Seventh Month Research Articles

The recurrent mutation in RNF220 also causes hypomyelination in China and is a CpG hot spot.

A recent study in Brain1 identified two homozygous missense variants in RNF220 [p.(R363Q) and p.(R365Q)] in five European pedigrees with ataxia, deafness, hypomyelinating leukodystrophy, liver dysfunction and dilated cardiomyopathy. The R365Q mutation was found in four families of Roma ethnic origin and proposed to be a founder mutation. However, here, we report a sixth family, of Chinese ethic descent, with the same p.(R363Q) variant. We also discuss the origin of this recurrence. Our patient, a 7-year-old boy, is the eighth pregnancy of a consanguineous Chinese couple. The couple’s mothers are sisters. The first three children were born prematurely in the seventh or eighth month of pregnancy, and the fourth child was born at term, all of whom were stillborn girls. The fifth child was a boy who presented with hand tremor at 1 year of age, and with hearing loss at 7 years of age. He died at the age of 9 years with fever and wheezing. The condition of the heart is unclear. Pale hair colour was also recorded. The sixth and seventh foetuses were aborted for personal reasons. At the age of 47 years, the mother gave birth to their eighth child, the index patient in this study (Fig. 1). The boy was born uneventfully at full term by caesarean section due to his mother’s advanced age. His birth weight was 2.8 kg. He could walk alone stably and speak at age 1. Other developmental milestones were also in the normal range, except for intention tremor in both hands emerging at the age of 1 year. Hearing loss was noted at 5 years old, and worsened quickly to complete hearing loss at age 7 years. Dysarthria appeared along with hearing loss. Cognitive ability is spared. Neither abnormal gait nor seizures were noted. Examined at 5 years of age, pale hair colour for hair and eyebrows, hyperreflexia, positive Babbitt sign and finger-nose test were recorded. Head circumference, eye movement, muscle strength and tension were all normal. Brain MRI performed at age 5 years of age demonstrated diffuse hypomyelination, thin corpus callosum, slightly atrophied cerebellum and decreased T2-weighted signals in bilateral pallidus globus and lentiform nucleus (Fig. 2). His heart function was normal and cardiac ultrasonography was not performed. Kidney function, lactic acid electrolyte and inborn metabolic error screening were all normal. For liver function, AST 15 IU/l is normal and ALT 48 IU/l is borderline.

Internecine War and Intra-Nicene Sin

The Russo-Ukrainian War, beginning with the invasion and illegal annexation of Crimea in 2014, witnessed a full-scale invasion of the entire nation in early 2022. As the renewed conflict enters into its seventh month, its repercussions threaten to impact other nations in myriad ways, ranging from radioactive catastrophes from attacks on civilian nuclear power plants to direct military aggression or spillover to other nations. One of these looming concerns is a famine in Ethiopia resulting from reduced access to Ukrainian wheat; the Black Sea shipping lanes are under threat by Russian warships and mines. This article offers a theological reflection on this conflict, and how famine is now being used as a weapon of war. The orations of Basil the Great are discussed in relation to economic analyses on the causes of famine by Nobel Laureate Amartya Sen. These are brought forward in relation to the Russo-Ukrainian War, which has become an internecine war within Orthodox Christianity.

Analysis of fruit ripening in Theobroma cacao pod husk based on untargeted metabolomics

The pod husk of Theobroma cacao (CPH) plays an important agronomical role, as its appearance is used as indicator of ripening, guiding the farmers in the harvest process. Cacao harvesting is not a standardized practice because farmers harvest between six up to eight months from flowering, guided by pod's color and shape. The mixture of cacao beans from different ripening stages (RS), negatively affecting the quality and price of grain. A way to help the farmers in the harvest standardization could be through the use of chemical markers and visual indicators of CPH ripening. This study analyses CPH's metabolic distribution of two cacao clones, ICS95 and CCN51 at six, seven, and eight months of ripening. Untargeted metabolomics was done using HPLC-MS/MS for biomarker discovery and association to cacao ripening. The results indicated a strong metabolic differentiation of the sixth month with the rest of the months independent of the variety. Also, metabolic differences were found between cacao clones for the seventh and eighth month. We annotated five potential biochemical markers including 3-caffeoylpelargodinin 5-glucoside, indoleacetaldehyde, procyanidin A dimer, procyanidin C1, and kaempferol. We further looked for correlation between patterns of progression of our markers against quantitative indicators of CPH appearance and texture, at the same ripening stages. We also performed a functional analysis and three possible metabolic pathways: flavone and flavonol biosynthesis, flavonoid biosynthesis, and tryptophan metabolism were identified associated with stress sensing, plant development and defense respectively. We found significant and positive correlations between green color density and all metabolites. For texture, the correlations were significantly negative with all metabolites. Our results suggest that about the sixth month is appropriate for harvesting cacao in the region of Caldas, Colombia in order to avoid all the metabolic variations occurring at later stages of ripening which impact the cacao bean quality. Therefore, studying the cacao ripening process can help in the estimation of the best harvest time and contribute to the standardization of harvest practices.

