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Jahangard A, Ashrafi M. Wideband Tympanometry (WBT) Features in Children with Cleft Palate and Otitis Media with Effusion Before and After Cleft Palate Surgery. Indian J Otolaryngol Head Neck Surg 2023; 75:3590-3595. [PMID: 37974839 PMCID: PMC10646051 DOI: 10.1007/s12070-023-04059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/01/2023] [Indexed: 11/19/2023] Open
Abstract
Aims In some cases, children with cleft palate undergo unnecessary tympanostomy along with palatoplasty because of inaccurate evaluations in determining the level of otitis media with effusion (OME). Recent studies have shown that wideband tympanometry (WBT) significantly contributes to the accurate evaluation of the middle ear status in children with cleft palate. Therefore, this study aimed to investigate WBT and auditory brainstem response (ABR) indices before and after cleft palate repair surgery. Materials and Methods The study involved 88 children with cleft palate, and ABR and WBT energy absorbance indices were measured in two phases. The first phase was conducted three months and three days prior to cleft palate repair surgery, and the second phase was carried out one, three, and six months after surgery. Results In the first phase, the energy absorbance index of low frequencies was below the normal range in all children, within the normal range at high frequencies in 78 children, and below the normal range in only 10 children three months before cleft palate surgery. In the second phase, the energy absorbance index and hearing thresholds at low frequencies after surgery showed a significant difference compared with the preoperative index (p = 0.001). Conclusion Monitoring WBT indices and hearing thresholds in children with cleft palate is effective in determining the appropriate surgery for children with otitis media with effusion (OME). Furthermore, the WBT plays a crucial role in accurately assessing middle ear function after cleft palate surgery.
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Affiliation(s)
- Ali Jahangard
- Student Research Committee, Department of Audiology, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Ashrafi
- Department of Audiology, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Trezena S, Machado RA, de Almeida Reis SR, Scariot R, Rangel ALCA, de Oliveira FES, Borges AJ, Silva AT, Martelli DRB, Martelli Júnior H. Isolated nonsyndromic cleft palate: multicenter epidemiological study in the Brazil. BMC Oral Health 2023; 23:486. [PMID: 37452401 PMCID: PMC10349487 DOI: 10.1186/s12903-023-03197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Nonsyndromic orofacial clefts (NSOC) are the craniofacial most common congenital malformations. There are evidences that the nonsyndromic cleft palate (NSCP) development differs from other NSOC. However, most of the publications treat NSCP without considering that information. Furthermore, few studies focus on NSCP. The aim of this study was to describe epidemiological findings of patients with isolated NSCP in Brazil. METHODS In this cross-sectional multicenter study, four reference Centers for treatment in three different Brazilian states was investigated. Data were obtained from clinical records of patients, between November 2021 and June 2022. Researched variables were sociodemographic, clinical characteristics and pregnancy and family history. Pearson's chi-square and ANOVA One-way tests were used for associations. RESULTS Majority were female (58.1%), white (60.7%) with incomplete NSCP (61.2%). There was an association between complete NSCP and a positive history of medical problems during pregnancy (p = 0.016; 27.9%; OR: 1.94; 1.12-3.35). Systemic alterations were perceived in 40.6% of the sample with odds ratio for development of the complete type (OR: 1.21; 0.74-1.97). Higher OR was visualized in medication use during pregnancy (OR: 1.35; 0.76-2.37) and positive family history of oral cleft (OR: 1.44; 0.80-2.55). Dental and surgical care was associated with higher age groups (p < 0.050). CONCLUSIONS NSCP was most prevalent in white skin color female. Complete NSCP is associated with medical problems during pregnancy. Medication use during pregnancy and positive family history of oral cleft increase the chance of developing complete NSCP.
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Affiliation(s)
- Samuel Trezena
- Postgraduate Program in Primary Health Care, State University of Montes Claros, UNIMONTES, Prof. Darcy Ribeiro University Campus, Prof. Rui Braga Avenue, Vila Mauricéia, Montes Claros, MG, Postal Code: 39401-089, Brazil.
