Effects of supplementation of different selenium sources on lipid profile, selenium, and vitamin E concentration of yolk.

Egg preference as a source of protein also provides beneficial fatty acids, vital for human consumption. However, rich in lipid products are prone to oxidative damage. The study aims to determine the effect of supplementing biogenic selenium (Se) from Stenotrophomonas maltophilia, ADS18 (ADS18) in laying hens' diet on yolk lipid oxidation status (MDA), beta-carotene (ß-carotene) content, cholesterol, fatty acids, Se, and vitamin E (VE) level. A total of one hundred and twenty (120) laying hens of Lohmann Brown strains aged 50 weeks, weighing 1500 to 2000 g were reared individually in A-shape two-tier stainless-steel cages sized 30 cm x 50 cm x 40 cm (width, depth height). The hens were randomly allotted into four treatments with six replications in a complete randomised design for the period of 12 weeks. The basal diet contains 100 mg/kg VE. Treatment diets consist of basal diet as control, SS containing 0.3 mg/kg sodium selenite, Se-yeast containing 0.3 mg/kg selenised yeast, and VADS18 containing 0.3 mg/kg of ADS18. Forty-eight eggs were collected and freeze-dried biweekly for analysis. The results of the present study showed that hens supplemented ADS18 had significantly (P < 0.05) lower MDA and cholesterol levels while their egg yolks had higher levels of Se and mono-unsaturated fatty acids (MUFA). The control group had significantly (P < 0.05) higher saturated fatty acid (SFA) contents than the VE and dietary Se-supplemented groups, while the ADS18 group had the lowest SFA contents. Conversely, in comparison to the inorganic and control groups, the VE content of the egg yolk was significantly (P < 0.05) higher in organic Se-supplemented (Se-yeast and VADS18) groups. Hens with SS supplementation had significantly (P < 0.05) higher egg yolk ß-carotene content. When compared to other treatment groups, the control group had higher (P < 0.05) polyunsaturated fatty acids (PUFA) content. The ADS18 is therefore deemed comparable to other Se sources. To prevent Se toxicity, however, a better understanding of the levels of ADS18 incorporation in poultry diets is required.

Effects of twin-block appliance on upper airway parameters in OSA children with class II malocclusion and mandibular retrognathia: a CBCT study.

Twin-block appliance had been advocated as a potential treatment option in paediatric obstructive sleep apnoea (OSA) due to their favourable effect in enhancing upper airway parameters and improving OSA symptoms. The aim of this study was to evaluate the effect of twin-block appliance therapy on upper airway parameters/dimensions and the apnoea-hypopnea indexes (AHIs) in OSA children with class II mandibular retrognathic skeletal malocclusion using cone-beam computed tomography. This prospective longitudinal study comprised 34 polysomnography-proven OSA growing children with class II mandibular retrognathic skeletal malocclusion between the ages of 8 and 12 years who had completed myofunctional twin-block therapy and matched corresponding controls. The upper airway was segmented into the nasopharynx, oropharynx, and hypopharynx, and the effect of twin-bock treatment on upper airway parameters/dimensions was assessed pre- and posttreatment using CBCT analysis, while a second standard overnight PSG was performed to determine changes in the AHI. At the nasopharynx level, minimal (nonsignificant) increases in all variables were observed within the twin-block group and between the groups (P > 0.05). At the level of the oropharynx, all variables increased significantly in the treatment group and between groups (P < 0.001), but these increases were nonsignificant in the control group. At the level of the hypopharynx, only the minimum cross-sectional area (MCA) increased significantly in the treatment group (P = 0.003). The change in MCA was also significant between the groups (P = 0.041). In addition, the upper airway length increased significantly in the twin-block group (P = 0.0154), and the AHI decreased by 74.8% (P < 0.001). CONCLUSION: Correction of class II mandibular retrognathic skeletal malocclusion with twin-block appliance resulted in a significant increase in upper airway volume, MCA, anteroposterior and lateral distances of the MCA at the level of the oropharynx, MCA at the level of the hypopharynx and upper airway length, and a significant decrease in AHI, but it had no effect on nasopharynx parameters. WHAT IS KNOWN: • CBCT imaging has been shown to be an effective and precise diagnostic tool for analyzing the upper airways and craniofacial structures. • Twin block appliance may be an effective treatment modality in children with OSA. WHAT IS NEW: • Minimal cross-sectional area of upper ways may be the most relevant potential parameter when explaining how the upper airway anatomy plays role of in the pathogenesis of pediatric OSA. • Twin block appliance induced favorable changes in upper airway morphology (oropharynx area mainly) and respiratory parameters in OSA children with class II malocclusion.

