Estudio de seroprevalencia de HVS 1-2 en gestantes y recién nacidos de 2017 a 2021

El virus herpes simple (VHS) pertenece a la subfamilia alfa virus, miembro de la familia Herpes viridae. Existen dos tipos de VHS íntimamente relacionados, el VHS tipo 1 (VHS1) y el VHS tipo 2 (VHS2), que causan enfermedades de diversa gravedad. El VHS1 se transmite principalmente por contacto de boca a boca y el VHS2 se transmite por vía sexual; ambos pueden causar herpes genital. La carga de morbimortalidad a nivel mundial derivada de patógenos de transmisión sexual compromete la vida, así como la salud sexual y reproductiva, y la salud del recién nacido. Objetivos: Determinar la seroprevalencia IgG e IgM por VHS1 y VHS2 de los recién nacidos y madres en el periodo de enero 2017 a julio 2021 en un hospital de tercer nivel. Materiales y Métodos: Estudio observacional, retrospectivo de corte transversal de enero 2017 a julio 2021. Se midió anticuerpos IgG e IgM en recién nacidos y gestantes de ultimo trimestre, utilizando el método de ELISA. Resultados: De un total de 4712 serologías IgG e IgM de madres y RN analizados la seroprevalencia de IgG en gestantes fue cercana al 100% con valor similar en los RN (87%), la seroprevalencia de IgM en las madres fue 0,23% y de los RN 0,36% con tendencia ascendente. Conclusión: la seroprevalencia de IgG para VHS es elevada, en cambio la seroprevalencia de IgM en gestantes y recién nacidos en el periodo de estudio es significativamente baja.

The herpes simplex virus (HSV) belongs to the alpha virus subfamily, a member of the family Herpes viridae. There are two closely related types of HSV, HSV type 1 and HSV-2, which cause diseases of varying severity. HSV-1 is transmitted mainly by mouth-to-mouth contact and HSV-2 is transmitted sexually, both of which can cause genital herpes. The global burden of morbidity and mortality from sexually transmitted pathogens compromises life, as well as sexual and reproductive health, and the health of the newborn. Objective: To determine the IgG and IgM seroprevalence for HSV 1 - 2 of newborns and mothers in the period from January 2017 to July 2021 in a third level hospital. Materials and Methods: Observational, retrospective, cross-sectional study of January 2017 to July 2021. IgG and IgM antibodies were measured in newborns and pregnant women in the last trimester, using the ELISA method. Results: Of a total of 4712 IgG and IgM serologies of mothers and newborns analyzed the seroprevalence of IgG in pregnant women was close to 100% with similar value in newborns (87%), IgM seroprevalence in mothers was 0.23% and the RN 0.36% with an upward trend. Conclusion: The IgG seroprevalence for HSV is high, while the IgM seroprevalence in pregnant women and newborns during the study period is significantly low.

Advances in international newborn screening / 中华实用儿科临床杂志

Newborn screening is an important national public health policy and measure to reduce birth defects and improve the quality of China′s birth population.In the early 1960s, Dr.Robert Guthrie of the United States invented the first newborn screening test, namely, semi-quantitative determination of phenylalanine in dry blood filter paper for screening phenylketonuria.In the 1990s, tandem mass spectrometry (MS/MS) began to be applied to the screening of genetic metabolic diseases in newborns.This technology enabled the detection of multiple diseases by one test, and increased the types of diseases detected.In the past 10 years, with the development of screening technology, the invention of new drugs, the improvement of treatment methods, and especially the application of new technologies such as newborn genetic screening, the source of mutations can be identified at the molecular level.Moreover, newborn screening is extended to patients who are not candidates for MS/MS.Many genetic diseases are able to be screened and diagnosed early.Effective management and quality control of newborn disease screening are prerequisites for improving the quality and accuracy of results.Secondary and multi-level detection strategies, different biochemical or biochemical genetic testing methods, and the integration of targeted and non-targeted multi-omics data have a wide range of applications and great clinical value.

