Nutritional and haematological parameters of cleft lip and/or palate patients in Lagos, Nigeria.

Introduction: Cleft Lip and Palate (CLP) deformities are the most common congenital abnormalities of the orofacial structures. The deformity is associated with certain peculiar problems including feeding disorders and recurrent infections. These may combine to affect the nutritional status of the patients. This study was carried out to assess the prevalence of malnutrition among patients with CLP deformities in Lagos, review the prevalence of anaemia and the burden of bacterial infections.Materials/methods: Serum albumin levels of patients with CLP invited for surgical intervention in Lagos between 2006 and 2008 were assessed to determine the nutritional status, the Packed Cell Volume for the presence of anaemia and total White Cell Count (WBC) to screen for the possibility of bacterial infection.Results: Two hundred and twenty five patients were studied comprising of 112 males and 113 females. Mean age was 5.05 ± 7.73 years. One hundred and one (44.89%) patients had complete cleft of the lip and palate, 27.22% had cleft lip, 13.78% had cleft of the lip and hard palate, while 7.11% had cleft of the soft palate alone. Various types of rare cleft deformities occurred in 8.88% patients out of which macrostomia or lateral cleft constituted 6.67%. Forty-eight (21.3%)patients had malnutrition. The type of CLP deformities was found to have no significant effect on the serum albumin level (p = 0. 089). Sixty-eight (30.2%) patients had anaemia. There was an association between the types of CLP deformities and the PCV levels (P=0.001). Twenty-two (9.8%) patients showed haematologic evidences of on-going bacterial infections with raised total WBC count.Conclusion: The prevalence of anaemia in patients with CLP is however higher than that of the general population. Patients with CLP require nutrition support and continuous medical monitoring

Measuring Sperm DNA Fragmentation and Clinical Outcomes of Medically Assisted Reproduction: A Systematic Review and Meta-Analysis.

Sperm DNA fragmentation has been associated with reduced fertilization rates, embryo quality, pregnancy rates and increased miscarriage rates. Various methods exist to test sperm DNA fragmentation such as the sperm chromatin structure assay (SCSA), the sperm chromatin dispersion (SCD) test, the terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labelling (TUNEL) assay and the single cell gel electrophoresis (Comet) assay. We performed a systematic review and meta-analysis to assess the value of measuring sperm DNA fragmentation in predicting chance of ongoing pregnancy with IVF or ICSI. Out of 658 unique studies, 30 had extractable data and were thus included in the meta-analysis. Overall, the sperm DNA fragmentation tests had a reasonable to good sensitivity. A wide variety of other factors may also affect the IVF/ICSI outcome, reflected by limited to very low specificity. The constructed hierarchical summary receiver operating characteristic (HSROC) curve indicated a fair discriminatory capacity of the TUNEL assay (area under the curve (AUC) of 0.71; 95% CI 0.66 to 0.74) and Comet assay (AUC of 0.73; 95% CI 0.19 to 0.97). The SCSA and the SCD test had poor predictive capacity. Importantly, for the TUNEL assay, SCD test and Comet assay, meta-regression showed no differences in predictive value between IVF and ICSI. For the SCSA meta-regression indicated the predictive values for IVF and ICSI were different. The present review suggests that current sperm DNA fragmentation tests have limited capacity to predict the chance of pregnancy in the context of MAR. Furthermore, sperm DNA fragmentation tests have little or no difference in predictive value between IVF and ICSI. At this moment, there is insufficient evidence to recommend the routine use of sperm DNA fragmentation tests in couples undergoing MAR both for the prediction of pregnancy and for the choice of treatment. Given the significant limitations of the evidence and the methodological weakness and design of the included studies, we do urge for further research on the predictive value of sperm DNA fragmentation for the chance of pregnancy after MAR, also in comparison with other predictors of pregnancy after MAR