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CC BY-NC-ND 4.0 · Indian J Plast Surg 2012; 45(01): 115-120
DOI: 10.4103/0970-0358.96602
Original Article
Association of Plastic Surgeons of India

A clinical and demographic profile of the cleft lip and palate in Sub-Himalayan India: A hospital-based study

Jyoti Dvivedi
Departments of Physiology, Himalayan Institute of Medical Sciences, HIHT University, Jolly Grant, Dehradun, India
,
Sanjay Dvivedi
Departments of Physiology and Plastic Surgery, Himalayan Institute of Medical Sciences, HIHT University, Jolly Grant, Dehradun, India
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Publication History

Publication Date:
31 December 2019 (online)

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ABSTRACT

Objectives: To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region. Design: A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years. Outcome measures: The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment. Results: Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results. Conclusion: This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.

KEY WORDS

Cleft lip - cleft palate - haematological - sub-Himalayan region - socioeconomic
 
  • 1 Mossey P, Little J. Addressing the challenges of cleft lip and palate research in India. Indian J Plast Surg 2009;42(suppl):9-18.
  • 2 Prevalence at birth of cleft lip with or without cleft palate: Data from the International Perinatal Database of Typical Oral Clefts (IPDTOC). Cleft Palate Craniofac J 2011;48:66-81.
  • 3 Smith WP. Cleft lip and Palate. In: Russell RC, Williams NS, Bulstrode CJ, editors. Bailey and Love′s Short practice of surgery. 23 rd ed. London: Arnold Publishers; 2000. p. 586-7.
  • 4 LaRossa D. Cleft lip and palate. In: Schwartz MW, Curry TA, Sargurt AJ, editors. Text Book of pediatric primary care (Problem oriented approach). 3 rd ed. Maryland Heights, Missouri: Mosby; 1997. p. 833-34.
  • 5 Orlagh H, Donald B, Peter H, Chris J. The psychosocial effects of cleft lip and palate - A systemic review. Eur J Orthod 2005;27:274-83.
  • 6 Berbert, Campos C. Legal considerations in the management of cleft lip and palate. Cleft Palate Craniofac J 2007;44:223-5.
  • 7 Kumari S, Choudhary AK, Negi G, kumar R, Harsh M, Pathak VP. Prevalence of anemia among the general population of Bihar, India. Ind Med Gaz 2009;11 418-21.
  • 8 Trindade IE, Manco JC, Trindade Jr AS. Pulmonary function of individuals with congenital cleft palate. Cleft Palate Craniofac J 1992;29:429-34.
  • 9 Greer, Foerster, Lukens, Rodgers. Wintrobe Clinical Haematology. Vol. 1, 2 nd ed. Philadelphia: Lipincott Williams and Wilkins; 2004. P. 325-9.
  • 10 Vasan N. Management of children with clefts of the lip or palate: An overview. NZ Dent J 1999;95:14-20.
  • 11 Orkar KS, Ugwu BT, Momoh JT. Cleft lip and palate: The Jos experience. East Afr Med J 2002;79:510-3.
  • 12 Song O, Shi B, Zheng Q. Study on repair approach of bilateral cleft lips and nose deformity. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2006;20:899-901.
  • 13 Nyberg DA, Sickler GK, Hegge FN, Kramer DJ, Kropp RJ. Fetal cleft lip with or without cleft palate: US classification and correlation with outcome. Radiology 1995;195:677-84.
  • 14 Yi NN, Yeow VK, Lee ST. Epidemiology of cleft lip and palate in Singapore-a 10-year hospital-based study. Ann Acad Med Singapore 1999;28:655-9.
  • 15 Zhou QJ, Shi B, Shi ZD, Zheng Q, Wang Y. Survey of the patients with cleft lip and palate in China who were funded for surgery by the Smile Train Program from 2000 to 2002. Chin Med J (Engl) 2006;119:1695-700.
  • 16 Richard PJ, William PS. Cleft lip and palate. Developmental abnormalities of the face, Palate, jaws and teeth. In: Russel RC, Williams NS, Bulstrode CJ, editors. Bailey and Love′s short practice of surgery. 23 rd ed. London: Arnold Publishers; 2000. p. 586-9.
  • 17 Blanco-Davila F. Incidence of cleft lip and palate in the northwest of Mexico: A 10- Year study. J Craniofac Surg 2003;14:533-7.
  • 18 Available from: http://www.euttaranchal.com/uttaranchal/demography.php [Last accessed on 2011 Dec 12].
  • 19 Puho E, Metneki J, Czeizel AE. Maternal employment status and isolated orofacial clefts in Hungary. Cent Eur J Public Health 2005;13:144-8.
  • 20 Reddy SG, Reddy RR, Bronkhorst EM, Prasad R, Ettema AM, Sailer HF, et al. Incidence of cleft Lip and palate in the state of Andhra Pradesh, South India. Indian J Plast Surg 2010;43:184-9.
  • 21 Andrew EC, Laszlo T, Rea S. Dose dependent effect of Folic acid on the prevention of Orofacial clefts. Paediatric 1999;104: e66.
  • 22 Gupta K, Bansal P, Dev N, Tyagi SK. Smile Train project: A blessing for population of lower socio-economic status. J Indian Med Assoc 2010;108:723-5.
  • 23 Sípek A, Gregor V, Horácek J, Masátová D. Birth defects occurrence in offspring of mothers taking 1 st trimester medication in the Czech Republic. Ceska Gynekol 2006;71:284-91.
  • 24 Available from: http://www.census2011.co.in/census/state/uttarakhand.html [Last accessed on 2011 Dec 12].
  • 25 Saxena I. Epidemiology of Cleft lip and palate. Br J Pre Soc Med 1975;29:103-10.
  • 26 Samuel MN, Philip KT. Unilateral Cheiloplasty. In: Mathes SJ, editor. Plastic Surgery. 2 nd ed. Philadelphia: Saunders Elsevier; 2006. p. 165-215.
  • 27 Gopalakrishna A, Agrawal K. A status report on management of cleft lip and palate in India. Indian J Plast Surg 2010;43:66-75.
  • 28 Lin CH, Lo LJ, Wang ML, Chen YR, Noordhoff MS Major Haematological Diseases associated with cleft lip and palate. Craniofacial J 2000;37:511-5.
  • 29 Patil SB, Kale SM, Khare N, Math M, Jaiswal S, Jain A. Changing patterns in demography of cleft lip-cleft palate deformities in a developing country: The Smile Train effect-what lies ahead? Plast Reconstr Surg 2011;127:327-32.