Delayed presentation resulted in morphological changes, increased complications, number of orchidectomy and reduced chance of testicular growth post orchidopexy.

The incidence of infantile hypertrophic pyloric stenosis has steadily decreased in developing countries, and this study was designed to confirm this and establish any protection conferred by exclusive breastfeeding. A retrospective study was done between July 1978 and June 2008, at the University of Benin Teaching Hospital, Benin City, Nigeria. A total of 57 children aged between 2 and 6 weeks (mean 3.5 +/- 1.2 weeks) comprising of 49 males and 8 females with male female ratio 6.1 : 1 were treated. Following the introduction of exclusive breastfeeding in late 1980s and early 1990 s in Nigeria, a steady drop in incidence was noticed, with only five cases seen in the last decade and just one case seen in the past 5 years. All were babies who had artificial feeds, with none recorded among babies exclusively breastfed. This decrease in the incidence of infantile hypertrophic pyloric stenosis may have been due to exclusive breastfeeding.

BACKGROUND: Ambulatory surgical care accounts for over 70% of elective procedures in Northern America. Ambulatory paediatric surgical practice is not widespread in Nigeria. This report examined clinical indicators for quality care in paediatric ambulatory surgery using common outcomes after day case procedures as benchmark. METHODS: This was a cross-sectional study of children who were presented for ambulatory surgical care in the University of Benin Teaching Hospital. A standardized questionnaire was employed to record the age, gender, indication for surgery, type of anaesthesia, timelines for the surgery and associated complications. RESULTS: A total of 93 patients had surgical procedures on ambulatory basis. The mean age of the patients was 4.1 ? 4.0yr and duration of surgical procedure 31.3 ± 12.1 min. The male/ female ratio was 3:1, and herniotomy was the most frequent procedure on ambulatory paediatric surgical care 60 (64.5%). The common anaesthetic techniques employed in the paediatric ambulatory setting were spontaneous respiration with face mask 40 (43%), Inhalation technique with tracheal intubations 31 (33.3%), general anaesthesia with relaxant technique five (5.4%), local infiltration with or without sedation eight (8.6%), GA plus caudal block eight(8.6%), and subarachnoid block one(1.1%). The indicators of quality care were unanticipated admission (5.4%), repeat hospital visit (4.3%), readmission (2.2%) and delayed discharge (21.5%). CONCLUSION: The practices of paediatric surgery on ambulatory services are feasible in our setting. The observable complications are within acceptable limits. The timelines in the scheduling and discharge appear not to be optimal for an effective ambulatory service. WAJM 2009; 28(5): 304-307.

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In 2000-09, 96 children comprising 57 males and 39 females who were presented between 2 h and 1 week of birth with omphalocele were prospectively managed using goal-oriented classification at the University of Benin Teaching Hospital, Nigeria. All were born through spontaneous vaginal delivery, out of which 9 (9.4%) were preterm. Eighty-two (85.4%) mothers in villages with no supervised antenatal care/delivery and/or prenatal diagnosis presented their babies late. Thirty-three (34.4%) babies in group A, with defect size ≤ 4.5 cm and intact sac, were managed conservatively and had fascial closure after neonatal period, resulting in 32 (97%) survivors. Forty-two (43.8%) babies in group B, with defect size > 4.5 cm and intact sac, were managed conservatively and had fascial closures for 9 months to 5 years, resulting in 40 (95.2%) survivors. Group C comprised of 21 (21.9%) babies with defect of any size/ruptured sac and who had immediate repair, resulting in two (9.5%) survivors owing to lack of facilities (p < 0.0001). Hospital delivery and provision of facilities are advocated.