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Papers by Francis Uba

African Journal of Paediatric Surgery, 2014

It is with much feeling of satisfaction that I am writing this editorial for the first issue of t... more It is with much feeling of satisfaction that I am writing this editorial for the first issue of the 10 th year anniversary of the existence of African Journal of Paediatric Surgery (AJPS), with the opportunity to provide our esteem readers with a brief account of how AJPS is faring. Many of you who will read this editorial in this, the first issue, of volume 11 of AJPS need to know that the Journal is just a decade old this year. Started like the mustard seed in 2004, AJPS has continued to grow in all its ramifications, against all thick and thin, to attain its current status, where it has created for itself a niche among internationally acclaimed biomedical journals focusing on the surgical aspect of child health.

African Journal of Paediatric Surgery, 2010

Nigerian Postgraduate Medical Journal

The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out t... more The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out to determine the pattern and outcome of management of anorectal malformations (ARM) in a Nigerian tertiary hospital. The clinical and operative records of consecutive children with anorectal anomaly managed between October 1990 and September 2000 at the Jos University Teaching Hospital, Jos, were reviewed. There were 82 patients, (57.3%) males and 35 (42.3%) females (m:f=1.3:1). There were 20 (24.4%) cases each of the high and intermediate types, 40 (48.8%) low variety and 2 (2.4%) cases of persistent cloaca. The high type was proportionately commoner in the males. Less than one-third presented within 24 hours. Eighty three percent of patients (mainly males) presented in acute intestinal obstruction. Passage of stools from abnormal sites and "imperforate" anus were complaints in 60 (73.1%) patients each. A total of 63 patients had definitive corrective procedure. Four patients with stenotic anus were treated by serial anal dilatations while 29 with low anomaly had anoplasty during the neonatal period. Twenty eight patients with intermediate or high anomalies or persistent cloaca had definitive repair or pull-through operations carried out 6-12 months after an initial colostomy. The definitive pull-through operations included abdominoperineal pull-through in 11 patients, PSARP in 15, while 2 girls with persistent cloaca had posterior sagittal anorectovaginoure-throplasty (PSARVUP). Twenty nine children were fully continent of stools after surgery; three patients developed occasional faecal soiling; while six patients had faecal incontinence. Anorectal anomaly is common, but presentation is late in our environment. Although mortality rate was high (26%), early results of definitive operation among survivors were generally good after a mean follow-up period of 19 months.

Annals of Medical Research and Practice

Objectives: Intussusception is the most common cause of intestinal obstruction in infants. In dev... more Objectives: Intussusception is the most common cause of intestinal obstruction in infants. In developing countries, presentation is usually late with an attendant high mortality rate. Material and Methods: Records of children managed for intussusception at the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State from 2013 to 2017 were retrieved. Information including the sociodemographic data, the pattern of presentation, treatment, and treatment outcomes were obtained and analyzed using tables. Results: There were 22 patients, 15 (62%) of whom were male (male-female ratio 2.1:1). Age at presentation ranged from 3 months to 14 years with a peak incidence at 7–8 months. The most common symptoms were vomiting (68%), abdominal pain (59%), and bloody stool (41%). Only 1 patient (4.5%) presented within 24 h of onset of symptoms while 13 (59%) presented after 72 h of onset of symptoms. All patients had open surgery, and ileocolic intussusception was the most common ty...

South African Journal of Surgery, 2010

Background. In the Nigerian setting the curriculum of each medical school is the sole responsibil... more Background. In the Nigerian setting the curriculum of each medical school is the sole responsibility of the senate of the respective university. This arrangement results in variability in learning objectives and in students’ acquisition of skills to manage clinical problems. Educational objectives can be used to both standardise and evaluate curricula. This study aimed to: (i) identify main objectives of paediatric surgery at the undergraduate level; (ii) establish students’ knowledge with regard to these objectives; (iii) evaluate the input of both specialists and non-specialists to these objectives; and (iv) examine the status of undergraduate paediatric surgery instruction in our medical schools. Materials and methods. This was a cross-sectional survey of students, teachers and undergraduate deans with regard to undergraduate paediatric surgery teaching. The cognitive and perceived level of knowledge about common paediatric surgical conditions of 4th- and 6th-year medical student...