The effect of feeding methods on fecal metabolites of infants delivered by cesarean section based on non-targeted metabolomics / 中华实用儿科临床杂志

Objective:To explore the effect of breast feeding versus mixed feeding on fecal metabolites of infants delivered by cesarean section.Methods:This was a cross-sectional study.Fecal samples were collected from 23 healthy 1-month-old infants delivered by cesarean section from autumn 2021 and winter 2022 in two maternal and infant care facilities in the North and South of Xi′an city.The samples were divided into the breast feeding group (11 cases) and mixed feeding group (12 cases). Fecal metabolites were analyzed by the non-targeted metabolomic approach and gas chromatography-mass spectrometry coupling, and differentially expressed fecal metabolites between groups were screened using the non-parametric Mann- Whitney U test.Metabolic pathways enriched in them were further analyzed. Results:A total of 155 metabolites were characterized, including 57 sugars and sugar derivatives, 34 fatty acids, 25 organic acids, 22 amino acids, 8 esters, 4 nucleosides, 3 vitamins and 2 other substances.The relative contents of the differentially expressed fecal metabolites were measured, and it was found that some types of sugars and sugar derivatives were highly expressed in the fecal samples of breast feeding group, while amino acids, organic acids and fatty acids were highly expressed in those of the mixed feeding group.A total of 28 metabolic pathways enriched in differentially expressed fecal metabolites were obtained.Among them, alanine, aspartic acid and glutamic acid metabolism, valine, leucine and isoleucine metabolism, arginine metabolism and the tricarboxylic acid (TCA) cycle influenced infant health.Conclusions:Feeding methods have an effect on the fecal metabolites in infants delivered by cesarean section born infants, and mixed feeding may speed up the process of TCA cycle and amino acid metabolism in the intestine of infants delivered by cesarean section to a certain extent.

Health communication issues related to latent tuberculosis infection treatment support for the foreign-born in Japan / 国際保健医療

Objective  To identify issues in health communication regarding treatment support for foreign-born who are diagnosed as latent tuberculosis infection (LTBI) in Japan, from the perspective of public health centers (PHCs).Methods  A self-administered survey was sent to 469 PHC, between June and July 2020. The survey asked closed and open-ended questions to tuberculosis (TB) program personnel on (1) their experiences of foreign-born patients who were eligible for LTBI treatment but did not start their treatment, and who started treatment but were lost to follow-up, and (2) health communication issues with foreign-born patients. Responses were summarized descriptively for close-ended questions, and analyzed qualitatively for open-ended question.Results  We obtained response from 307 PHCs, regarding 315 foreign-born patients. Twenty-five patients did not initiate, and 52 were lost to follow-up after initiating LTBI treatment. Of the 77 patients who either did not start treatment or were lost to follow-up, 45 apparently could hold everyday conversation in Japanese but had difficulties understanding technical terms, and 19 could not even exchange basic conversation, with PHC staff. Barriers to LTBI treatment initiation and completement, as perceived by PHC staff, included “lack of correct knowledge about TB and LTBI”, “different attitudes to health” and “economic difficulties”. Conclusion  Issues in health communication between PHC staff and foreign-born patients included not only a language barrier, but also the unconscious mind among PHC staff, which sought reasons for refusal or termination of LTBI treatment in patients. We argue that this mind is based on positivism, whereby health personnel consider themselves as the provider of “scientific knowledge” and that “lay persons” can act rationally once enlightened. However, PHC staff may need to reflect upon such position as the provider of scientific knowledge, but instead, learn from foreign-born patients about how they perceive health, TB or LTBI, to conduct better communication.

Availability of maternal, newborn care and child health Services at primary health care unit during COVID-19 outbreak in Ethiopia

Background: The COVID-19 pandemic is putting a pressure on global health systems. The disruption of essential health services (EHS) has an impact on the health of mothers, neonate and children in developing countries. Therefore, the main aim of this study was assessing the availability of Maternal, Newborn care and Child health (MNCHS) services at primary health care unit during COVID-19 outbreak. Methods: A cross-sectional survey was conducted in five regions of Ethiopia in 2021. Descriptive analyses were undertaken using STATA 16 software and the results presented using tables and different graphs. A continuity of EHS assessment tool adopted from WHO was used for data collection. Result: During COVID -19 pandemic, 30 (69.8%) of woreda health offices, 52 (56.5%) of health centers (HCs), 7 (44.4%) of hospitals, and 165 (48%) of health posts (HPs) had a defined list of EHS. In comparison with other EHS, family planning is the least available service in all regions. At HPs level care for sick children and antenatal care (ANC) were available at 59.1 and 58.82% respectively. Except immunization services at SNNP, all other maternal, newborn, and child health EHS were not available to all HPs at full scale. Conclusion: Immunization services were most available, while ANC and care for sick children were least available during COVID-19 at the HPs level. There was regional variation in MNCH EHS service availability at all levels.