FEATURES OF THE STRUCTURE OF THE LABYRINTH WALL OF THE TYMPANIC CAVITY IN THE THIRD TRIMESTER OF PREGNANCY

Acute otitis media is one of the most common diagnoses among young children, and prematurity is the most common risk factor for its occurrence. The immaturity of the organs and systems of these children often lead to the development of pathological symptom complexes, including from the organ of hearing, which may necessitate surgical intervention. Modern microsurgical technologies signifi cantly increase the quality of operations and reduce the risk of possible complications. The surgeon’s work on these structures requires accurate knowledge of the anatomical and topographic features of the structure of the temporal bone, including in prematurely born children. The syntopy and structure of the labyrinth wall of the tympanic cavity were studied in 35 human fetuses of the seventh to tenth months of intrauterine development and 11 newborn cadavers. It has been established that the dimensions of the structures of the labyrinthine wall of the tympanic cavity in prematurely born children do not have defi nitive dimensions and their location diff ers from that in those born at term. In prematurely born children, the bone wall of the facial nerve canal is absent, in those born on time it is partially present in 18.18% of cases, the angle of passage of the facial nerve canal decreases from 33° in fetuses of the seventh month of intrauterine development to 25° in newborns. The identifi ed features are important in improving technologies and the adequacy of surgical treatment in prematurely born children.

Fetal Exposure to Air Pollution in Late Pregnancy Significantly Increases ADHD-Risk Behavior in Early Childhood.

Background: Air pollution nowadays has seriously threatened the health of the Chinese population, especially in the vulnerable groups of fetuses, infants and toddlers. In particular, the effects of air pollution on children’s neurobehavioral development have attracted widespread attention. Moreover, the early detection of a sensitive period is very important for the precise intervention of the disease. However, such studies focusing on hyperactive behaviors and susceptible window identification are currently lacking in China. Objectives: The study aims to explore the correlation between air pollution exposure and hyperactive behaviors during the early life stage and attempt to identify whether a susceptible exposure window exists that is crucial for further precise intervention. Methods: Based on the Longhua Child Cohort Study, we collected the basic information and hyperactivity index of 26,052 children using a questionnaire conducted from 2015 to 2017, and the Conners’ Parent Rating Scale-revised (CPRS-48) was used to assess hyperactive behaviors. Moreover, the data of air pollution concentration (PM10, PM2.5, NO2, CO, O3 and SO2) were collected from the monitoring station between 2011 to 2017, and a land-use random forest model was used to evaluate the exposure level of each subject. Furthermore, Distributed lag non-linear models (DLNMs) were applied for statistic analysis. Results: The risk of child hyperactivity was found to be positively associated with early life exposure to PM10, PM2.5 and NO2. In particular, for an increase of per 10 µg/m3 in PM10, PM2.5 and NO2 exposure concentration during early life, the risk of child hyperactivity increased significantly during the seventh month of pregnancy to the fourth month after birth, with the strongest association in the ninth month of pregnancy (PM10: OR = 1.043, 95% CI: 1.016–1.071; PM2.5: OR = 1.062, 95% CI: 1.024–1.102; NO2: OR = 1.043, 95% CI: 1.016–1.071). However, no significant associations among early life exposure to CO, O3 and SO2 and child hyperactive behaviors were observed. Conclusions: Early life exposure to PM10, PM2.5 and NO2 is associated with an increased risk of child ADHD-like behaviors at the age around 3 years, and the late-prenatal and early postnatal periods might be the susceptible exposure windows.

Reactivation and Foetal Infection in Pregnant Heifers Infected with Neospora caninum Live Tachyzoites at Prepubertal Age.