Annals of Medical Research and Practice, 2020

Annals of African medicine

Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be re... more Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be rehabilitated to ambulate erect by reconstructive operations, use of orthosis and physiotherapy. This study assesses the problems of post polio paralysis, rehabilitative interventions and calls for a surgical reawakening in this regard. Patients and Methods: A retrospective study of management of children with severe post polio paralysis is presented Results: Eight patients aged between 8 and 16 years with varying degrees of disabilities and deformities were managed. Six of them crawled on the ground and only two of them attended school. Reconstructive surgery and physiotherapy enabled all to ambulate in erect position using calipers and crutches. Conclusion: Children with post polio paralysis can be rehabilitated by reconstructive surgery and physiotherapy. Dwindling interest of surgeons in surgery of poliomyelitis needs to be reawakened Keywords : Post polio paralysis, Reconstructive surgery, Physiotherapy, Rehabilitation African Journal of Paediatric Surgery Vol. 3 (1) 2006: pp. 30-34

Pediatric Surgery International, 2007

Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctionin... more Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctioning colostomy. The purpose of this study was to examine the feasibility of single-stage resection and anastomosis without intraoperative colonic lavage for acute left-sided colonic obstruction in children. Between October 2000 and May 2006, nine consecutive patients who had a one-stage left-sided colon resection without preceding colonic lavage were evaluated. The main outcome measures were anastomotic leakage, wound infection and death. There were nine patients: six were males and three were females (M:F = 2:1). Their ages ranged from 2-10 years (mean age 6 years). The obstruction was due to irreducible colo-colic intussusceptions in two patients and colo-colic intussusceptions with colonic perforation in four patients, and colo-colic intussusceptions with gangrene in three. All the patients had resection and primary anastomosis without on-table colonic lavage. There were no anastomotic leakages or deaths. Postoperative complications included superficial wound infections in two patients and dry cough in four other patients. Three patients were lost to follow up after 3 years of follow up, but the remaining six are presently doing well. Primary anastomosis without colonic lavage is safe for resection of the left colon in children in an emergency setting.

Seminars in Pediatric Surgery, 2012

The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4... more The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4 distinct phases, starting from early 1920s till the present. The pace of development has been quite variable in different parts of Africa. Despite all recent developments, the practice of pediatric surgery in Africa continues to face multiple challenges, including limited facilities, manpower shortages, the large number of sick children, disease patterns specific to the region, late presentation and advanced pathology, lack of pediatric surgeons outside the tertiary hospitals, and inadequate governmental support. Standardization of pediatric surgery training across the continent is advocated. Collaboration with well-established pediatric surgical training centers in Africa and other developed countries is necessary. The problems of delivery of pediatric surgical services need to be addressed urgently, if the African child is to have access to essential pediatric surgical services like his or her counterpart in the high-income parts of the world.

Nigerian Journal of Surgical Research, 2010

Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.

Nigerian Journal of Surgical Research, 2010

A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right... more A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end anastomosis. This is a rare occurrence in infants and seems to result from late presentation. Health education coupled with early referral and prompt repair of inguinal hernia in neonates and infants would reduce this complication.

West African Journal of Medicine, 2005

Pediatric Surgery International, 2008

Pediatric surgery international, 2004

The study was carried out to determine the characteristics and outcome of management of anorectal... more The study was carried out to determine the characteristics and outcome of management of anorectal malformations (ARM) in Nigerian children at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in Ile-Ife, Nigeria, between January 1986 and December 2002. Eighty-six children with ARM were studied, 48 males and 38 females. Only 12 (13.9%) presented to the hospital within 24 h of birth. Twenty-four (27.9%) patients had one or more associated congenital anomalies, with oesophageal atresia with tracheo-oesophageal fistula being the most common associated malformation. A low variety was identified in 26 (30.2%) cases, while 60 (69.8%) had intermediate or high lesions. Twenty-two patients with the low type of anomaly were offered primary anoplasty in the neonatal period, whereas 59 patients with intermediate or high malformations were offered a preliminary colostomy. A definitive pull-through procedure was ultimately performed in 27 of these 59 cases. Twenty-six patients (30...

