28th Day Of Life Research Articles

Perinatal Outcomes of Women with Recurrent Pregnancy Loss Undergoing Frozen Embryo Transfer from the Society of Assisted Reproductive Technology Database

To assess whether infants born to women with a history of recurrent pregnancy loss (RPL) have an increased risk of adverse perinatal outcomes following frozen embryo transfer (FET) compared to women without a history of infertility or RPL. Retrospective cohort study utilizing the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) database between 2014 and 2020. Patients in the SART CORS database who underwent their first FET resulting in live birth either with a diagnosis of RPL (cases n=3,299) or without a history of RPL or infertility, the comparison population being tubal ligation (TL) only (n=1408). Recurrent pregnancy loss MAIN OUTCOME: Low birthweight (<2500g), additional outcomes included gestational age (continuous), birthweight (continuous), preterm delivery (< 37 weeks), mode of delivery, and neonatal death, defined as death prior to the completion of the 28th day of life. We observed no statistically significant difference in low birthweight, birthweight overall, mode of delivery or risk of neonatal death between patients with RPL compared to women with tubal ligation who underwent their first FET resulting in live birth. Patients with history of RPL compared to TL utilizing FET were more likely to have a later gestational age at delivery (p<0.001). Patients with RPL were also less likely to have a preterm delivery (imputed AOR 0.75 [0.64, 0.89]) than the TL patients. Furthermore, performing preimplantation genetic testing for aneuploidy (PGTA) in both patients with recurrent pregnancy loss or tubal ligation did not impact perinatal outcomes compared to patients who did not undergo PGTA. Patients with history of recurrent pregnancy loss do not have an increased risk of adverse perinatal outcomes when they undergo FET compared to patients without infertility or recurrent pregnancy loss. In addition, performing IVF/PGTA in patients with RPL does not adversely impact birth outcomes of their infants.

Prevalence and Risk Factors of Bronchopulmonary Dysplasia Among Very Premature Infants in a Tunisian Neonatal Intensive Care Unit.

Bronchopulmonary dysplasia (BPD) stands as the primary chronic respiratory complication in premature infants, posing a substantial public health concern due to its rising prevalence, potential mortality, and socioeconomic burden. The aim of this study was to determine the prevalence of BPD in very preterm infants and identify its associated risk factors. We conducted a retrospective, descriptive, and analytical study including all premature infants born between 26 and 31 weeks of gestation age (GA) who survived beyond the 28th day of life, over a five-year period (2017-2021). Patients were divided into two groups based on the presence or absence of BPD, which was defined by the need for oxygen supplementation for at least 28 days. we included 231 newborns. The prevalence of BPD was 37.7% among survivors on the 28th day of life and 36.7% among those reaching 36 weeks postmenstrual age. BPD was mild, moderate and severe in 25.2%, 4.9% and 6.6% of cases, respectively. Multivariate analysis identified maternal hypertensive disorders (RR=6.15, 95%CI=[2.27-16.67], p<0.001), chorioamnionitis (RR=4.23, 95%CI=[1.25 -14.27], p=0.02), intrauterine growth restriction (IUGR) (RR =20.4, 95%CI=[3.39 -122.66], p=0.001), GA less than 30 weeks (RR=26.97, 95%CI=[10.23 -71.14], p<0.001), and mechanical ventilation (MV) (RR=5.33, 95%CI=[1.95-14.54], p=0.001) as independent factors associated with BPD occurrence. The mortality rate was 10.3% among patients with BPD versus 0.7% in patients without BPD (p = 0.001). Our study revealed a high prevalence of BPD in very preterm infants and identified several independent risk factors such as maternal hypertensive disorders, IUGR, chorioamnionitis, MV, and GA less than 30 weeks.