| | - Renato Assis Machado
- Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
- Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Rafaela Scariot
- Department of Oral and Maxillofacial Surgery, School of Health Science, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Ana Lúcia Carrinho Ayroza Rangel
- Center of Biological Sciences and of the Health, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil
| | - Fabrício Emanuel Soares de Oliveira
- Postgraduate Program in Primary Health Care, State University of Montes Claros, UNIMONTES, Prof. Darcy Ribeiro University Campus, Prof. Rui Braga Avenue, Vila Mauricéia, Montes Claros, MG, Postal Code: 39401-089, Brazil
| | - Anna Júlia Borges
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of José Rosário Vellano, Alfenas, Minas Gerais, Brazil
| | - Alissa Tamara Silva
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of José Rosário Vellano, Alfenas, Minas Gerais, Brazil
| | - Daniella R Barbosa Martelli
- Postgraduate Program in Primary Health Care, State University of Montes Claros, UNIMONTES, Prof. Darcy Ribeiro University Campus, Prof. Rui Braga Avenue, Vila Mauricéia, Montes Claros, MG, Postal Code: 39401-089, Brazil
- Department of Oral Diagnosis, Dental School, State University of Montes Claros, UNIMONTES, Montes Claros, Minas Gerais, Brazil
| | - Hercílio Martelli Júnior
- Postgraduate Program in Primary Health Care, State University of Montes Claros, UNIMONTES, Prof. Darcy Ribeiro University Campus, Prof. Rui Braga Avenue, Vila Mauricéia, Montes Claros, MG, Postal Code: 39401-089, Brazil
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of José Rosário Vellano, Alfenas, Minas Gerais, Brazil
- Department of Oral Diagnosis, Dental School, State University of Montes Claros, UNIMONTES, Montes Claros, Minas Gerais, Brazil
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Nahas LD, Alzamel O, Dali MY, Alsawah R, Hamsho A, Sulman R, Alzamel M, Omar A. Distribution and risk factors of cleft lip and palate on patients from a sample of Damascus hospitals - A case-control study. Heliyon 2021; 7:e07957. [PMID: 34541358 PMCID: PMC8436068 DOI: 10.1016/j.heliyon.2021.e07957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 09/03/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This case-control study was conducted to determine the distribution of cleft lip and/or palate, its association with family history, syndromes and serous otitis media (SOM), and its relation with several risk factors. METHODS The case group comprised of 133 children born with cleft lip and/or palate, and the control was 133 non-cleft children born full-term. Data was collected including age, gender, origin and risk factors for cleft lip and palate from patients' files, interviewing supervising doctors, and the patient. Data was then filled out into Excel and underwent statistical analysis using the Goodness of Fit Test and Chi-Square to determine the significance of the results. RESULTS Cleft lip and/or palate (CL/P) was slightly higher among males (51.9%). Combined cleft lip and palate (CLP) was the most common presentation (42.1%). Cleft lips (CL) were mostly complete cleft (51,5%) incomplete cleft comprised (41.1%), In the sample 35.4% of the cases were bilateral, 32.3% were right unilateral, 28.3% were left unilateral and 4% were median cleft. Cleft palate (CP) was mostly complete (46.6%) there were incomplete clefts (40%), and the remainder were submucosal (13.4%). Isolated CL and combined CLP were higher in males (51.6%, 62.5% respectively). Both isolated CP and Tessier anomaly were more common in females (64.7% and 58.3% respectively). consanguineous marriages accounted for 36.1% of cases. 21.8% of the sample had a first-degree relative and 24.8% had a second degree relative born with CL/P. There were only 7 cases (0.05%) of syndromic CL/P: Down's (4), Pierre Robin's (2), and Van der Woude Syndrome (1). A relationship was found between CL/P and the risk factors: taking anticonvulsants (without specifying the drug) (p = 0.025, OR = 10.73 C.I. 95%), taking retinoic acid (p-value = 0.049, OR = 4.75 C.I. 95%), not consuming folic acid (p-value = 0.00, OR = 28.23 C.I. 95%), and smoking cigarettes (p-value = 0.046, OR = 2.00 C.I. 95%). There was no relationship with maternal alcohol consumption or maternal diabetes (p-values = 0.652 and 0.210, respectively). SOM was present in 63.2% of patients with CL/P and were mostly isolated CP. CONCLUSION CL/P was only slightly higher among males. The most common condition was CLP. There was higher incidence of CL/P among second-degree relatives than first degree. Down's, Pierre Robin's, and Van der Woude Syndromes may be associated with CL/P. Taking anticonvulsants, taking retinoic acid, not consuming folic acid, and smoking cigarettes all have a role in the incidence of CL/P. More than half of the sample had an associated SOM.
