Natural history and outcome of inflammatory bowel diseases in children in Saudi Arabia: A single-center experience

Background/Aim: Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder which includes ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis (IC). The natural history of pediatric IBDs is poorly understood and generally unpredictable. We aim to study the natural history of IBD in Saudi children including the extraintestinal manifestations, changes in diagnosis, disease behavior, medical management, and surgical outcome. Patients and Methods: A retrospective review of all the charts of children less than 14 years of age who were diagnosed as IBD and followed up in King Faisal Specialist Hospital and Research Center (KFSH and RC) from January 2001 to December 2011 was performed. Results: Sixty-six children were diagnosed with IBD, 36 patients (54.5%) had CD, 27 patients (41%) had UC, and 3 patients (4.5%) had IC. Change in the diagnosis from UC to CD was made in 5 patients (7.6%). Extraintestinal manifestations were documented in 32% of all patients, and the most common was bone involvement (osteopenia/osteoporosis) in 16.7% of the patients. Arthritis (13.6%) was the second most common manifestation. Sclerosing cholangitis was reported in 2.8% in CD compared to 14.8% in UC. At the time of data collection, 8 patients (12%) were off therapy, 38 patients (57.6) were on 5-ASA, 31 patients (47%) were on azathioprine, and 12 patients (18.2%) were receiving anti-TNF. Of the children with CD, 10 patients (27.8%) underwent 1 or more major operations. Of the children with UC, 18.5% underwent 1 or more major intraabdominal procedures. Conclusions: Many issues in pediatric IBD can predict the natural history of the disease including growth failure, complications, need for more aggressive medical treatment, and/or surgery. More studies are needed from the region focusing on factors that may affect the natural history and disease progression

Effect of Skim Milk Powder and Whey Protein Concentrate Addition on the Manufacture of Probiotic Mozzarella Cheese

This work aimed to study the effect of adding skim milk powder (SMP) and whey protein concentrate (WPC) to probiotic mozzarella cheese. Pasteurized cow milk was heated to 55 °C and divided into five parts: PMC1 (control), PMC2 (1% SMP), PMC3 (1.5% SMP), PMC4 (1% WPC), and PMC5 (1.5% WPC). After mixing powders in the respective concentrations in the treatments, the milk was cooled to 35 °C, and Bifidobacterium bifidum culture (5%) was added. Proximate analysis, calcium, soluble nitrogen (SN), total Bifidobacterium bifidum count, cheese yield, hardness, and meltability tests were carried out at 0, 14, and 28 days of storage. The mozzarella cheese samples with WPC added had higher acidity, total solids, and protein content than the mozzarella cheese samples with SMP added and the control samples during storage. The addition of WPC led to a significant increase (p Bifidobacterium bifidum during storage at 5 °C. The cheeses with WPC added had increased meltability, higher hardness, and higher browning on pizza compared to those of the mozzarella cheese with SMP added. A sensory evaluation showed that the addition of WPC increased sensory scores, compared to the addition of SMP. As storage time progressed, there was a significant (p Bifidobacterium bifidum, meltability, and sensory scores of PMC in all treatments

Effect of fat extraction methods on the fatty acids composition of bovine milk using gas chromatography

Abstract Milk fat is a complex natural fat and contains around 400 fatty acids. The objectives of this study were to extract fat from bovine milk using two different methods, including Bligh and Dyer and Mojonnier, and to determine the fatty acid content in the extracted fats using gas chromatography (GC). No differences (p > .05) were detected in the fat content and fatty acids content as a percentage of total fat (FA%TF) extracted using both methods. No differences (p > .05) were detected in some saturated fatty acids (SFAs) and unsaturated fatty acids (USFAs) extracted from both methods, such as C11:0 (undecylic acid), C16:0 (palmitic acid), C18:0 (stearic acid), C14:1 (myristoleic acid), and C16:1 (palmitoleic acid). However, the majority of SFAs were different (p < .05) in Mojonnier method as compared to Bligh and Dyer method and vice versa for USFAs. The short (6.54% vs. 5.95%) and medium (21.86% vs. 20.73%) chains FAs determined by GC were high in Mojonnier fat as compared to Bligh and Dyer fat, while the long‐chain FAs were higher in the last (66.61%) relative to Mojonnier fat (65.51%). This study found that Mojonneir method has resulted in fewer errors. In contrast, the Bligh and Dyer extraction method has more experimental error, which led to decreasing the total fat, as well as was not able to detect C9:0