PHYSICAL CHARACTERISTICS OF TYPICAL CHORDAE TENDINEAE OF ATRIOVENTRICULAR VALVULAR HEART APPARATUSES IN CHILDREN OF THE NEONATAL PERIOD IN NORM

This article presents the microscopic structure and polarization characteristics of the chordae tendineae of the mitral and tricuspid heart valves of normal newborns based on histological sections.The purpose – to study histological specimens of chordae tendineae of atrioventricular heart valves of newborn children using light microscopy, as well as using the method of laser polarimetry.Material and methods. The studies were performed on 34 atrioventricular valves taken from the hearts of newborn children (from birth to the 28th day of life). The light-optical and polarization methods were used in the research.Results. The structural components of the chordae tendineae of the mitral and tricuspid heart valves of newborns in norm were studied using the morphological method and the histoarchitectonics of their components at the polarization level was established.Conclusions. Thus, the obtained data of these studies using the method of laser polarimetry completely confirmed the data of the structure of the typical chordae tendinea of the cardiac atrioventricular valvular apparatuses of newborns using light microscopy. This method makes it possible to differentiate fibrous components of the extracellular matrix of connective tissue and contractile cardiac muscle cells within the chordae tendinea, as well as to differentiate chordae tendinea into two types: fibro-muscular and fibrous.

Age-Dependent Effects of Yolkin on Contact Sensitivity and Immune Phenotypes in Juvenile Mice.

Yolkin, an egg yolk immunoregulatory protein, stimulates the humoral but inhibits the cellular immune response in adult mice. The aim of this investigation was to evaluate the effects of yolkin administration on the immune response using a model of juvenile, i.e., 28-day- and 37-day-old, mice. We examined the yolkin influence on the magnitude of the cellular immune response, which was determined as contact sensitivity (CS) to oxazolone (OXA), and the humoral immune response, which was determined as the antibody response to ovalbumin (OVA). Yolkin was administered in drinking water, followed by immunization with OXA or OVA. In parallel, the phenotypic changes in the lymphoid organs were determined following yolkin treatment and prior immunization. The results showed that yolkin had a stimulatory effect on CS in the mice treated with yolkin from the 37th day of life but not from the 28th day of life. In contrast, no regulatory effect of yolkin on antibody production was found in 28-day- and 37-day-old mice. Phenotypic studies revealed significant changes in the content of B cells and T cell subpopulations, including CD4+CD25+Foxp3 regulatory T cells. The association between the effects of yolkin on the magnitude of CS and phenotypic changes in main T- and B-cell compartments, as well the importance of changes in T-regulatory and CD8+ cells in the age categories, are discussed. We conclude that the immunoregulatory effects of yolkin on the generation of CS in mice are age dependent and change from stimulation in juvenile to suppression in adult mice.

INFLUENCE OF FEED ADDITIVE "ENZAKTIVE MIX" ON THE HEMATOLOGICAL PROFILE OF THE BLOOD OF SOWS AND THEIR PIGLETS

The dynamics of the haematological profile changes and the productivity of sows and piglets obtained from them when feeding the feed additive "EnzActive Mix" were described in the article. The feed additive contains yeast of the genus Saccharomyces cerevisiae with an activity of at least 1.5 x 10^10 CFU/g and a six enzymes complex with protease, cellulase, xylanase, ɑ-amylase, β-gluconase, phytase, which are located under the layer of yeast cells. The results of the study showed that the use of "EnzActive Mix" in sows and their piglets’ diet has a stimulating effect on the oxygen transport function of blood. This is evidenced by a higher number of erythrocytes and platelets, a higher concentration of haemoglobin and haematocrit in the blood of sows of the experimental group compared to the control group on 21st day of lactation (p&lt;0.05). Addition of the feed additive "EnzActive Mix" to the diet caused changes in certain forms of leukocytes ratio in the sows’ blood. Thus, during this period, a higher (p&lt;0.05) relative lymphocytes number and a tendency to decrease of segmented neutrophils number in the blood of experimental group sows compared to the control group were found. Similar changes were noted in the haematological parameters study of piglets obtained from these sows. In particular, the leukocytes number in the blood of the experimental group piglets at 5-, 14- and 28-day age was higher than in their peers of the control group. At the same time, on the 5th day of life, the differences relatively to the control group animals were significant (p&lt;0.05). Feeding of the feed additive led to a decrease in the segmented neutrophils relative number in the blood of the experimental group piglets on the 14th and 28th day of life (p&lt;0.05) and an increase in the lymphocytes number (p&lt;0.05) during the indicated periods of the study. The positive effect of the feed additive "EnzActive Mix" on the productivity parameters of the studied animals was established. In particular, the body weight of experimental group piglets at 5-, 14- and 28-day age was 7.8%, 13.7% (p&lt;0.05) and 8.4% (p&lt;0.01) higher, respectively, than that of the control group.

