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This study aimed to investigate whether plasma 25-hydroxyvitamin D (25-OHD) at diagnosis predicts poor outcomes in patients with urothelial bladder cancer. A total of 177 patients with non-muscle-invasive bladder cancer (NMIBC) were prospectively followed up over a period extending beyond 6 years. Data on poor outcomes (ie., recurrence, progression, and mortality) were collected. Plasma 25-OHD was measured by immunoassay. Cutoff-Finder web application was used to determine the best 25-OHD cutoff point to predict a specific poor outcome. Cox-hazard models were applied to test how plasma 25-OHD affect patients outcome while adjusting for potential confounding factors. During the follow-up period, tumor recurrence and progression occurred in 40.7% and 14.1% of patients, respectively and 11.3% of patients died. Baseline 25-OHD was lower in patients who experienced poor outcome (12.2 ± 7.44

This randomized controlled trial aimed to test whether vitamin D (VD) supplementation affects measures of physical performance in VD-deficient, mildly trained children. Thirty-six recreationally soccer player boys were randomly assigned to single dose (200 000 IU) of VD3 (n = 19) or placebo (n = 17). Plasma 25-hydroxyvitamin D (25-OHD) was assessed and measures of physical performance (i.e., vertical and standing broad jumps, triple hop, 10-m and 30-m sprints, shuttle run) were performed before and 12 weeks after the loading dose. Mixed ANCOVA models were performed and effect size was estimated by partial eta squared (ηp2). Baseline 25-OHD and physical variables were equivalent in the 2 groups. Twelve weeks after VD loading, plasma 25-OHD increased and physical variables improved only in the VD group. There was a significant interaction effects for group by time for vertical jump (F = 14.9, p = 0.001, ηp2 = 0.394), triple hop jump (F = 24.2, p < 0.001, ηp2 = 0.513), 10-m (F = 4.46, p = 0.046, ηp2 = 0.162) and 30-m (F = 6.56, p = 0.017, ηp2 = 0.222) sprints, and shuttle run (F = 13.4, p = 0.001, ηp2 = 0.369). In conclusion, a single bolus of VD3 resulted in significant improvements in jumping ability, agility, and running speed in mildly trained children that are deficient in VD. The findings suggest that correcting VD deficit might be beneficial for physical performance. Novelty A mega dose of VD3 improves jumping ability, agility, and running speed in VD-deficient, mildly trained children. Effect of VD on measures of physical performance is noticeable 3 months after the loading dose.

We aimed to evaluate, in this study, the effect of Rosmarinus officinalis L. and Salvia officinalis L. in the amelioration of liver hypothermic conservation in male wistar rats. Livers from each rat were collected and preserved for 24 h at 4 °C in a Krebs solution with or without increasing doses of sage or rosemary infusions (25, 50, and 100 mg/mL). Liver hypothermic conservation induced a decrease in the activity of superoxide dismutase, catalase, and glutathione peroxidase and a significant increase in lipid peroxidation. S. officinalis L. infusion at 25 mg/mL normalized this oxidative disturbance but appears toxic at 50 and 100 mg/mL due to the presence of large amount of pyrogallol which contribute to the cytoplasmic alteration of hepatocytes. The addition of different doses of R. officinalis L. infusion induced an increase in catalase and glutathione peroxidase activities and a decrease in lipid peroxidation with an amelioration of cellular architecture. In conclusion, increasing doses of R. officinalis L. infusion protect against hepatic hypotermic-ischemia while S. officinalis L. infusion could have an hepatoprotective role when administrated at lower dose.