Knowledge, attitude and practices regarding dengue and its vector among medical practitioners in Malakand region, Pakistan

Abstract Dengue fever (DF) is increasingly recognized as one of the worlds major mosquito borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Dengue fever is endemic in most part of Pakistan and continues to be a public health concern. Knowledge, attitude and practices can play an important role in management of the disease. Current study was aimed to determine the level of knowledge, attitude and practices regarding dengue fever among health practitioners, to study the level of knowledge and attitude with preventive practices for dengue fever. A cross sectional study was carried out in medical practitioners of the four districts of Malakand region during October to November 2019. A pre-structured questionnaire was used to collect data from medical practitioners. Data was analyzed using Graph Pad version 5. Significant value was considered when less than 0.05 (at 95% confidence of interval). The results revealed that most of participants have seen dengue vector (62%), the media being the most quoted source of information. Nearly 81.2% participants were aware from transmission of dengue fever is by mosquito bite. Practices based upon preventive measures were found to be predominantly focused towards prevention of mosquito bites rather than elimination of breeding places. Although the knowledge regarding DF and mosquito control measure was quite high among the medical practitioners but this knowledge was not put into practice. Further studies are required to aware the people about dengue and its vector in order to get prevention and control.

Resumo A dengue (DF) é cada vez mais reconhecida como uma das principais doenças transmitidas por mosquitos do mundo e causa significativa morbidade e mortalidade em países tropicais e subtropicais. A dengue é endêmica na maior parte do Paquistão e continua a ser um problema de saúde pública. Conhecimento, atitude e práticas podem desempenhar papel importante no manejo da doença. O presente estudo teve como objetivo determinar o nível de conhecimento, atitude e práticas em relação à dengue entre os profissionais de saúde, para estudar o nível de conhecimento e atitude com as práticas preventivas da dengue. Um estudo transversal foi realizado com médicos dos quatro distritos da região de Malakand de outubro a novembro de 2019. Um questionário pré-estruturado foi usado para coletar dados de médicos. Os dados foram analisados no Graph Pad versão 5. Valor significativo foi considerado quando menor que 0,05 (com intervalo de confiança de 95%). Os resultados revelaram que a maioria dos participantes já viu o vetor da dengue (62%), sendo a mídia a fonte de informação mais citada. Quase 81,2% dos participantes sabiam que a transmissão da dengue é por picada de mosquito. Constatou-se que as práticas baseadas em medidas preventivas se concentravam predominantemente na prevenção de picadas de mosquitos, e não na eliminação de criadouros. Embora o conhecimento sobre DF e medidas de controle de mosquitos fosse bastante elevado entre os médicos, esse conhecimento não foi colocado em prática. Mais estudos são necessários para conscientizar a população sobre a dengue e seu vetor, a fim de se obter prevenção e controle.

Multi-level scoring approach to discover multi-targeting potency of medicinal plant phytochemicals against protein targets in SARS-CoV-2 and human ACE-2 receptor

SARS-CoV-2 pandemic has become a major threat to human healthcare and world economy. Due to the rapid spreading and deadly nature of infection, we are in a situation to develop quick therapeutics to combat SARS-CoV-2. In this study, we have adopted a multi-level scoring approach to identify multi-targeting potency of bioactive compounds in selected medicinal plants and compared its efficacy with two reference drugs, Nafamostat and Acalabrutinib which are under clinical trials to treat SARS-CoV-2. In particular, we employ molecular docking and implicit solvent free energy calculations (as implemented in the Molecular Mechanics -Generalized Born Surface Area approach) and QM fragmentation approach for validating the potency of bioactive compounds from the selected medicinal plants against four di?erent viral targets and one human receptor (Angiotensin-converting enzyme 2 -ACE-2) which facilitates the SARS-CoV-2entry into the cell. The protein targets considered for the study are viral 3CL main protease (3CLpro), papain-like protease (PLpro), RNA dependent RNA polymerase (RdRp), and viral spike protein-human hACE-2 complex (Spike:hACE2)including human protein target (hACE-2). Herein, thereliable multi-level scoring approach was used to validate the mechanism behind the multi-targeting potency of selected phytochemicals from medicinal plants. The present study evidenced that the phytochemicals Chebulagic acid, Stigmosterol, Repandusinic acid and Geranin exhibited efficient inhibitory activity against PLpro while Chebulagic acid was highly active against 3CLpro. Chebulagic acid andGeranin also showed excellent target specific activity against RdRp.Luteolin, Quercetin, Chrysoeriol and Repandusinic acid inhibited the interaction of viral spike protein with human ACE-2 receptor. Moreover Piperlonguminine and Piperine displayed significant inhibitory activity against human ACE-2 receptor. Therefore, the identified compounds namely Chebulagic acid, Geranin and Repandusinic acid can serve as potent multi-targeting phytomedicine for treating COVID-19