Biochemical and hematological characteristics of blood indicators, productivi-ty of piglets under the influence of additional feed “Activo”

The article discusses the issue of the condition of the piglets' bodies before and after weaning after feeding the additional feed “Activo.” The object of the study was piglets born from sows of the large white breed of ADN genetics. Piglets were divided into control (n = 111) and experimental (n = 110). From the 5th to the 43rd day of life, the piglets were given pre-starter compound feed in loose form. In the research group's pre-starter compound feed, “Activo,” was introduced in the amount of 0.2 kg/t of finished compound feed. Blood was collected from the cranial vena cava of the piglets of the control and experimental groups for biochemical and hematological parameters on the 28th and 43rd days of the piglets' life. Productivity control was carried out by weighing animals on the day of birth, at weaning, and on the 43rd day of life. Feed consumption was monitored, and average daily gains and feed conversion were determined. According to the results of the research on piglets before weaning, we can see an increase in the total protein level in the experimental group's blood by 2.85 % compared to the control group. The albumin concentration in the control group's piglets was 47.33 %, and the experimental group was 48.00 %, which is 1.42 % more than the control group. There was also an increase in α-, β-, and γ-globulins in the experimental group. After piglets were weaned, a probable increase in total protein and albumin was noted in the experimental group by 3.96 % and 1.85 %, respectively, in the control group. At the beginning of the experiment, the piglets of the control and experimental groups had a slight difference in live weight, which was 3.35 % in favor of the control group. Already on the 28th day of life, the piglets of the research group had a live weight statistically higher by 6.58 % (P &lt; 0.001) concerning the control. Thus, for 14 days of the experiment after weaning, the increase in live weight of piglets of the experimental group probably increased by 11.9 % (Р &lt; 0.01), and the difference in the weight of piglets between the control and experimental groups was 0.88 kg, or 8.15 % (P &lt; 0.001). The average daily growth rate of piglets in the experimental group also increased by 11.8 % (Р &lt; 0.01). The difference in feed conversion between the control and experimental groups is 0.19 kg or 10.8 %.

Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study.

Neonatal mortality reduction is a global goal, but its factors are seldom studied in most resource-constrained settings. This is the first study conducted to identify the factors affecting perinatal and neonatal deaths in Sao Tome & Principe (STP), the smallest Central Africa country. Institution-based prospective cohort study conducted at Hospital Dr. Ayres Menezes. Maternal-neonate dyads enrolled were followed up after the 28th day of life (n = 194) for identification of neonatal death-outcome (n = 22) and alive-outcome groups (n = 172). Data were collected from pregnancy cards, hospital records and face-to-face interviews. After the 28th day of birth, a phone call was made to evaluate the newborn's health status. Crude odds ratios and corresponding 95% confidence intervals were obtained. A p value <0.05 was considered statistically significant. The mean gestational age of the death-outcome and alive-outcome groups was 36 (SD = 4.8) and 39 (SD = 1.4) weeks, respectively. Death-outcome group (n = 22) included sixteen stillbirths, four early and two late neonatal deaths. High-risk pregnancy score [cOR 2.91, 95% CI: 1.18-7.22], meconium-stained fluid [cOR 4.38, 95% CI: 1.74-10.98], prolonged rupture of membranes [cOR 4.84, 95% CI: 1.47-15.93], transfer from another unit [cOR 6.08, 95% CI:1.95-18.90], and instrumental vaginal delivery [cOR 8.90, 95% CI: 1.68-47.21], were factors significantly associated with deaths. The odds of experiencing death were higher for newborns with infectious risk, IUGR, resuscitation maneuvers, fetal distress at birth, birth asphyxia, and unit care admission. Female newborn [cOR 0.37, 95% CI: 0.14-1.00] and birth weight of more than 2,500 g [cOR 0.017, 95% CI: 0.002-0.162] were found to be protective factors. Factors such as having a high-risk pregnancy score, meconium-stained amniotic fluid, prolonged rupture of membranes, being transferred from another unit, and an instrumental-assisted vaginal delivery increased 4- to 9-fold the risk of stillbirth and neonatal deaths. Thus, avoiding delays in prompt intrapartum care is a key strategy to implement in Sao Tome & Principe.