Neospora caninum is recognised for causing cattle abortion, provoking severe economic losses in the livestock industry worldwide. The aim of the present study was to evaluate the reactivation and foetal infection in pregnant heifers inoculated with live N. caninum tachyzoites before puberty. A total of 15 30-month-old pregnant heifers were allocated into four groups: animals inoculated with live tachyzoites of NC-Argentina LP1 isolate before puberty and challenged with live tachyzoites of NC-1 strain at 210 days of gestation (DG) (Group A); animals mock inoculated before puberty and challenged with NC-1 strain at 210 DG (Group B), animals inoculated before puberty but not subsequently challenged (Group C); and noninfected and nonchallenged animals (Group D). The results of this study showed that 100% of animals infected before puberty (Groups A and C) suffered reactivation of the infection at the seventh month of gestation. In addition, in three and two calves from Groups A and C, respectively, congenital infection was confirmed. Interestingly, we provide evidence that the use of live N. caninum tachyzoites in young animals as a strategy to induce protection is neither safe nor effective.

Thoracic kidney nephrectomy due to recurrent Bochdalek hernia in an adult

Congenital diaphragmatic hernia incidence is one in 3000 live births, Bochdalek hernia occurs through a posterolateral defect. It is very rare in adults. We present a case of late relapsed one diagnosed in an adult male. He underwent an open intervention of Bochdalek hernia at first day of life and required reintervention at seventh month due to recurrence. Now, computerized tomography scan demonstrates a right diaphragmatic defect with intrathoracic hydronephrotic kidney. Nephrectomy was performed with Video-assisted Thoracic Surgery using laparoscopic ports and material. The diaphragmatic defect was closed with a polypropylene mesh. The patient was discharged after 72 h.

Assessment of Fetal Aortic, Thoracic, and Heartbeat in Healthy Donkey Pregnancies

Practitioners are frequently requested to diagnose and stage pregnancy in donkeys with unknown breeding dates; however, scant work has been done to stage pregnancy in the species. Therefore, this study aimed to determine the association between measurements of fetal aortic, thoracic, and heartbeat with gestational age in donkeys carrying and delivering healthy foals. Multiparous Dezhou donkeys (n = 50) ranging from 4 to 16 years were enrolled in the study by 150 days of gestation. Transabdominal ultrasonography coupled with a 3.5 MHz sectorial convex transducer was performed at 30 day-intervals until delivery to obtain fetal aortic, thoracic, and fetal heartbeat measurements. Data were tested for normality with Shapiro- Wilk's test and then ANOVA and Tukey's. Statistical significance was set at P < .05. The mean duration of pregnancy was 356.6 ± 10.6 days (339–368). There were significant associations between gestational age and fetal aortic (r = 0.89) and thoracic (r = 0.88) measurements. Fetal heartbeat (r = -0.76) was negatively correlated with gestation length. The fetal aortic and thoracic measurements increased from the seventh month of gestation to the term (P < .001). The fetal heartbeat remained steady from 150 days to 270 days of gestation, then continuously decreased from 270 days until parturition (P < .001). In conclusion, fetal aortic and thoracic measurements are strongly associated with gestational age in donkeys. Fetal heartbeat decreases with advanced pregnancy.

The Relationship of Body Mass Index In Third Trimester of Pregnancy With Low Back Pain Incidence

Background : Low Back Pain is pain in the lower back which is a sign of disorder that causes a state of discomfort in performing daily activities and is felt in the anatomical area, especially in the fifth lumbal and sacral area. Low Back Pain will increase as gestational ages. This discomfort begins between the fifth and seventh months of pregnancy. Purpose : To find the relationship between body mass index in the third trimester of pregnancy with Low Back Pain incidence. Method : This research is an observational analytical research with cross-sectional approach. The population of this research is pregnant women in the third trimester who visited poly Obstetrics and Gynecology Hermina Padang Hospital with 77 samples by using consecutive sampling technique. Data analysis uses univariate and bivariate analysis with data processing using the computerized SPSS 23.0 version. Results : The most age were 26-35 years which is 44 people (57,1%), the most likely respondents were those who did not work which is 48 people (62,3%), and the most respondents gestational age is &gt; 36 weeks that is 40 people (51,9 %). The average body weight of the respondent is 65.8277 kg with a minimum body weight 51.51 kg and maximum 80.40 kg. The average height of respondent is 157.99 cm with a minimum height 148 cm and maximum 170 cm. The majority of respondents with an overweight body mass index were 50 people (64,9%), the highest level of LBP pain is 2 (a little pain) which is 26 people (33,8%), with respondents experienced LBP of 61 people (79,2%). Based on the bivariate analysis, it is known that there is a relationship between body mass index in the third trimester of pregnancy with Low Back Pain incidence (p=0.022). Conclusion : The third trimester of pregnant women, the most age is early adulthood (26-35 yars), with the most work is not working, and the most gestational age &gt;36 weeks. The average body weight of the respondent is 65.8277 kg and the average height of the respondent is 157.99cm, the most body mass index is overweight, the highest level of LBP pain is 2 (a little pain), and in the third trimester pregnant women experience the most LBP incidence is yes and there is a relationship between body mass index in the third trimester of pregnancy with low back pain incidence.