Presentación atípica de celulitis orbitaria en recién nacido / Typical Orbital Cellulitis Presentation in Newborn

La celulitis orbitaria representa una causa frecuente de inflamación de la órbita, constituyendo una urgencia médica que requiere un manejo multidisciplinario. Se presenta caso de una recién nacida con clínica de aumento de volumen en región bipalpebral derecha y fiebre de 24 horas de evolución. Al examen físico se evidencia proptosis de ojo derecho, aumento de volumen bipalpebral que impide la apertura del globo ocular en su totalidad con signos de flogosis y secreción purulenta en borde palpebral. Los laboratorios reportan leucocitosis y trombocitosis reactiva; tomografía de orbita muestra tumefacción y edema periorbitario derecho, aumento difuso de densidad grasa post-septal extra e intraconal, hallazgos sugestivos de celulitis orbitaria derecha. Se indica antibioticoterapia con vancomicina y cefotaxime, ameritando además drenaje de absceso, obteniéndose secreción purulenta, en la que se aísla Estafilococo aureus meticilino resistente. Siendo una patología inusual en este grupo etario, se recomienda la publicación de este caso(AU)

Orbital cellulitis represents a frequent cause of inflammation of the orbit, constituting a medical emergency that requires multidisciplinary management. We present a case of a newborn with clinic of volume increase in right bipalpebral region and fever of 24 hours of evolution. Physical examination reveals proptosis of right eye, increase of bipalpebral volume that prevents the opening of the eyeball in its entirety with signs of flushing and purulent eyelid margin secretion. Laboratories report leukocytosis and reactive thrombosis; orbital tomography scan shows right periorbital swelling and edema, diffuse increase of extra and intraconal post-septal fat density, suggestive findings of right orbital cellulitis, covered with vancomycin and cefotaxime; subsequently requires abscess drainage where Staphylococcus aureus methycilin- resistant is isolated. Being an unusual pathology in this age group, the publication of this case is recommended(AU)

Ectopia cordis abdominal. Apropósito de un caso

Resumen Introducción: La ectopia cordis es una malformación congénita poco frecuente y grave caracterizada por el desplazamiento del corazón fuera de la cavidad torácica, Existe discreto predominio en el sexo femenino y se asocia a teratógenos no potentes y relacionado también a factores genéticos, su diagnóstico prenatal es muy importante y su pronostico es desfavorable en casi la totalidad de los casos. Objetivo: Describir el manejo con una paciente con ectopia cordis en Letsholathebe Memorial Hospital II Republica de Botswana. Descripción: Se describe el manejo por parte del pediatra y el cardiólogo desde su diagnóstico desde su nacimiento hasta sus ingresos hospitalarios. Conclusiones: Ectopia cordis es una malformación congénita rara que tiene un mal pronóstico incluso después del enfoque quirúrgico y su gravedad está relacionada con la presencia de otras anomalías.

ABSTRACT Introduction: Ectopia cordis is a rare and severe congenital malformation characterized by the displacement of the heart outside the chest cavity, there is discreet predominance in the female sex and is associated with non-potent teratogens and also related to genetic factors, its prenatal diagnosis is very important and its prognostic is unfavorable in almost all cases. Objective Describe management with a patient with ectopia cordis at Letsholathebe Memorial Hospital II Republic of Botswana. Description: It describes the management by the pediatrician and the cardiologist from his diagnosis from birth to his hospital admissions. Conclusions: Ectopia Cordis is a rare congenital malformation that has a poor prognosis even after the surgical approach and its severity is related to the presence of other abnormalities.

Role of doppler ultrasonography in prediction of adverse perinatal outcome in intrauterine growth retardation (IUGR)

Introduction: A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through the blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome - Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation. Materials and methods: A total of 172 singleton pregnancies between 33 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus. Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Duration of this study was two years, from December 2019 to November 2021. Results: Out of 172 cases, 146 were live born and 26 were neonatal death. There were 7 cases of intrauterine death of fetuses and 5 were still born. Out of the live born 27 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia. Conclusion: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse fetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised fetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised fetuses and helps to determine the optimal time of delivery.

