Genome-Wide Scan for Parent-of-Origin Effects in a sub-Saharan African Cohort With Nonsyndromic Cleft Lip and/or Cleft Palate (CL/P)

OBJECTIVE

Nonsyndromic cleft lip and/or cleft palate (NSCL/P) have multifactorial etiology where genetic factors, gene-environment interactions, stochastic factors, gene-gene interactions, and parent-of-origin effects (POEs) play cardinal roles. POEs arise when the parental origin of alleles differentially impacts the phenotype of the offspring. The aim of this study was to identify POEs that can increase risk for NSCL/P in humans using a genome-wide dataset.

METHODS

The samples (174 case-parent trios from Ghana, Ethiopia, and Nigeria) included in this study were from the African only genome wide association studies (GWAS) that was published in 2019. Genotyping of individual DNA using over 2 million multiethnic and African ancestry-specific single-nucleotide polymorphisms from the Illumina Multi-Ethnic Genotyping Array v2 15070954 A2 (genome build GRCh37/hg19) was done at the Center for Inherited Diseases Research. After quality control checks, PLINK was employed to carry out POE analysis employing the pooled subphenotypes of NSCL/P.

RESULTS

We observed possible hints of POEs at a cluster of genes at a 1 mega base pair window at the major histocompatibility complex class 1 locus on chromosome 6, as well as at other loci encompassing candidate genes such as ASB18, ANKEF1, AGAP1, GABRD, HHAT, CCT7, DNMT3A, EPHA7, FOXO3, lncRNAs, microRNA, antisense RNAs, ZNRD1, ZFAT, and ZBTB16.

CONCLUSION

Findings from our study suggest that some loci may increase the risk for NSCL/P through POEs. Additional studies are required to confirm these suggestive loci in NSCL/P etiology.

Policy Proposal for Integration of Tobacco Cessation Interventions into Oral Health Care in Dental Settings

BACKGROUND

Due to the health consequences and economic losses associated with tobacco, the WHO Framework Convention on Tobacco Control, a worldwide effort to control the effects of tobacco smoking on human health enacted a set of policies to curb tobacco use. Smoking cessation services aim to ensure that every patient is screened for tobacco use, their tobacco use status is documented, and patients who use tobacco are advised to quit. Dental health professionals are strategically positioned to reach many tobacco users and this proposal provides a simple framework whereby dentistry could play a major role in smoking cessation efforts.

INTERVENTIONS

Strategies for incorporating Cessation Services into Oral Health Care Delivery include the School Oral Health programs through Public Health Dentistry, updating the Dental School Curriculum through dental education regarding tobacco use prevention and cessation; including Tobacco Treatment Specialists certification in Postgraduate Curriculum for Dental Public Health; Continuing Medical Education (CME) focused on cessation services for dental personnel; Clinical Smoking Cessation Interventions in Dental settings; Compensation of Dental personnel for tobacco use prevention and cessation services; and ongoing research, evaluation and monitoring.

CONCLUSION

Incorporation of these evidence-based treatments into dental practice would result in more individuals achieving long-term abstinence and thus reduce tobacco-related death, disease, and economic loss worldwide.

The Knowledge, Perception and Practices regarding the Novel COVID-19 among Undergraduate Clinical Dental Students in Nigeria

BACKGROUND

Corona virus disease 2019 (COVID -19), is an infectious disease that has become a major public health emergency of international concern. It is necessary that Nigerian dental students have adequate knowledge about prevention/control of COVID-19 pandemic in dental practice. This study aimed to assess the knowledge and perception about COVID-19 among Nigerian dental students and its impact on their academic life.

MATERIAL AND METHODS

A web-based questionnaire assessing knowledge and perception with a total of 46 scoreable responses was created using Survey Monkey, an online survey tool. We surveyed 178 out of 507 clinical dental students attending the 10 dental schools. Bivariate analysis was conducted to test the association between students' age, gender and knowledge and perception of COVID 19 infection. Logistic regression was also conducted to determine the predictors of having good knowledge of COVID 19. The effect of all significant factors was inferred at P< 0.05.

RESULTS

The mean knowledge score of the dental students about infection control and COVID-19 was 32.19 (SD: 7.30, Range: 2-46). Knowledge scores significantly differed across genders, age-groups, class levels, university of study, previous lectures on infection prevention and control and risk-perception. The linear regression analysis showed that male gender (vs. female, β: 0.242, P<0.001), age-group of 18-24 years (vs. 45-54years, β: -0.305, P<0.001), class level 600 (vs. 500 level, β: -0.154, P<0.001), previous lectures on infection prevention and control (vs. no lecture, β: -0.186 , P=0.007), and a high-risk perception of COVID-19 ( vs. low-risk perception, β: 0.220, P=0.001) were significantly associated with higher knowledge scores.

CONCLUSION

The students were knowledgeable about mode of transmission, complications and diagnosis of COVID-19 but had limited understanding of the extra precautionary measures against COVID-19. These results imply that there is a need for an update of the infection prevention and control curriculum for dental students and improved quality assurance.

Early decompressive craniectomy for traumatic brain injury in resource poor centres:a tertiary institution experience

Decompressive craniectomy (DC) is the surgical management of increasing intracranial pressure (ICP) following a severe traumatic brain injury (TBI) as well as severe cerebrovascular insult. Established protocols for the use of DC include monitoring ICP and going through non-surgical methods to reduce ICP before DC which is the last resort. ICP monitors and facilities to render patients hypothermic and for inducing barbiturate coma are not readily available in resource depleted facilities, hence the need for a timely DC. DC when timely done saves lives and improves chances of survival following severe brain injury.

AIMS AND OBJECTIVES

This study intends to justify early and appropriate DC in selected patients with radiological and clinical increasing ICP in resource poor centres.

PATIENTS AND METHOD

A one-year prospective study of patients with severe brain injury with CT and clinical evidence of increasing ICP who had DC as the main modality of management.

RESULTS

Ten patients were recruited into the study on the basis of deterioration in level of consciousness and CT evidence of raised intracranial pressure. Males were 8 (80%) and females were 2 (20%) with a ratio of 4:1. RTA accounted for 80% of aetiology of TBI. Out of the ten patients, 4 (40%) died after DC. Six (60%) of the patients survived and had cranioplasty with bone flap replacement (3), titanium (2) and acrylic (1). Two (20%) were discharged with GOS of 5, another 2 (20%) with 4 and last 2 (20%) with GOS of 3.

CONCLUSION

Early decompressive craniectomy is beneficial for selected groups of patients most especially in settings where facilities for ICP monitoring and other medical options are not available.