Effects of supplementing organic- and inorganic-based selenium with vitamin E on intestinal histomorphology, caecal bacterial proliferation, and short-chain fatty acid profile in layer hens.

The effects of supplementing different dietary selenium (Se) sources on intestinal histomorphology, caecal bacterial proliferation, and caecum short-chain fatty acid in layer chickens were studied. A total of 120 of 54-week-old Lohman Brown Classic laying hens were subjected to four dietary treatments: control group with no Se supplementation (T1), 0.3 mg/kg of sodium selenite (T2), 0.3 mg/kg of selenium yeast (T3), and 0.3 mg/kg of bacterial Se (Stenotrophomonas maltophilia, ADS18) (T4). All treatments were also supplemented with 250 mg/kg of vitamin E. Results showed significantly (p < 0.05) higher villus height in different small intestine parts in hens fed with diets containing organic Se sources (T3 and T4), as compared to inorganic sources (T2) and control (T1). A greater crypt depth was observed for the T1 group, as compared to T3 and T4 groups. The total bacterial populations of Bifidobacteria spp. and Lactobacilli spp. were significantly increased (p < 0.05), and tEscherichia coli population was significantly decreased (p < 0.05) in T3 and T4 groups. No effect on the total caecal short-chain fatty acid (SCFAs) content was observed. However, there was a significant increase (21.5%) of the butyric acid content in T4 group. In conclusion, organic Se supplementation, particularly bacterial organic Se, enhances intestinal histomorphology, increases the beneficial caecal bacterial proliferation, and increases butyric acid content.

Gender differences in osteoporotic hip fractures in Sarawak General Hospital.

INTRODUCTION: Osteoporosis and osteoporotic fracture pose a major public health problem in our ageing population, and particularly concerning is the increased morbidity and mortality associated with osteoporotic hip fractures. While overall diagnosis and treatment for osteoporosis have improved, osteoporosis in men remains underdiagnosed and undertreated. We aim to describe the difference in clinical characteristics between elderly men and women with osteoporotic hip fractures in Sarawak General Hospital. MATERIALS AND METHODS: All patients diagnosed with osteoporotic hip fracture admitted to Sarawak General Hospital from June 2019 to March 2021 were recruited, and demographic data and clinical features were obtained. RESULTS: There were 140 patients with osteoporotic hip fracture, and 40 were men (28.6%). The mean age for males was 74.1 ± 9.5 years, while the mean age for females was 77.4 ± 9.1 years (p=0.06). The types of fracture consisted of neck of femur=78, intertrochanteric=61 and subtrochanteric=1. More men were active smokers (15% vs 1%, p<0.001). There were 20 men with secondary osteoporosis (50%), while 13 women (13%) had secondary osteoporosis (p<0.001). The causes of secondary osteoporosis among the men were hypogonadism, COPD, glucocorticoid-induced osteoporosis, renal disease, androgen deprivation therapy, thyroid disorder, prostate cancer and previous gastrectomy. There were two deaths among the men and four deaths among the women during the inpatient and 3 months follow-up period. There was no statistical significance between the mortality rates between male patients (5%) and female patients (4%) (p=0.55). CONCLUSION: There were more females with osteoporotic hip fractures, and there were significantly more males with secondary osteoporotic hip fractures.

Colorectal cancer in patient younger than 50-year-old in Kelantan: Two case reports.

Although young-onset colorectal cancer (CRC) is commonly linked to genetic predispositions such as Lynch syndrome, there has been an increasing trend in the prevalence of sporadic type youngonset CRC. We highlighted two cases of young patients diagnosed with CRC. Both patients came at the late stage of presentation with right sided colon tumour and local lymph nodes involvement. Loss of MLH1 expression with positive BRAF V600E was seen on immunohistochemistry staining. Additionally, they have no chronic disease or familial history of malignancy. The follow-up surveillance CT scan and the surveillance colonoscopy of case 1 showed no local recurrence and distant metastasis. However, another patient defaulted on the subsequent follow-up. In this report, we review the clinicopathological characteristics of these two cases and discuss the importance of the screening for the BRAF V600E and the four MMR proteins to characterise the sporadic and hereditary subgroups of young-onset CRC.