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Affiliation(s)
- Louei Darjazini Nahas
- Department of Surgery Division of Otorhinolaryngology, Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Omar Alzamel
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Rama Alsawah
- Faculty of Medicine, Syrian Private University, Damascus, Syria
- Resident at Internal Medicine Department, Damascus University, Damascus, Syria
| | - Ahmad Hamsho
- Faculty of Medicine, Syrian Private University, Damascus, Syria
- Department of Otorhinolaryngology, Damascus, Syria
| | - Rafi Sulman
- Department of Otorhinolaryngology, Damascus, Syria
| | - Mohamad Alzamel
- Faculty of Medicine, Syrian Private University, Damascus, Syria
- Department of Otorhinolaryngology, Damascus, Syria
| | - Abdullah Omar
- Faculty of Medicine, Syrian Private University, Damascus, Syria
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Global prevalence of cleft palate, cleft lip and cleft palate and lip: A comprehensive systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:110-120. [PMID: 34033944 DOI: 10.1016/j.jormas.2021.05.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Birth defect is widely used as a term for congenital anomalies. Children with cleft lip and palate may have serious speech, hearing, nutrition, and mental and social development disorders; therefore, this study was designed to determine the overall prevalence of cleft palate, lip, and cleft palate through systematic review and meta-analysis. METHODS In this study, systematic review and meta-analysis of data from studies on the prevalence of cleft lip and palate in Scopus, Embase, Magiran, Web of Science (WoS), PubMed and Science Direct databases were extracted between January 2000 and June 2020. In order to perform the analysis of qualified studies, the model of random effects was used and the inconsistency of studies with I2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2). RESULTS According to the results of the present study on cleft palate, the total number of samples entered in the study in 59 studies were 21,088,517 individuals, the prevalence of cleft palate based on the meta-analysis of the reviewed studies in every 1000 live births was obtained 0.33 (95% CI: 0.28-0.38). In the case of cleft lip, the total number of samples entered in the 57 reviewed studies were 17,907,569 individuals. The prevalence of cleft lip obtained based on the meta-analysis of the reviewed studies was 0.3 in every 1000 live births (95% CI: 0.26-0.34), and in the case of cleft lip and palate, the total number of samples entered in the 55 reviewed studies was 17,894,673. The prevalence of cleft lip and palate based on the meta-analysis of the studies reviewed in each 1000 live births was 0.45 (95% CI: 0.38-0.52). CONCLUSION Due to the high prevalence of oral clefts such as cleft palate, cleft lip, and cleft lip and palate; health system policymakers need to take precautionary measures to reduce the number of patients, as well as diagnostic and therapeutic measures to reduce the effects of this disorder in children.
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Abstract
OBJECTIVES The main objective of this study was to report the prevalence and other relative risk factors of oral clefts among newborn infants. METHODS In this study, we reviewed the data regarding 234 infants with cleft anomalies as collected in questionnaires from 2004 to 2019 and demographic parameters were assessed. RESULTS Cleft lip and palate was the most common anomaly (66.7%), followed by isolated cleft palate (28.2%), isolated cleft lip (3.8%), and cleft lip and alveolus (1.3%). The study also showed that 54.3% of all cleft patients were boys and 45.7% were girls (with a rate of 1.18) and the difference between both sexes was significant (P-value = 0.010). In addition, cleft lip and palate was more common in males and isolated cleft palate was seen more in girls (P-value = 0.002, P-value = 0.001, respectively). The parents (56.4%) had consanguinity and 20% of them had a history of cleft in their family. CONCLUSION Cleft lip and palate in boys and cleft palate in girls was more common. Parents' consanguinity and history of cleft in their family are also important factors to consider. Further studies on cleft anomalies along with or without genetic factors are required.
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Galeh SD, Nouri-Vaskeh M, Alipour M, Fakhim SA. Clinical and Demographical Characteristics of Cleft Lip and/or Palate in the Northwest of Iran: An Analysis of 1500 Patients. Cleft Palate Craniofac J 2021; 58:1281-1286. [PMID: 33380223 DOI: 10.1177/1055665620980633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Orofacial clefts (OFCs) can occur as an isolated defect or as a manifestation of other syndromes. The current study aimed to evaluate demographic characteristics and distribution of different types of accompanying anomalies for OFCs in the northwest of Iran. DESIGN A retrospective cohort study. SETTING Tertiary pediatric hospital. PATIENTS AND PARTICIPANTS This study was conducted on 1500 cleft lip and/or palate patients born between July 2010 and June 2020 in the northwest of Iran. MAIN OUTCOME MEASURES Demographic and clinical characteristics of the children with OFCs including familial history, accompanying anomalies and syndromes, maternal passive smoking, mothers' and fathers' age, consanguineous marriage, and birth order. RESULTS Among 1500 patients, 441 had cleft lip, 615 had cleft palate, and 444 had cleft lip and palate. The positive family history of OFCs was found to be 20.9% to 25.4% depending on the cleft type. Accompanying anomalies were identified in 29.8% of cases. Cardiac, facial, and ear abnormalities were the most common types. Also, 2.9% were identified with syndromes and sequences. These included Pierre Robin Sequence, Velo-cardio-facial syndrome, and Down syndrome most frequently. CONCLUSION These findings may provide references for appropriate resources to establish and direct counseling and primary preventive projects in the northwest of Iran.