The Study of the 17β-estradiol content in raw milk during the lactation period

There is a large number of different contaminants that can affect the safety of milk consumption. In particular, the biological nature of pollution is provided by microorganisms, while the chemical pollution is controlled by heavy metal salts, inhibitory substances, hormones, etc. Recent studies report the delivery of milk and other livestock products for processing with a high content of steroidal estrogenic hormones of synthetic and natural origin. The aim of this study was to determine the content of 17β-estradiol in raw milk during lactation and estrous cycle. The amount of 17β-estradiol in raw milk was determined by using enzyme-linked immunosorbent assay through the RIDASCREEN®17β-őstradiol test system (Art-Biopharm / R-Biopharm, Darmstadt, Germany). During cow gestation observed on two farms, it was found that the 17ß-estradiol concentration in raw milk gradually increased, as indicated by probable changes compared to the first month of pregnancy. In particular, during the first three months of pregnancy, the amount of 17ß-estradiol did not exceed 100 pg/ml of milk with an average ranging between 42.4 ± 7.7 to 68.3 ± 7.8 pg/ml. From the fourth month onwards, the amount of steroid hormone increased on an average of 139.4 ± 11.8 pg/ml, which is 3.2, 2.7 and 2.0 times (P &lt; 0.05) more, compared to the first, second and third months of pregnancy, respectively. The dynamics of growth of 17ß-estradiol in the following months of pregnancy was even more significant. Importantly, on the fifth month the amount of hormones was estimated at 497.3 ± 36.7 pg/ml, which is 3.5 times (P &lt; 0.05) more than in the fourth month and almost 10 times more than in the first month of pregnancy. Before the end of the seventh and eighth month of pregnancy, the maximum concentration of 17ß-estradiol in milk was detected – 1105.3 ± 78.5 and 1209.8 ± 82.4 pg/ml, respectively. The results indicate that the lowest amount of content of 17ß-estradiol hormone in raw milk was during the first seven days of the study with a concentration of 57.1 to 65.6 pg/ml. during the estrous cycle in cows. Starting from the 15th to the 19th day of the estrous cycle, the amount of 17ß-estradiol ranged from 365.5 to 391.3 pg/ml. However, the highest amount of 17ß-estradiol was recorded in milk on the 19th day with a content of 407.3 ± 39.5 pg/ml. Thus, milk obtained at the end of lactation and estrous cycle is significantly enriched with estrogenic hormones that end up in dairy milk products and organisms of final consumers.

Ankyloblepharon Filiforme Adnatum in a Newborn Baby Girl

Introduction: One type of congenital defect, ankyloblepharon filiforme adnatum (AFA), is characterized by a single or many strands of connective tissue connecting the upper and lower eyelids. It occurs only infrequently at the lateral or medial canthus. The eyelids normally begin to form within the fifth month of pregnancy, and they usually begin to separate entirely into an upper and lower lid by the seventh month of pregnancy. This type of tissue always originates from the grey line, which is located anterior to the meibomian gland orifices and posterior to the cilia. Case presentation: A 22-day-old female child was taken to the Surabaya Eye Clinic with a congenital eye condition. Because his top and lower eyelids were stuck together at birth, she was unable to open his eyes fully. The infant, who weighed 2.8 kg at birth, was delivered by elective caesarean section at 39 weeks gestation to a 28-year-old primigravida mother. There were no abnormalities discovered during the prenatal, intranatal, or postnatal stages. Except for iron and vitamins, the mother is not taking any medications. There was no prior history of X-ray exposure found. There was no history of congenital abnormalities or consanguinity in the patient’s family. Conclusions: Ankyloblepharon filiforme adnatum (AFA) is a rare case. Early diagnostic and comprehensive management including surgical correction should be performed promptly to minimize any risk of amblyopia, and enable full examination of the eye.