Effect of organic and inorganic dietary selenium supplementation on gene expression in oviduct tissues and Selenoproteins gene expression in Lohman Brown-classic laying hens.

BACKGROUND: The oviduct of a hen provides a conducive environment for egg formation, which needs a large amount of mineral elements from the blood via trans-epithelial permeability. Eggshell is the calcified layer on the outside of an egg that provides protection and is critical for egg quality. However, little is known about the genes or proteins involved in eggshell formation, and their relationship to dietary microminerals. We hypothesized that dietary selenium supplementation in chickens will influence genes involved in eggshell biomineralization, and improve laying hen antioxidant capacity. The objective of this research was to investigate how organic and inorganic dietary selenium supplementation affected mRNA expression of shell gland genes involved in eggshell biomineralization, and selenoproteins gene expression in Lohman Brown-Classic laying hens. RESULTS: Shell gland (Uterus) and liver tissue samples were collected from hens during the active growth phase of calcification (15-20 h post-ovulation) for RT-PCR analysis. In the oviduct (shell gland and magnum) and liver of laying hens, the relative expression of functional eggshell and hepatic selenoproteins genes was investigated. Results of qPCR confirmed the higher (p < 0.05) mRNA expression of OC-17 and OC-116 in shell gland of organic Se hen compared to inorganic and basal diet treatments. Similarly, dietary Se treatments affected the mRNA expression of OCX-32 and OCX-36 in the shell gland of laying hens. In the magnum, mRNA expression of OC-17 was significantly (p < 0.05) higher in hens fed-bacterial organic, while OC-116 mRNA expression was down-regulated in dietary Se supplemented groups compared to non-Se supplemented hens. Moreover, when compared to sodium selenite, only ADS18 bacterial Se showed significantly (p < 0.05) higher mRNA levels in GPX1, GPX4, DIO1, DIO2 and SELW1, while Se-yeast showed significantly (p < 0.05) higher mRNA levels in TXNRD1 than the non-Se group. CONCLUSIONS: Dietary Se supplementation especially that from a bacterial organic source, improved shell gland and hepatic selenoproteins gene expression in laying hens, indicating that it could be used as a viable alternative source of Se in laying hens. The findings could suggest that organic Se upregulation of shell gland genes and hepatic selenoproteins in laying hens is efficient.

Management of dry socket with low-level laser therapy.

OBJECTIVE: The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah. MATERIALS AND METHOD: Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment. RESULTS: Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1-2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket. CONCLUSION: LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms. CLINICAL RELEVANCE: LLLT may be an additional effective tool for managing dry sockets in general dental practice.

Tonsil Size and Mallampati Score as Clinical Predictive Factors for Obstructive Sleep Apnea Severity in Children.

AIM AND OBJECTIVE: The aim of this study was to determine the clinical utility of body mass index (BMI), tonsil size, and Mallampati scoring in predicting both the presence of and severity of pediatric obstructive sleep apnea (OSA). MATERIALS AND METHODS: This prospective cross-sectional study comprised 78 growing children in the age range of 11-14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p <0.05. RESULTS: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis. CONCLUSION: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies. CLINICAL SIGNIFICANCE: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.

Trends in antimicrobial resistance in Malaysia.

INTRODUCTION: Antibiotic resistance is a burgeoning problem worldwide. The trend of bacterial resistance has increased over the past decade in which more common bacteria are becoming resistant to almost all the antibiotics currently in use, posing a threat to humans and even livestock. METHODS: The databases used to search for the relevant articles for this review include PubMed, Science Direct, and Scopus. The following keywords were used in the search: Antimicrobial resistance, Malaysian action plan, antibioticresistant bacteria, and Malaysian National Surveillance on Antimicrobial Resistance (NSAR). The relevant articles published in English were considered. RESULTS: The antibiotic-resistant bacteria highlighted in this review showed an increase in resistance patterns to the majority of the antibiotics tested. The Malaysian government has come up with an action plan to create public awareness and to educate them regarding the health implications of antibiotic resistance. CONCLUSION: Antimicrobial resistance in Malaysia continues to escalate and is attributed to the overuse and misuse of antibiotics in various fields. As this crisis impacts the health of both humans and animals, therefore a joined continuous effort from all sectors is warranted to reduce the spread and minimize its development.

