Nigerian Teaching Hospital Research Articles

Incidence of postoperative residual paralysis in a nigerian teaching hospital.

Postoperative residual paralysis (PORP) is a known risk factor after general anesthesia (GA) for critical respiratory events and increased postoperative morbidity. PORP is defined as a train-of-four ratio (TOFR) of <0.9 using acceleromyography (AMG). TOFR <0.9 has been associated with increased risk of aspiration, obstruction of the upper airway and an impaired hypoxic ventilatory response. The aim of this study was to determine the incidence of PORP, associated factors related with its occurrence and critical respiratory events in the postanesthesia recovery room (PAR) at our institution. Forty-one adult patients were scheduled for elective surgeries requiring GA with the use of at least 1 dose of a nondepolarizing neuromuscular blocking drug (NMBD). An independent anesthetist quantitatively measured TOFR of recruited patients postoperatively in the recovery room using the TOF-watch SX acceleromyograph (Organon Teknika) 5 min after arrival. The incidence of PORP was 75.6% (n = 31), with severe PORP (TOFR <0.7) seen in 41.5% (n = 17) of patients. Median time to full recovery in the PAR was 33 min (range 5-164 min). There was no statistical difference in the incidence of PORP related to the choice of NMBD (P = 0.186) or duration of surgery (P = 0.175). No respiratory complications or events were observed in patients with residual blockade. The incidence of PORP is quite high and undetected in our environment. Quantitative monitoring for residual paralysis is advocated as part of routine monitoring with the use of NMBDs for improved patient safety.

Firearm injuries received in emergency room of a Nigerian Teaching Hospital: Aanalysis of pattern, morbidity, and mortality.

The morbidity and mortality associated with civilian firearm injury in developing countries is appreciable. The increasing incidence of gunshot casualties received in hospital emergency rooms is an emerging concern. The aim of this study was to determine the pattern and outcome of firearm injuries in a civilian setting of a developing country. This was a retrospective analysis of data on the entire patients with firearm injury received in the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to December 2014. There were 214 casualties, male-to-female ratio was 8:1, and mean age was 31.7 ± 0.80 years. The causes of injuries were armed robbery (59.9%), assault (33.6%), and accidental (6.5%). The incidence of armed robbery-related injury peaked in May and was higher in rainy season (P < 0.018), urban areas (P < 0.001) and at night-time (P < 0.033), whereas the incidence of assault-related injury peaked in April and was higher in dry season in rural areas and at day-time. Duration of hospital admission ranged from 1 to 184 days and mean was 16 days. Prolonged duration of hospital admission correlated with perforating wound (P < 0.001), high-velocity gunshot (P < 0.001), fractures (P < 0.001) and wound infection (P < 0.001). Preventable death rate was high, although mortality rate was 5.6%. A high mortality rate correlated with visceral injury (P < 0.001) and hypovolaemic shock (P < 0.001). The temporal distribution of firearm injury varies in location and aetiology of gunshot. This and the factors for relatively high morbidity and preventable death rate observed call for preventive strategies as well as improvement in pre-hospital and emergency room care.

Antepartum Hemorrhage: A Retrospective Analysis from a Northern Nigerian Teaching Hospital.

Background:Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality associated with this condition.Objectives:The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the fetomaternal outcome of pregnancies complicated by APH in Aminu Kano Teaching Hospital, Kano.Materials and Methods:A 5 years retrospective study of all pregnancies complicated by APH at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 1, 2009, and December 31, 2013, was conducted.Results:A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constituting 68.3% and 30.0%, respectively. Sociodemographic characteristics associated with the occurrence of APH included age, booking status, parity, and socioeconomic status. The peak prevalence of APH was observed in the 35–39 year age group accounting for 33.0%. There were 123 live births and 92 stillbirths. The cesarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia necessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatality rate of 2%.Conclusion:The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpartum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.

The prevalence and course of preinvasive cervical lesions during pregnancy in a Northern Nigerian Teaching Hospital.