An unusual presentation of an intraorbital abscess associated with an extensive dental caries and pulp gangrene in a 14-years old boy with asthma and obesity

We present an unusual case of a 14-year-old patient who was admitted as an emergency to the hospital with oedema of right orbit with restricted eye movements. Severe asthma from the seventh month of age and obesity were reported. Radiologic examination showed the existence of an intraorbital abscess. He also presented an extensive dental caries and pulp gangrene in seventeen teeth and unilateral sinusitis confirmed in the Computed Tomography scan. Emergency treatment including an oral surgeon’s intervention, which is extraction of seventeen teeth, drainage of the abscess, antibiotics and glucocorticoids was introduced resulting in an immediate improvement of patient’s health status, leading to recovery. The objective of this clinical presentation is to highlight associations between dental status and cellulitis. Infection from decayed teeth in children can lead to unilateral sinusitis, resulting in severe complications such as an intraorbital abscess. It is strongly recommended to put more effort into oral hygiene and healthy lifestyle to avoid serious complications – especially in asthmatic patients.

Residual efficacy of Fludora Fusion against Anopheles arabiensis in simple huts in Ethiopia.

Emergence and spread of malaria vectors resistant to the available insecticides required a new and efficacious insecticide. Residual efficacy of Fludora® Fusion was evaluated against insecticide susceptible Anopheles arabiensis in ten circular huts similar to the residential huts. Fludora® Fusion WP-SB 56.25, FICAM WP80 and Clothianidin WG70 were sprayed, by experienced technician, on interior wall surfaces: paint, dung, smooth mud, and rough mud. WHO cone bioassays were carried out a month after spraying and thereafter on monthly intervals for 12 months. Knockdown was recorded at 60 minutes and mortality at 24 hours, 48 hours and 72 hours holding time post-exposure. Fludora Fusion induced 100% An. arabiensis mortality during the first four months post-treated on all surface types at 24 hours holding time post-exposure. Its activity remained over 80% from the fifth to the twelfth month post-treated on the surfaces with the exception of two assessment points, at seventh month and eleventh month, on paint and smooth mud surfaces. FICAM induced 100% mortality rate during the first 4 months and 92% mortality during the fifth month post-treatment on painted surfaces. Its activity was over 96% mortality 1-month post-treatment on smooth mud and rough mud surfaces and 92% mortality 2-month post-treatment on dung surfaces. Clothianidin caused 89% and 86% mortality 1-month post-treatment on smooth mud and rough mud surfaces. Fludora Fusion can be used as alternative indoor residual insecticide spraying against An. arabiensis in Ethiopia.

The Effect of Soy Flour on the Chemical Composition of Milk and Milk Producing Ability in the Diets of Cows During Their Lactation

This article deals with the study of the effect of heat-treated soy bean flour included in the diet of lactating cows on amino acids, mineral composition of milk; the content of dairy protein, its fat, as well as on the milk producing ability of animals. As a result of the conducted research, it was revealed that the content of free amino acids, both interchangeable and irreplaceable in the milk of animals of the experimental group who received soy flour, was higher than in the control group during the lactation. With the course of lactation, qualitative and quantitative changes are noted in the amino acid composition of milk in animals of both groups. The content of minerals such as calcium, phosphorus, magnesium, sodium, potassium in milk was slightly higher during all periods of milk productivity in the experimental group of animals than in the control group. During the whole lactation period, the studied macronutrients were subjected to quantitative changes. It was revealed that the introduction of soy flour into the diet leads to a significant increase of fat in the milk of experimental cows compared with control animals. Moreover, the difference in fat content in favor of animals receiving soy flour is insignificant during the first four months of lactation, after which this indicator increases sharply in the seventh month, and then gradually decreases by the tenth month. There is a definite tendency in the milk protein content to decrease in the second month of lactation and then to a gradual increase by the end of it. It should be noted that the amount of protein, unlike fat, increases evenly during lactation - for each month by an average of 0.05%, reaching the maximum value by the 10th month. From the analysis of the dynamics of average daily milk yields in experimental cows by months of lactation, it follows that in the first four months soy flour stimulates milk formation, and the average daily milk yield in animals of the experimental group during this period is significantly higher than the milk yield in the control group, respectively, by months of lactation by 10,35%; 13,26%; 12,22%; 14,57% with a significant difference. In the subsequent fifth, sixth and seventh months, the milk productivity of the experimental animals is also higher than in the control group, but this difference is less pronounced. Starting from the eighth month, the animals of the experimental group are inferior in terms of the average daily milk yield to the animals of the control group. The introduction of soy flour into the diet for the first 120 days of lactation has a stimulating effect on the formation of milk, and in the last 80 days - an inhibitory effect on this process.

