prevent such infections from becoming established. After the elimination of hypovolemic shock as a cause of death, infections constitute the leading cause of morbidity and mortality in burn patients. Aims and Objectives: This study aimed to determine the incidence of infection in our burn unit and to demonstrate how our burn unit routine leads to a low incidence of infection in our setting. Materials and Methods: This is a retrospective review of the records of patients attended to between 2009 and 2013 in the burn unit of Federal Teaching Hospital, Gombe, Nigeria. Details of the treatment and follow-up data were obtained from patients' case files using a predesigned pro forma. All patients were within 24 h of burn and had wounds cleaned under general anesthesia before admission to the unit. In addition, all patients with major burns received infusion of glucose, potassium, and insulin (GKI). Antibiotics use was strictly regulated and was guided by known antimicrobial and sensitivity patterns. Results: Thirty-three patients were admitted within the study period, of whom 27 patients had complete information and were analyzed. The mean age of the burn patients was 11 ± 16.7 (SD) years. There were 16 (59.3%) males and 11 (40.7%) females. Scalding and flame burns accounted for 20 (74.1%) and seven (25.9%) patients, respectively. Only four (14.8%) patients developed wound infection on admission (three were in the age range of 11 years and below, while one was 57 years old) and one patient had gastrointestinal tract (GIT) infection. One patient died from suspected thromboembolism within 24 h of burn, and 14 (51.8%) and 12 (44.4%) patients were discharged with and without residual burn wounds, respectively. The average burn surface area was 18.9%. The average length of stay (LOS) was 18.65 days and the average LOS per patient per percentage burn surface was 0.98 days. On follow-up at 2 weeks after discharge, four (14.8%) patients had delayed wound healing and seven (25.9%) patients developed hypertrophic scars. Conclusion: Our findings indicate a low incidence of infection related complications and it appears that our burn unit routine may play a significant role.
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Inventory of potential reconstructive needs in patients with post-burn contractures
Abdulrasheed Ibrahim, Ferdinand O Ijekeye, Malachy E Asuku
July-December 2014, 10(2):1-5
DOI:10.4103/0794-9316.155165  
Background: The inventory of potential reconstructive needs records the specific reconstructive needs of the patient with burns and allows systematic planning for future reconstruction and rehabilitation. It also assists patients to evaluate and prioritize reconstructive options with the guidance of the plastic surgeon, as well as facilitating the adoption of realistic expectations on the part of the patient and family. Materials and Method: A survey of the potential reconstructive needs was carried out using the inventory of reconstructive needs form. The form is applicable to all body regions and is divided into three sections. Each section is subdivided into anatomic units: head and neck (anatomic units 1-5); upper extremity (anatomic units 6-9); and trunk and lower extremity (anatomic units 10-13). The results are presented in tabular form and analyzed using simple frequency distribution. Results: The anatomic region with the highest number of reconstructive needs was the head and neck in adults 25 (42%).The trunk and lower extremity accounted for the least reconstructive needs in adults 12 (20%). When the reconstructive needs were stratified by anatomic units in the head and neck, the upper eyelids 8 (32%) and the neck 6 (24%) had the highest frequency of reconstructive needs in adults. The upper extremity had the highest reconstructive needs in children 51 (52%). The upper eyelid, mouth and neck accounted for 13 (76%) of the reconstructive needs in children. Seventy-eight (50%) of the 157 patients had at least two contractures. Conclusion: There were more reconstructive needs in children than adults. The anatomic region with the highest number of reconstructive needs was the head and neck in adults and the upper extremity in children. This study underscores the importance of positioning and intensive therapy intervention in the prevention of post-burn contractures.
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Psychiatric morbidity and quality of life among mothers of children with orofacial cleft disorders in Enugu: A pilot study
Ifeanyichukwu I Onah, Justin U Achor
July-December 2014, 10(2):10-14
DOI:10.4103/0794-9316.155170  
Introduction: This work investigates the prevalence of psychiatric morbidity and its impact on the quality of life of mothers of children with orofacial cleft. Mothers bear stresses and care burdens of ill family members and it affects their mental health. Little is known about the psychiatric morbidity of such mothers in South-eastern Nigeria. Materials and Methods: Participants were assessed using the Brief Screen for Depression (BSD), the EUROHIS-QOL 8-item Index, and the Self-Reporting Questionnaire (SRQ). The data was analyzed using SPSS version 15. Results: Of the 48 participating mothers, 50% screened positive for psychiatric morbidity with the SRQ, whereas 62.5% screened positive for depression using the BSD. Psychiatric morbidity was found more among mothers with lower levels of education, having more children; older index children and with over-representation of affected female children. The mean quality of life score was 3.34 ± 0.86. Mothers that screened positive for psychiatric morbidity reported a significantly lower quality of life than those without morbidity (2.82 ± 0.90 versus 3.85 ± 0.40). Conclusion: Features of psychosocial distress and depression are common among mothers of cleft children and exert negative effects on their quality of life.
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