The Effect Of Honey Give As Oral Drops In Precipitating  Epithelialization Of Lateral Palatal Defects Post TwoFlap Palatoplasty

Background : Two-flap palatoplasty, which is a very common technique used including in our institution, will result in lateral palatal defects without any periosteal coverage. Faster epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. In our institution, the retrospective study showed a fair maxillary growth (mean GOSLON score=3.5). Thus, we explore possibilities to precipitate the epithelialization process in pursuit of good maxillary growth in the future.Method :This is a prospective cohort study conducted in Cipto Mangunkusumo Hospital, on consecutive patients who underwent two-flap palatopasty from October 2010-February 2011. We followed up these patients weekly for 4 consecutive weeks to observe the rate of epithelialization of the lateral palatal defects.Result : Two-flap palatoplasty was performed in 48 patients, 23 among them were given honey as oral drops. Eighty-seven point five percent had unilateral complete cleft lip and palate and 12.5% had bilateral complete cleft lip and palate. Faster epithelialization of the lateral palatal defects post two-flap palatoplasty was significantly in!uenced by intraoral honey application on the wound as oral drops (RR 2.1, 95% CI 1.314 - 3.391, p < 0.001).Conclusion: Honey given as oral drops significantly precipitates the epithelialization process of the lateral palatal defects post two flap palatoplasty 2.1 times faster.

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Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

10.21203/rs.3.rs-41322/v2 ◽

2021 ◽

Author(s):

Prajwal Paudel ◽

Avinash K Sunny ◽

Rejina Gurung ◽

Abhishek Gurung ◽

Honey Malla ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Prospective Cohort Study ◽

Birth Defects ◽

Prospective Cohort ◽

Birth Defect ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Birth Asphyxia ◽

Neonatal Infection

Abstract Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.

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Trajectories of the Psychological Status of Mothers of Infants With Nonsyndromic Orofacial Clefts: A Prospective Cohort Study From the Japan Environment and Children’s Study

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620951399 ◽

2020 ◽

pp. 105566562095139 ◽

Cited By ~ 1

Author(s):

Yukihiro Sato ◽

Eiji Yoshioka ◽

Yasuaki Saijo ◽

Toshinobu Miyamoto ◽

Kazuo Sengoku ◽

...

Keyword(s):

Cohort Study ◽

Psychological Distress ◽

Prospective Cohort Study ◽

Postnatal Depression ◽

Prospective Cohort ◽

Cleft Lip ◽

Psychological Status ◽

Control Group ◽

Orofacial Clefts ◽

Distress Scale

Objective: This study examined psychological status trajectories of mothers of infants with nonsyndromic orofacial clefts in Japan. Design: Prospective cohort study. Setting: Data from the Japan Environment and Children’s Study. Participants: Infants with a nonsyndromic cleft (N = 148) including cleft lip and palate (CLP; n = 72), cleft lip (CL; n = 46), and cleft palate (CP; n = 30). The control group included unaffected infants (N = 84 454). Main Outcome Measures: At 15 weeks and 27 weeks of pregnancy and 12 months after birth, the Kessler Psychological Distress Scale (clinical cutoff ≥5) was used. At 1 month and 6 months after birth, the Edinburgh Postnatal Depression Scale (clinical cutoff ≥9) was used. Results: Prenatal diagnosis rates were unavailable. Mothers of infants with CLP had higher psychological distress than controls at 27 weeks of pregnancy (prevalence ratio [PR] = 1.36, 95% CI: 1.06-1.74) and postnatal depression at 1 month after birth (PR = 2.21, 95% CI: 1.53-3.19). Mothers of infants with CP showed heightened psychological distress at 27 weeks of pregnancy (PR = 1.62, 95% CI: 1.21-2.17) and postnatal depression 6 months after birth (PR = 1.86, 95% CI: 1.01-3.43). There was no significant association between CL and maternal psychological status. At 12 months after birth, no differences in distress were found between mothers of infants with a cleft and controls. Conclusions: Mothers of infants with orofacial clefts may need psychosocial support, particularly during pregnancy and the first year after birth.

