Browsing by Author "Etwire, V."
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Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country(African Journal of Paediatric Surgery, 2015-10) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates. Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country | Request PDF. Available from: https://www.researchgate.net/publication/304269798_Complications_of_hypospadias_surgery_Experience_in_a_tertiary_hospital_of_a_developing_country [accessed Sep 14 2018].Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country(African Journal of Paediatric Surgery, 2015-10) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Go to: Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Go to: Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates.Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country.(Afr J Paediatr Surg., 2015-12) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates.Item Gastrointestinal food allergy in Ghanaian children: a case series(Ghana Medical Journal, 2017-09) Afaa, T.J.; Afrane, A.K.A.; Etwire, V.Background: Food allergy is an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food. Food allergies are classified into three types: Ig(immunoglobulin)E mediated, mixed IgE and cell mediated and cell-mediated non IgE mediated. Gastrointestinal (GIT) food allergy has classically encompassed a number of different clinical entities: food protein-induced enterocolitis syndrome (FPIES), food protein- induced proctocolitis (FPIP), food protein-induced enteropathy and eosinophilic gastrointestinal disorders (EGID). Case presentations: These are 5 cases of infants and toddlers who presented with various features of gastrointestinal food allergies, the commonest of which is lower gastrointestinal bleed. Two infants on exclusive breast feeding, presented with lower gastrointestinal bleeding and these resolved with maternal dietary milk and all dairy elimination. The third infant had rectal bleeding at age 6 months after the introduction of infant formula. The bleeding and eczema resolved with the introduction of hydrolyzed formula. One of the toddlers presented with severe eczema and malnutrition which improved with 6 food elimination. The last case had massive lower gastrointestinal bleed which resulted in hemicolectomy with no improvement until dietary elimination was instituted. Conclusion: Gastrointestinal food allergy is not uncommon in children in Ghana. A high index of suspicion is required to make the right diagnosis, to minimize morbidity and unnecessary therapyItem Paediatric day care surgery at the korle-bu teaching hospital, accra, ghana(Update in Anaesthesia, 2009-06) Hesse, A.A.J.; Amponsah, G.; Mensah, A.W.; Addy, G.H.; Etwire, V.This paper documents an example of successful daycare surgery in a developing country. We report the prospective experience of paediatric daycare surgery from a paediatric surgery unit of a teaching hospital in an urban centre of a developing country and assess the degree of parental satisfaction of the procedure. The literature regarding daycare surgery for children has mainly come from developed countries where daycare is well established, especially in many sub-specialties such as otorhinolaryngology. Examples from developing countries are few although the potential for provision of service to larger groups of children is understated in developing countries in particular. A questionnaire was developed and administered to the parents of patients undergoing daycare surgery under general anaesthesia over the six-month period in our unit.Item Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience(African Journal of Paediatric Surgery, 2011-05) Mensah, Y.; Glover-Addy, H.; Etwire, V.; Twum, M.; Asiamah, S.; Appeadu-Mensah, W.; Hesse, A.Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months). Twelve (67%) of the cases were reduced successfully while 6 (33%) failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7%) cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.Item Pneumatic reduction of intussuseception in children at the Korle-Bu Teaching Hospital- an initial experience(African Journal of Paediatric Surgery, 2011) Mensah, Y.B.; Glover-Addy, H.; Etwire, V.; Twum, M.B.; Asiamah, S.; Appeadu-Mensah, W.; Hesse, A.A.J.