Metastatic leiomyosarcoma of the thyroid: A rare entity.

Cancer metastasis to the thyroid gland from non-thyroid sites is a rare presentation in clinical practice. The most frequent primary cancers that metastasise to the thyroid are renal cell carcinoma, followed by colorectal, lung and breast. We report a case of a 64-year-old Malay lady who presented with anterior neck swelling 4 years after an initial diagnosis of uterine leiomyosarcoma. She had undergone a hysterectomy procedure four years ago. Fine needle aspiration cytology of the thyroid mass suggested undifferentiated thyroid carcinoma. After multi-disciplinary discussion, the patient underwent thyroidectomy and the final histopathological diagnosis was metastatic leiomyosarcoma of the thyroid. The diagnosis was aided by an immunohistochemistry panel of positive myogenic markers, negative epithelial markers as well as the previous medical history of uterine leiomyosarcoma. Metastatic leiomyosarcoma of the thyroid may mimic primary undifferentiated (anaplastic) thyroid carcinoma (UTC) with a sarcomatoid pattern, medullary thyroid carcinoma (MTC) with spindle cells morphology and spindle cell tumour with thymus-like differentiation (SETTLE). Hence, a multidisciplinary approach must be practised by pathologists, surgeons and radiologists to consider metastatic lesions of the thyroid gland, especially when a previous history of cancer exists or is suspected.

Influence of bacterial organic selenium on blood parameters, immune response, selenium retention and intestinal morphology of broiler chickens.

BACKGROUND: Several studies indicated that dietary organic selenium (Se) usually absorbed better than an inorganic source, with high retention and bioavailability. Dietary Se as an antioxidant element affects the immune system and hematological status in animals. Therefore, the aim of this study was to evaluate the effect of dietary supplementation of bacterial selenium as an organic source on hematology, immunity response, selenium retention, and gut morphology in broiler chickens. RESULTS: The present results revealed that supplementation of inorganic Se was associated with the lowest level of RBC, HB, and PCV with significant difference than ADS18-Se. In the starter stage, both T2 and T5 were associated with the significantly highest IgG level compared to the basal diet, while all supplemented groups showed higher IgM levels compared to the control group. In the finisher phase, all Se supplemented groups showed significant (P ˂ 0.05) increases in IgG, IgA, and IgM levels compared to T1. Birds fed bacterial-Se showed high intestinal villus height and better Se retention more than sodium selenite. The organic selenium of ADS18 had a superior action in improving Se retention compared to ADS1 and ADS2 bacterial Se. CONCLUSIONS: Bacterial organic Se had a beneficial effect on the villus height of small intestine led to high Se absorption and retention. Thus, it caused a better effect of Se on hematological parameters and immunity response.

Morning and evening salivary melatonin, sleepiness and chronotype: A comparative study of nurses on fixed day and rotating night shifts.

AIMS: To compare morning and evening salivary melatonin levels, sleep quality and chronotype between nurses working fixed day shifts and those working rotating night shifts. BACKGROUND: Rotating night shift work is an inevitable part of nursing and is a major reason for disrupted sleep. DESIGN: Cross-sectional comparative design. PARTICIPANTS AND SETTINGS: We used cluster sampling to recruit 520 female nurses working fixed day and rotating night shifts in the United Arab Emirates. METHODS: Morning and evening melatonin were measured from corresponding saliva samples. The Pittsburgh Sleep Quality Index used to evaluate sleep quality and self-assessment of preferred circadian times was used to assess participants' chronotypes. Data were collected between October 2017-December 2018. RESULTS: Rotating night shift nurses had significantly lower evening melatonin compared with the fixed day shift group. No significant difference was found in sleep quality between the groups, although more participants in the rotating night shift group (N = 110, 42.31%) expressed better sleep quality than those in the fixed day group (N = 90, 36.00). Participants in the rotating night shift group expressed better subjective sleep, longer sleep duration, less disturbed sleep and better daily function (p > .05) than the fixed day group. Rotating night shift participants were more likely to have evening or intermediate chronotypes and more likely to report alignment of shift work to their chronotype compared with fixed day shift participants (p = .001). Longer shift duration, marital status and city location were associated with reduced evening melatonin among nurses on rotating night shifts. CONCLUSION: Rotating night shift nurses showed evidence of better sleep than those from the fixed day shift. Proper shift assignment, chronotype and alignment with shift work appeared to produce better sleep quality. IMPACT: Organizational policy must consider a novel model for work schedules that allow adequate off-duty days for sleep recovery among nurses.