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Affiliation(s)
- Sima Dabbaghi Galeh
- Department of Otorhinolaryngology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nouri-Vaskeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahdieh Alipour
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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The Role of Environmental Factors in the Etiology of Nonsyndromic Orofacial Clefts. J Craniofac Surg 2020; 31:113-116. [PMID: 31821209 DOI: 10.1097/scs.0000000000005924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Nonsyndromic orofacial clefts (NSOFCs) represent the most common congenital anomalies in the head and neck region. Multiple factors contribute to the occurrence of this anomaly. The etiology of NSOFCs in the Ethiopian population has not been investigated prior to this study. AIMS OF THE STUDY To assess the role of maternal environmental factors in the occurrence of NSOFCs in the Ethiopian Population. METHODS The authors used unmatched case control study design and evaluated the role of environmental factors to the occurrence of NSOFCs in the Ethiopian population. The participants were recruited from the same institution (Yekatit 12 Hospital Medical College). The authors studied 760 mothers (359 mothers of children born with NSOFCs and 401 mothers of children born without any congenital anomalies). Univariate and multivariate logistic regression analyses were used to calculate relative risk by odds ratio and 95% confidence interval. RESULTS Mothers who gave history of bronchial asthma and mothers who were admitted for threatened abortion had a higher risk of delivering a child with NSOFCS P value=0.013; AOR=0.194, 95% CI [0.053-0.712], P value <0.001; AOR= 0.179, 95% CI [0.091-0.352] respectively. Higher number of children with NSOFCs were born to mothers who were exposed to diagnostic X-ray investigation during early pregnancy than those who were not exposed P value 0.048; AOR=0.375, 95% CI [0.142-0.990]. CONCLUSION Maternal exposure to diagnostic x-ray, maternal chronic illness like bronchial asthma and threatened abortion were found to be associated with the occurrence of NSOFCS in the studied population.
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Epidemiology of lip and palate clefts in northwest of Iran: Prevalence, surgery complications and unrepaired patients younger than 18 years old. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Nagalo K, Ouédraogo I, Laberge JM, Caouette-Laberge L, Turgeon J. Congenital malformations and medical conditions associated with orofacial clefts in children in Burkina Faso. BMC Pediatr 2017; 17:72. [PMID: 28292285 PMCID: PMC5351250 DOI: 10.1186/s12887-017-0833-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Orofacial clefts are usually isolated cases but can be associated with other congenital malformations that are either recognised or unrecognised syndromes. The reported prevalence and pattern of such associated malformations, however, vary among studies. OBJECTIVES To assess the frequencies and aetiologies of congenital malformations and associated medical conditions in children with orofacial clefts in Burkina Faso (Western Africa). METHODS A retrospective descriptive study was carried out at the El Fateh-Suka Clinic in Ouagadougou, Burkina Faso. All children who attended surgery for the repair of a cleft lip and/or palate were included in this study. RESULTS The frequency of congenital malformations associated with cleft lip and/or palate was 39/185 (21.1%). In the group with multiple congenital malformations of unknown origin (34 patients; 18.4%), 66.7% had cleft lip and palate, followed by isolated cleft lip (27.4%) and isolated cleft palate (5.9%). The digestive system (35.3%), the musculoskeletal system (19.6%), and eye, ear, face, and neck (15.7%) were the most affected systems. In the group of syndromic malformations (five patients; 2.7%), amniotic band syndrome (one patient), Van der Woode syndrome (one patient), Goltz syndrome (one patient), and holoprosencephaly (two patients) were identified. Medical conditions included anaemia (39.4%), infections (9.2%), malnutrition (7.5%), and haemoglobinopathies (4.3%). CONCLUSIONS Congenital malformations and medical co-morbidities were frequent in children with OFCs. Further studies and a National Malformations Registry are needed to improve the comprehension of OFCs in Burkina Faso.