Background:In spite of knowledge of the causes and prevention of cervical cancer, screening programs for cervical cancer have not yet been fully implemented in most developing countries including Nigeria. Documented data on the prevalence of preinvasive cervical lesion in pregnancy are scarce in our environment.Objectives:To determine the prevalence, risk factors, and course of preinvasive cervical lesion in pregnant women attending an antenatal clinic in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northern NigeriaStudy Design:This was a cross-sectional longitudinal study.Setting:The study was conducted in an antenatal clinic of ABUTH Zaria.Materials and Methods:A prospective cross-sectional longitudinal analysis was carried out at an Antenatal Clinic of ABUTH Zaria, Nigeria. A total of 250 consecutive pregnant women who fulfilled the inclusion criteria and have given their consent were recruited into the study at the time of their first prenatal (booking clinic) visit for antenatal care. Data from the pregnant women were obtained using a pro forma to evaluate sociodemographic characteristics and risk factors for preinvasive disease. Conventional Papanicolaou smear was taken using the standard procedure. The cytopathologic findings of initial and postpartum Pap smear were documented in the pro forma. Prevalence, persistence, progression, and regression rates of preinvasive diseases were determined.Results:Out of the 250 pregnant women who had cervical cytology by Pap smear during the study, 15 had preinvasive cervical lesion, giving a prevalence rate of 6%; 13 (87%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (13%) were high-grade squamous intraepithelial lesion (HGSIL). Negative smears were seen in 158 women (63.2%). Inflammatory and other conditions of the cervix which are technically negative smears made up the remaining 30.8%. At postpartum follow-up of the 13 women with LGSIL, 2 (15.4%) became negative while persistence of the disease was observed in 9 (69.2%) of the cases. Two women with LGSIL were lost to follow-up. Of the two women with HGSIL, persistence of the disease was seen in one woman (50%) and regression of the disease was seen in the other woman. Risk factors that were found to be associated with preinvasive cervical lesion were age at coitarche <16 years, number of sexual partners since coitarche, and previous history of sexually transmitted infection and human immunodeficiency virus. Parity, smoking, and use of contraception were found not to be significant risk factors.Conclusion:Preinvasive lesion of the cervix is relatively common among antenatal clients in our center. Antenatal clients with HGSIL should have a repeat smear at the end of the puerperium before treatment. Routine Pap smear should be offered to all antenatal clients in our setting.

The etiology and antimicrobial susceptibility patterns of urinary tract infections at a private Nigerian teaching hospital in South West Nigeria

Background: Urinary tract infections (UTI’s) are among the commonest bacterial infectious disease in clinical practice with a wide range of etiologic agents. It frequently occurs in both the hospital and the community. Aims/Objectives: To determine the etiology of UTI at BUTH and obtain data on their susceptibility and resistance patterns. Methods: This was a prospective analysis of data on patients with UTI obtained from in and outpatients over a six month period. Samples had been obtained by clean catch mid-stream urine or suprapubic aspiration. The organisms had been identified by biochemical methods with susceptibility and resistance testing performed. Data analysis was with EPI-INFO version 3.5.1 Results: There were a total of 200 urine samples that had positive growth. Prevalent organisms were Escherichia coli (48%) and Klebsiella spp (24%), followed by Staphylococcus aureus (10%) and Coagulase Negative Staphylococci (6.5%). The risk factors for UTI were female gender (p = 0.00), Diabetes mellitus (p = 0.03) and genitourinary surgery (p = 0.04). Effective antibiotics in-vitro to Escherichia coli were Nitrofurantoin and Cefepime at 84.8% and 92.3% respectively; while Cotrimoxazole performed poorly (32.5% susceptibility). Conclusion: Urinary tract infections are an important cause of morbidity in our environment and inaccuracies in diagnosis will prolong morbidity and may lead to costly and unsafe treatments.The prevalent pathogens in our environment are the Gram negative bacilli, Escherichia coli and Klebsiella pneumoneae . Nitrofurantoin retains efficacy to both urinary pathogens. Keywords: Urinary Tract Infection, Catheterization, Escherichia coli , Risk factors, Nitrofurantoin