Cytokines, Serological, and Histopathological Assessment of Recombinant Vaccination Strategies for Combatting Infectious Bursal Disease in Broiler Chickens.

Infectious bursal disease (IBD) represents a greatly transmissible viral disease found worldwide, causing significant health and production challenges in young chickens. The aim of this research was to assess the immune reaction induced by different vaccines targeting IBD. These vaccines included recombinant (Vac1; HVT-IBD vector), immune complex (Vac2; Bursa-Plex®), and intermediate plus (Vac3; Bursine plus) IBD vaccines. Our assessment relied on serological and histopathological analyses, as well as the pattern of immune-related cytokine expression in the bursal tissue. The vaccinated groups, along with a control positive (CP) group, were subjected to a vvIBDV challenge on their 28th day of life, while the control negative (CN) group received a mock vaccination with PBS. Our study revealed that Vac1 resulted in the most favorable growth performance, as well as maintained normal liver and kidney function, mitigating the impact of IBDV infection. Serological analysis using VP2 ELISA kits indicated that Vac1 induced the strongest immunological response among all vaccines. Histopathological examination demonstrated that Vac1 caused minimal lymphoid depletion observed in the lymphoid organs, followed by Vac2. Analysis of cytokine expression profiles showed significant upregulation in all vaccinated groups, particularly Vac1, during the pre-challenge period. Following IBDV infection, Vac1 resulted in a noteworthy increase in the expression of IL2 and IFN-γ, Vac2 showed a significant upregulation in TNF-α and granzyme, and both Vac1 and Vac3 exhibited increased levels of IL1β and IL10. In conclusion, our study suggests that the various vaccines triggered immune responses against IBD through both humoral and cell-mediated immunity. However, recombinant followed by immune complex vaccines appeared to induce more robust immunity while also being safer for broiler chickens in contrast to the intermediate plus vaccine.

Determination of the feed additive “Activo” effect on the productivity of lactating sows and young piglets under paratypic factors