This cohort study aimed to investigate prognostic significance of plasma folate and cobalamin in non-muscle-invasive bladder cancer (NMIBC). A total of 177 NMIBC patients were followed over a period extending to 6 years. Cox regression models were applied to estimate risks for recurrence and progression according to plasma vitamins tertiles. Compared to first tertile, third tertile of plasma folate [HR (95% CI), 10.5 (1.32-83.4)

Introduction: Patients in intensive care units (ICUs) are at high risk of unfavorable outcomes. Considering the role of vitamin D (Vit D) in cardiovascular and immune functions, Vit D deficiency could affect ICU patients’ outcomes. This study aimed to evaluate Vit D status and its predictive value for outcome in ICU patients. Patients and Methods: A total of 169 ICU patients were followed during ICU stay. Primary outcome was the occurrence of at least one major adverse event; secondary outcomes were organ failure, septic shock, ICU-acquired infection, other adverse events, and ICU mortality. Plasma 25-hydroxyvitamin D (25(OH)D) was assessed by immunoassay. Multivariate Cox regression analyses were performed to test the associations of low 25(OH)D levels with poor outcomes. Results: Around 75% of patients had 25(OH)D levels Conclusions: Hypovitaminosis D is very common in ICU patients. Results of the present study show that low plasma 25(OH)D levels are associated with increased risk of unfavorable outcomes in these patients. Additional research is needed to investigate the impact of Vit D status and effect of Vit D supplementation in ICU patients.

Juvenile myoclonic epilepsy (JME) is characterized by seizures, severe cognitive abnormalities, and behavior impairments. These features could evolve over time and get worse, especially when the encephalopathy is pharmacoresistant. Thus, genetic studies should provide a better understanding of infantile epilepsy syndromes. Herein, we investigate the genetics of JME in a consanguineous family analyzing the copy number variations detected using over 700 K SNP arrays. We identified a 254-kb deletion in the 22q11.2 region, including only the TOP3B gene, detected in the patient and her father. TOP3B encodes a topoisomerase DNA (III) β protein and has been implicated in several neurological diseases such as schizophrenia and autism. In this study, we discuss the implication of the 22q11.2 region in neurodevelopmental disorders and the association of TOP3B with epilepsy.

Objectives: Omentin-1 is a recently discovered adipokine, mainly produced by visceral adipose tissue, which is thought to improve insulin sensitivity. The study aimed to assess the association of plasma omentin-1 with cardiometabolic traits and physical performance and to test its response to high-intensity interval training (HIIT) in obese and normal-weight subjects. Methods: Nine overweight/obese (OG) and 9 normal-weight (NWG) young men performed an 8-week HIIT program. Body composition, physical performance, homeostasis model assessment index for insulin resistance (HOMA-IR) as well as plasma omentin-1and lipid levels were assessed before and after the HIIT program. Results: Baseline plasma omentin-1 was lower in OG than NWG men (359 ± 138 vs. 470 ± 114 ng/ml; p = 0.052). Plasma omentin-1 was related to body fat (r = -0.57; p = 0.03) and LDL-cholesterol (r = -0.49; p = 0.04). There was a trend towards significant association of omentin-1 with BMI (r = -0.47; p = 0.06) and VO2max (r = 0.41; p = 0.09). However, no association was observed with HOMA-IR. Following the HIIT program, omentin-1 concentrations have significantly (p < 0.01) increased in OG (359 ± 138 to 455 ± 126 ng/ml) and NWG men (470 ± 114 to 572 ± 115 ng/ml). In parallel, the cardiometabolic profile has improved with a significant decrease of HOMA-IR in OG. Conclusions: HIIT resulted in a plasma omentin-1 increase and an improvement with regard to cardiometabolic traits in the OG men, which may contribute to modulate insulin sensitivity.

This randomized controlled trial aimed to test whether vitamin D (VD) supplementation affects measures of physical performance in VD-deficient, mildly trained children. Thirty-six recreationally soccer player boys were randomly assigned to single dose (200 000 IU) of VD3 (

The study aimed to examine circulating vitamins A, E, D, and B12 and folate in patients with urothelial bladder cancer (UBC) and detect potential interaction effects of these micronutrients on UBC risk. A case-control study was conducted on 262 UBC patients and 254 matched controls. Vitamins A and E were assessed by ultra performance liquid chromatography, and vitamins D and B12 and folate were assessed by immunological methods. Binary logistic regression models were used to test associations of plasma vitamins tertiles with UBC risk. A multifactor dimensionality reduction method (MDR) was applied to assess interactive effects of the vitamins and tobacco on UBC risk. Higher levels in vitamins A, E, and D were associated with lower occurrence of UBC. No significant association was observed in plasma folate or vitamin B12 with UBC. There were redundancy interactions of plasma vitamin D with tobacco and with plasma vitamin A on UBC risk. Even though the study could not ascertain causality, the findings suggest that vitamins A, E, and D might be protective against UBC. Vitamins A and D interact antagonistically with each other's and with tobacco to modulate UBC risk. These interactions should be taken in consideration for the prevention of UBC.

