Incidence of cleft lip and palate in gorgan - northern Iran: an epidemiological study

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, North of Iran during 2004-2009. 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. 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 for boys [46%] but CL was more common among boys. The results showed that the incidence of oral clefts in the study population as being at 1.05 per 1,000 live births, which nas increased from 0.97 per 1,000 live births reported in an earlier study in this area

role of IL-6 for predicting neonatal sepsis: a systematic review and meta-analysis

Neonatal sepsis [NS] is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 [IL-6] may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS. This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were [cytokine], [neonate], [sepsis] and [interleukin-6]. We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC [SROC] curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test. Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity [i.e., the Q value] in SROC curve was 0.82 and the area under curve [AUC] was 0.89 [95% CI: 0.84-0.94]. Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant [P=0.07]. IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units