Factors Associated with Spontaneous Preterm Delivery in a Nigerian Teaching Hospital

Objective (s): To determine the aetiological factors of preterm deliveries at Aminu Kano Teaching Hospital, Kano, Nigeria..Materials and methods: This case-control study was conducted between 1st June 2006 and 31st May 2007.One hundred and forty eight women with preterm deliveries (cases) were compared with seven hundred and forty women who delivered at term (control). Data analysis was done using Epi- Info software (6.0 CDC Atlanta Georgia, USA). Univariate and multivariate logistic regression analysis were performed and the results were expressed as odds ratio (OR) with 95% confidence interval (CI). The contribution of the risk factors were estimated using chi square test and a p-value of &lt; 0.05 was taken as significant.Results: The period incidence of preterm deliveries was 69 per 1000 births. Unbooked and low socioeconomic statuses, primigravidity, previous preterm deliveries, multiple pregnancies, pre-eclampsia, and malaria in pregnancy were significant risk factors that were associated with preterm delivery. These associations were still demonstrable after adjusting for confounding variables.Conclusion: Early girl marriage and childbearing and spontaneous pre-labour rupture of membranes not to be independent risk factors in this study. Women with risk factors should be managed in specialist hospitals.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 9-14

An audit of the quality of surgical operation notes in a Nigerian teaching hospital

Background: Operation note records are important tools for ensuring patients’ continuity of care, for research purposes and medico-legal reasons. They can effectively serve these purposes only if well documented. The main objective of this study was to assess the practice of recording the operation notes among surgical trainees in a Nigerian Teaching Hospital. Methods: Operation notes completed by doctors in the Surgery Department over a 2-month period were audited for completeness, legibility and conformity to the standards of the Royal College of Surgeons of England. Results: There were 100 operation notes reviewed, two-thirds of these were written by Senior Registrars, majority of which were for elective operations (63%). Only 37 of the operation notes were appropriately completed with about two-thirds either incomplete or wrongly filled. The cadre of the surgical trainee did not significantly influence the completeness of the operation notes. Legibility of the operation notes was associated significantly with completeness (p<0.04). Conclusion: Standards of operation note writing in our practice needs to be improved upon. The challenges of legibility and completeness of documentation can be overcome by the use of an aide-memoire as well as computerized operation notes.

Psychological distress and quality of life of people living with HIV/AIDS in a Nigerian teaching hospital

ABSTRACTPresence of psychological distress and poor quality of life (QoL) may affect the outcome of HIV/AIDS. One hundred and seventeen consecutive and consenting participants were interviewed using a Socio-demographic questionnaire, Kessler Psychological Distress Scale (K10) and World Health Organization Quality of Life-HIV Bref. Fifty-six (47.9%) participants scored 20 and above on K10 Scale. QoL was significantly higher in married participants, those who perceived their state of health as being good, asymptomatic participants and those who scored well–mild on K10. The older age group scored higher on QoL Scale than the younger age group in the physical health domain while the married participants scored higher in the domains of physical health, psychological health, environment and spiritual/religion. The participants who perceived their state of health as being good scored higher than those who perceived their health as poor in all domains. There is a high level of psychological distress and poor QoL in people living with HIV/AIDS.

Challenges of Radiation Therapy Delivery at a Nigerian Teaching Hospital

Challenges of Radiation Therapy Delivery at a Nigerian Teaching Hospital

Presentations, Management and Outcomes of Temporomandibular Disorders (TMDs) in Port Harcourt: One-Year Prospective Analysis

Temporomandibular joint disorders (TMDs) constitute a spectrum of chronic orofacial pain condition for which no specific treatment modality has proven to be always effectual. Experiences and outcomes vary between patients. Management is always a dilemma for clinicians who must be skilled and knowledgeable in making diagnosis and providing holistic care for the TMD patient. Literature documenting clinical experiences with TMD patients is very sparse; in fact, none was found from the Nigerian medical literature. This article presents our experience in a Nigerian teaching hospital and a secondary state facility for oral and maxillofacial care. It is a record of management of TMD patients encountered over a one-year period during which patients were prospectively followed and their treatment profiled according to a self designed protocol adopted by our department. Here, we present our experience with fifteen patients followed up for a minimum of 6 months during the study period. Treatments were administered at various levels according to our protocol and outcome was satisfactory in over 50% of cases.