Health policy and systems research capacity development to support maternal, newborn, child and adolescent health in West and Central Africa

Objectives: To examine how and why a South-South capacity development and networking program for leadership, research, practice and advocacy on maternal new-born, child and adolescent health and health policy and systems strengthening in West Africa and Cameroon worked and identify lessons for low- and middle-income countries. Design: Single qualitative case study drawing on data from document review, observations, key informant interviews and a deliberative workshop. Ethics approval for primary data collection was obtained from the Ghana Health Service Ethical Review Committee (GHS-ERC 012/10/18). Setting: West Africa and Cameroon Participants: Researchers, policy and programme managers and frontline health workers Interventions: Networking and capacity development Results: The programme made good progress in implementing many but not all planned capacity development and networking activities. The opportunity to network with other organisations and individuals and across countries, disciplines, and languages as well as to learn, to develop skills, and obtain mentorship support, were considered valuable benefits of the partnership. Human and financial resource constraints meant that not all planned interventions could be implemented. Conclusions: Lessons for health policy and systems research capacity building in LMIC include the potential of South-South partnerships, the need for dedicated resources, the potential of Sub-regional health organizations to support capacity building and recognition that each effort builds on preceding efforts of others, and that it is important to explore and understand where the energy and momentum for change lies.

Current Scenario and Future Direction of Newborn Screening and Management Program for Phenylketonuria in Bangladesh

Abstract Phenylketonuria (PKU) is a correctable inborn error of metabolism which causes lethal intellectual delay and neurobehavioral anomalies. A screening package, especially for early recognition can support to regulate the PKU process of most patients. New-born screening program in any country focuses at the earliest detection of inheritance deficiency disorders in order to avoid the most severe repercussion by appropriate medication. This screening program needs a concomitant diagnosis and involves additional clinical research. Strategies from developed countries recommend that new-born screening should be done as soon as possible after birth before hospital/clinic discharge because if detected later, it conveys to significantly increase in disability as well as morbidity. Although exact protocol differs among different countries, testing procedures for PKU should be followed universally recognized in the developed world. Unfortunately, new-born screening program in Bangladesh is in lying-in room or possibly in pilot study in particular hospital, because the health-care system is classically targeted mortality (like childbirth complications) and transmittable morbidities (such as COVID-19) but not inborn frailties. Although policies and management of childbirth complications have been successfully lowered infant and mother mortality rates, the number of disabled babies increased tremendously. The study aims to investigate the current status of new-born screening (NBS) program of PKU in the Rajshahi Division Bangladesh, and focus on future plans to manage with life-long treatment. The primary challenges such as financial support for newborn screening, publicity, should be identified and implemented for national PKU-NBS policy as a role model of Bangladesh for developing countries.

Congenital elbow luxation grade I treated by radial head ostectomy in an English Bulldog / Luxação congênita de cotovelo grau I tratada por ostectomia da cabeça do rádio em um Bulldog Inglês

O objetivo deste relato foi o de apresentar o acompanhamento tardio de um caso de luxação congênita de cabeça de rádio (LCCR) em um Buldog Inglês jovem, tratada por ostectomia da cabeça radial (OCR). A LCCR é uma condição incomum nos cães, mas é a forma mais comum de luxação de cotovelo nos mesmos (grau I). Um Bulldog Inglês, macho, 6 meses, 14 quilos, foi atendido com suspeita de luxação do cotovelo. Exame físico revelou uma proeminência na superfície lateral do cotovelo direito, além de claudicação grau I e dor leve. Amplitude de movimento apresentava-se normal. Radiografias e tomografia prévias confirmaram LCCR. Optou-se pela OCR ao invés de técnicas corretivas, devido à idade do animal à época do procedimento e à dificuldade no reposicionamento do rádio na articulação. Após 3 anos e meio de pós-operatório, foram realizados novos exames clínicos e radiográficos. O paciente não apresentava dor, apresentava bom apoio do membro e boa amplitude de movimento, permitindo bom movimento do cotovelo. Houve um novo crescimento parcial do segmento proximal da cabeça do rádio ocasionando melhor readequamento do mesmo na articulação. Sinais leves de degeneração articular estavam presentes. A OCR se mostrou efetiva neste caso, provando ser uma boa técnica a ser utilizada nos casos de LCCR quando tratamento conservativo ou técnicas de redução já não podem ser mais utilizados.