East African Medical Journal, 2002

Objective: Oesophageal foreign bodies (EFBs) are a common emergency issue in paediatrics, and few... more Objective: Oesophageal foreign bodies (EFBs) are a common emergency issue in paediatrics, and few studies have revealed its clinical features and treatment methods. We conducted this retrospective study to provide our 10-year clinical evidence for the diagnosis and treatment of EFB and reduce the incidence of complications. Methods: We retrospectively reviewed all paediatric cases diagnosed with EFB from January 2012 to December 2021 at Shenzhen Children's Hospital. The age and sex of the patients, types of foreign bodies (FBs), preoperative examination, location and duration of FB impaction, clinical symptoms, surgical methods, therapeutic effects and complications were analysed. Results: Among the 1355 cases, 759 were boys and 596 were girls, with a median age of 2.9 years (4 months to 16 years). The shortest FB lodged time was 1 hour, while the longest time was 3 months. The types of foreign bodies included coins and blunt objects (812,59.9%), bones and sharp objects (278,20.5%), button batteries (86,6.3%), food impactions (84,6.2%), toys (51,3.8%) and plastic objects (44,3.2%). A total of 720 of 812 cases impacted by coins and blunt subjects were successfully treated with a Foley catheter without any complications. A total of 558 patients underwent rigid oesophageal endoscopy under general anaesthesia, and foreign bodies were successfully removed in 525 cases. No FB was found in 33 cases, and FBs pushed into the lower digestive tract during operation in 5 cases. Oesophageal injury was found in 130 cases (23.3%). Our study showed that the age of the patient, time of foreign body incarceration, type of foreign body, location of the lodged foreign body, and fever or cough were risk factors leading to oesophageal foreign body complications, and the differences were statistically significant (P < 0.05). Conclusion: Children with EFB have a risk of complications, especially if the FB is a button battery. The appropriate surgical method should be selected through the analysis of the clinical characteristics of the foreign body in the oesophagus and the risk factors for complications to reduce the incidence of complications. Health education and effective care are the keys to the prevention of EFB.

African Journal of Paediatric Surgery, 2014

It is with much feeling of satisfaction that I am writing this editorial for the first issue of t... more It is with much feeling of satisfaction that I am writing this editorial for the first issue of the 10 th year anniversary of the existence of African Journal of Paediatric Surgery (AJPS), with the opportunity to provide our esteem readers with a brief account of how AJPS is faring. Many of you who will read this editorial in this, the first issue, of volume 11 of AJPS need to know that the Journal is just a decade old this year. Started like the mustard seed in 2004, AJPS has continued to grow in all its ramifications, against all thick and thin, to attain its current status, where it has created for itself a niche among internationally acclaimed biomedical journals focusing on the surgical aspect of child health.

African Journal of Paediatric Surgery, 2010

Nigerian Postgraduate Medical Journal

The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out t... more The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out to determine the pattern and outcome of management of anorectal malformations (ARM) in a Nigerian tertiary hospital. The clinical and operative records of consecutive children with anorectal anomaly managed between October 1990 and September 2000 at the Jos University Teaching Hospital, Jos, were reviewed. There were 82 patients, (57.3%) males and 35 (42.3%) females (m:f=1.3:1). There were 20 (24.4%) cases each of the high and intermediate types, 40 (48.8%) low variety and 2 (2.4%) cases of persistent cloaca. The high type was proportionately commoner in the males. Less than one-third presented within 24 hours. Eighty three percent of patients (mainly males) presented in acute intestinal obstruction. Passage of stools from abnormal sites and &amp;amp;amp;amp;quot;imperforate&amp;amp;amp;amp;quot; anus were complaints in 60 (73.1%) patients each. A total of 63 patients had definitive corrective procedure. Four patients with stenotic anus were treated by serial anal dilatations while 29 with low anomaly had anoplasty during the neonatal period. Twenty eight patients with intermediate or high anomalies or persistent cloaca had definitive repair or pull-through operations carried out 6-12 months after an initial colostomy. The definitive pull-through operations included abdominoperineal pull-through in 11 patients, PSARP in 15, while 2 girls with persistent cloaca had posterior sagittal anorectovaginoure-throplasty (PSARVUP). Twenty nine children were fully continent of stools after surgery; three patients developed occasional faecal soiling; while six patients had faecal incontinence. Anorectal anomaly is common, but presentation is late in our environment. Although mortality rate was high (26%), early results of definitive operation among survivors were generally good after a mean follow-up period of 19 months.

