Correlation of arterial PaCO2 to end tidal CO2 in children undergoing laparoscopic abdominal surgery: An observational study.

Background and Aims: The reliability of end tidal carbon dioxide (ETCO2) as a measure of arterial carbon dioxide (PaCO2) in pediatric laparoscopy is unclear. We evaluated the correlation of arterial to end tidal P(a-ET) CO2 during pediatric laparoscopy at two hours of pneumoperitoneum as the primary objective. We also compared P(a-ET) CO2 and alveolar to arterial oxygen gradient P(A-a) O2 and haemodynamics at fixed time points during surgery. Material and Methods: A cross-sectional study was conducted in 25 children undergoing laparoscopic abdominal surgery. Arterial blood gases were drawn at T0, baseline, T10: ten minutes, T1h: 1 hour, T2h: 2 hours of pnuemoperitoneum and T 10d: 10 mins after deflation. The P(a-ET) CO2, P(A-a) O2, were measured from the blood gas and ETCO2 and FiO2 values on the monitor. The Pearson's correlation coefficient, the Wilcoxon rank test and Chi square test were used for statistical analysis. Results: At T2h moderate correlation of P(a-ET) CO2 (r = 0.605, P = 0.001) with 40% children documenting accurate P(a-ET) CO2, -1 to +1 mm Hg was seen. Moderate correlation was also seen at T0, T10, T 10d but poor correlation at T 1h. The P(A-a) O2 increased progressively with surgery and did not correlate with P(a-ET) CO2. Heart rate was stable, but systolic blood pressures at T 10 and diastolic at T10, T 1h, T 2h were higher than baseline. Conclusion: Moderate correlation was seen between PaCO2 and ETCO2 at 2 h of pnuemoperitoneum and at T0, T 10, and T 10d. P(A-a) O2 increased with surgery but did not correlate with P(a-ET) CO2.

Influence of inclusion level of barley in wheat-based diets and supplementation of carbohydrase on growth performance, nutrient utilisation and gut morphometry in broiler starters.

1. The influence of barley inclusion level and supplementation of a multi-component non-starch polysaccharide degrading enzyme on performance and nutrient utilisation in broilers was investigated. Normal-starch hulled barley was evaluated with five levels of inclusion (0, 141, 283, 424 and 565 g/kg) in a wheat-based diet and two levels of enzyme supplementation (0 and 150 g/tonne of feed; a 5 × 2 factorial arrangement of 10 dietary treatments). All diets were equivalent in metabolisable energy and digestible amino acid contents. A total of 400, one-d old male broilers (five cages/treatment; eight birds/cage) were used in the experiment.2. Regardless of enzyme supplementation, weight gain (WG) increased up to 283 g/kg of barley and was reduced afterwards (P < 0.01). Increasing levels of barley resulted in greater (P < 0.001) gain per feed (G/F). Enzyme addition increased WG (P < 0.05) and G/F (P < 0.001) at each barley inclusion level.3. Birds fed diets with 0 and 565 g/kg barley showed the lowest and highest (P < 0.001to 0.05) digestibility for all nutrients measured, respectively. Digestibility of all nutrients was improved by enzyme supplementation at each barley inclusion level (P < 0.05). The nitrogen-corrected apparent metabolisable energy improved with increasing inclusion of barley (P < 0.001) and supplemental enzyme (P < 0.01). Increasing inclusion of barley increased the relative weight of gizzard (P < 0.001) and reduced jejunal digesta viscosity (P < 0.001). Supplemental enzyme (P < 0.001) reduced digesta viscosity.4. The optimum inclusion level of barley, with respect to growth performance, was 283 g/kg of diet. Increasing barley inclusion improved nutrient and energy utilisation, possibly through lowered digesta viscosity and better function of the gizzard. Feed efficiency and nutrient and energy utilisation can benefit from carbohydrase supplementation in barley-based diets, regardless of barley inclusion level.

Nutritional evaluation of two barley cultivars, without and with carbohydrase supplementation, for broilers: metabolisable energy and standardised amino acid digestibility.