Clinical and Radiological Evaluation of Sinus Membrane Osteogenicity Subsequent to Internal Sinus Lifting and Implant Placement.

To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.

Post COVID-19 lockdown: measures and practices for dental institutes.

Resuming regular clinical activities at dental premises after the COVID-19 lockdown period or post COVID-19 is likely to be a challenge for all dental institutes. When returning to the dental practice or training, staff and students alike should abide by the new rules and regulations. In the process of controlling viral spread, clinical dental facilities face a higher risk of disease transmission among patients as well as clinical and non-clinical staff. Aerosols formation and diffusion into the surrounding air can be a real concern of viral transmission, if no protective measures are established. We aim in this review to present the currently implemented measures and propose changes in clinical dental facilities to minimize the risk of transmission. Dental professionals should be prepared to treat every patient as a suspected COVID-19 carrier and be ready to receive and manage an overwhelming number of patients. We suggest that dental practices establish a sensible workforce shift schedule, improve ventilation levels, reduce dental aerosol generating procedures, and develop a comprehensive guidance to Healthcare Workers to reduce the risk of COVID-19 transmission.

Do final-year medical students have sufficient knowledge of pain management?

BACKGROUND: The prevalence of pain is high and there have also been serious complications related to undermanaged pain. Deficiency in pain education is among the causes of the problem. Studies in the last two decades have consistently reported that knowledge and attitude regarding pain management was generally poor among the medical students. The aim of this study is to assess the knowledge and attitudes among the Universiti Malaysia Sarawak (UNIAMS) final year medical students regarding pain management. METHODS: This is a cross-sectional study and "Knowledge and Attitudes Survey Regarding Pain (KASRP)" questionnaire developed by Ferrell and McCaffery (revised in 2014) was used. Data was collected in July 2019 in which students had to complete the hard copy questionnaire before a teaching session began. Participation of students was voluntary, anonymous and written informed consent was also obtained. Data were analysed using SPSS, version 16. RESULTS: Out of 118 enrolled students, 110 participated in this study giving a response rate of 93%. The results showed a low number of correct response to the questions on analgesics, assessment, and treatment. The mean percentage score of correct answers was 52.23±8.67% (range: 29.27% to 70.73%). The results reflected that students were poor in both knowledge and attitude regarding pain management. CONCLUSION: Final year medical students, frontliners-to-be in hospital care, should have good knowledge and attitudes in pain management. Findings, however, revealed that UNIMAS final year medical students still need to get improved in this aspect of patient care. A larger study involving students from all the medical schools in Malaysia is needed before reviewing the undergraduate curriculum for pain.

Personalised management of Chronic Obstructive Pulmonary Disease (COPD): Malaysian consensus algorithm for appropriate use of inhaled corticosteroid (ICS) in COPD patients.

BACKGROUND: Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a "preferred therapy" according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients. OBJECTIVE: To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence. METHODS: A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group. RESULTS: According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy. CONCLUSION: A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.

Effects of corn supplementation on meat quality and fatty acid composition of Dorper lambs fed PKC-Urea treated rice straw.

BACKGROUND: The increasing costs of feed has subsequently increased the costs of production of livestock, thereby decreasing the profit margin of this sector. The utilization of agro-industrial by-products has to some extent substitute some of the corn grains and soyabean meal, commonly used in animal feeds. In Malaysia, palm kernel cake (PKC) is a by-product of the oil palm industry and is frequently used to supply both crude protein (14-16% CP) and energy (11 MJ/kg) in ruminants. The energy and protein content are adequate for maintenance in the majority of ruminants. However, highly available energy supplementation is known to improve growth performance and protein deposition. This study was carried out to determine the effect on the quality of meat and fatty acid composition of the semitendinosus (ST), supraspinatus (SS), and longissimus lumborum (LL) muscles of Dorper lambs by including corn as an energy source in a basal diet of PKC urea-treated rice straw. RESULTS: The results show that the LL muscle-drip loss was greater in animals supplemented with 5% corn compared to the other groups. Higher pH values of SS and LL muscles were observed in animals supplemented with 5 and 10% corn. Furthermore, the L* value of ST muscle was increased in lambs fed on 5% corn while, reduced in those fed on 0% corn, but the a* and b* values were not significantly different in the treatment groups. The fatty acid composition of the SS muscles showed that lambs fed on 10% corn had higher levels of sum PUFA n-3 compared to those fed on 0% corn. The concentration of C18:1trans11 and CLA c12 t10 in ST muscle from the lambs fed on supplemented diets were higher than those of the controls. CONCLUSION: This study has concluded the supplementation of corn as a source of energy into a PKC urea-treated rice straw-based diet increased the PUFA concentrations of muscles as compared to control groups.