Annals of Medical Research and Practice

Objectives: Intussusception is the most common cause of intestinal obstruction in infants. In dev... more Objectives: Intussusception is the most common cause of intestinal obstruction in infants. In developing countries, presentation is usually late with an attendant high mortality rate. Material and Methods: Records of children managed for intussusception at the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State from 2013 to 2017 were retrieved. Information including the sociodemographic data, the pattern of presentation, treatment, and treatment outcomes were obtained and analyzed using tables. Results: There were 22 patients, 15 (62%) of whom were male (male-female ratio 2.1:1). Age at presentation ranged from 3 months to 14 years with a peak incidence at 7–8 months. The most common symptoms were vomiting (68%), abdominal pain (59%), and bloody stool (41%). Only 1 patient (4.5%) presented within 24 h of onset of symptoms while 13 (59%) presented after 72 h of onset of symptoms. All patients had open surgery, and ileocolic intussusception was the most common ty...

South African Journal of Surgery, 2010

Background. In the Nigerian setting the curriculum of each medical school is the sole responsibil... more Background. In the Nigerian setting the curriculum of each medical school is the sole responsibility of the senate of the respective university. This arrangement results in variability in learning objectives and in students’ acquisition of skills to manage clinical problems. Educational objectives can be used to both standardise and evaluate curricula. This study aimed to: (i) identify main objectives of paediatric surgery at the undergraduate level; (ii) establish students’ knowledge with regard to these objectives; (iii) evaluate the input of both specialists and non-specialists to these objectives; and (iv) examine the status of undergraduate paediatric surgery instruction in our medical schools. Materials and methods. This was a cross-sectional survey of students, teachers and undergraduate deans with regard to undergraduate paediatric surgery teaching. The cognitive and perceived level of knowledge about common paediatric surgical conditions of 4th- and 6th-year medical student...

Annals of Medical Research and Practice, 2020

Annals of African medicine

Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be re... more Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be rehabilitated to ambulate erect by reconstructive operations, use of orthosis and physiotherapy. This study assesses the problems of post polio paralysis, rehabilitative interventions and calls for a surgical reawakening in this regard. Patients and Methods: A retrospective study of management of children with severe post polio paralysis is presented Results: Eight patients aged between 8 and 16 years with varying degrees of disabilities and deformities were managed. Six of them crawled on the ground and only two of them attended school. Reconstructive surgery and physiotherapy enabled all to ambulate in erect position using calipers and crutches. Conclusion: Children with post polio paralysis can be rehabilitated by reconstructive surgery and physiotherapy. Dwindling interest of surgeons in surgery of poliomyelitis needs to be reawakened Keywords : Post polio paralysis, Reconstructive surgery, Physiotherapy, Rehabilitation African Journal of Paediatric Surgery Vol. 3 (1) 2006: pp. 30-34

Pediatric Surgery International, 2007

Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctionin... more Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctioning colostomy. The purpose of this study was to examine the feasibility of single-stage resection and anastomosis without intraoperative colonic lavage for acute left-sided colonic obstruction in children. Between October 2000 and May 2006, nine consecutive patients who had a one-stage left-sided colon resection without preceding colonic lavage were evaluated. The main outcome measures were anastomotic leakage, wound infection and death. There were nine patients: six were males and three were females (M:F = 2:1). Their ages ranged from 2-10 years (mean age 6 years). The obstruction was due to irreducible colo-colic intussusceptions in two patients and colo-colic intussusceptions with colonic perforation in four patients, and colo-colic intussusceptions with gangrene in three. All the patients had resection and primary anastomosis without on-table colonic lavage. There were no anastomotic leakages or deaths. Postoperative complications included superficial wound infections in two patients and dry cough in four other patients. Three patients were lost to follow up after 3 years of follow up, but the remaining six are presently doing well. Primary anastomosis without colonic lavage is safe for resection of the left colon in children in an emergency setting.