1. Two experiments were conducted to assess the nitrogen-corrected apparent metabolisable energy (AMEn; Exp. 1; 288 Ross 308 male broilers at d 14; 36 cages with eight birds each) and coefficient of standardised ileal digestibility (CSID) of amino acids (AA; Exp. 2; 336 Ross 308 male broilers at d 21; 42 cages with eight birds each) of two barley cultivars for broilers in comparison to wheat, without or with a multi-component non-starch polysaccharide (NSP) degrading enzyme. A 3 × 2 factorial arrangement of treatments was used in both experiments with three types of grains (normal starch hulled barley [NSH], waxy starch hull-less barley [WSHL], and wheat) and two levels of enzyme supplementation (0 and 200 g/tonne of feed). Enzyme supplemented diets contained 406 and 128 of endo-1, 4-ß-xylanase and endo-1, 3 (4)-ß-glucanase units per kg of feed, respectively. 2. Analysis showed that the starch content was higher in NSH (610 g/kg) than in wheat (537 g/kg) and WSHL (554 g/kg), and the composition of starch differed markedly among the grain types. The ß-glucan content was considerably higher in WSHL (68.6 g/kg) compared to NSH (38.5 g/kg) and wheat (7.74 g/kg). The contribution of soluble fraction to the total non-starch polysaccharides was higher in WSHL (38.2%) compared to NSH and wheat (17.1% and 13.3%, respectively). 3. A significant (P < 0.01) interaction was observed between the grain type and enzyme supplementation for AMEn. The WSHL, with the highest content of ß-glucan, showed the greatest response to enzyme supplementation for AMEn. 4. Birds fed wheat- and WSHL-based diets had the highest and lowest CSID of nitrogen and most of AA, respectively, with NSH diets being intermediate. Regardless of grain type, enzyme supplementation increased (P < 0.05) the CSID of nitrogen. 5. These data suggest that ß-glucan content plays an important role in determining the digestibility of nutrients in barley for broilers, resulting in a better feeding value for NSH over WSHL. Supplementation of a multi-component NSP-degrading enzyme can improve the feeding value of barley in broiler diets by increasing the digestibility with the effect being more pronounced in WSHL barley.

Measurement of true ileal calcium digestibility in meat and bone meal for broiler chickens using the direct method.

The objective of the study that is presented herein was to determine the true ileal calcium (Ca) digestibility in meat and bone meal (MBM) for broiler chickens using the direct method. Four MBM samples (coded as MBM-1, MBM-2, MBM-3 and MBM-4) were obtained and analyzed for nutrient composition, particle size distribution and bone to soft tissue ratio. The Ca concentrations of MBM-1, MBM-2, MBM-3 and MBM-4 were determined to be 71, 118, 114 and 81 g/kg, respectively. The corresponding geometric mean particle diameters and bone to soft tissue ratios were 0.866, 0.622, 0.875 and 0.781 mm, and 1:1.49, 1:0.98, 1:0.92 and 1:1.35, respectively. Five experimental diets, including four diets with similar Ca concentration (8.3 g/kg) from each MBM and a Ca and phosphorus-free diet, were developed. Meat and bone meal served as the sole source of Ca in the MBM diets. Titanium dioxide (3 g/kg) was incorporated in all diets as an indigestible marker. Each experimental diet was randomly allotted to six replicate cages (eight birds per cage) and offered from d 28 to 31 post-hatch. Apparent ileal Ca digestibility was calculated by the indicator method and corrected for ileal endogenous Ca losses to determine the true ileal Ca digestibility. Ileal endogenous Ca losses were determined to be 88 mg/kg dry matter intake. True ileal Ca digestibility coefficients of MBM-1, MBM-2, MBM-3 and MBM-4 were determined to be 0.560, 0.446, 0.517 and 0.413, respectively. True Ca digestibility of MBM-1 was higher (P < 0.05) than MBM-2 and MBM-4 but similar (P > 0.05) to that of MBM-3. True Ca digestibility of MBM-2 was similar (P > 0.05) to MBM-3 and MBM-4, while that of MBM-3 was higher (P < 0.05) than MBM-4. These results demonstrated that the direct method can be used for the determination of true Ca digestibility in feed ingredients and that Ca in MBM is not highly available as often assumed. The variability in true Ca digestibility of MBM samples could not be attributed to Ca content, percentage bones or particle size.