Temporomandibular Joint Ankylosis Leading to Obstructive Sleep Apnea.

Temporomandibular joint ankylosis in children commonly lead to difficulty in feeding, poor oral hygiene, retrognathic mandible and obstructive sleep apnea. Surgical release of the ankylosis has always been the standard treatment. The authors report a 12 year old boy with unilateral temporomandibular joint ankylosis and obstructive sleep apnea underwent surgical release of the ankylosis with successful gain in mouth opening. However, he continued to suffer from obstructive sleep apnea as confirmed by post-operative polysomnography. Orthognathic surgery for mandibular advancement is not favorable due to his young age and mandibular distraction osteogenesis was not a choice. A mandibular advancement device similar to orthodontic myofunctional appliance was the preferred choice in the post-operative period while waiting for definitive retrognathia surgical treatment after skeletal maturity. Surgical release of temporomandibular joint ankylosis corrects the oral problem but does not adequately address the narrow pharyngeal airway space. Assessment of pharyngeal airway with a high suspicion of obstructive sleep apnea is mandatory in the management of TMJ ankylosis.

Cultivated oral mucosal epithelial transplantation (COMET) and penetrating keratoplasty in long-standing severe ocular surface injury.

Ocular chemical injury is a true ophthalmic emergency requiring immediate medical intervention. Damages can be devastating and potentially resulting in blindness, corneal perforation and phthisis bulbi. We describe here a successful treatment outcome in a patient who sustained Roper-Hall Grade 4 injury to both eyes. Patient received medical therapy followed by serial ocular surgeries with eventual visual recovery in one eye from counting finger to 6/15 after a decade. In conclusion, after maximum medical therapy, a carefully planned serial surgeries of cultivated oral mucosal epithelial transplantation (COMET) and PK has proven beneficial for this patient with advanced limbal stem cell deficiency (LSCD).

Effects of vitamin E, inorganic selenium, bacterial organic selenium, and their combinations on immunity response in broiler chickens.

BACKGROUND: Selenium (Se) and vitamin E (Vit E) can act synergistically and affect biological processes, mainly antioxidant and immunity. The use of excess dietary Vit E and Se in animals' feed could enhance immune response and induce disease resistance. Moreover, different Se sources may provide different alterations in the immune system. Accordingly, the aim of the current study was to assess the impact of dietary supplementation of Vit E, inorganic Se (sodium selenite, SS), bacterial organic Se of ADS18, and their different combinations on the plasma immunoglobulins, ceacum microbial population, and splenic cytokines gene expression in broiler chickens. RESULTS: Present results showed that, Se and Vit E synergistic effect was clear in plasma IgM level at day 42 and in splenic cytokines expression (TNF-α, IFN-γ, IL-2, IL-10). The combination of 0.3 mg/kg ADS18-Se with 100 mg/kg Vit E showed the highest IgM level compared to Vit E- SS complex. The combination of either SS or ADS18-Se with Vit E had no significant effect on IFN- γ and IL-10 compared to Vit E alone, while Vit E alone showed the significantly lowest TNF-α compared to the Se combinations. Supplementation of 100 mg/kg Vit E had no effect on microbial population except a slight reduction in Salmonella spp. The main effect of Se sources was that both sources increased the day 42 IgA and IgG level compared to NS group. ADS18-Se modulate the caecum microbial population via enhancing beneficial bacteria and suppressing the E-coli and Salmonella spp. while both Se and Vit E factors had no effect on lymphoid organ weights. CONCLUSIONS: The inclusion of 100 mg/kg Vit E with 0.3 mg/kg ADS18-Se, effectively could support the immune system through regulation of some cytokines expression and immunoglobulin levels more than using ADS18-Se alone, while no difference was observed between using SS alone or combined with Vit E.