Cord Care Practices and Omphalitis among Neonates Aged 3 - 28 Days at Pumwani Maternity Hospital, Kenya

Background: Omphalitis (umbilical cord infection) among new-borns is common and a major cause of neonatal deaths in developing countries. Annually about 4 million neonatal deaths occur around the world;of these, more than 30% are caused by infections. Majority of these infections start as umbilical cord infection. Objective: The aim of the present study was to establish cord care practices associated with omphalitis among neonates aged 3-28 days at Pumwani Maternity Hospital, Kenya. Methodology: Cross-sectional descriptive study was employed among 178 mothers with neonates of 3-28 days. Participants were selected systematically and data was collected on new-born cord care practices. Omphalitis was defined as pus discharge, redness with or without pus and swelling of umbilical cord. Pearson’s chi-square test (P < 0.05) was performed to compare the significant discrepancies. Crude and adjusted odds ratios with corresponding 95% confidence interval were also used to determine the strength of association between omphalitis and cord care practices. Results: Among 178 neonates, 67 (37.6%) were diagnosed with omphalitis. In logistic regression analysis, the main predictors of omphalitis were initiation of breastfeeding after one hour of delivery [AOR = 2.47;95%CI = 1.15 - 5.30;P < 0.05] compared to within one hour and application of saliva to the cord [AOR = 6.59;95%CI = 2.02 - 21.46;P < 0.01] compared to dry cord. Conclusion: The prevalence of omphalitis among neonates was high. Health workers need to participate in educating the mothers to initiate breastfeeding within one hour and to avoid application of harmful cord care practices.

Postnatal Total Serum Protein Concentration Influences the Health and Growth Parameters of Preweaned Female Holstein Friesian Calves