Effect of limestone particle size and calcium to non-phytate phosphorus ratio on true ileal calcium digestibility of limestone for broiler chickens.

The purpose of this study was to determine the effect of limestone particle size and calcium (Ca) to non-phytate phosphorus (P) ratio on the true ileal Ca digestibility of limestone for broiler chickens. A limestone sample was passed through a set of sieves and separated into fine (<0.5 mm) and coarse (1-2 mm) particles. The analysed Ca concentration of both particle sizes was similar (420 g/kg). Six experimental diets were developed using each particle size with Ca:non-phytate P ratios of 1.5:1, 2.0:1 and 2.5:1, with ratios being adjusted by manipulating the dietary Ca concentrations. A Ca-free diet was also developed to determine the basal ileal endogenous Ca losses. Titanium dioxide (3 g/kg) was incorporated in all diets as an indigestible marker. Each experimental diet was randomly allotted to 6 replicate cages (8 birds per cage) and fed from d 21 to 24 post hatch. Apparent ileal digestibility of Ca was calculated using the indicator method and corrected for basal endogenous losses to determine the true Ca digestibility. The basal ileal endogenous Ca losses were determined to be 127 mg/kg of dry matter intake. Increasing Ca:non-phytate P ratios reduced the true Ca digestibility of limestone. The true Ca digestibility coefficients of limestone with Ca:non-phytate P ratios of 1.5, 2.0 and 2.5 were 0.65, 0.57 and 0.49, respectively. Particle size of limestone had a marked effect on the Ca digestibility, with the digestibility being higher in coarse particles (0.71 vs. 0.43).

Measurement of true ileal phosphorus digestibility in meat and bone meal for broiler chickens.

An experiment was conducted to estimate true ileal phosphorus (P:) digestibility of 3 meat and bone meal samples (MBM-1, MBM-2: , and MBM-3:) for broiler chickens. Four semipurified diets were formulated from each sample to contain graded concentrations of P. The experiment was conducted as a completely randomized design with 6 replicates (6 birds per replicate) per dietary treatment. A total of 432 Ross 308 broilers were assigned at 21 d of age to the 12 test diets. The apparent ileal digestibility coefficient of P was determined by the indicator method, and the linear regression method was used to determine the true P digestibility coefficient. The apparent ileal digestibility coefficient of P in birds fed diets containing MBM-1 and MBM-2 was unaffected by increasing dietary concentrations of P (P > 0.05). The apparent ileal digestibility coefficient of P in birds fed the MBM-3 diets decreased with increasing P concentrations (linear, P < 0.001; quadratic, P < 0. 01). In birds fed the MBM-1 and MBM-2 diets, ileal endogenous P losses were estimated to be 0.049 and 0.142 g/kg DM intake (DMI:), respectively. In birds fed the MBM-3 diets, endogenous P loss was estimated to be negative (-0.370 g/kg DMI). True ileal P digestibility of MBM-1, MBM-2, and MBM-3 was determined to be 0.693, 0.608, and 0.420, respectively. True ileal P digestibility coefficients determined for MBM-1 and MBM-2 were similar (P < 0.05), but were higher (P < 0.05) than that for MBM-3. Total P and true digestible P contents of MBM-1, MBM-2, and MBM-3 were determined to be 37.5 and 26.0; 60.2 and 36.6; and 59.8 and 25.1 g/kg, respectively, on an as-fed basis.

Digestion of fat and fatty acids along the gastrointestinal tract of broiler chickens.