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Affiliation(s)
- Kisito Nagalo
- Service of Paediatrics, El Fateh-Suka Clinic, Ouagadougou, Burkina Faso
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Isso Ouédraogo
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
- Service of Paediatric Surgery, Charles De Gaulle Pediatric University Teaching Hospital, Ouagadougou, Burkina Faso
| | - Jean-Martin Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatric Surgery, The Montreal Children’s Hospital, McGill University, Montreal, Canada
| | - Louise Caouette-Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Surgery, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
| | - Jean Turgeon
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatrics, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
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Abid A, Maatouk F, Berrezouga L, Azodo C, Uti O, El-Shamy H, Oginni A. Prevalence and Severity of Oral Diseases in the Africa and Middle East Region. Adv Dent Res 2017; 27:10-7. [PMID: 26101335 DOI: 10.1177/0022034515582062] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review aims to determine the prevalence and severity of oral health diseases in the Africa and Middle East region (AMER). The profile of oral diseases is not homogeneous across the AMER. There are large disparities between groups. Reliable data are scarce. The prevalence and severity of oral diseases appear to be increasing in the African region, as does associated morbidity. There are substantial differences in inequalities in oral health. Dental caries prevalence is less severe in most African countries than in developed countries, but the high rate of untreated caries reflects the limited resources available and difficulties of access and affordability to essential oral health care services. The prevalence of gingival inflammation is very high in all age groups in several African countries. The prevalence of maxillofacial trauma has increased in many countries, with a wide variation of the incidence and high prevalence of traumatic dental injuries in primary and permanent teeth. Orofacial clefts are among the most common birth defects. Annual incidence of oral cancer is estimated as 25 cases per 100,000 people in Africa. Noma is a major public health problem for the Middle East and North African (MENA) region. Data about human immunodeficiency virus/AIDS are limited, particularly in the MENA region. According to the World Health Organization Regional Committee for Africa report, some fundamental key basic knowledge gaps need to be underlined. They include inequalities in oral health, low priority for oral health, lack of adequate funding, inadequate dental student training, obstacles to medical and dental research, and poor databases. There are very few effective public prevention and oral health promotion programs in the AMER. Universal health coverage is not achievable without scientific research on the effectiveness of health promotion interventions.
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Affiliation(s)
- A Abid
- Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, Monastir, Tunisia
| | - F Maatouk
- Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, Monastir, Tunisia
| | - L Berrezouga
- Department of Medical Microbiology-Immunology, Faculty of Dental Medicine, Monastir & Department of Dental Medicine, F. Bourguiba University Hospital, Monastir, Tunisia
| | - C Azodo
- Department of Periodontics, University of Benin Teaching Hospital, Ugbowo, Benin City, Edo State, Nigeria
| | - O Uti
- Department of Preventive Dentistry, University of Lagos, Lagos, Nigeria
| | - H El-Shamy
- Department of Conservative Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - A Oginni
- Department of Restorative Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Abreu MHNG, Lee KH, Luquetti DV, Starr JR. Temporal trend in the reported birth prevalence of cleft lip and/or cleft palate in Brazil, 2000 to 2013. ACTA ACUST UNITED AC 2016; 106:789-92. [PMID: 27256471 DOI: 10.1002/bdra.23528] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND The birth prevalence of cleft lip with or without cleft palate (CL/P) in Brazil increased between the years from 1975 to 1994 but has not been evaluated for temporal trend since then. METHODS We used data from the Brazilian National Health Information System for the years 2000 through 2013. We calculated the reported CL/P birth prevalence each year per 10,000 live births and estimated the average increase in reported prevalence per year (and 95% confidence interval [CI]) by fitting a negative binomial regression model. We also estimated the temporal trend in each of the five Brazilian regions for this time period. RESULTS The overall reported birth prevalence was 4.85 (95% CI, 4.78-4.91) per 10,000 live births. The reported birth prevalence of CL/P increased over this time period, from 3.94 (95% CI, 3.73-4.17) per 10,000 in 2000 to 5.46 (95% CI, 5.20-5.74) per 10,000 in 2013. The temporal trend differed for different Brazilian geographic regions, being confined primarily to the Northeast (4.7% per year; 95% CI, 4.0%-5.5%), North (3.3% per year; 95% CI, 1.8%-4.7%), and Central (2.9% per year; 95% CI, 0.9%-4.9%) regions. CONCLUSION In recent years, there appears to be an upward trend in the reported prevalence of CL/P in Brazil, confined to the less developed regions of the country. The increase likely reflects improved surveillance; whether it also reflects etiologic differences is unknown. Birth Defects Research (Part A) 106:789-792, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kyu Ha Lee
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts
| | | | - Jacqueline Rose Starr
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts.