Non-Fat Yogurt Fortified with Whey Protein Isolate: Physicochemical, Rheological, and Microstructural Properties

The demand for low- and non-fat products has recently increased due to the health problems, such as obesity, diabetes, and cardiovascular diseases, that have resulted from high-fat products. However, the reduction in fat can affect the quality of products adversely. The objective of this work was to explore the potential of whey protein isolate (WPI) in improving the quality of non-fat yogurt prepared using skim milk powder (SMP). Yogurt mixes (standardized at 14% total solids) were formulated using SMP as a milk base enriched with WPI. The SMP was replaced by WPI in the yogurt mixes at a rate of 3, 5, 7, and 9%. Full-fat and non-fat set-style yogurts were prepared from whole milk and skim milk, respectively, as controls. Yogurts were fermented at 43 °C to get a pH of 4.6 and stored at 4 °C for the next day. The texture, microstructure, rheological characteristics, and sensory properties of the yogurt samples were studied. The incorporation of WPI increased the water holding capacity to 50% as compared to the non-fat control. This improved the rheological properties while the yogurt viscosity increased in direct proportion with increasing the WPI. The firmness of yogurt was inversely proportional to the increase in WPI, which resulted in 180 g firmness when 9% WPI was added to the non-fat yogurt formulations. Yogurts’ microstructure improved by the addition of WPI. The non-fat yogurt incorporated with 3 and 7% WPI had comparable sensory and textural characteristics to the full-fat yogurt. WPI can be used as a fat replacer to develop low-fat yogurt with desired features. WPI may be a natural and economical ingredient for producing low- and non-fat fermented dairy food products

A novel process to improve the characteristics of low‐fat ice cream using date fiber powder

Abstract The objective of this study was to improve the characteristics of low‐fat ice cream (LFIC) using date fiber powder (DFP). DFP was added to LFIC mix (3% fat, 14% milk solids nonfat, 15% sucrose, 0.3% stabilizer, and 0.1% vanilla) at a rate of 1.5%, 2.5%, and 3.5%. Control treatment with no DFP was also manufactured for comparison. The LFIC mix was analyzed for physicochemical and microbiological analyses. After manufacture, microbiological, rheological, and sensory characteristics of LFIC were evaluated during storage at −18˚C for 30 days. The addition of DFP to the LFIC mix led to increasing (p < .05) the density and weight per gallon (lb) of final product. Thus, a 3.5% of DFP led to increasing the density of LFIC from 0.6 to 1.0 g/cm3 and weight per gallon from 5.2 to 9.0 lb, while the overrun of LFIC was decreased (p < .05) from 50.0% to 24.0%. Additionally, the melting resistance of LFIC made with DFP was higher (p < .05) as compared to control. Approximately 60% of LFIC made with DFP was melted after 50 min compared to 100% in control. The total bacterial count (TBC) and yeast and molds' count slightly increased in LFIC with adding DFP. However, there was a slight decrease in these counts during storage for 30 days. Psychrotrophic and coliform bacteria were not detected in the LFIC. Organoleptically, LFIC made with DFP showed higher scores (p < .05) of body and texture, melting quality, and appearance as compared to control during the 30 days of storage. However, the flavor was slightly decreased (p < .05) as the concentration of DFP was increased. The overall scores were increased with increasing the DFP concentrations up to 15 days as compared to control, followed by a decrease at 30 days of storage

Measurement of carbohydrates and organic acids in varieties of cheese using high-performance liquid chromatography

Lactose is converted to lactic acid through fermentation and ripening of cheese using starter cultures. The content of lactic acid and organic acids formed during storage of cheese is different based on the type of starter cultures, pH, processing, and storage conditions. The objective of this study was to determine the carbohydrates and organic acids of four different commercial cheese samples (Parmesan, Mozzarella, Swiss, and Cheddar cheese) using high-performance liquid chromatography (HPLC). The lactose content in Cheddar cheese was significantly high (p &lt; .05) as compared to Parmesan cheese while Mozzarella and Swiss cheese did not have lactose. However, galactose was low in Swiss cheese as compared to other cheese types, while glucose did not detect in all cheese samples. Organic acids such as citric, succinic, lactic, and butanoic acids were high in Parmesan cheese relative to other cheese types. Additionally, pyruvic and propanoic acids were high (p &lt; .05) in Swiss cheese while acetic and orotic acids were elevated (p &lt; .05) in Mozzarella cheese relative to other types of cheese