Two experiments were conducted. The first experiment investigated the digestion of fat and fatty acids (FA) from soybean oil and tallow along the gastrointestinal tract of broiler chickens. The second experiment was conducted to determine endogenous fat and FA losses and the FA profile of chicken bile. In experiment 1, 2-wk-old broilers were fed corn-soy diets supplemented with 50 g/kg of soybean oil or tallow for 7 d and digesta were collected from the duodenum, upper jejunum, upper ileum, and lower ileum. Apparent digestibility coefficients were calculated using the titanium marker ratio in diets, and digesta. Digestibility of fat was determined to be negative in the duodenum, indicating marked net secretion of fat into this segment. Fat was rapidly digested in the jejunum, with digestibility coefficients of 0.60 to 0.64 being determined at the end of the jejunum. The digestion of fat continued in the upper ileum. The apparent digestibility coefficient of fat determined at lower ileum in soybean oil diets was higher (P < 0.05) than that in tallow diets (0.82 vs. 0.74). Linoleic acid was digested throughout the intestinal tract, whereas the digestion of palmitic, stearic, and oleic acids started only in the jejunum. Measurements at the lower ileal level showed that the unsaturated FA (linoleic and oleic acids) were well digested (0.90 to 0.94), irrespective of the source of fat. In contrast, the digestibility of saturated FA (palmitic and stearic acids) was influenced (P < 0.05) by the fat source. Digestibility coefficients of palmitic and stearic acids at lower ileum were markedly higher (P < 0.05) in the diet containing soybean oil (0.77 to 0.85) compared with that containing tallow (0.58 to 0.68). In experiment 2, ileal endogenous fat loss was determined to be 1,714 mg/kg of DM intake. Endogenous fat was composed mainly of palmitic (75 g/kg), stearic (131 g/kg), oleic (73 g/kg), linoleic (133 g/kg), and arachidonic (60 g/kg) acids. Fatty acid profile of endogenous fat was found to be remarkably similar to that of the bile, suggesting that the reabsorption of fat and FA from the bile was incomplete in growing broiler chickens.

Influence of prepelleting inclusion of whole corn on performance, nutrient utilization, digestive tract measurements, and cecal microbiota of young broilers.

The objective of the present study was to examine the effects of prepelleting inclusion of graded levels of whole corn on performance, digestive tract measurements, nutrient utilization, and cecal microbiota in broiler starters. Five diets, containing 600 g/kg of ground corn or 150, 300, 450, and 600 g/kg of whole corn replacing (wt/wt) ground corn, were formulated and cold-pelleted at 65°C. Each diet was offered ad libitum to 6 replicates (8 birds per replicate cage) from d 1 to 21 posthatch. The proportion of coarse particles (>1 mm) increased with increasing prepelleting inclusion of whole corn. Pellet quality, measured as pellet durability index, increased (quadratic effect, P < 0.001) with the inclusion of whole corn to 450 g/kg and then plateaued. Weight gain and feed intake decreased (linear effect, P < 0.001) with increasing prepelleting inclusion of whole corn. Feed per gain (quadratic effect, P < 0.05) increased as the inclusion level of whole corn increased to 300 g/kg and then plateaued with further inclusions. Relative gizzard weight (quadratic effect, P < 0.05) increased with increasing inclusion of whole corn up to 300 g/kg and then levelled off. The AME (quadratic effect, P < 0.05) increased up to 300 g/kg of whole corn inclusion and then decreased with further inclusion. Apparent ileal digestibility of DM (P < 0.001), N (linear effect, P = 0.07), and starch (linear effect, P < 0.001) increased with increasing inclusion levels of whole corn. Based on the fluorescence in situ hybridization method, a linear (P < 0.05) effect was determined for cecal microbiota numbers. Lactobacillus spp. counts increased and counts of Clostridium spp., Campylobacterium spp., and Bacteroides spp. decreased with increasing inclusion levels of whole corn. The present data showed that, despite increased gizzard weight and nutrient utilization, weight gain of broilers was poorer with prepelleting inclusion of whole corn due to reductions in the feed intake.

Measurement of true ileal digestibility and total tract retention of phosphorus in corn and canola meal for broiler chickens.