The aim of this study is to report a long term follow up of a congenital luxation of the radial head (CLRH) case of a young Bulldog treated by radio head ostectomy (RHO). CLRH is an uncommon condition in dogs, but it is the most commom form of elbow dislocation (grade I). An English Bulldog, male, 6 months, 14 kilograms, was suspected of elbow dislocation. Physical examination revealed a lateral proeminence on the lateral surface of the right elbow, as well as grade I lameness and mild pain. Range of motion was normal. Previous radiographs and tomography confirmed CLHR. RHO was chosen instead of corrective techniques, due to the age of the animal at the time of the procedure and the difficulty in repositioning the radial head in the joint. Three and a half years after surgery, new clinical and radiographic examaminations were performed. The patient had no pain, good limb support and good range of motion, allowing good elbow movement. There was a partial regrowth of the proximal segment of the radial head causing better readjustment of it in the joint. Mild signs of joint degeneration were present. RHO proved to be effective in this case, proving to be a good technique to be used in cases of CLRH when conservative treatment or reduction techniques can no longer be used.

Congenital elbow luxation grade I treated by radial head ostectomy in an English Bulldog / Luxação congênita de cotovelo grau I tratada por ostectomia da cabeça do rádio em um Bulldog Inglês

The aim of this study is to report a long term follow up of a congenital luxation of the radial head (CLRH) case of a young Bulldog treated by radio head ostectomy (RHO). CLRH is an uncommon condition in dogs, but it is the most commom form of elbow dislocation (grade I). An English Bulldog, male, 6 months, 14 kilograms, was suspected of elbow dislocation. Physical examination revealed a lateral proeminence on the lateral surface of the right elbow, as well as grade I lameness and mild pain. Range of motion was normal. Previous radiographs and tomography confirmed CLHR. RHO was chosen instead of corrective techniques, due to the age of the animal at the time of the procedure and the difficulty in repositioning the radial head in the joint. Three and a half years after surgery, new clinical and radiographic examaminations were performed. The patient had no pain, good limb support and good range of motion, allowing good elbow movement. There was a partial regrowth of the proximal segment of the radial head causing better readjustment of it in the joint. Mild signs of joint degeneration were present. RHO proved to be effective in this case, proving to be a good technique to be used in cases of CLRH when conservative treatment or reduction techniques can no longer be used.

O objetivo deste relato foi o de apresentar o acompanhamento tardio de um caso de luxação congênita de cabeça de rádio (LCCR) em um Buldog Inglês jovem, tratada por ostectomia da cabeça radial (OCR). A LCCR é uma condição incomum nos cães, mas é a forma mais comum de luxação de cotovelo nos mesmos (grau I). Um Bulldog Inglês, macho, 6 meses, 14 quilos, foi atendido com suspeita de luxação do cotovelo. Exame físico revelou uma proeminência na superfície lateral do cotovelo direito, além de claudicação grau I e dor leve. Amplitude de movimento apresentava-se normal. Radiografias e tomografia prévias confirmaram LCCR. Optou-se pela OCR ao invés de técnicas corretivas, devido à idade do animal à época do procedimento e à dificuldade no reposicionamento do rádio na articulação. Após 3 anos e meio de pós-operatório, foram realizados novos exames clínicos e radiográficos. O paciente não apresentava dor, apresentava bom apoio do membro e boa amplitude de movimento, permitindo bom movimento do cotovelo. Houve um novo crescimento parcial do segmento proximal da cabeça do rádio ocasionando melhor readequamento do mesmo na articulação. Sinais leves de degeneração articular estavam presentes. A OCR se mostrou efetiva neste caso, provando ser uma boa técnica a ser utilizada nos casos de LCCR quando tratamento conservativo ou técnicas de redução já não podem ser mais utilizados.

A study of relationship between maternal serum vitamin D levels during peripartum period and neonatal birth weight

Background: An observational study was undertaken to study the relationship between maternal serum vitamin D levels during peripartum period and neonatal birth weight.Methods: This study was done on 569 patients to study the relationship between maternal serum vitamin D levels during peripartum period and neonatal birth weight. The data included was maternal serum samples (taken during peri-partum period) and neonatal birth weight. The primary objective of this project was to assess the vitamin D levels in maternal serum and to study its relationship, if any, with birth weight in the neonates.Results: A total of 569 samples of maternal serum were analyzed for serum 25(OH)D levels out of which 457(80%) mothers were found to have sufficient, 101(18%) insufficient and 11(2%) deficient Vitamin D levels as per US Endocrinological society guidelines. Out of total 569 newborns, 104 (18.27%) were low birth weight (LBW) and 465 (81.27%) were normal birth weight (NBW). Out of total LBW (104), 19(18.27%) were born to vitamin D deficient (VDD) mothers and 85 (81.72%) were born to vitamin D sufficient (VDS) mothers. Out of total NBW(465), 86(18.45%) were born to VDD mothers and 379 (81.17%) were born to VDS mothers. These results were not statistically significant (p=0.76456749).Conclusions: Maternal 25(OH)-vitamin D status during late pregnancy did not have any statistically significant effect on the neonatal birth weight.