This study focuses on the effect of the total serum protein(TSP)concentrations at 3 days after birth on the health and growth parameters of preweaned female Holstein Friesian calves.A total of 165 female calves were enrolled and evaluated for morbidity which included diarrhea(D),respiratory disease(Rd)and omphalitis(O).Also,calves with more than one disorder in the same time were recorded as multi-morbid.Body weight(BW)was determined at birth,30 and 60 days of age.Blood samples were taken at 3 days after birth and TSP was determined using a digital Brix refractometer.For statistical analysis all female calves based on TSP concentration were grouped into 3 categories:1-TSP≥6.2 g/dL,2-TSP 5.8-6.1 g/dL,and 3-TSP<5.8 g/dL.Overall,the average of TSP concentration was 6.38 g/dL.The prevalence of diarrhea,respiratory disease(Rd)and omphalitis(O)was 16.96%,7.88%and 4.85%respectively,in calves with one disorder and 6.06%in calves with D+Rd,3.64%in calves with Rd+O,3.03%in calves with O+D,and 3.64%in calves with D+Rd+O.As the TSP concentration in calves decreased from≥6.2 g/dL to<5.8 g/dL the calf hood disorders increased in female calves with one disorder and with more than one disorder.The female calves with fair to poor immunity(category 3-TSP<5.8 g/dL)were significantly more likely(OR 6.28,95%CI 2.91-13.5,p value<0.001)to be affected by diseases compared with female calves with excellent immunity(category 1-TSP≥6.2 g/dL).Also BW and average daily gain(ADG)at 30 and 62 days of life decreased as TSP concentrations decreased.The female calves with TSP≥6.2 g/dL at 3 days of life had the greatest BW at 30 and 62 days of age(51.8 kg and 77.1 kg respectively)compared with female calves with TSP<5.8 g/dL at 3 days of life(46.6 and 70.6 kg respectively).Moreover,starter feed intake during the first 30 days of life,31 to 62 days of life and 1 to 62 days of life was greater in female calves with excellent immunity(TSP≥6.2 g/dL)than female calves with good immunity(TSP 5.8-6.1 g/dL)or with fair to poor immunity(<5.8 g/dL TSP).Measuring the TSP at 3 days of calf’s This study focuses on the effect of the total serum protein(TSP)concentrations at 3 days after birth on the health and growth parameters of preweaned female Holstein Friesian calves.A total of 165 female calves were enrolled and evaluated for morbidity which included diarrhea(D),respiratory disease(Rd)and omphalitis(O).Also,calves with more than one disorder in the same time were recorded as multi-morbid.Body weight(BW)was determined at birth,30 and 60 days of age.Blood samples were taken at 3 days after birth and TSP was determined using a digital Brix refractometer.For statistical analysis all female calves based on TSP concentration were grouped into 3 categories:1-TSP≥6.2 g/dL,2-TSP 5.8-6.1 g/dL,and 3-TSP<5.8 g/dL.Overall,the average of TSP concentration was 6.38 g/dL.The prevalence of diarrhea,respiratory disease(Rd)and omphalitis(O)was 16.96%,7.88%and 4.85%respectively,in calves with one disorder and 6.06%in calves with D+Rd,3.64%in calves with Rd+O,3.03%in calves with O+D,and 3.64%in calves with D+Rd+O.As the TSP concentration in calves decreased from≥6.2 g/dL to<5.8 g/dL the calf hood disorders increased in female calves with one disorder and with more than one disorder.The female calves with fair to poor immunity(category 3-TSP<5.8 g/dL)were significantly more likely(OR 6.28,95%CI 2.91-13.5,p value<0.001)to be affected by diseases compared with female calves with excellent immunity(category 1-TSP≥6.2 g/dL).Also BW and average daily gain(ADG)at 30 and 62 days of life decreased as TSP concentrations decreased.The female calves with TSP≥6.2 g/dL at 3 days of life had the greatest BW at 30 and 62 days of age(51.8 kg and 77.1 kg respectively)compared with female calves with TSP<5.8 g/dL at 3 days of life(46.6 and 70.6 kg respectively).Moreover,starter feed intake during the first 30 days of life,31 to 62 days of life and 1 to 62 days of life was greater in female calves with excellent immunity(TSP≥6.2 g/dL)than female calves with good immunity(TSP 5.8-6.1 g/dL)or with fair to poor immunity(<5.8 g/dL TSP).Measuring the TSP at 3 days of calf’s life,offers information directly correlated to an individual calf’s immunity status,their likeliness of morbidity,mortality and body development and overall the effectiveness of the colostrum management program in the dairy farm.life,offers information directly correlated to an individual calf’s immunity status,their likeliness of morbidity,mortality and body development and overall the effectiveness of the colostrum management program in the dairy farm.

Three novel homozygous ITGB2 mutations among two patients with leukocyte adhesion defect type-1:Two case reports

BACKGROUND A leukocyte adhesion defect(LAD) is a rare primary immunodeficiency disorder. LAD type 1(LAD-1) is the most common, which is caused by ITGB2 mutation resulting in dysfunction of β2 integrin, which impairs leukocyte adherence to the endothelium.CASE SUMMARY The first two cases of LAD-1 in Thailand presented with recurrent omphalitis, soft tissue infection, marked leukocytosis, and neutrophilia. One patient experienced delayed umbilical cord separation. Mutation analysis was performed by direct DNA sequencing of the ITGB2 gene. The results revealed two novel homozygous missense mutations, c.920C>T(p.Leu307Pro) in exon 8 and c.758G>A(p.Arg-253His) in exon 7, and one novel homozygous nonsense mutation, c.262C>T(p.Gln88Ter) in exon 4, in the genomic DNA of the first and second patients, respectively. Heterozygous mutations were identified in the parents of both patients, suggesting a carrier status. The patients were administered intravenous antibiotics for infections with good clinical responses. Hematopoietic stem cell transplantation could not be performed due to the unavailability of matched donors. However, a significant decline in infections was observed after antibiotic prophylaxis. Several follow-up visits were conducted for both patients. They are currently 6 years old.CONCLUSION Molecular analysis is essential for definitive diagnosis, early treatment implementation, and prevention of LAD-1 in future pregnancy.