To determine whether low vitamin D levels in pregnant women are associated with the occurrence of neural tube defects (NTDs) in Tunisia.In a prospective study, pregnant women were recruited at a center in Tunis between January 1, 2012, and December 30, 2013. Women carrying a fetus with a severe NTD were recruited before elective termination. Matched, healthy pregnancy women were enrolled into a control group. Plasma levels of 25-hydroxyvitamin D were measured by a competitive chemiluminescence immunoassay.Overall, 68 women formed the NTD group and 64 the control group. The mean maternal vitamin D level was significantly lower in the NTD group (20.65±10.25nmol/L) than in the control group (28.30±13.82nmol/L; P0.001). Vitamin D deficiency was recorded for 53 (78%) women in the NTD group and 39 (61%) in the control group. Vitamin D insufficiency was recorded for 15 (22%) women in the NTD group and 20 (31%) in the control group. Vitamin D sufficiency was found only in the control group (n=5 [8%]; P0.001).The findings confirm an association between a decreased vitamin D level in pregnant women and the risk of fetal NTDs.

The study aimed to investigate association of circulating leptin, adiponectin, chemerin, and omentin-1 with metabolic syndrome (MetS) and cardio-metabolic risk factors in youths. Thirty eight young males were enrolled. Participants underwent anthropometric and blood pressure measures, and fasting blood sampling. Plasma leptin, adiponectin, chemerin, omentin-1 and insulin were measured by ELISA methods. Multiple linear regression models, adjusting for age, MetS traits, C-reactive protein (CRP) and homeostasis model assessment of insulin resistance (HOMA-IR), were applied to determine correlates for each adipokine. Eleven participants meet criteria of MetS. These individuals had higher leptin and chemerin and lower adiponectin plasma concentrations than those without MetS. Plasma leptin and chemerin were positively related, and adiponectin and omentin-1 were inversely related to cardio-metabolic traits. In multivariate models, predictors of leptin were age (β, 0.20, P = 0.01), abdominal obesity (β, 0.24, P = 0.06), raised blood pressure (β, 0.40, P = 0.01), raised triglycerides (β, 0.19, P = 0.01) and CRP (β, 0.31, P = 0.01). Chemerin was associated with abdominal obesity (β, 0.33, P = 0.09) and CRP (β, 0.29, P = 0.04), and adiponectin was associated with raised triglycerides (β, −0.26, P = 0.05), decreased HDL-C (β, −0.28, P = 0.06) and CRP (β, −0.48, P = 0.01). HOMA-IR (β, −0.39, P = 0.09) was the only predictor for omentin. MetS is associated with an altered plasma adipokines profile, with increased leptin and chemerin and decreased adiponectin circulating levels. These findings suggest a beneficial potential of adiponectin and omentin, but a detrimental potential of leptin and chemerin. Further research is needed to lighten the role of adipose tissue-derived adipokines in cardio-metabolic health.

Doxorubicin (DOX) exhibits a wide-ranging spectrum of antitumor activities which maintain its clinical use despite its devastating impact on highly proliferating cells. The present work was designed to develop a new approach which aims to protect male germ cells from DOX cytotoxicity. Thus, an assessment of the protective potential of a new thioamide analog (thiocyanoacetamide; TA) compared to selenium (Se) was performed in rat sperms exposed to DOX in vitro. Oxygen consumption rate (OCR) was measured after exposure to three different doses (0.5, 1, 1.5 and 2 μM) of DOX, Se or TA, and the suitable concentrations were selected for further studies afterwards. Motility, OCR in a time-dependent manner, glucose extracellular concentration and lipid peroxidation (LPO) were measured. Fatty acid (FA) content was assessed by gas chromatography (GC-FID). Cell death, superoxide anion (O2 −), mitochondrial membrane potential (MMP), and DNA damage were evaluated by flow cytometry. TA association with DOX increased OCR and glucose uptake, improved cell survival and decreased DNA damage. The co-administration of DOX with Se increased OCR, significantly prevented O2 − overproduction, and decreased LPO. Collected data brought new insights regarding this transformed TA, which showed better efficiency than Se in reducing DOX cytotoxic stress in sperms.

