28th Day Of Life Research Articles

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.

Annually, infections contribute to approximately 25% of the 2.8 million neonatal deaths worldwide. Over 95% of sepsis-related neonatal deaths occur in low- and middle-income countries. Hand hygiene is an inexpensive and cost-effective method of preventing infection in neonates, making it an affordable and practicable intervention in low- and middle-income country settings. Therefore, hand hygiene practices may hold strong prospects for reducing the occurrence of infection and infection-related neonatal death. To determine the effectiveness of different hand hygiene agents for preventing neonatal infection in both community and health facility settings. Searches were conducted without date or language limits in December 2022 inthe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Cumulated Index to Nursing and Allied Health Literature (CINAHL), clinicaltrials.gov and International Clinical Trials Registry Platform (ICTRP) trial registries. The reference lists of retrieved studies or related systematic reviews were screened for studies not identified by the searches. SELECTION CRITERIA: We included randomized controlled trials (RCTs), cross-over trials, and cluster trials that included pregnant women, mothers, other caregivers, and healthcare workers who received interventions within either the community setting or in health facility settings, and the neonates in the neonatal care units or community settings. We used standard methodological procedures expected by Cochrane and theGRADE approach to assess the certainty of evidence.Primary outcomes were incidence of suspected infection (author-defined in study) within the first 28 days of life, bacteriologically confirmed infection within the first 28 days of life, all-cause mortality within the first seven days of life (early neonatal death), and all-cause mortality from the 8th to the 28th day of life (late neonatal death). Our review included six studies: two RCTs, one cluster-RCT, and three cross-over trials. Three studies involved 3281 neonates; the remaining three did not specify the actual number of neonates included in their study. Three studies involved 279 nurses working in neonatal intensive care units (NICUs). The number of nurses included was not specified by one study. A cluster-RCT included 103 pregnant women of over 34 weeks gestation from 10 villages in a community setting (sources of data: 103 mother-neonate pairs) and another community-based study included 258 married pregnant women at 32 to 34 weeks of gestation (the trial reported adverse events on 258 mothers and 246 neonates). Studies examined the effectiveness of different hand hygiene practices for the incidence of suspected infection (author-defined in study) within the first 28 days of life. Three studies were rated as having low risk for allocation bias, two studies were rated as unclear risk, and one was rated as having high risk. One study was rated as having a low risk of bias for allocation concealment, one study was rated as unclear risk, and four werw rated as having high risk. Two studies were rated as having low risk for performance bias and two were rated as having low risk for attrition bias. One class of agent versus another class of agent: 2% chlorhexidine gluconate (CHG) compared to alcohol hand sanitiser (61% alcohol and emollients) For this comparison, no study assessed the effect of the intervention on the incidence of suspected infection within the first 28 days of life. Two percent chlorhexidine gluconate (CHG) probably reduces the risk of all infection in neonates compared to 61% alcohol hand sanitiser in regard to the incidence of all bacteriologically confirmed infection within the first 28 days of life (RR 0.79, 95% confidence interval (CI) 0.66 to 0.93; 2932 participants, 1 study; moderate-certainty evidence), number needed to treat for an additional beneficial outcome (NNTB): 385. The adverse outcome was reported as mean self-reported skin change and mean observer-reported skin change. There may be little to no difference between the effects of 2% CHG on nurses' skin compared to alcohol hand sanitiser, based on very low-certainty evidence for mean self-reported skin change (mean difference (MD) -0.80, 95% CI -1.59 to 0.01; 119 participants, 1 study) and on mean observer reported skin change (MD -0.19, CI -0.35 to -0.03; 119 participants, 1 study), respectively. We identified no study that reported on all-cause mortality and other outcomes for this comparison. None of the included studies assessed all-cause mortality within the first seven days of lifenorthe duration of hospital stay. One class of agent versus two or more other classes of agent:CHG compared to plain liquid soap + hand sanitiser We identified no studies that reported on our primary and secondary outcomes for this comparison except for author-defined adverse events. We are very uncertain whether plain soap plus hand sanitiser is better than CHG for nurses' skin based on very low-certainty evidence (MD -1.87, 95% CI -3.74 to -0.00; 16 participants, 1 study; very low-certainty evidence). One agent versus standard care: alcohol-based handrub (hand sanitiser) versus usual care The evidence is very uncertain whether alcohol-based handrub is better than 'usual care' in the prevention of suspected infections, as reported by mothers (RR 0.98, CI 0.69 to 1.39; 103 participants, 1 study, very low-certainty evidence). We are uncertain whether alcohol-based hand sanitiser is better than 'usual care' in reducing the occurrence of early and late neonatal mortality (RR 0.29, 95% CI 0.01 to 7.00; 103 participants, 1 study; very low-certainty evidence) and (RR 0.29, CI 0.01 to 7.00; 103 participants, 1 study; very low-certainty evidence), respectively. We identified no studies that reported on other outcomes for this comparison. We found a paucity of data that would allow us to reach meaningful conclusions pertaining to the superiority of one form of antiseptic hand hygiene agent over another for the prevention of neonatal infection. Also, the sparse available data were of moderate- to very low-certainty. We are uncertain as to the superiority of one hand hygiene agent over another because this review included very few studies with very serious study limitations.