The study reported herein was conducted to determine and compare the nonphytate P, digestible P, and retainable P contents of corn and canola meal for broiler chickens. Four semipurified diets were formulated from each of ingredient to contain graded concentrations of nonphytate P. The experiment was conducted as a randomized complete block design with 4 weight blocks of 8 cages each (6 birds per cage). A total of 192 broilers (Ross 308), 21 d old, were assigned to the 8 test diets. Ileal digestibility and total tract retention coefficients of P were determined by the indicator and total collection methods, respectively, and linear regression method was used to determine the true P digestibility and true P retention coefficients. The apparent ileal digestibility of P in corn was influenced (quadratic, P < 0.05) by increasing dietary nonphytate P concentrations, whereas P retention was unaffected (P > 0.05). The apparent ileal P digestibility in broilers fed diets based on canola meal was similar (P > 0.05) at different P concentrations. Phosphorus retention in broilers fed diets based on canola meal (linear, P < 0.01) decreased with increasing P concentrations. True ileal P digestibility and true P retention coefficients of corn were determined to be 0.676 and 0.632, respectively. The corresponding values for canola meal were 0.469 and 0.486, respectively. In both ingredients, the determined true ileal digestibility and total tract retention coefficients were not different (P > 0.05). Total P, nonphytate P, true digestible P, and true retainable P contents of corn were determined to be 2.5, 0.8, 1.7, and 1.6 g/kg (as received), respectively. The corresponding values for canola meal were 9.7, 2.8, 4.6, and 4.7 g/kg (as received), respectively. The present data demonstrated that the regression method can be successfully used to measure true P digestibility of low and high P feed ingredients and that both true ileal digestibility and retention coefficients are suitable to assess P availability in broilers.

Influence of feeding coarse corn on performance, nutrient utilization, digestive tract measurements, carcass characteristics, and cecal microflora counts of broilers.

The objective of the present study was to examine the effects of feeding coarsely ground corn on performance, digestive tract measurements, nutrient utilization, and cecal microflora counts in broilers. Five diets containing 600 g/kg of finely ground corn (hammer milled) or 150, 300, 450, and 600 g/kg of coarse corn (cracked in roller mill) replacing (wt/wt) finely ground corn were formulated. Each diet in mash form was offered ad libitum to 6 replicate cages of broilers (8 birds per cage) from d 11 to 35 posthatch. Weight gain increased (linear effect, P < 0.01) with increasing inclusion levels of coarse corn. Feed intake (quadratic effect, P < 0.05) increased at 150 g/kg of coarse corn inclusion, plateaued until 450 g/kg, and then increased again to 600 g/kg. Feed per gain increased (quadratic effect, P < 0.05) as inclusion of coarse corn increased to 300 g/kg and then decreased with further inclusion. Apparent metabolizable energy and total tract DM retention (quadratic effect, P < 0.01) was unaffected up to 300g/kg inclusion, and then decreased with further inclusion of coarse corn. Relative gizzard weight increased (linear effect, P < 0.05) with increasing inclusion of coarse corn. Inclusion of coarse corn had no effect (P > 0.05) on ileal digestibility of DM, N, and starch. Breast meat yield decreased (linear effect, P < 0.05 and abdominal fat increased (linear effect, P < 0.001) with increasing inclusion levels of coarse corn, but there was no effect (P > 0.05) on the carcass yield. A linear (P < 0.05) effect was observed for cecal microflora counts. Lactobacillus spp. and Bifidobacteria spp. counts increased and counts of Clostridium spp., Campylobacterium spp., and Bacteroides spp. decreased with increasing inclusion levels of coarse corn. The present data showed that feeding of coarse corn increased weight gain and gizzard size, and modified gut microflora profile toward beneficial species and that it can totally replace ground corn in broilers fed mash diets.

Ethics of Managing an Adolescent Living with Disability.

An ethical challenge arose when the parents of an adolescent girl living with severe intellectual disability requested for a permanent surgical intervention (hysterectomy) that would cause cessation of menstruation and reduce the possibility of pregnancy following nonconsensual sex. The family background was rural with poor access to extended family/community support, financial and social welfare resources. The parental distress was real with the adolescent incompetent to give informed consent. Is a non-therapeutic hysterectomy in an adolescent living with severe intellectual disability ethical? Views of a pediatrician, adolescent specialist, nurse, and an ethicist referring to literature suggesting an approach to an ethical decision are discussed herein.

Influence of pellet diameter and length on the quality of pellets and performance, nutrient utilisation and digestive tract development of broilers fed on wheat-based diets.