Knowledge and practices regarding anaphylaxis management in children and adolescents among teachers in KSA

Introduction: Anaphylaxis is a common emergency and a serious allergic reaction that can be life threatening.&nbsp; School going children are prone to many allergic reactions and&nbsp; the knowledge and practices of teachers regarding these reactions and their management is poor. The literature is scarce regarding the school teachers’ awareness of anaphylaxis in KSA, therefore this study was undertaken to assess the awareness of anaphylaxis among teachers in Saudi Arabia and to assess their knowledge and practices&nbsp; in anaphylaxis management among school going children.Material and Methods: This six month cross-sectional study was conducted among randomly selected Saudi teachers working in different regions of the Kingdom. The knowledge and attitude about their role in anaphylaxis management among students was assessed. Data was collected through self-administered electronic questionnaires and analyzed by using SPSS software version 22.0.Results: Out of 384 Saudi teachers the majority was middle aged and was women. Nearly 26.8% of the respondents had witnessed a student suffering from anaphylaxis. Majority (60.9%) of teachers hadn’t any awareness about anaphylaxis. In terms of the first administered drug in case of anaphylaxis, 25.3% teachers reported that they would use an antihistamine, whereas 16.4% reported that they would use epinephrine injection. Majority of the teachers (77.3%) did not know the proper route of epinephrine administration, which is intramuscular injection. Only 15.4% teachers had knowledge of epinephrine as a medication and 37.2% were aware of the administration method of self‑injection using an Epinephrine. Furthermore, 17.4% informed that there was an action plan in their&nbsp; school in cases of anaphylaxis, and 11.7% reported that their school had an first aid medicine in case of an anaphylactic reaction.Conclusion: The knowledge and practices of Saudi teachers regarding anaphylactic reactions need to be strengthened. Teachers need further education regarding the management of allergic reactions encountered among student

Valorization of Different Dairy By-Products to Produce a Functional Dairy–Millet Beverage Fermented with <i>Lactobacillus paracasei</i> as an Adjunct Culture

Fermented dairy products not only have a long shelf-life but also have beneficial nutritional values. The products are deficient in dietary fiber and certain bioactive compounds. Adding grains to dairy products is a widespread practice to improve the nutritional and economic aspects. In this work, we studied the effect of fermented millet–milk beverages (FMBs) using pearl millet grains and three different dairy by-products (sweet whey, sweet buttermilk, and skimmed milk). A control treatment prepared with water was also manufactured for comparison. Samples were continuously prepared and fermented using a commercial yogurt starter culture (YC-381) containing L. delbrueckii subsp. bulgaricus, Streptococcus thermophilus, and a pure strain of L. paracasei subsp. Paracasei. Four FMBs (water based: WB-FMB, whey based: WHB-FMB, buttermilk based: BMB-FMB, and skimmed milk based: SMB-FMB) were analyzed during cold storage at 4 °C for up to 15 days for chemical, microbiological properties, minerals content, antioxidant properties, glycemic index, and glycemic load on days 1, 8, and 15. The sensory characteristics of the FMBs were also evaluated during cold storage (4 °C/15 days). In general, the progression of acidity was slower in SMB-FMB and WHB-FMB samples during fermentation compared to in the BMB-FMB sample. The longest fermentation time was for the SMB-FBM sample (3 h), while the shortest was for the BMB-FMB sample (1.5 h). Reflecting the good manufacturing practices, all samples were free of coliform, mold, and yeast. No bacterial growth was detected in the WB-FMB sample at days 8 and 15 of storage, while the growth of Lactobacillus spp. and S. thermophilus was significantly higher (9.97 ± 0.01 and 9.48 ± 0.06, respectively) in the BMB-FMB sample compared to in the other three FMBs. The FMBs produced using dairy by-products had more antioxidant properties. All samples were better perceived during sensory evaluation by panelists than the water-based sample, except for the BMB-FMB sample, in which a bitter taste appeared. In the BMB-FMB sample, the proteolytic degree was significantly higher (4.8 ± 0.09) after 3 h of fermentation by about 460% than in the fresh sample. All samples had a low glycemic index and glycemic load. In addition, acidity progression was slower in SMB-FMB and WHB-FMB samples during fermentation and storage compared to the WB-FMB sample. Therefore, it could be recommended that it is more beneficial to prepare fermented millet–milk beverages using dairy by-products and suitable starter cultures under optimal fermentation conditions instead of using water to maximize the nutritional and economic aspects