The research was carried out at the pig farm of LLC Barkom, village Dublyany of Sambirsky district, Lviv region, and PE “Chernyuk” from Hrushvytsia Persha, Rivne district, Rivne region. According to the principle of analogs, two groups of farrowing sows of the PIC genetic company of the large white breed (2–3 farrowing) of 5 animals each were formed – control and trial. The animals were kept in the same house under the same conditions. The trial group received a standard diet similar to the control group, but the feed additive “Activo” was added to the diet in 0.1 kg/t of finished feed. From the fifth day after birth until weaning, newborn piglets of the trial group were fed pre-starter feed, to which 0.2 kg of the feed additive “Active” was added. The environmental parameters in the houses where the animals were kept differed according to the following leading indicators: the air temperature (°C) in the box with manual control of the supply-exhaust ventilation system in 5-, 14-, and 28-day-old piglets were, respectively, by 3; 2 and 4 °C higher compared to the temperature regime provided by the Big Duchman microclimate system; air movement speed (m/s) lower by 21.4; 33.3 and 8.3 %, respectively; carbon dioxide concentration (ppm) higher in 1.9; 1.8 and 2.1 times, respectively; ammonia concentration (mg/m3) higher in 4.5; 6.1 and 6.1 times, respectively; hydrogen sulfide concentration (mg/m3) higher in 1.8; 4 and 5.4 times, respectively. During the trial period, a probable tendency to decrease feed consumption by sows of the control group by 3.4 % (Р &lt; 0.01) was noted at LLC “Barkom”, and at PE “Chernyuk”, it amounted to 6.22 % (Р &lt; 0.001). At the same time, the loss of live weight in sows of the control group amounted to 10 % at the end of the period at LLC Barcom in the control group; namely, the sows of the group (K) lost an average of 23 kg during the trial period. The sows of the group (E) lost 17 kg. At the PE “Chernyuk” pig farm, the loss of live weight in sows at the end of the period in the control group was 25.8 kg, and in the trial group 19.4 kg, (Р &lt; 0.001), that is 24.8% less compared to the control group. At the pig complex of LLC "Barkom," when applying the feed additive “Activo” to lactating sows, an increase in the live weight of piglets in the trial group from birth to the fifth day after birth was noted by 18.3 %, compared to the control group. A significant increase in the live weight of piglets in the trial group was 17.16 % on the 14th day and 13.76 % (Р &lt; 0.001) on the 28th day of life, respectively. When calculating the average daily growth from birth to weaning (28 days of piglets' life), the difference was 18.54 % (Р &lt; 0.001). Piglets born from sows of the control group at the PE “Chernyuk” pig complex that did not consume the trial feed additive had a slightly lower live weight at birth by 9.4 % compared to the trial group. On the fifth day of life, the live weight of the piglets in the trial group was significantly greater than 30.2 % (Р &lt; 0.001). The tendency to increase the piglet's live weight on the 14th and 28th day of life was observed in the trial group by 20.1 % (Р &lt; 0.01) and 14.1 % (Р &lt; 0.001), respectively, in the control group. When calculating the average daily weight gain from birth to weaning (28 days of piglets' life), the difference was 15.15 % (Р &lt; 0.001).

Insight Into Neonatal Sepsis: An Overview.

There are approximately 1.3 million cases of neonatal sepsis reported worldwide with deathsoccurring more commonly in preterm and low-weight newborns. Neonatal sepsis is the third major cause of neonatal deaths resulting in 203,000 deaths per year. It is divided into two subtypes based on time of occurrence: early-onset neonatal sepsis (ENS), occurring within the first 72 hours of birth usually due to perinatal risk factors, and late-onset neonatal sepsis (LOS) usually occurring after the first week of life and up to 28th day of life. There are many complications associated with neonatal sepsis including septic shock, multiple organ failure, and death. It is vital for clinicians to know the signs and symptoms of neonatal sepsis in order to diagnose it early. Preventive measures, early diagnosis, appropriate antibiotic administration, timely supportive management, and the establishment of efficient management are vital in the prevention of severe complications or death. In this review, we aim to provide the most up-to-date information regarding risk factors, pathophysiology, signs and symptoms, diagnosis, and treatment of neonatal sepsis. We discuss the maternal and neonatal risk factors involved in the pathogenesis of neonatal sepsis and the signs and symptoms of early and late neonatal sepsis.We focus on the different pathogens involved and the markers used in the diagnosis and treatments available for each.

Congenital Central Hypoventilation Syndrome (Ondine’s Curse): Clinical Case

Background. Congenital central hypoventilation syndrome (CCHS), or Ondine’s Curse, is rare, incurable and life-threatening disease characterized by autonomic nervous system disorders, it manifests with disability to maintain ventilation function during sleep. Sensitivity to hypoxia and hypercapnia is reduced in case of CCHS, thus, it leads to recurrent episodes of deep apnea. The world literature describes just over 1000 cases of this disease. Clinical case description. An infant born at 37th week of gestation, weight of 3330 g, had episodes of apnea and hypercapnia from the first day of life. CCHS was suspected by the 28th day of life after excluding other causes of respiratory disorders, and it was genetically confirmed by the 43rd day of life — pathogenic variant of PHOX2B gene was revealed. Mechanical ventilation has been initiated by the age of 1 month after disease worsening. Analysis of CCHS cases published in Russian-language medical literature was performed. Typical symptoms and timing of their manifestation, as well as the time before correct diagnosis were mentioned. Conclusion. Symptoms that can be suggestive of CCHS presence early after birth and can urge to perform all the necessary genetic testing that are crucial for timely treatment onset and for minimizing the negative effect of hypoxemia and hypercapnia on the child are described.