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Long Term Evaluation Of Maxillary Growth After ‘The Non Denuded Palatoplasty’ Technique

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v5i2.254 ◽

2019 ◽

Vol 5 (2) ◽

pp. 203-210

Author(s):

Prasetyanugraheni Kreshanti ◽

Siti Handayani ◽

Maulina Rachmasari ◽

Julieta Pancawati ◽

Amila Jeni Susanto ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Small Sample Size ◽

Small Sample ◽

Wound Contraction ◽

Class Iii ◽

Significant Difference ◽

Term Evaluation ◽

Growth Evaluation ◽

Maxillary Growth

Background : Conventional Two Flap Palatoplasty technique will produce lateral defects without any periosteal coverage. These denuded lateral defects are prone to contamination and infection. These will result in wound contraction, scar formation and maxillary growth impairment. In 2011, we studied “The Non Denuded Palatoplasty” technique. This technique precipitated the epithelialization process of the lateral defects. Faster epithelialization is expected to decrease wound contraction and good maxillary growth. Method : This is a case control study to compare the maxillary growth of 2 groups consists of unilateral cleft lip and palate patients repaired with “The Non Denuded Palatoplasty” technique and Conventional Two Flap Palatoplasty. The outcome will be evaluated from cephalometry and the dental cast for each patient is evaluated using GOSLON YARDSTICK method. Data will be analyzed using SPSS version 20. Result : A total of 4 patients in The Non Denuded Palatoplasty group and 10 in the Conventional Two Flap Palatoplasty. The cephalometric SNA, SNB and ANB point showed Class III skeletal jaw relationship or deficient maxilla. Meanwhile the GOSLON yardstick type III are the most common GOSLON on both group with good inter-ratter reliability (p=0.839) based on Mann Whitney test. In these study, there was no correlation between cephalometric variables with GOSLON score. Conclusion: Our results showed that modification (The Non Denuded Palatoplasty) technique made no statistically significant difference to the maxillary growth. However this study has several limitations, one of which being the small sample size due to family, social and other factors that are beyond the control of the investigating team. Also the evaluation was conducted in patients aged 7-9 years, hence the result of this study is not the final outcome. Keywords: maxillary growth evaluation, cephalometry, Goslon Yardstick, two flap palatoplasty

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Lip Height Improvement during the First Year of Unilateral Complete Cleft Lip Repair Using Cutting Extended Mohler Technique

Plastic Surgery International ◽

10.1155/2012/206481 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8

Author(s):

Cassio Eduardo Raposo-Amaral ◽

André Pecci Giancolli ◽

Rafael Denadai ◽

Frederico Figueiredo Marques ◽

Renato Salazar Somensi ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cleft Lip ◽

First Year ◽

Average Amount ◽

Scar Contracture ◽

Cleft Lip Repair

Objective. To compare the cutaneous lip height at early and late postoperative periods and to objectively determine the average amount of lip height improvement during the first year of unilateral complete cleft lip repair using Cutting extended Mohler technique. Methods. In this prospective cohort study, 26 unilateral complete cleft patients and 50 noncleft subjects were included. Photographs were taken between 12 and 16 weeks (T1) and also taken between 12 and 13 months after surgery (T2). The cutaneous lip height distance (photogrammetric lip analysis) obtained in these two periods of time were measured and statistically analyzed. Results. The average lip heights were in T1 and in T2 (). The average lip height asymmetry in the noncleft individuals was . Conclusion. Since all principles to obtain a symmetrical Cupid’s bow were performed, the postoperative pull-up of Cupid’s bow is probably owed to the scar contracture, which improves by 2 times during the first year after surgery.

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Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

BMC Pediatrics ◽

10.1186/s12887-021-02525-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Prajwal Paudel ◽

Avinash K. Sunny ◽

Rejina Gurung ◽

Abhishek Gurung ◽

Honey Malla ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Prospective Cohort Study ◽

Birth Defects ◽

Prospective Cohort ◽

Birth Defect ◽

Cleft Lip ◽

Birth Asphyxia ◽

Neonatal Infection

Abstract Background Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal. Method This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age < 20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18–2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46–2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41–2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12–2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93–4.69). Conclusion Maternal age younger than 20 years and advantaged ethnicity were risk factors of birth defects. Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted. Funding Swedish Research Council (VR).

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