1. The influence of pellet diameter and length on the quality of pellets and performance, nutrient utilisation and digestive tract development of broilers given wheat-based diets was examined from 10 to 42 d of age. The experimental design was a 2 × 2 factorial arrangement of treatments evaluating two pellet diameters (3 and 4.76 mm) and two pellet lengths (3 and 6 mm). From 0 to 9 d of age, all birds were offered a common starter diet pelleted with a 3-mm diameter die and 3-mm length. Broiler grower (d 10 to 21) and finisher (d 22 to 42) diets, based on wheat, were formulated and then subjected to the 4 different treatments. 2. In grower diets, increasing pellet diameter and pellet length reduced the gelatinised starch (GS) content of the diets. In finisher diets, GS content of 3-mm diameter pellets did not change with increasing pellet length but decreased in 4.76-mm diameter pellets. 3. In grower and finisher diets, increments in intact pellet weight, pellet durability index and pellet hardness with increasing pellet length were greater in 3-mm diameter pellets than those with 4.76-mm diameter. 4. Increasing pellet length from 3 to 6 mm increased apparent metabolisable energy values. Neither the interaction nor main effects were significant for the ileal digestibility of nitrogen and starch. 5. During the grower period (d 10 to 21), birds given pellets of 6-mm length had greater body-weight gain than those given 3-mm length pellets. Feeding 6-mm length pellets decreased feed per body-weight gain compared to 3-mm length pellets. During the finisher (d 22 to 42) and whole grow-out (d 10 to 42) periods, while different pellet lengths had no effect on feed per body-weight gain values at 3-mm pellet diameter, increasing the pellet length decreased feed per body-weight gain at 4.76-mm pellet diameter. 6. Increasing pellet diameter and pellet length reduced the relative length of duodenum. Birds given 3-mm diameter pellets had heavier proventriculus compared to those given 4.76-mm diameter pellets. 7. Overall, the data suggest that increasing the pellet length from 3 to 6 mm improved the body-weight gain and feed per body-weight gain during the grower period (d 10 to 21). While the positive effect on body-weight gain disappeared as the birds grew older, improvements in feed per body-weight gain were maintained over the finisher and whole grow-out periods only in 4.76-mm diameter pellets. Small diameter die holes and longer pellet lengths may be considered as potential manipulations to manufacture high-quality pellets under low conditioning temperatures.

Perception of family medicine as the career option among young Indian graduates.

Aims and Objectives: 1. To estimate the number of graduates who had exposure to family medicine specialty. 2. To estimate the number of graduates who consider family medicine as the carrier option. 3. To compare the perception of family medicine as career option among the young graduates who had exposure to family medicine during their training or practice with no exposure. Materials and Methods: It is a cross-sectional, questionnaire-based study. The doctors graduated 2018 onwards were contacted through SIMSA (South Indian Medical Students Association) and WhatsApp groups (students doing the rural health service and intern WhatsApp). Subjects who consented for the study filled the google form. Filled Google forms were evaluated. Results: First choice of among the graduates is general medicine followed by general surgery and paediatrics. Family medicine is 4th in the order. There is overall a very positive perception about the family medicine among the respondents irrespective of exposure to family medicine. Majority of them feel that it gives good financial gain (55.55%), interesting (67.03%), work and family balance (75.55%), which contributes to individual and community health (84.07%) and essential part of healthcare system (83.33%). Graduates feel that career growth (26.66%) and academic growth (33.70%) are less and it is not popular (38.88%). If there is an opportunity, majority would choose family medicine (54.44%). Conclusions: Around 5.9% are open to choose family medicine as the career option. Medical graduates perceive family medicine subject to give them good work and family balance and the subject is essential part of healthcare system and contributes to the individual and community health, and at the same time, it may not give them great financial gain, academic and career growth.

Nutritional value of narrow-leafed lupin (Lupinus angustifolius) for broilers.