Hand hygiene for the prevention of infections in neonates.

Hand hygiene for the prevention of infections in neonates.

Oat Hull as a Source of Lignin-Cellulose Complex in Diets Containing Wheat or Barley and Its Effect on Performance and Morphometric Measurements of Gastrointestinal Tract in Broiler Chickens

The purpose of the experiment was to determine the effect of oat hull on the performance and morphometric measurements of the gastrointestinal tract, and to correlate the results of these measurements with the type of the determined dietary fiber in feed and the number of microorganisms. The Asp method is simpler and quicker than non-starch polysaccharide analysis, and can give quick information in the analysis of fiber fractions (soluble and insoluble) in the component or in a diet, and also related the obtained results with the performance of broiler chickens. The utilization of oat hull in the amount of 1% of the diet of broiler chickens results in the highest body weight on the 28th day of life (p &lt; 0.05) in comparison to the group not receiving oat hull in the diet and with a 3% share of this structural component. Oat hull in the diet of broiler chickens in the amount of 1% also reduces the total length of the intestines (p &lt; 0.05), compared with the share of 0 and 3%. The soluble fiber contained in the grains of barley and wheat has an influence on the higher metabolic weight of the glandular stomach of broiler chickens compared to the birds receiving corn grain in their diet. Barley grain and oat hull in the amount of 3% significantly (p &lt; 0.01) increase the weight of gizzards. The increase in the weight of the proventriculus (r = 0.392), gizzard (r = 0.486) and duodenum (r = 0.657) was positively correlated with the growth of E. coli bacteria in the crop. The opposite effect in the case of negative correlation was determined in the case of the duodenum and E. coli count (r = −0.593).

Effect of Fermented Rapeseed Meal in Feeds for Growing Piglets on Bone Morphological Traits, Mechanical Properties, and Bone Metabolism

Quality feed is essential for correct bone development and proper functioning of animals. Post-weaned piglets experience a radical change in eating behaviour that can influence their feed intake. For this reason, functional feed additives and ingredients that can be used in post-weaning feeds are needed. The objective of this study was to evaluate the effects of partially replacing wheat with rapeseed meal fermented using Bacillus subtilis strain 87Y on overall bone quality and bone metabolism in weaner piglets. From the 28th day of life, barrows were fed either a standard wheat-based diet or a diet containing 8% fermented rapeseed meal (FRSM) with or without a feed additive containing enzymes, antioxidants, probiotics, and prebiotics. The experimental period lasted 60 days, after which femur quality indices were assessed. Differences in bone length and weight were observed, but there were no changes in bone mineralization or bone mid-diaphysis morphometrical traits between treatments. FRSM inclusion reduced bone mid-diaphysis biomechanical properties, but these changes were dependent on feed-additive supplementation. Analysis of the levels of serum bone turnover markers suggests the intensification of bone resorption in FRSM-fed groups as deoxypyridinoline levels increase. The results obtained warrant further research on what the disturbances in bone mechanical properties and metabolism observed in FRSM-fed weaners means for the subsequent fattening period.

Comparaison de la mortalité fœtale et néonatale des grossesses gémellaires monochoriales monoamniotiques et monochoriales biamniotiques

ObjectivesTo compare the mortality of monochorionic-monoamniotic (MCMA) and monochorionic-biamniotic (MCBA) twin pregnancies, from 14weeks of gestation to 28th day of life, before and after exclusion of major congenital malformations. MethodsWe conducted a retrospective cohort study in two level 3 maternity units of the Hospices civils de Lyon (France) including all patients with a monochorionic twin pregnancy between January 2013 and December 2020. We excluded TRAP sequences and conjoined twins. ResultsA total of 38 MCMA and 658 MCBA pregnancies were included. We showed an increase in overall mortality in the MCMA group compared to the MCBA group (31.6% versus 16.4%, P=0.03) even after exclusion of major congenital malformations (20.3% versus 9.5%, P=0.01). The main cause of mortality found in the MCMA group was the occurrence of unexpected IUGR. ConclusionsMCMA pregnancies have a higher foetal and neonatal mortality rate than MCBA pregnancies even after exclusion of congenital malformations related to the occurrence of unexpected MFIU.