Fatty acids (FAs) are thought to impact carcinogenesis by affecting cell signaling. A case-control study including 250 patients with urothelial bladder cancer (UBC) and 250 controls was conducted. Plasma FAs composition was assessed using capillary gas chromatography. Associations of individual and classes of FAs with UBC were controlled for the main risk factors for UBC. Plasma FAs profile was different in patients compared to controls. Higher levels (third tertile vs. first tertile) in palmitic acid (PA) [multi-adjusted OR (95% CI), 1.83 (1.14-2.92)], and n - 6:n - 3 FA ratio [4.13 (2.38-7.16)] were associated with increased risk for UBC [multi-adjusted OR (95% CI), 1.83 (1.14-2.92)]. In contrast, higher levels (third tertile vs. first tertile) in oleic [0.54 (0.34-0.86)], dihomo-γ-linolenic (DGLA) [0.47 (0.29-0.74)], eicosapentaenoic (EPA) [0.32 (0.19-0.52)], and docosahexaenoic (DHA) acids [0.33 (0.20-0.53)] were associated with lower risk for UBC. Although the study design does not allow proving causality, the findings suggest a possible protective role of oleic acid and marine n - 3 polyunsaturated FAs (PUFAs) against bladder carcinogenesis.

Objective: This study aims to investigate the association of 5,10-methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) and methionine synthase reductase (MTRR A66G) gene polymorphisms with neural tube defects (NTDs) in a Tunisian population. Methods: Genotyping was performed by polymerase chain reaction with restriction fragment length polymorphisms (PCR-RFLPs) using the restriction enzymes. Allele and genotype frequencies were compared between mothers and fathers of fetuses with NTDs with matched controls based on an association analysis using SPSS software. Results: MTHFR (C677T, A1298C) and MTRR A66G polymorphisms were found to be protector factors for NTD fetuses in the mother group. In addition, a combination of the three wild-type alleles C677/A1298/A66 has increased four-fold the incidence of NTDs (p = 0.004, OR = 3.96, 95% CI: 1.53–10.23). In the father group, MTHFR C677T was a risk factor for NTDs. However, no association was found between MTHFR A1298C, MTRR A66G, and the occurrence of this anomaly. The analysis of MTHFR C677T and MTRR A66G polymorphisms has demonstrated a significant difference in vitamin B12 levels between recessive and dominant genotypes in case mothers (p < 0.05). Conclusion: Additional studies are required to better understand the roles of parental gene polymorphisms related to folate-homocysteine metabolism in the pathogenesis of NTD.

BACKGROUND/AIM: Accumulated data suggested that Vascular Endothelial Growth Factor is a major mediator in vasculogenesis, angiogenesis and recently in tumorigenesis. Therefore, we aimed to investigate for the first time the association between VEGF gene variants (‐2549I/D (rs35569394), ‐2578C/A (rs699947), and +936C/T (rs3025039)) with urothelial bladder cancer (UBC) in Tunisian population. METHODS: A total of 218 UBC patients and 204 controls were recruited and genotyped by Polymerase Chain Reaction technique. Odds ratios (OR) and 95% confidence intervals (CIs) were used to access the association between the VEGFA gene polymorphisms and UBC. RESULTS: We found a significant decreased risk association of ‐2578 C/A polymorphism with UBC (OR (95% CI), 0.62 (0.41‐0.94), P = .026) for CA genotype and (OR (95% CI), 0.40 (0.21‐0.76), P = .005) for double homozygous mutant genotype. No associations were found in case of both polymorphic sites of VEGF, vis. ‐2549I/D and +936C/T, respectively. Haplotype analysis revealed a strong linkage disequilibrium between ‐2578C/A and ‐2549I/D and CIC combination is the significant haplotype associated with increased risk of UBC (OR (95% CI), 3.63 (1.47‐8.97), P = .005). Regarding tumor grade/stage and family history of cancer, no associations were found for ‐2578C/A polymorphism. CONCLUSION: CIC haplotype of VEGF gene may be important risk factor for UBC development in Tunisia.