1. Two experiments were conducted to evaluate the nutritional value of three cultivars (Wallan, Tanjil and Borre) of narrow-leafed lupin (Lupinus angustifolius) for broilers. 2. In Experiment 1, the apparent metabolisable energy (AME) and the apparent ileal amino acid digestibility of the three cultivars were determined. The cultivar effects were not significant for AME and apparent ileal amino acid digestibility coefficients. In general, amino acids in narrow-leafed lupin were well digested, with the notable exception of methionine. Among the indispensable amino acids, arginine had the highest digestibility coefficient (0·92-0·95), while the lowest was for methionine (0·74-0·83). 3. In Experiment 2, using the energy and digestible amino acid values determined in Experiment 1, diets containing 200 g/kg of the three lupin cultivars were formulated and the effects of feeding these diets on the performance and the digestive tract development of broiler starters were investigated. 4. Weight gain, feed intake and feed per gain of broilers fed narrow-leafed lupins diets were similar to those fed on the maize-soy basal diet. The performance of birds fed on diets containing different cultivars of lupins was also similar. Birds fed on lupin diets had similar excreta scores to those fed on the basal diet. 5. Inclusion of 200 g/kg lupins in broiler diets had no effects on the relative weight and length of the intestinal tract. Broilers fed on lupin diets, however, had higher relative weights of liver. 6. These results suggest that narrow-leafed lupins are good sources of protein, but poor sources of AME and sulphur-containing amino acids. It is concluded that, when diets are properly balanced in terms of AME and digestible amino acids, lupins can be included at 200 g/kg inclusion level in broiler starter diets with no adverse effects on performance.

Influence of conditioning temperature on the performance, nutrient utilisation and digestive tract development of broilers fed on maize- and wheat-based diets.

1. The influence of conditioning temperature on the performance, nutrient utilisation and digestive tract development of broilers fed on maize- and wheat-based diets was examined up to 21 d of age. The experimental design was a 2 × 3 factorial arrangement of treatments evaluating two grain types (maize and wheat) and three conditioning temperatures (60°C, 75°C and 90°C). Broiler starter diets, each based on one grain (maize or wheat), were formulated and pelleted at the three temperatures. 2. Increasing conditioning temperature decreased the body-weight gain and feed intake in wheat-based diets, but birds fed on maize-based diets conditioned at 60°C and 90°C had higher body-weight gain and feed intake than those fed on the diet conditioned at 75°C. Increasing conditioning temperature increased feed per body-weight gain in both grain-type diets but improved pellet durability index (PDI) only in wheat-based diets; PDI was unaffected in maize-based diets. 3. In wheat-based diets, increasing conditioning temperature decreased the ileal digestibility of nitrogen and starch. Ileal nitrogen digestibility of maize-based diets conditioned at 60°C and 90°C was higher than at 75°C. Starch digestibility was unaffected by conditioning temperature in maize-based diets. No effect of conditioning temperature was found for apparent metabolisable energy (AME). Increasing conditioning temperature decreased digestible protein and AME intakes in wheat-based diets but, in maize-based diets, birds fed on the diet conditioned at 75°C had lower digestible protein and AME intakes compared to those fed on diets conditioned at 60°C and 90°C. 4. Small intestine was longer in birds fed on diets conditioned at 75°C and 90°C compared with those fed on diets conditioned at 60°C. 5. Overall, the data suggest that while the effects of conditioning temperature on body-weight gain and feed intake of broilers to 21 d of age differed depending on the grain type, feed per body-weight gain was adversely affected by higher conditioning temperatures.

Studies on the measurement of ileal calcium digestibility of calcium sources in broiler chickens.