Neonatal Tetanus: case series from Dilla univeristy referal hospital, Ethiopia

Background: Neonatal tetanus is a deadly infection leading to 7-8% of neonatal mortality in de-veloping countries. WHO defines Neonatal tetanus as an illness in a child who has the normal ability to suck in the first 2 days of life, presented with failure to suck between 3rd and 28th days of life and has rigidity and spasms? Though Ethiopia declared maternal and neonatal tetanus elimination in 2017, there has been significant number of neonates presenting with this problem in Neonatal ICU’sMethods: This review characterized clinical profile, demography and outcome of seven neona-tal tetanus cases admitted at Dilla University hospital, neonatal ICU from September 11, 2018 to September11, 2020.Results: All mothers gave birth at home with unskilled birth attendant, local blade or knife was used to cut the cord. Median age for mothers was 26 years and two out of seven had antenatal care (ANC) follow up and took Two doses of tetanus toxoid (TT) vaccine. Fever, failure to suck, spasm and convulsions were the common presenting symptoms. The overall mortality was 70%.Conclusion: Continuous emphasis on antenatal tetanus immunization and safe delivery practic-es should be maintained. Clinicians caring for neonates should be aware of the presentations of neonatal tetanus to allow them to diagnose these patients early and initiate appropriate lifesaving management.

Estimating glomerular filtration rate via cystatin C in preterm infants: a comparative analysis

Background: We aimed to determine the course of serum creatinine (sCr), serum cystatin C (sCysC) and urine cystatin C (uCysC) levels and calculate estimated glomerular filtration rate (eGFR) by using sCr- and sCysC-based formulas in preterm infants in the first 28 days of life.&#x0D; Methods: A total of 52 neonates were included in this prospective study. According to gestational age (GA), the neonates were divided into three groups. Group 1 composed of neonates who were born ≤28 weeks (n=15), group 2 and 3 consisted of infants who were born 29-31 weeks (n=16) and 32-34 weeks (n=21), respectively. Blood and urine samples were obtained at the 24-48 hours of life and then weekly until 28th day of life. sCr- and sCysC-based formulas were applied to determine the value and course of eGFR.&#x0D; Results: sCr level was negatively correlated with GA (r=-0.36, p=0.014) but not with BW (r=-0.15, p=0.31). While sCr levels showed significant variations in all study groups on day 7, day 14, and day 21 however, sCysC did not differ by GA at any time-points. All study groups had significantly different uCysC levels, except day 28. eGFR results calculated with sCr-based formula were detected to be closer to inulin.&#x0D; Conclusion: In preterm infants, sCr seemed to be a more reliable marker than sCysC to calculate eGFR. Moreover, in the same population, uCysC levels may reflect renal maturation more than sCysC.

Influence of microbial additive on the number of dominant intestinal microorganisms of piggies under action of stress weaning

The article presents the results of the study of the number of dominant intestinal microorganisms in piglets during weaning for 28 days of life (under stress), as well as in different periods of resistance (20 and 60 days after weaning) and the inclusion in the diet of microbial supplements “Biovir”. The experiments were performed on clinically healthy piglets 5–90 days of the age of the Poltava white breed. On the 28th day of life, the piglets were weaned from the sow, which served as industrial stress for the animals. Piglets of the experimental group were additionally fed from 5 to 45 days of age feed supplement “Biovir,” the use and doses of which are agreed following the instructions and offered by the manufacturer – biotechnology company “Ariadna” in Odessa. The analysis of the obtained results indicates that during weaning (28 days of life) in the intestines of piglets that did not receive supplements of microbial origin “Biovir,” the number of dominant microorganisms is within the specified age of animals, which is a sign of microorganisms, healthy animals and indicates a sufficient level of adaptive responses of their body. It was found that under stress in the ileum and colon of piglets that did not receive supplements, the number of dominant intestinal microorganisms is characterized by a decrease in bifidobacteria and lactobacilli, as well as the growth of Escherichia coli by an average of two orders of magnitude (P &lt; 0.05), resistance 20 days after weaning. There was no stabilization of the number of groups of microorganisms studied in the intestines of piglets 60 days after weaning. The use of “Biovir” supplements in piglets from 5 to 45 days of age has a positive effect on the number of dominant intestinal microorganisms before and after exposure to weaning stress (at the stage of resistance) due to a stable and probably higher number of bifidobacteria and lactobacilli on average, by 15.8 % (P &lt; 0.05), as well as redistribution of Escherichia coli even after cessation of feeding (60 days after weaning). The results show that the components of “Biovir” supplements – products of lactic acid and bifidobacteria metabolism – affect the function of the intestinal mucosa and help restore normal microflora.