Background This study was conducted to determine whether low folate and vitamin B12 levels, as well as high homocysteine levels in pregnant women are associated with neural tube defects (NTDs) in Tunisia. Methods A total of 75 NTDs pregnancies and 75 matched controls were included in the study. Their vitamin B12, folate, and red blood cell folate concentrations were measured using a radio-immunoassay kit and total homocysteine concentrations were determined using a fluorescent polarization immunoassay. Results Vitamin B12 and folate concentrations were lower in NTD-affected pregnant women than in controls (respectively, p = 0.009 and p < 0.001). Total homocysteine concentration was significantly higher in the NTDs group than in controls (p = 0.008). In the case group, the folate levels were positively related with vitamin B12 levels (r = 0.54; p < 0.001) and negatively correlated with total homocysteine levels (r = -0.19; p = 0.04). Besides, red blood cell folate levels were positively correlated with folate levels (r = 0.24; p = 0.02) and negatively correlated with total homocysteine levels (r = -0.37; p = 0.001). Conclusion Lower concentrations of folate and vitamin B12 are related to the increased risk of NTDs. Both folate and vitamin B12 intake insufficiency could contribute to the increased risk of NTDs. A dietary supplement, combining folate and vitamin B12, might be an effective measure to decrease the NTDs incidence in Tunisia. Birth Defects Research (Part A), 2015. © 2015 Wiley Periodicals, Inc.

Chemerin is an adipose tissue-derived adipokine thought to decrease insulin sensitivity and increase cardiometabolic risk. This study aimed to assess the association of chemerin with cardiometabolic risk and physical performance and examine its response to high-intensity interval training (HIIT).Eighteen young men have been applied a HIIT program during 8 weeks. Plasma chemerin together with several cardiometabolic factors and physical performance indices were determined before and after the training program. Plasma chemerin and insulin were assessed using immunoenzymatic methods. The homeostasis model assessment (HOMA-IR) index was calculated as an estimate of insulin resistance.Basal plasma chemerin was positively correlated with body mass index (r=0.782, p0.001), body fat (r=0.767, p0.001), total (r=0.686, p=0.002) and LDL (r=0.587, p=0.010) cholesterol, triglycerides (r=0.775, p0.001), HOMA-IR (r=0.673, p=0.002) and C-reactive protein (r=0.765, p0.001). With regards to physical performance, chemerin was negatively correlated with maximal oxygen uptake (r=-0.572, p=0.013) and squat jump (r=-0.627, p=0.005), but positively related to 10-m sprint (r=0.716, p=0.001) and 30-m sprint (r=0.667, p=0.002) times. HIIT program resulted in significant improvements in body composition, plasma lipids and insulin sensitivity. However, no significant change was detected for plasma chemerin in response to HIIT (134±50.7 ng/mL vs. 137±51.9 ng/mL, p=0.750).Basal plasma chemerin is associated with cardiometabolic health and physical performance in young men. Following HIIT, cardiometabolic health and physical performance had improved, but no significant change had occurred for plasma chemerin.