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.

To Determine the Frequency of Mortality in Neonates with Sepsis Having High MPV

Introduction: A high MPV on admission in septic patients may be a useful indicator associated with poor outcome especially when it is associated with decreasing platelet numbers. Objective: To determine the frequency of mortality in neonates with sepsis having high MPV. Material &amp; Method: Study design: Descriptive case series study Settings: NICU, Shifa International Hospital, Islamabad Methodology: All newborns of both genders up to 28th day of life who have culturally proven sepsis or probable sepsis with gestational age of ≥28 weeks, birth weight &gt; 700gms were enrolled. The initial investigations on admission was carried out as per NICU septic screening protocol includes complete blood count CBC, C-Reactive Protein (CRP), electrolytes, renal function tests, blood C/S, urine R/E urine C/S, x-ray chest while the other investigations including CSF analysis, gram staining and culture, tracheal secretions and catheter tips for culture and sensitivity are performed when indicated clinically. Outcome was measured till discharge or death. Results: Mean age of the patients was mean ±SD 6.58 ±5.72 days. Most of the neonates 59 (62.1%) were males whereas 36 (37.9%) were females. Mean CRP, TLC count, platelet count, TLC count at baseline were 21.23 ±42.34, 15190.5 ±4619.32, 254348.42 ±101479.87 respectively. MPV at baseline 10.56 ±0.85 and at 48 hours was 9.96 ±0.81 respectively. Mortality was observed in 22 (23.2%) neonates. Conclusion: The frequency of mortality was found to be 23.2% in neonates with sepsis having high MPV. Keywords: Mortality, Neonates, Sepsis, Mean Platelet Volume

Management of Two Cases of Spina Bifida and Neonatal Genital Prolapse at the University Hospital of Parakou and Review of the Literature

Spina bifida, or spinal dysraphism, is a malformative pathology related to an anomaly in the development of the nervous system, occurring during embryogenesis. The neural tube does not close properly around the 28th day of life and affects the development of the spinal column and spinal cord. Spina bifida is characterised by damage to the nervous system and will generate handicaps and damage of varying degrees: neurological motor, sensory, cognitive, genito-phincter (bladder and anorectal) deficits with consequences for the quality of life of these people. The literature describes the association between spinal dysraphism and genital prolapse. However, genital prolapse is an exceptional and rare entity in newborns. We report the observations of two newborns: the first case of a newborn born at term, at 7 days of age, who presented a prolapse of the uterine cervix in association with myelomeningocele, without any neuromuscular repercussions, and the second case of a newborn at 10 days of age, presenting with a lumbosacral spina bifida and a uterine prolapse. They benefited from conservative medical treatment characterised by manual reduction of the prolapse in both cases with a favourable evolution. In the case of spina bifida, a cure of myelomeningocele was performed surgically with simple postoperative course.

Features of the Neonatal Period in Perinatally HIV-Exposed Children Receiving Combined Сhemoprophylaxis of mother-to-child Transmission of HIV

The aim. To study the features of the course of the neonatal period in children, perinatally exposed to HIV, who receive an enhanced regimen of chemoprophylaxis of HIV mother-to-child transmission.Patients and methods. A retrospective longitudinal cohort study of mother – child pairs for the period from 2017 to 2019 was carried out. The clinical observation group included HIV-positive women with a high risk of vertical transmission of the immunodeficiency virus (n = 213) and their newborn children (n = 214), who were prescribed an enhanced chemoprophylaxis regimen of HIV transmission from mother to child. Results. According to the results of the study of HIV-positive mothers we revealed a high prevalence of secondary diseases and a high per partum viremia – 1700 (222–18342) copies/ml. 35.9 % of children were born prematurely, 27.5 % – had low birth weight by gestational age. In newborns, diseases of the respiratory (24.3 %) and nervous (17.2 %) systems prevailed. 17.2 % of children developed intrauterine infection; HIV RNA was detected in 3.7 %. Congenital malformations were observed in 7.4 % of children. Symptoms of enteropathy were noted in 24.7 % of newborns. A decrease in red blood counts was found in all children by the 28th day of life (pw &lt; 0.001).Conclusion. The study confirms the need for increased attention and improvement of approaches to medical support of children who were perinatally exposed to high risk of vertical HIV infection.