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Chi C, Wang S, Wojnarowska F, Kirtschig G, Davies E, Bennett C. Safety of topical corticosteroids in pregnancy. Cochrane Database Syst Rev 2015; 2015:CD007346. [PMID: 26497573 PMCID: PMC8558096 DOI: 10.1002/14651858.cd007346.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Topical corticosteroids are the most frequently prescribed dermatological treatment and are often used by pregnant women with skin conditions. However, little is known about their safety in pregnancy. OBJECTIVES To assess the effects of topical corticosteroids on pregnancy outcomes in pregnant women. SEARCH METHODS This is an update of a review previously published in 2009. We updated our searches of the following databases to July 2015: the Cochrane Skin Group Specialised Register, the Cochrane Pregnancy and Childbirth Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 6), MEDLINE, EMBASE, and LILACS. We also searched five trials registers and checked the reference lists of included studies, published reviews, articles that had cited the included studies, and one author's literature collection, for further references to relevant RCTs. SELECTION CRITERIA Randomised controlled trials and cohort studies of topical corticosteroids in pregnant women, as well as case-control studies comparing maternal exposure to topical corticosteroids between cases and controls when studies reported pre-specified outcomes. The primary outcomes included mode of delivery, major congenital abnormality, birth weight, and preterm delivery (delivery before 37 completed weeks gestation); the secondary outcomes included foetal death, minor congenital abnormality, and low Apgar score (less than seven at 5 min). DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two authors independently applied selection criteria, extracted data, and assessed the quality of the included studies. A third author was available for resolving differences of opinion. A further author independently extracted data from included studies that were conducted by authors of this systematic review. MAIN RESULTS We included 7 new observational studies in this update, bringing the total number to 14, including 5 cohort and 9 case-control studies, with 1,601,515 study subjects.Most studies found no causal associations between maternal exposure to topical corticosteroids of any potency and pregnancy outcomes when compared with no exposure. These outcomes included: mode of delivery (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.95 to 1.15, 1 cohort study, n = 9904, low quality evidence); congenital abnormalities, including orofacial cleft or cleft palate and hypospadias (where the urethral opening is on the underside of the penis) (RR 0.82, 95% CI 0.34 to 1.96, 2 cohort studies, n = 9512, low quality evidence; and odds ratio (OR) 1.07, 95% CI 0.71 to 1.60, 1 case-control study, n = 56,557); low birth weight (RR 1.08, 95% CI 0.86 to 1.36; n = 59,419, 4 cohort studies; very low quality evidence); preterm delivery (RR 0.93, 95% CI 0.81 to 1.08, 4 cohort studies, n = 59,419, low quality evidence); foetal death (RR 1.02, 95% CI 0.60 to 1.73, 4 cohort studies, n = 63,885, very low quality evidence); and low Apgar score (RR 0.84, 95% CI 0.54 to 1.31, 1 cohort study, n = 9220, low quality evidence).We conducted stratified analyses of mild or moderate potency, and potent or very potent topical corticosteroids, but we found no causal associations between maternal exposure to topical corticosteroid of any potency and congenital abnormality, orofacial clefts, preterm delivery, or low Apgar score. For low birth weight, although the meta-analysis based on study-level data was not significant for either mild to moderate corticosteroids (pooled RR 0.90, 95% CI 0.74 to 1.09, 3 cohort studies, n > 55,713) or potent to very potent corticosteroids (pooled RR 1.58, 95% CI 0.96 to 2.58, 4 cohort studies, n > 47,651), there were significant differences between the two subgroups (P = 0.04). The results from three of the individual studies in the meta-analysis indicated an increased risk of low birth weight in women who received potent to very potent topical corticosteroids. Maternal use of mild to moderate potency topical steroids was associated with a decreased risk of foetal death (pooled RR 0.70, 95% CI 0.64 to 0.77, 2 studies, n = 48,749; low quality evidence), but we did not observe this effect when potent to very potent topical corticosteroids were given during pregnancy (pooled RR 1.14, 95% CI 0.69 to 1.88, 3 studies, n = 37,086, low quality evidence).We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) Working Group approach to rate the overall quality of the evidence. Data from observational studies started at low quality. We further downgraded the evidence because of imprecision in low birth weight and inconsistency in foetal death. Lower quality evidence resulted in lower confidence in the estimate of effect for those outcomes. AUTHORS' CONCLUSIONS This update adds more evidence showing no causal associations between maternal exposure to topical corticosteroids of all potencies and pregnancy outcomes including mode of delivery, congenital abnormalities, preterm delivery, foetal death, and low Apgar score, which is consistent with the previous version of this review. This update provides stratified analyses based on steroid potency; we found no association between maternal use of topical corticosteroids of any potency and an increase in adverse pregnancy outcomes, including mode of delivery, congenital abnormality, preterm delivery, foetal death, and low Apgar score. Similar to the previous version of the review, this update identified a probable association between low birth weight and maternal use of potent to very potent topical corticosteroids, especially when the cumulative dosage of topical corticosteroids throughout the pregnancy is very large, which warrants further investigation. The finding of a possible protective effect of mild to moderate topical corticosteroids on foetal death could also be examined.