Pattern of gunshot deaths in a Nigerian Tertiary Health Institution

The present study was aimed to determine the pattern of injuries, manner of death, and demographic parameters of gunshot deaths in a Nigerian teaching hospital. This was a prospective descriptive autopsy study of gunshot deaths seen in the University College Hospital (UCH), Ibadan, over a period of twelve months from January to December 2006. All the coroner autopsies for the period involving gunshot deaths were reviewed with emphasis on the sex, age, occupation, circumstances surrounding the event, manner of death, likely motive in cases of homicidal or suicidal gunshot, type of gun used and site(s) of injury. Gunshot deaths formed eleven (1.6%) of the 697 coroner cases performed at UCH in 2006. Ten of the 11 cases were male, and the overall age range was 10-60 years. The manner of death in ten of such cases was homicide, and unascertained in one case. Rifled weapons were used in 64% of the cases and shotguns, illegally acquired, accounted for the remaining 36%. Most were victims of armed robbery attacks. The head, abdomen, chest and lower limbs were sites of injuries in descending order of frequency. Gunshot deaths were the commonest form of homicide in the period under review. Young males and victims of armed robbery attacks are most susceptible. It is important to note the absence of suicidal gunshot deaths in this study. Keywords: Pattern of injuries; Gunshot deaths; Demographic parameters; Nigeria

Abstract #222: Health-Related Quality of Life in Patients with Diabetic Foot Disease in a Nigerian Teaching Hospital

Abstract #222: Health-Related Quality of Life in Patients with Diabetic Foot Disease in a Nigerian Teaching Hospital

Compliance of Radiation Dose and Image Quality in a Nigerian Teaching Hospital with the European Guidelines for Pediatric Screen-Film Chest Radiography

Introduction Blue light is a part of the spectrum with the highest energy content, which can reach the retina. The damage that it can cause to the retina is called photochemical or blue-light retinal injury. For the retinal injury assessment of the photochemical and aphakic retinal hazards in the wavelength range of 300-700 nm, use of effective spectral radiance limits (W.m-2.sr-1) seems to be slightly perplexing for ophthalmologists. However, in this study, the temperature (OC) that can emit the same effective spectral radiance limit was detected using a computer code; this method could help prevent blue-light retinal injury. Materials and Methods The limits proposed by International Commission on Non-Ionizing Radiation Protection for blue-light induced photochemical and aphakic eye hazards were expressed in terms of temperature by a computer code for 13 Planckian sources that produce the same radiance. The calculated temperature by the computer code, here known as threshold temperature, is the maximum source temperature that for a specified viewing distance and source diameter does not cause the exposure at the receptor position to exceed the exposure limit. Results In terms of threshold temperature, the exposure limits for aphakia or infant retinal injury are much lower than retinal photochemical damage. For light sources with more effective radiances, these differences reach 800 K. Conclusion This method allows evaluation of photochemical and aphakic retinal hazard only by comparing the calculated threshold temperature by a computer code with the temperature of the radiant source, which may be beneficial for hygienist and ophthalmic clinicians.

In-vitro Antibiotic Susceptibility Tests of Bacterial Isolates from Abdominal Wound Infection in a Nigerian Teaching Hospital

In-vitro Antibiotic Susceptibility Tests of Bacterial Isolates from Abdominal Wound Infection in a Nigerian Teaching Hospital

Pattern of surgical periodontal treatment in a Nigerian Teaching Hospital: A 37 month review