Results from 3 experiments relating to the measurement of ileal calcium (Ca) digestibility in 4 different Ca sources for broiler chickens are presented herein. The first experiment was conducted to determine the effect of basal diet composition on the true Ca digestibility of limestone, meat and bone meal (MBM), monocalcium phosphate (MCP), and dicalcium phosphate (DCP). Eight experimental diets were developed based on 2 basal diets (corn-based or corn starch-based) with each of the 4 Ca sources. Two Ca-free diets representing both basal diets were used to determine the endogenous Ca losses. Each diet was randomly allotted to 6 replicate cages (6 birds per cage) and fed from 21 to 24 D post-hatch. Calcium digestibility of corn-based diet was higher (P < 0.05) than the corn starch-based purified diet. The average true Ca digestibility coefficients of limestone, MBM, MCP, and DCP were determined to be 0.51, 0.41, 0.43, and 0.32, respectively. The second experiment was conducted to examine the effect of indicator type on the apparent Ca digestibility of limestone. Two experimental diets with either titanium dioxide or acid insoluble ash (Celite) were developed. Each diet was randomly allotted to 6 replicate cages (8 birds per cage) and fed from 21 to 24 D post-hatch. Total tract Ca retention was also measured using the indicator ratios. Indicator type had no influence (P > 0.05) on the digestibility measurements. Ca retention determined using acid insoluble ash was higher (P < 0.05) compared to that determined using titanium dioxide. The third experiment was conducted to determine the effect of dietary adaptation length on apparent Ca digestibility of limestone. The experimental diet was offered from day 21 to 6 replicates (6 birds per cage) each for 24, 72, 120, or 168 h and the ileal digesta were collected. Calcium digestibility at 24 h was higher (P < 0.05), and increasing the adaptation length from 72 to 120 h had no effect (P > 0.05) on the digestibility.

Nutrient digestibility and energy utilisation of diets based on wheat, sorghum or maize by the newly hatched broiler chick.

1. Two experiments were conducted to measure changes in nutrient utilisation in the newly hatched broiler chicken. The first experiment determined the nitrogen-corrected apparent metabolisable energy (AME(N)) and total tract digestibility of starch and fat in diets based on wheat, sorghum and maize during the first two weeks post-hatch. The second experiment was conducted to confirm the results of Experiment 1 using wheat- and maize-based diets and was of 21 d duration. 2. In both experiments, changes to AME(N) with age were similar irrespective of the diet type, declining from d 3 to d 5-9 and then increasing after d 9. 3. In Experiment 1, the total tract digestibility of starch and fat exhibited a pattern similar to that of AME(N). 4. In Experiment 1, cereal effects were significant, with maize- and sorghum-based diets having higher AME(N) values than the wheat-based diet. Total tract starch digestibility determined for d 5, 7 and 14 showed no cereal differences. Total tract fat digestibility on d 7 was significantly lower for the wheat- and sorghum-based diets than for the maize-based diet, but no cereal differences were observed on d 5 or 14. 5. In Experiment 2, cereal effects were significant, with the maize-based diet having a higher AME(N) than the wheat-based diet. 6. These results showed that nutrient utilisation is compromised during the first week of life of the broiler chick.

Health for all in an unequal world: Obligations of global bioethics.

The theme of the joint 14th World Congress of Bioethics and 7th National Bioethics Conference Congress "Health for all in an unequal world: Obligations of global bioethics" is of critical relevance in the present global context. Although the world is better off in terms of improved health status of people by many measures than before, there exist colossal gaps across and within populations. Much needs to be done to respond to the lack of access to healthcare, poor quality of living and working conditions, and deteriorating quality of overall environment which affects more adversely the already deprived. We take this opportunity to make a few observations about the current status of affairs on this front, and offer brief analytical insights into the complex origins of the global health scenario characterised by disparities. We revisit the original conception of bioethics and suggest that it is well placed to respond to the current global crisis of inexorably widening disparities in health and wealth, and that global bioethics has an obligation to engage with this crisis.

On the integration of Ethics into the Physiology curriculum.

A one-day state-level workshop was organised in Karnataka to share the experience of a programme implemented earlier, in 2015-16, at St John's Medical College, Bengaluru that integrated the teaching of ethics into the physiology curriculum. The aim was to develop the programme further, list the challenges likely to be faced while scaling it up, and identify other colleges which could participate in the scaling up. Twenty-eight participants, representing 13 medical colleges, and five resource persons attended the workshop. There was a consensus that the integration of ethics into the physiology course was relevant and desirable, although the participants identified several critical challenges which might arise. These included the lack of institutional support, a possible lack of student "buy-in" since it was beyond the requirements of the examinations, and time constraints. Specific areas of integration were identified. Three medical colleges, including the host institution, opted to implement the programme and refine it further.