System of antioxidant protection of the body of piglets under the action of feed additive “Sylimevit”

One of the conditions for obtaining high-quality pig products is the use of feed additives, which contain all the necessary biologically active substances, eliminating their deficiency in feed and acting as catalysts for metabolic processes in pigs. That is why the aim of the study was to study the effect of feed additive “Sylimevit” on the enzymatic and non-enzymatic parts of the antioxidant system of piglets after weaning. Two groups of piglets were formed – control and experimental, in the amount of 10 individuals in each group, selected on the principle of analogues – age, breed and body weight. During the weaning period, the piglets were kept under the sow in special machines, had constant access to the mother, and from the age of 5 days – free access to concentrated feed. Feeding of animals was carried out in accordance with the norms for a given age of pigs. Prior to the study, a clinical and physiological examination of the piglets was performed. Their general condition and activity when eating food were taken into account. On the 28th day of life, the piglets were weaned from the sow and regrouped from different nests in order to be further maintained during the period of fattening and rearing with a change in the structure of the diet, which served as technological stress for the animals. From the age of 5 days, piglets of all groups were fed pre-starter feed. Piglets of the experimental group, from 21 to 40 days of age, were additionally fed the feed supplement “Sylimevit” at a dose of 100 mg/kg body weight per day. Feeding piglets Silimevit feed enhances their antioxidant status. The use of this feed additive in piglets contributed to the activation of both enzymatic and non-enzymatic parts of the antioxidant defense system of piglets after weaning, as indicated by an increase in blood 35-day-old piglets superoxide dismutase activity by 26.9 % (P &lt; 0.001), catalase – 41.1 % (P &lt; 0.001), glutathione peroxidase – by 52.7 % (P &lt; 0.05), glutathione reductase – by 53.5 % (P &lt; 0.05), the content of reduced glutathione – by 75 % (P &lt; 0.001). This is due to the fact that silimevit contains active substances such as milk thistle and vitamins, which are strong direct-acting antioxidants and directly interact with free radicals and reactive oxygen species.

The level of products of lipid peroxidation in the blood of piglets at the action feed additive “Sylimevit”

Intensive pig breeding has been reported in the literature to suggest that early weaning of piglets from sows is an extreme stimulus that reduces the protective and adaptive responses of piglets. That is why the aim of the study was to study the effect of the feed additive “Sylimevit” on the level of lipid peroxidation products of piglets after weaning. Two groups of piglets were formed – control and experimental in the amount of 10 individuals in each group, selected on the principle of analogs – age, breed and body weight. During the weaning period, the piglets were kept under the sow in special machines, had constant access to the mother, and from the age of 5 days – free access to concentrated feed. While feeding of animals was carried out in accordance with the norms for a given age of pigs. Prior to the study, a clinical and physiological examination of the piglets was performed. Their general condition and activity when eating food were taken into account. On the 28th day of life, the piglets were weaned from the sow and regrouped from different nests in order to be further maintained during the period of fattening and rearing with a change in the structure of the diet, which served as technological stress for the animals. From the age of 5 days, piglets of all groups were fed pre-starter feed. Piglets of the experimental group, from 21 to 40 days of age, were additionally fed the feed supplement “Sylimevit” at a dose of 100 mg/kg body weight per day. The technological stress of weaning piglets from sows is accompanied by a gradual probable intensification of lipid peroxidation processes. Feeding Sylimevit feed to piglets after weaning helped to reduce the content of intermediate and final products of lipid peroxidation: lipid hydroperoxides – by 52 % (P &lt; 0.001) and TBA-active products – by 22.5 % (P &lt; 0.01). Thus, feeding the piglets of the experimental group of the feed additive “Sylimevit” helped to suppress the processes of lipid peroxidation in animals. Thus, the results of the use of feed additive “Sylimevit” in weaned piglets showed a pronounced antioxidant effect. The components of the feed additive directly interacted with reactive oxygen species and free radicals, preventing the development of oxidative stress.

Lung Ultrasound in Bronchopulmonary Dysplasia: Patterns and Predictors in Very Preterm Infants

Introduction: Lung ultrasound (LUS) is useful for respiratory management in very preterm infants (VPI), but little is known about the echographic patterns in bronchopulmonary dysplasia (BPD), the relation between the image findings, and the severity of the disease and its long-term outcomes. We aimed to describe LUS patterns in BPD and analyze the accuracy of LUS to predict the need for respiratory support at 36 weeks postmenstrual age (PMA) in VPI. Methods: Preterm infants ≤30.6 weeks of gestational age were recruited. LUS was performed at admission, at 7th, and 28th day of life (DOL) with a standardized protocol (6 zones: anterior, lateral, and posterior fields). Clinical data, respiratory outcomes, and image findings were recorded. Results: Eighty-nine patients were studied. Infants with BPD had significantly higher LUS score at admission, at 7th, and 28th DOL. Patients with BPD exhibited more consolidations and pleural line abnormalities at 7th and 28th DOL than those without BPD (p < 0.001), regardless of the definition used for BPD. LUS at 7th DOL predicted NICHD 2001-BPD with R² = 0.522; AUC = 0.87 (0.79–0.94), p < 0.001, and Jensen 2019-BPD with R² = 0.315 (AUC = 0.80 [0.70–0.90], p < 0.001). A model including mechanical ventilation >5 days, oxygen therapy for 7 days and LUS score at 7th DOL accurately predicted the need for respiratory support at 36 weeks PMA (R² = 0.655, p < 0.001) with an AUC = 0.90 (0.84–0.97), p < 0.001. Conclusion: LUS score, pleural line abnormalities, and consolidations can be useful to diagnose BPD in VPI and to predict its severity after the first week of life.