Objective: Periodontal diseases are treated using nonsurgical treatment methods and surgical treatment methods. There is a paucity of information on surgical periodontal treatment in Nigerian periodontal healthcare settings. The objective of the study was to determine the indications and pattern of surgical periodontal treatment in the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: This retrospective review of patients that had surgical periodontal treatment at University of Benin Teaching Hospital, Benin City, Nigeria, over a 37 month period (January 2013–2016) was done using a self developed proforma as the data collection tool. A total of 52 patients out of the 5111 patients treated within the period had surgical periodontal treatment and were subsequently analyzed using SPSS version 20.0. Results: The patients aged between 16 and 81 years with a mean age of 44.15 ± 18.99 years and a median age of 45 years had surgical periodontal treatments. The majority of the patients were older adults (57.7%) (middle-age adults [34.6%] and elderly [23.1%]) and females (75.0%). The indications for the surgical periodontal treatment were mainly periodontal abscess and gingival enlargement. The gingival enlargement was majorly pyogenic granuloma in 41.2% (7/17) and fibrous epulis in 23.5% (4/17). Incision and drainage and gingivectomy constituted the main surgical periodontal treatments among the patients in this study. Age and gender were found to be significantly associated with the indications for surgical periodontal treatment and the pattern of surgical periodontal treatment among the patients. Conclusion: Periodontal abscess and gingival enlargement constituted the main indications for surgical periodontal treatment while incision and drainage and gingivectomy were the main surgical periodontal treatments in this study.

Predictors of knowledge regarding Ebola virus disease among medical and nursing students in a Nigerian teaching hospital

Background: The Ebola Virus disease is one of the deadliest re-emerging diseases; the 2014 outbreak has been devastating with thousands of deaths resulting in global panic. Methods: A cross-sectional study was conducted involving 423 under-graduate medical and nursing students from University of Maiduguri Teaching Hospital using multi-stage stratified random sampling. Data was collected using a pretested self-administered questionnaire and analyzed using IBM-SPSS version 22. Chi-square was used for association between categorical variables while Spearman’s correlation was used for correlation between continuous variables. Multiple Logistic regressions were used to determine independent predictors of knowledge. Results: Mean knowledge score was 30.4±6.4, only 40.9% had good knowledge. Predictors of knowledge were Age (AOR=1.164, 95% CI=1.07-1.26), Field of study (AOR=4.64, 95% CI=2.33-9.23) and Year of studies (AOR=2.27, 95% CI = 1.06-4.84). Conclusions: There is still poor knowledge regarding this disease and the need for improvements.

Video-assisted thoracic surgery in a Nigerian teaching hospital: Experience and challenges.

Video-assisted thoracic surgery (VATS) is well established. Its application in Nigeria has however been limited and not been reported. The aim of this study was to describe our institutional experience and challenges with VATS. This was a retrospective cross-sectional study of all patients that underwent VATS in our institution between March 2008 and June 2013. Data were extracted from a prospectively maintained database. Two hundred and sixty-one patients were assessed as potential VATS cases. VATS was initiated in 26 patients, but completed in 25 patients (9.6%) as there was one case of conversion of a planned VATS bullectomy due to the failure of one lung ventilation. There were 12 males and 13 females. Mean age was 40.7 ± 13.9 years. The indication was interstitial lung disease in 9 patients (36%), malignant pleural effusion in 6 patients (24%), spontaneous pneumothorax in 5 patients (20%), indeterminate pulmonary nodule in 2 patients (8%), pleural endometriosis in 2 patients (8%) and bronchogenic cyst in one patient (4%). Procedures performed were lung biopsy in 13 patients (52%), pleural biopsy and pleurodesis in 6 patients (24%), bullectomy and pleurodesis in 5 patients (20%) and excision of bronchogenic cyst in one patient (4%). Mean hospital stay was 4 ± 0.7 days. There were no complications and no mortalities. VATS is being performed in our institution with successful outcomes. The use of VATS in Nigeria is encouraged. The relatively high cost of VATS is, however, a major limitation to more widespread use.

Low back pain as seen in orthopedic clinics of a Nigerian Teaching Hospital.