Relação entre irmãos: a percepção do primogênito / Relationship between siblings: the perception of the firstborn child

O nascimento do segundo filho constitui, de maneira simultânea, o início da relação fraterna e do conflito intrageracional. O presente estudo investigou os impactos do nascimento do segundo filho para o primogênito, com ênfase em como ocorre a relação fraterna na perspectiva do irmão mais velho em idade adulta. A pesquisa teve cunho qualitativo com caráter exploratório. Assim, foram entrevistados seis primogênitos com idade entre vinte e quarenta anos, escolhidos a partir de sugestões de profissionais psicólogos da rede de contatos das pesquisadoras e por intermédio da técnica da bola de neve. A análise dos dados foi realizada de modo qualitativo, com base na análise de conteúdo. Constatou-se que o vínculo fraterno é uma relação estabelecida na continuidade do tempo. As lembranças partilhadas no decorrer da infância e da adolescência e as memórias da vivência familiar irão auxiliar na manutenção, ou não, do vínculo entre irmãos na vida adulta.

The birth of a second child constitutes, simultaneously, the beginning of a fraternal relationship and an intragenerational conflict. This study investigated the impact of the second child's birth on the firstborn, with emphasis on how the fraternal relationship occurs from the older sibling's perspective in adulthood. The research was qualitative and exploratory. Thus, six firstborns aged between twenty and forty years old were interviewed, who were chosen from suggestions done by professional psychologists from the researcher's business network and through the snowball technique. The interview with the participants was based on a semi-structured script with open questions related to the theme. Data analysis was performed qualitatively, based on content analysis. Findings showed that fraternal bond is a relation established over time. Memories shared during childhood and adolescence and family life memories will help in keeping (or not) the bond between siblings in adulthood.

Awareness and attitude regarding postnatal care and immunization practice among antenatal mothers

Background: Under 5 mortality is a key indicator of health status of the country. Optimum care in postnatal period with immunization as per recommended schedule and exclusive breastfeeding with appropriate technology are the most essential factors for optimum growth and development of the child and to prevent under five mortality. The study was done to assess the knowledge and attitude of antenatal mothers on vaccination and postnatal care.Methods: Total 150 pregnant women were required to answer a series of questionnaire related to demographic data, awareness and attitude towards postnatal care, breastfeeding and immunization.Results: Total 90% of the women are aware regarding immunization at birth, 87% of them got the information from a person, who is directly related to health system. Statistically 97.3% mother were aware about importance to keep the baby covered. Every 3 out of 4 women knew that breastfeeding to be started within 1 hour of life. Only 40% were aware that prelacteal feed should never be given to newborns and 74% of the women think that jaundice in newborn requires evaluation.Conclusions: There is a need to educate antenatal mothers about various aspects of immunization and postnatal care including breastfeeding.

Síndrome de tetraamelia: informe de un caso / Tetra-amelia syndrome: a case report

A still born male baby with tetra-amelia syndrome is reported, with craniofacial abnormalities and pulmonary agenesis. It presented complete absence of all four limbs in association with cleft lip and palate on the right side. The mother medical history revealed no remarkable details. The fetus died shortly after its birth. The embryonic correlation of the case is discussed. Proper health education, antenatal screening and genetic counseling can reduce the risk of such congenital anomalies.

Se informa el caso clínico de un mortinato del sexo masculine con el síndrome de tetraamelia, que mostró ausencia de las cuatro extremidades, unido a anomalías craneofaciales y agenesis pulmonar. Presentó ausencia total de las 4 extremidades unido a labio leporino, paladar hendido del lado derecho. Los antecedentes maternos no revelaron detalles considerable. El feto falleció poco después de su nacimiento. Se discute la correlación embriónica del caso. La educación para la salud adecuada, la pesquisa prenatal y el consejo genético pueden reducir el riesgo de estas anomalías congénitas.