Incidence and risk factors of urinary tract infection in neonatal sepsis

BackgroundNeonates with sepsis may have concurrent urinary tract infection (UTI), which may be asymptomatic or have nonspecific symptoms. Failure to diagnose UTI, resulting in a delay of appropriate therapy, has been reported to cause renal scarring, hypertension, and kidney failure among infants. This study aimed to determine the contribution of UTI to neonatal sepsis and to assess different risk factors that could be associated with UTI. This cross-sectional study was conducted at the Neonatal Intensive Care Unit (NICU) of Fayoum University Hospital, Fayoum, Egypt, between March 2018 and January 2019. Neonates of both genders from birth to the 28th day of life with clinical features of either early- or late-onset sepsis (during or after the first 3 days of life, respectively) were enrolled in this study. All neonates were subjected to complete history taking from the parents, full clinical examination, and laboratory investigations including complete blood count, C-reactive protein, blood culture, and urine culture.ResultsThe current study included 100 neonates admitted to the NICU with clinical and laboratory features of sepsis. Positive blood culture (proven sepsis) was detected in 60%, and the proportion of positive urine culture (UTI) in the entire study group was 11%. The incidence of UTI was 11.7% in proven sepsis compared to 10% in suspected sepsis, and it was 16.36% in late-onset sepsis (LOS) versus 4.44% in early-onset sepsis (EOS). There was a statistically significant association between poor feeding and feeding intolerance and positive urine culture (UTI). Leukopenia and expert panel criteria score showed high sensitivity (81.80% and 90.90%, respectively) but low specificity for the diagnosis of UTI.ConclusionsGram-negative bacteria have been highly suspected in cases of neonatal sepsis. Poor feeding and feeding intolerance have association with positive urine culture. Finally, urine culture for sepsis was recommended especially in the late type.

Structural epilepsy in children who have suffered a hemorrhagic stroke

The relevance of studying the consequences of hemorrhagic strokes in young children is due to the frequency of cerebrovascular pathology, the formation of persistent neurological deficits, including post-stroke epilepsy, and high mortality. It is known that hemorrhages are diagnosed in the first 28 days of life in 6-7 out of 100,000 infants, in children from the 28th day of life to 18 years of age from 0.7 to 5.1 cases per 100 thousand children. Mortality in hemorrhagic and ischemic strokes in children ranges from 7 to 28%. Epileptic seizures of the acute and acute period of stroke are prognostically unfavorable factors of the course of the disease. The article presents brief literature data on the etiology and localization of hemorrhagic strokes, their role in the formation of pharmacoresistant epilepsy. Special attention is paid to the role of late hemorrhagic disease of newborns, accompanied by intracranial hemorrhages, in the formation of structural epilepsy in the future. The paper describes own clinical observations of 25 patients suffering from epilepsy after a hemorrhagic stroke with a description of the clinical picture, features of paroxysmal states and their therapy, neuroimaging data, electroencephalographic phenomena. A clinical example is presented in which the clinical, anamnestic, electrophysiological data of a patient with pharmacoresistant epilepsy developed as a result of a hemorrhagic stroke on the background of late hemorrhagic disease of newborns are considered.&#x0D; Structural epilepsy in children, formed after a hemorrhagic stroke, is accompanied by significant multi-regional damage, pronounced neurological deficit and is characterized by a pharmacoresistant course.