Reduced incidence of maternal health conditions associated with the home-based newborn care intervention package in Rural Gadchiroli, India: a 13 years before – after comparison

Background To evaluate the association between home-based neonatal care interventions and the incidence of maternal health conditions as well as to estimate the longitudinal trend of the incidence of maternal health conditions over 13 years in 39 villages of the field program area of the of home-based neonatal care from rural Gadchiroli, India. Methods This was a before-after comparative analysis of a program implemented in thirty-nine villages in Gadchiroli, India. The home-based newborn care interventions were incrementally introduced during the field trial (1995 – 1998) and continued as a service program until 2008. Over thirteen years (1995–2008), pregnant women were recruited and followed up from the seventh month of pregnancy to 28 days postpartum by trained female community health workers who made antenatal, natal and post-natal home visits, provided health education to mothers for behavior change, managed normal and sick neonates as well as encouraged seeking medical care when necessary. They recorded maternal symptoms and signs, which a physician supervisor verified. Based on these symptoms and signs, a computer algorithm diagnosed 20 different maternal health conditions. The incidence of these conditions in the first year (1995-96) was compared with the intervention’s last two years (2006 - 2008). Result The mean coverage of home-based newborn care, assessed on eight indicators, increased from 48.5% in 1995 – 96 to 87.1% in 2006 – 08. The proportion of women with any maternal health conditions during pregnancy reduced by 44.76% (P&lt;0.001), during labor by 44.59% (P &lt;0.001) and during the postpartum period by 77.82% (P&lt;0.001). The mean number of maternal conditions per 100 women reduced by 69% (P&lt;0.001). The need for emergency obstetric care was reduced by 78.83% (P&lt;0.001). The proportion of women free of any maternal health condition increased from 32.9 % to 64.6 %. Conclusions Home-based neonatal care interventions were associated with a significant reduction in the incidence of maternal health conditions. Developing a dedicated package of home-based maternal care in combination with neonatal care may further improve maternal health.

Assessment of heterologous lumpy skin disease vaccine-induced immunity in pregnant cattle vaccinated at different times of gestation period and their influence on maternally derived antibodies

The present study aimed to evaluate the cell-mediated and the humoral immune response to Romanian sheep pox vaccine in pregnant cows (n = 12) vaccinated at different times of gestation period and the duration of maternal immunity in calves born to these cows. Evaluation of cellular immunity revealed an increase in lymphocytic proliferation that peaked at 10th day post vaccination (dpv) then gradually decreased. Capripoxvirus-specific antibodies were detected by SNT and ELISA in sera collected from vaccinated dams and also in calves born to these cows. In cows, the antibody titers persisted above the protective level till the seventh month post-vaccination. Passively transferred antibody titers in newly born calves started from the first week after parturition and persisted in a protective level until 2, 3 or 4 months of ages in calves born to cows vaccinated at ≤4th, 4.5:6th, or >6:8th months of pregnancy respectively. Results proved that the average neutralizing antibody titers did not differ between pregnant cows vaccinated at different times of gestation period however, the longevity of maternally derived antibodies depends on the pregnancy stage at which the dam receive vaccine.