Disease Pattern and Health Outcome among the Neonate in A NICU at Tertiary Care Hospital, Bangladesh

Background: According to the World Health Organization(WHO) and UNICEF under-five death rate, often known byU5MR, neonatal mortality are nearly two-thirds of infantmortality rate and one-third of under-five mortalities worldwide.Objective: The objective of the studywas to document theamount, disease pattern and outcome of patients admitted tothe neonatal intensive care unit (NICU). Data acquired from thepattern of admission and outcome may uncover variousaspects and should contribute and help in managingresources, infrastructure, and skilled hands for a far betteroutcome within the future.Methods: This retrospective study was done on 343 neonateswho were admitted at Uttara Adhunik Medical College andHospital, Dhaka within the neonatal intensive care unit (NICU)within the Department of Pediatrics from July 2017 to July2018.Results: 343 newborns admitted within 28 days of birth wereincluded in the study. Among them, 199 were male and 144female neonates, (Male: female11:0.42). The low birth weight(LBW) babies were 21.25%, very low birth weight (VLBW)4.66% and only 0.29% were extremely low birth weight (ELBW)in our study. Among the varied disease pattern of NICUadmission, Neonatal Jaundice was present in 98 (28.57%) ofneonates, Perinatal Asphyxia of 81 (23.62%) and NeonatalSepsis 43 (12.54%) being the foremost common causes ofneonates. The incidence of Respiratory Distress Syndromewas 38 (11.04%). The neonatal mortality rate found 6% in ourstudy. IUGR and Transient Tachypnea were also found the 2others commonest causes of neonatal admission in NICU. Lowbirth weight records had the very best cases death rate, whichindicates the necessity to develop an efficient group of excessin teaching hospitals that will provide highly specialized andfocused care to the present cohort of vulnerable neonates.Conclusion: This study has shown neonatal jaundice,perinatal asphyxia, and sepsis because of the predominantcauses of neonatal morbidity. Perinatal asphyxia and sepsisare preventable among three. Our health-care programsshould be directed toward addressing the danger factors withinthe community liable for the event of those three morbidities.The preterm and low birth weight babies had significantly highmortality even with standard intensive care; therefore, a robustand effective antenatal program with extensive coverage of allpregnant females specifically in outreach areas should bedeveloped which can help in decreasing preterm deliveries andalso lower the incidence of low birth weight babies.

The care provided by the family to the premature newborn: analysis under Leininger's Transcultural Theory / El cuidado realizado por la familia al neonato prematuro: análisis bajo la teoría transcultural de Leininger / O cuidado realizado pela família ao recém-nascido prematuro: análise sob a teoria transcultural de Leininger

ABSTRACT Objective: To analyze the care practices of family members of premature infants admitted to a Neonatal Intensive Care Unit in the light of Leininger's transcultural theory. Methods: Qualitative, descriptive and exploratory study. Participant observation and semi-structured interviews were conducted with 16 family members of newborns, admitted to the neonatal unit of a public maternity hospital, during the months of May and June 2019. The software called Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire ® and the Bardin Content Analysis technique. Results: Two thematic categories emerged: Family care in the neonatal unit; (in)effective support for shared care. Conclusion: The participation of families in the care of babies is still unstable, but it must be an inseparable element of culturally congruent care, thus collaborating with the full recovery of the premature.

RESUMEN Objetivo: Analizar las prácticas de cuidado de los familiares de prematuros internados en una Unidad de Terapia Intensiva Neonatal a la luz de la teoría transcultural de Leininger. Método: Estudio cualitativo, descriptivo y exploratorio. Han sido realizadas observación participante y entrevistas semiestructuradas con 16 familiares de neonatos internados en la unidad neonatal de una maternidad pública, durante los meses de mayo y junio de 2019. Se ha utilizado el software denominado Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire ® y la técnica Análisis de Contenido de Bardin. Resultados: Emergieron dos categorías temáticas: Cuidado de la familia en la unidad neonatal; Suporte (in)eficaz para el cuidado compartido. Conclusión: La participación de las familias en el cuidado a los bebés aún es inestable, sin embargo debe ser elemento indisociable del cuidado culturalmente congruente, colaborando, así, con la recuperación integral del prematuro.

RESUMO Objetivo: Analisar as práticas de cuidado dos familiares de prematuros internados em uma Unidade de Terapia Intensiva Neonatal à luz da teoria transcultural de Leininger. Método: Estudo qualitativo, descritivo e exploratório. Foram realizadas observação participante e entrevistas semiestruturadas com 16 familiares de recém-nascidos internados na unidade neonatal de uma maternidade pública, durante os meses de maio e junho de 2019. Utilizou-se o software denominado Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire ® e a técnica Análise de Conteúdo de Bardin. Resultados: Emergiram duas categorias temáticas: Cuidado da família na unidade neonatal; Suporte (in)eficaz para o cuidado compartilhado. Conclusão: A participação das famílias no cuidado aos bebês ainda é instável, porém deve ser elemento indissociável do cuidado culturalmente congruente, colaborando, assim, com a recuperação integral do prematuro.