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Aidah Abu El Soud Alkaissi An-Najah National University Faculty of Nursing Signs and symptoms With mild to moderate increases in the plasma bilirubin concentration and prothrombin time ratio The prolongation of the prothrombin time reflects acute impairment of synthesis of the vitamin K-dependent clotting factors There is little or no increase in the plasma alkaline phosphatase activity unless liver damage is severe or the patient is a chronic alcoholic Dr

Orthognathic surgery (if required) is planned at 14 to 16 years of age in females, 16 to 18 years in males to address the maxillary hypoplasia, mandibular skeletal disharmony, and sleep-disordered breathing that is common in cleft patients

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