Effect of feeding Moringa oleifera leaves on growth, haematobiochemical profiles and puberty in Malabari doelings

The study was conducted to assess the effect of supplementation of Moringa oleifera leaves on reproductive performance in Malabari doelings. Apparently healthy Malabari kids (n=32) of age three months were selected and randomly allocated to two different treatment groups. Control group (T1, n= 16) was fed with complete feed as pellets and experimental group (T2, n=16) was given complete feed pellets in which 50 per cent of concentrate was replaced with M. oleifera leaves on dry matter (DM) basis. The mean initial and final body weight and dry matter intake did not differ significantly but showed a linear increase in both the groups. Haematological parameters (Hb, Haematocrit, TEC, TLC) did not vary significantly between groups, however, mean total protein was significantly higher (p&lt; 0.05) and mean ALT was significantly lower in T2. Post weaning mean progesterone profile remained less than 1ng/mL until fifth month of age, showed significant increase during sixth month (T1- 0.24 ng/mL, T2- 0.44ng/mL; p&lt; 0.5) and was elevated more than 1ng/mL during seventh month in T2 (T1- 0.72 ± 0.22 ng/mL, T2- 1.14 ± 0.29 ng/mL). First behavioural oestrus was observed during sixth month age without any significant variation. The present study revealed safe and effective means of replacing 50 per cent concentrate feed with in M. oleifera leaves in Malabari doelings in advancing puberty without affecting the growth performance.

Complicated Case of Multidrug-Resistant Tuberculosis with Multiple Comorbidities, Successfully Treated After Several Treatment Modifications

A 59-year-old man with relapsed pulmonary TB developed rifampin resistance. He presented with chronic untreated hepatitis B, which developed into liver cirrhosis, type 2 diabetes with diabetic retinopathy, and osteoarthritis of right knee. His initial MDR regimen included levofloxacin, cycloserine, bedaquiline, linezolid, and high-dose isoniazid. He developed episodes of linezolid-induced myelosuppression, resulting in temporary discontinuation and dose reduction, and ultimately, substitution of linezolid. On the seventh month of treatment, he developed severe depression with visual hallucination, resulting in cycloserine dose reduction. We maintained the principle of at least 4 active drugs throughout his treatment. He was considered cured after 26 months of treatment.

Complicações na técnica de regeneração óssea guiada associada à membrana de PTFE-d: relato de caso

ABSTRACT Guided bone regeneration aims to gain vertical and horizontal bone volume in atrophic ridges, using different regenerative techniques associated with biomaterials, with occasional post-surgical complications. The objective of the case report was to describe the successive approaches to minimize and eliminate the complications presented in the postoperative period of a patient submitted to the guided bone regeneration technique. In the first surgery, the dense expanded polytetrafluoroethylene membrane (d-PTFE), supported by the tent technique and autogenous platelet graft, was used to perform the guided bone regeneration technique. After three months, the membrane was exposed, with the membrane and the retaining screws removed in the seventh month, with the installation of three Internal Hexagon implants in the areas of teeth 13, 14 and 15. The exposed threads were covered with hydroxyapatites resorbable and covered with d-PTFE membrane. A four-month postoperative panoramic radiograph suggested implant osseointegration. The guided bone regeneration technique associated with the d-PTFE membrane enabled bone neoformation, enabling the installation of osseointegrated implants in an aesthetic and functional position. The exposure of the edges of the membrane allowed the penetration of fluids and contamination, suggesting the worsening of the signs of infection and purulent secretion. On the contrary, the exposure of central areas did not cause inflammatory and infectious signs.

The effectiveness of an education intervention based on self-care model on diabetes self-management behaviors and glycemic control

IntroductionThe needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications and increasing their awareness to participate in self-management. The study aimed to analyze the effectiveness of an education intervention based on self-care model to Diabetes self-management behaviour (DSM behaviour). MethodsThe study was conducted from January to August 2021 at diabetic clinics of Thika level 5 hospital (TL5H) and Kiambu level 5 hospital (KL5H). The study employed a pre-test post-test non-equivalent quasi-experimental study design. There were 96 adolescents with Type 1 Diabetes Mellitus (T1DM) obtained by stratified random sampling technique, and assigned into experimental (48 respondents) and control group (48 respondents). Diabetes self-management behaviours were evaluated in the first and seventh month using The Summary of Diabetes Self Care Activities (SDSCA) questionnaire. Paired sample T-Test and Independent T-test was used to analyze data. ResultsPaired sample T-test statistical revealed a significant difference in increasing level of DSM Behaviour and decreasing HbA1c (p < 0.05) before and after the intervention; Independent T-test discovered a significant difference on DSM Behaviour and HbA1c (p < 0.05) between the intervention and control group at post-intervention. ConclusionsEducation intervention based on self-care model is an effective program that can improve DSM Behaviour and HbA1c level. In addition, the education intervention based on self-care model needs to be implemented continuously to prevent complications and improve self-care and HbA1c level for diabetic patients.