Seminars in Pediatric Surgery, 2012

The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4... more The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4 distinct phases, starting from early 1920s till the present. The pace of development has been quite variable in different parts of Africa. Despite all recent developments, the practice of pediatric surgery in Africa continues to face multiple challenges, including limited facilities, manpower shortages, the large number of sick children, disease patterns specific to the region, late presentation and advanced pathology, lack of pediatric surgeons outside the tertiary hospitals, and inadequate governmental support. Standardization of pediatric surgery training across the continent is advocated. Collaboration with well-established pediatric surgical training centers in Africa and other developed countries is necessary. The problems of delivery of pediatric surgical services need to be addressed urgently, if the African child is to have access to essential pediatric surgical services like his or her counterpart in the high-income parts of the world.

Nigerian Journal of Surgical Research, 2010

Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.

Nigerian Journal of Surgical Research, 2010

A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right... more A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end anastomosis. This is a rare occurrence in infants and seems to result from late presentation. Health education coupled with early referral and prompt repair of inguinal hernia in neonates and infants would reduce this complication.

West African Journal of Medicine, 2005

Pediatric Surgery International, 2008

Pediatric surgery international, 2004

The study was carried out to determine the characteristics and outcome of management of anorectal... more The study was carried out to determine the characteristics and outcome of management of anorectal malformations (ARM) in Nigerian children at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in Ile-Ife, Nigeria, between January 1986 and December 2002. Eighty-six children with ARM were studied, 48 males and 38 females. Only 12 (13.9%) presented to the hospital within 24 h of birth. Twenty-four (27.9%) patients had one or more associated congenital anomalies, with oesophageal atresia with tracheo-oesophageal fistula being the most common associated malformation. A low variety was identified in 26 (30.2%) cases, while 60 (69.8%) had intermediate or high lesions. Twenty-two patients with the low type of anomaly were offered primary anoplasty in the neonatal period, whereas 59 patients with intermediate or high malformations were offered a preliminary colostomy. A definitive pull-through procedure was ultimately performed in 27 of these 59 cases. Twenty-six patients (30...

East African Medical Journal, 2002

Objective: Oesophageal foreign bodies (EFBs) are a common emergency issue in paediatrics, and few... more Objective: Oesophageal foreign bodies (EFBs) are a common emergency issue in paediatrics, and few studies have revealed its clinical features and treatment methods. We conducted this retrospective study to provide our 10-year clinical evidence for the diagnosis and treatment of EFB and reduce the incidence of complications. Methods: We retrospectively reviewed all paediatric cases diagnosed with EFB from January 2012 to December 2021 at Shenzhen Children's Hospital. The age and sex of the patients, types of foreign bodies (FBs), preoperative examination, location and duration of FB impaction, clinical symptoms, surgical methods, therapeutic effects and complications were analysed. Results: Among the 1355 cases, 759 were boys and 596 were girls, with a median age of 2.9 years (4 months to 16 years). The shortest FB lodged time was 1 hour, while the longest time was 3 months. The types of foreign bodies included coins and blunt objects (812,59.9%), bones and sharp objects (278,20.5%), button batteries (86,6.3%), food impactions (84,6.2%), toys (51,3.8%) and plastic objects (44,3.2%). A total of 720 of 812 cases impacted by coins and blunt subjects were successfully treated with a Foley catheter without any complications. A total of 558 patients underwent rigid oesophageal endoscopy under general anaesthesia, and foreign bodies were successfully removed in 525 cases. No FB was found in 33 cases, and FBs pushed into the lower digestive tract during operation in 5 cases. Oesophageal injury was found in 130 cases (23.3%). Our study showed that the age of the patient, time of foreign body incarceration, type of foreign body, location of the lodged foreign body, and fever or cough were risk factors leading to oesophageal foreign body complications, and the differences were statistically significant (P < 0.05). Conclusion: Children with EFB have a risk of complications, especially if the FB is a button battery. The appropriate surgical method should be selected through the analysis of the clinical characteristics of the foreign body in the oesophagus and the risk factors for complications to reduce the incidence of complications. Health education and effective care are the keys to the prevention of EFB.