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Affiliation(s)
- Ching‐Chi Chi
- Chang Gung Memorial HospitalDepartment of Dermatology and Centre for Evidence‐Based Medicine6, Sec West, Chia‐Pu RoadPuzihChiayiTaiwan61363
- Chang Gung UniversityCollege of MedicineTaoyuanTaiwan
| | - Shu‐Hui Wang
- Far Eastern Memorial HospitalDepartment of Dermatology21, Sec 2, Nanya S RdBanciao DistrictNew Taipei CityTaiwan220
| | | | - Gudula Kirtschig
- University of TübingenInstitute of General Medicine and Interprofessional CareTübingenGermany
| | - Emily Davies
- Amersham Hospital, Buckinghamshire Healthcare NHS TrustDepartment of Dermatology100 Gilbert Scott CourtWhielden StreetAmershamBuckinghamshireUKHP7 0JD
| | - Cathy Bennett
- Coventry UniversityCentre for Technology Enabled Health Research (CTEHR)Priory StreetCoventryUKCV1 5FB
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Jalilevand N, Jalaie S. Prevalence of cleft lip and palate among four provinces in the West and North-West of Iran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:548-53. [PMID: 26600829 PMCID: PMC4621648 DOI: 10.4103/1735-1995.165951] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 06/24/2015] [Accepted: 08/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND One of the most common anomalies in newborn infants is cleft lip and/or cleft palate (CL/P). In spite of several studies about the prevalence of this, no investigation evaluated this prevalence in the West and North-West of Iran. With due attention to different ethnic groups in this area, the aim of this study is to investigate whether the distribution of CL/P live births varies regionally in this area of Iran. MATERIALS AND METHODS A cross-sectional study was conducted using hospital registry records to identify all children born with CL/P. The hospitals with a maternity unit were selected in the capital cities of four provinces in the West and North-West of Iran, East Azarbaijan, Kurdestan, Gilan, and Markazi. The population under study included all infants born alive from 2008 to 2012. RESULTS During the study period, 107,317 live births were registered in the hospitals with a maternity unit of four cities, and 52 infants (0.485/1000 live births) were born with CL/P. The prevalence in Rasht, Arak, Sanandaj, and Tabriz cities was 0.557, 0.352, 0.503, and 0.559/1000 live births, respectively (P < 0.05), and in cleft types (P < 0.05). Of the 52 infants who were born with CL/P, 24 (46.15%) were girls and 28 (53.85%) were boys (P > 0.05), whereas the prevalence of CL/P based on sex was statistically different among the four provinces (P < 0.05). CONCLUSION This study shows regional variations in the birth prevalence of clefts and various cleft types. The different effects of gender on the birth prevalence of CL/P from city-to-city may be explained environmentally and/or by genetic factors affecting the development of oral clefts.
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Affiliation(s)
- Nahid Jalilevand
- Department of Speech Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shohreh Jalaie
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Sabbagh HJ, Ahmed Hassan MH, Innes NPT, Baik AA, Mossey PA. Parental Consanguinity and Nonsyndromic Orofacial Clefts in Children: A Systematic Review and Meta-Analyses. Cleft Palate Craniofac J 2014; 51:501-13. [DOI: 10.1597/12-209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To assess whether individuals born to consanguineous parents had a higher frequency of nonsyndromic orofacial clefts compared with those with no parental consanguinity. Design A prespecified plan for a search strategy, inclusion/exclusion criteria, and data extraction from studies reporting consanguinity in relation to nonsyndromic orofacial clefts (NSOFC) was carried out. Papers reporting observational studies with control populations were included, without language restrictions, and these reports were assessed for quality. Sensitivity analyses using subgroups, homogeneity evaluation, and assessment of publication bias were carried out, and meta-analyses of extracted data were performed. Results Sixteen studies fulfilled the selection criteria and were included in the metaanalyses. There were statistically significant relationships between consanguinity and NSOFC for all 16 studies combined ( P = .0003), with odds ratio (OR) = 1.83 and 95% confidence interval (CI) = (1.31, 2.54); 10 case-control studies ( P = .006), with OR = 2.06 and 95% CI = (1.23, 3.46); six cross-sectional studies ( P = .03), with OR = 1.34 and 95% CI = (1.02, 1.76); first cousins consanguineous marriages ( P = .04), with OR = 1.40 and 95% CI = (1.01, 1.93); cleft palate alone ( P = .01), with OR = 1.89 and 95% CI = (1.14, 3.13); and cleft lip with or without cleft palate cases ( P = .002), with OR = 1.56 and 95% CI = (1.18, 2.07). Conclusion Although there was a high level of study heterogeneity, the evidence is consistent in suggesting that consanguinity is a risk factor for NSOFC, with an overall OR of 1.83 (95% CI, 1.31 to 2.54), implying that there was almost twice the risk of a child with NSOFC being born if there was parental consanguinity.