Vitamin D is thought to regulate skeletal muscle function and boost physical performance. The aim of this study was to assess the relationship between vitamin D and physical performance in physically active children. This cross-sectional study included 125 children who practice football as a leisure activity. Plasma 25-hydroxyvitamin D (25-OHD) was assessed using a chemiluminescence immunoassay method. Vitamin D inadequacy was defined as 25-OHD < 20 ng/mL. Physical performance testing included measurements of muscle strength (maximal isometric contraction), jumping ability (vertical jump, standing broad jump, triple hop test), linear sprint (10 m and 20 m), and agility (9 × 4-m shuttle run). Plasma 25-OHD concentrations were positively correlated with muscle strength (r = 0.539; p < 0.001), vertical jump (r = 0.528; p < 0.001), and standing broad jump (r = 0.492; p < 0.001) but inversely correlated with sprint performance (r = –0.539; p < 0.001). In multivariate analysis models, plasma 25-OHD concentrations were associated with each physical performance parameter independently of age, maturity status, body mass index, fat mass, and protein and calcium intakes. In conclusion, a low plasma 25-OHD level was associated with decreased muscle strength, agility, and jumping and sprinting abilities in physically active children. Vitamin D inadequacy may limit exercise performance. Further research should verify whether correction of vitamin D deficiency enhances physical performance.

Little evidence suggests an impact of vitamin D on bladder cancer risk in Caucasians. This study aimed to investigate association of plasma 25-hydroxyvitamin D (25-OHD) with urothelial bladder cancer (UBC) risk in Tunisians. A case-control study included 250 patients with UBC and 250 healthy controls. Plasma 25-OHD was assessed by a competitive chemiluminescence immunoassay. Vitamin D deficiency and insufficiency were defined as 25-OHD

BACKGROUND Vitamin D deficiency seems to be common in pregnant women and would be associated with an increased risk of maternal and fetal poor outcomes. This study aimed to determine the prevalence and the main risk factors for vitamin D deficiency in pregnant women living in a sun-rich environment. METHODS A total of 255 pregnant women living in Tunis City (latitude, 36 degrees N) were randomly selected at 12 - 18 weeks of gestation. Plasma 25-hydroxyvitamin D (25-OHD) was assessed by chemiluminescence immunoassay method. A logistic regression model adjusting for confounding variables was used to identify the independent risk factors for vitamin D deficiency. RESULTS Plasma 25-OHD concentrations ranged from 4.02 to 78.3 nmol/L [median (IQR), 18.0 (13.6)]. More than 96% of the study population had 25-OHD levels below 50 nmol/L with 82.3% of women having vitamin D deficiency (25-OHD < 30 nmol/L) and 31.4% of women having severe vitamin D deficiency (25-OHD < 15 nmol/L). Daily dietary vitamin D intake [median (IQR), 3.49 (2.92) μg] was clearly lower than the recommended dose. Vitamin D deficiency was more frequent during the low-sunshine season, and in veiled women and those with an average level of education. In multivariate analysis, the independent predictors of vitamin D deficiency were low sunshine season [multi-adjusted OR (95% CI), 2.29 (1.24 - 4.22); p < 0.01], covering clothing [OR (95% CI), 2.54 (1.23 - 5.24); p < 0.05], and average level of education [OR (95% CI), 2.11 (1.09 - 5.91); p < 0.05]. CONCLUSIONS Tunisian pregnant women, especially those with average/high level of education, are exposed to a high risk of vitamin D deficiency. The main causes of hypovitaminosis D are low sunshine exposure and little dietary vitamin D intake. Public health policies should target the awareness for optimal and safe sun exposure and adequate vitamin D dietary intake. Otherwise, tolerable vitamin D supplementation should be prescribed.

The aim of the study was to test whether the VDR FokI polymorphism is associated with the risk of urothelial bladder cancer (UBC) in Tunisians. The study included 200 unrelated patients with UBC and 200 healthy controls. Genotyping of the VDR FokI polymorphism was determined by PCR-RFLP method. Plasma 25-hydroxyvitamin D concentrations were measured by immunoassay. Binary logistic regression model was applied to test how the association of VDR FokI polymorphism is independent of potential confounding factors. Genotype distribution (FF, 45 vs. 55 %; Ff, 52.1 vs. 47.9 %, and ff, 12 vs. 5.5 %, respectively) and allele frequencies (F, 66.5 vs. 74.8 % and f, 33.5 vs. 25.2 %, respectively) were significantly different between UBC patients and controls. The "ff" genotype [OR (95 % CI), 2.66 (1.24-5.73); p = 0.012] and "f" allele [1.49 (1.09-2.02); p = 0.010] were associated with increased risk of UBC. The association remained significant in multivariate analysis. Stratified analyses showed that VDR FokI polymorphism is only associated with UBC risk in ever-smokers, subjects exposed to chemical carcinogens and those with plasma 25-hydroxyvitamin D over 12 μg/L. The "f" allele of VDR FokI polymorphism is associated with a higher risk of UBC in Tunisians, especially in smokers as well as subjects with occupational exposition and subjects without vitamin D deficiency. These results should be replicated in other ethnic groups and the influence of other genetic factors and environments on this association should be investigated.