Low back pain is not a specific disease though a common health concern worldwide. There is regional variation in its etiology and patterns of presentation. In West African sub-region, there are very limited data on this important aspect of low back pain. We aimed to determine the etiology and pattern of presentation of low back pain among patients seen in our orthopedic outpatient clinics. This was a retrospective review of database of all new patients with low back pain seen at the orthopedics clinics of Federal Teaching Hospital, Abakaliki between 2003 and 2013. There were 2914 new patients seen in the orthopedic clinics -291 (10%) of them presented with low back pain. The female to male ratio was 1:1.04 and the mean age was 45.8 ± 1.67 years. The mechanical low back pain was involved in 82.1% of the patients, and the incidence was significantly higher in females than males (53.1% vs. 46.9%, P < 0.003). The males were significantly more afflicted than females by pain from spinal infections (58.3% vs. 41.7%) and tumors (92.3% vs. 7.7% P <0.003). Low back pain associated with radiculopathy was observed in 75 (25.7%) patients and the incidence was significantly higher in the married than the singles (30.2% vs. 13.9%, P < 0.005). Lifting of heavy object was the most common predisposing factor of low back pain. Hypertension and peptic ulcer disease were two top medical co-morbidities while osteoarthritis of hip and knee was the most common associated musculoskeletal disorders. Low back pain of mechanical origin (recurrent and chronic in a significant proportion of patients) is predominant in our environment. This pattern calls for prevention as well as the early and appropriate care of the patient with low back pain.

Giant pleomorphic adenoma of major salivary glands: A review of ten cases

Background: Pleomorphic adenoma (PA) of the major salivary glands has been documented to occur in various sizes ranging from 1 cm to 10 cm in their widest diameter; however, they can assume a grotesque proportion as a consequence of uninhibited growth in cases with delayed presentation. Patients and Methods: A retrospective study of all patients with PA of the major salivary glands with sizes >10 cm in its widest dimension and seen over a 10-year period was undertaken by retrieving sociodemographic and clinical data from patients’ case files from the Oral and Maxillofacial Unit of a Nigerian Teaching Hospital. Results: Case files of ten patients (4 males and 6 females) were reviewed over the study period. The ages ranged from 14 to 61 years, mean 33.8 ± 17.97 years. Equal distribution of five cases of PA was noted in the parotid and submandibular glands, respectively. The onset of symptoms ranged from 3 to 20 years and the largest tumor was 27 cm in its largest diameter. Only one case of malignant PA was recorded. Conclusion: Prevalence of giant PA from the study was found to be 13.5%, with a greater occurrence in the female (60%) patients compared to the male (40%) patients and with an equal distribution in both parotid and submandibular glands. PA of major salivary glands can assume a grotesque proportion when timely surgical intervention is not sought. Complete surgical excision in benign lesions can guarantee a cure and restore self-esteem.

Postoperative complications from primary repair of cleft lip and palate in a semi-urban Nigerian teaching hospital.

Background:This paper seeks to investigate the incidence of short-term postoperative complications in children and adult patients undergoing primary surgery of cleft lip and palate.Patients and Methods:One hundred and fifteen patients consisting of children (below 12 years) and adult (12 years and above) who were operated for both cleft lip and palate within a 2-year period at the University of Maiduguri Teaching Hospital were reviewed postoperatively at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year intervals, respectively. The complications encountered within the periods of the review were recorded.Results:One hundred and twenty surgeries were performed on 115 patients (85 children 30 Adults). A total of 43 complications (31 in children and 12 in adults) were recorded over the study period. Eighteen (41.9%) of these complications were noticed in unilateral cleft lip repair, while 12 (27.9%) and 13 (30.2%) complications were observed in bilateral cleft lip and cleft palate surgeries, respectively. A higher complication rate (72.0%) was recorded in children compared with adults. Major complications (13.9%) were, however, observed more in adults than children.Conclusion:Although every surgeon attempts to prevent complications during surgery, they may still occur. The high complication rate observed in our study may be due to a small sample size. General complications observed among children are due to cross infection during a hospital stay, contributing immensely to the higher rate of complications in children. Moreover, this may be reduced by short hospital stay following surgery. We also advocate early contact with children with cleft, and early surgical intervention in other to prevent some of the major complications encountered in adult patients.