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Affiliation(s)
- Heba J. Sabbagh
- King Abdulaziz University, Jeddah, Saudi Arabia
- Dundee University, Scotland, United Kingdom
| | - Mona Hassan Ahmed Hassan
- Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | - Alaa Al Baik
- King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
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Fontes MÍB, Almeida LN, De Oliveira Reis Junior G, Filho JIV, Santos KMD, Anjos FSD, De Andrade AKM, Porciuncula CGG, De Oliveira MC, Pereira RM, Vieira TAP, Viguetti-Campos NL, Gil-Da-Silva-Lopes VL, Monlleó IL. Local Strategies to Address Health Needs of Individuals with Orofacial Clefts in Alagoas, Brazil. Cleft Palate Craniofac J 2013; 50:424-31. [DOI: 10.1597/11-069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To describe demographic and clinical-genetic characteristics of patients from a poor area of Brazil and to share experience on how the local genetic unit has addressed their major health needs. Design Descriptive cohort. Setting A clinical-genetic unit, a cytogenetics unit, and a regional cleft team located in the northeast and southeast of Brazil. Participants A total of 133 individuals with orofacial clefts who attended the surgical call of a nongovernmental organization. From this group, 125, 77, and 13 patients completed phases 1, 2, and 3, respectively. Methods Phase 1 comprised a description of demographic characteristics recorded through interviews. Phase 2 included a clinical-genetic evaluation using a pretested form, as well as cytogenetic analyses of selected patients. Phase 3 comprised collaborative action to address major health needs of patients without primary surgery. The Fisher test was used for statistics with p value < .05. Results A majority of patients were rural residents with isolated cleft lip with cleft palate. Ages ranged between 0 and 30 years. Fifty percent had never undergone surgery; whereas, 100% had never attended a genetic evaluation. Isolated cleft was diagnosed in 77.9%, syndromes in 14.3%, and multiple congenital abnormalities in 7.8%. Positive familial history of clefts occurred in 28%; whereas, parental consanguinity was present in 7.8% cases. A total of 23 individuals without cleft surgery were registered for multidisciplinary treatment. Conclusions Findings revealed high levels of unmet medical needs and provided an evidence base for health care planning. Collaborative action was crucial and might be applied to other regions in Brazil.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Isabella Lopes Monlleó
- Department of Pediatrics, State University of Alagoas and Medical Genetics Sector, Federal University of Alagoas, Maceió, Alagoas, Brazil
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Mirfazeli A, Kaviany N, Hosseinpour KR, Golalipour MJ. Incidence of cleft lip and palate in gorgan - northern iran: an epidemiological study. Oman Med J 2012; 27:461-4. [PMID: 23226815 DOI: 10.5001/omj.2012.110] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 10/03/2012] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Cleft lip with or without cleft palate is the most common orofacial congenital anomaly among live births. This study was carried out to determine the incidence rate of oral clefting in Gorgan, Northern Iran during 2004-2009. METHODS This descriptive hospital-based study was performed on 35,009 live newborns in Dezyani Hospital in Gorgan, Northern Iran during 2004-2009. All newborns were screened for oral clefts. Data including birth date, gender, type of oral clefts, parents' consanguinity, parental ethnicity and presence of other congenital anomalies were recorded for analysis. RESULT The overall incidence rate of oral clefts during this 6-year period was 1.05 per 1000, or 1 per 946 live births. The incidence of cleft lip and isolated cleft palate was 0.08 and 0.37 per 1,000 live births, respectively. The ratio for different cleft types was 1:7:4 (CL: CLP: CP). The incidence of oral clefting was 1.2 per 1,000 male births and 0.86 per 1,000 female births (RR=1.40; 95% CI: 0.73-2.71). According to parental ethnicity, the incidence of oral clefting was 0.7, 1.7 and 1.26 per 1,000 in Native Fars, Turkman and Sistani, respectively. The relative risk for oral clefting in Turkman to native Fars group was 2.56 (p<0.02). In this study, 56.7% of clefts were CL+P, 8.1% were CL and 35.1% of cases were CP. CP was more common among girls (54%) than among boys (46%) but CL was more common among boys. CONCLUSION The results showed that the incidence of oral clefts in the study population as being 1.05 per 1,000 live births, which has increased from 0.97 per 1,000 live births reported in an earlier study in this area.
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Affiliation(s)
- Arezou Mirfazeli
- Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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