The term spina bifida refers to a group of neural tube defects that result in malformations of the spinal cord and the surrounding vertebrae. Though the etiologies of spina bifida remain largely unknown, several risk factors have been identified, including feto-maternal characteristics.To discover possible underlying reasons for the increase of spina bifida and identify intervention targets, an investigation was undertaken comparing spina bifida-affected pregnancy notifications in 2008-2011 with notifications in the period 1991-1994.Characteristics and outcomes of births with spina bifida and pregnancy characteristics of mothers were recorded in the medical chart. Comparisons of pregnancies affected by a spina bifida in 2008-2011 were made with pregnancies affected by a spina bifida in the period 1991-1994. Statistical analysis was undertaken using Poisson regression and Chi-squared tests.From 1991 through 1994, the prevalence of identified spina bifida cases was equal to 0.3/10,000 births compared to 1.6/10,000 births in 2008-2011. This increase was statistically significant (P0.001). The prevalence of females was equal to 0.45 per 10,000 births over the period 1991-1994 compared to 1.88 per 10,000 births during the period 2008-2011. As for males, the prevalence was equal to 0.16 per 10,000 births in 1991-1994 compared to 1.88 in 2008-2011. The difference was statistically significant (P0.001) between both genders. A mother's age of over 30 years had significant impact on the emergence of spina bifida (P=0.02, OR=3.93, CI=1.23-12.47). As well as, maternal blood type was a significant risk factor for the appearance of spina bifida (P=0.008). Results also had shown that fetal weight and term, gestity and parity were significant risk factors for the occurrence of spina bifida (P0.05).In this study, results have been interpreted with caution due to analyses not being adjusted.This analysis highlighted areas where prevention efforts should be strengthened and surveillance data improved.

Neural tube defects are common major congenital anomalies that result from very early disruption in the development of the brain and spinal cord.We conducted an epidemiological study to determine the impact of some feto-maternal characteristics in the occurrence of NTD subtypes.Characteristics and outcomes of births with NTD and pregnancy characteristics of mothers over a period of twenty years (1991-2011) were recorded in the medical chart.From 1991 through 2011, 769 stillborns with NTD were delivered, yielding a prevalence of 2.02/10,000. The increase in NTD prevalences over these years was statistically significant (P = 0.000). In addition, differences between prevalences of NTD subtypes over season (P = 0.003) and between genders (P0.001) were significant. The highest frequency was noticed in winter with 3, 7 per 10,000 births among females. The difference in fetal term between subtypes was significant (P = 0.017). The probability to have a malformed fetus with a weight less than 1500 g was three times higher in myelomeningocele than in craniorachischisis, two times higher in anencephaly and encephalocele, but two times lower than rachischisis. Mothers with one gestation were two fold higher in anencephaly than in encephalocele. Nulliparous mothers' cases were significantly more likely to have NTD than uni- or multiparous mothers. O+ mother's blood type presented a significant risk factor and was significantly less common in myelomeningocele than in rachischisis, but three times higher than in craniorachischisis. Consanguinity was present in cases with rachischisis and was two times higher than in cases with anencephaly, and three times higher than in cases with encephalocele. In this study, the results have been interpreted with caution due to analyses not being adjusted.One of the main findings of the study is that there are many differences between NTD subtypes, which suggests that there may be etiologic differences between subtypes. This suggests that, although epidemiologic studies frequently do not distinguish between NTD subtypes in analyses, they should be analyzed separately when possible.