Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

BACKGROUND: Severe acute malnutrition (SAM) accounts for two million deaths worldwide annually. In those hospitalised with SAM, concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital. METHODS: A 4-year prospective descriptive study involving 1,206 children aged 6 months to 12 years, hospitalized with SAM and managed in accordance with WHO guidelines. Data on clinical features, haematological, biochemical and microbiological findings for children with diarrhoea (≥ 3 watery stools/day) were systematically collected and analyzed to identify risk factors associated with poor outcome. RESULTS: At admission 592 children (49%) had diarrhoea of which 122 (21%) died compared to 72/614 (12%) deaths in those without diarrhoea at admission (Χ(2) = 17.6 p<0.001). A further 187 (16%) children developed diarrhoea after 48 hours of admission and 33 died (18%). Any diarrhoea during admission resulted in a significantly higher mortality 161/852 (19%) than those uncomplicated by diarrhoea 33/351 (9%) (Χ(2) = 16.6 p<0.001). Features associated with a fatal outcome in children presenting with diarrhoea included bacteraemia, hyponatraemia, low mid-upper arm circumference <10 cm, hypoxia, hypokalaemia and oedema. Bacteraemia had the highest risk of death (adjusted OR 6.1; 95% C.I 2.3, 16.3 p<0.001); and complicated 24 (20%) of fatalities. Positive HIV antibody status was more frequent in cases with diarrhoea at admission (23%) than those without (15%, Χ(2) = 12.0 p = 0.001) but did not increase the risk of death in diarrhoea cases. CONCLUSION: Children with SAM complicated by diarrhoea had a higher risk of death than those who did not have diarrhoea during their hospital stay. Further operational and clinical research is needed to reduce mortality in children with SAM in the given setting

Influence of substituting dietary soybean for air-classified sunflower (Helianthus annuus L.) meal on egg production and steroid hormones in early-phase laying hens

Contents: Soybean meal (SBM) is the most widely and expensive protein source used in the formulation of poultry diets; however, when the price of SBM increases, poultry nutritionists seek alternative sources that are more economical in formulating least-cost rations. This research aimed to evaluate the effects of dietary air-classified sunflower meal (SFM) on some productive parameters and plasma steroid hormones in laying hens. In this trial, 20-week-old laying hens (ISA Brown strain) in the early phase of production were randomly assigned to two groups and fed wheat middlings-based diets containing soybean (135 g/kg; 48% CP) or air-classified SFM (160 g/kg; 41% CP) as the main protein source. Laying performance, egg size and feed conversion ratio were evaluated for 10 week. Plasma steroid hormones (progesterone and oestradiol) in the hens were quantified weekly. Substituting SBM with air-classified SFM did not change (p > 0.05) the hens' growth performance, whereas feed consumption and efficiency were positively influenced (p < 0.05) by SFM treatment. Egg production rate was improved in hens fed the SFM diet (p < 0.05), as well as the percentage of medium-size eggs that was higher for SFM treatment (p < 0.05). Steroid hormones levels were affected by dietary treatment (p < 0.01). From our findings, it could be effective to include air-classified SFM in early-phase laying hen diets as an alternative protein source substituting SBM, without negative influence on productive performance and egg traits, reducing also the production costs

Effect of Aloe vera and vitamin E supplementation on the immune response of broilers

Abstract Background: herbs are among the feed supplements under investigation that could replace antibiotics to improve humoral and cellular immune response in birds. Objective: this study evaluated the potential of Aloe vera (Aloe barbadensis Miller) and vitamin E as immunostimulants on humoral and cellular immune responses in broilers. Methods: broilers were randomly assigned to three dietary treatments: a negative control (basal diet+ with no additive), basal diet + 1% Aloe vera gel in drinking water, and basal diet + 100 mg/Kg vitamin E in the feed. Antibody titers against sheep red blood cells and Newcastle disease virus were used to examine the humoral immune response, whereas cellular immune response was evaluated using the phytohemagglutinin-P tests. Results: the highest level of antibody titer against sheep red blood cells on examination days 28 and 38, and the highest response to injection of phytohemagglutinin-P on day 38 was observed in the Aloe vera gel group (p0.05). In addition, the greatest antibody level against Newcastle disease virus was obtained on days 25 and 35 in the vitamin E group, with no significant difference from the Aloe vera gel group (p>0.05). Conclusion: in general, our findings demonstrated that both Aloe vera gel and vitamin E can enhance humoral and cellular immune responses of broilers, while Aloe vera gel can be used as an immunostimulant in chickens.Resumo Antecedentes: na indústria avícola, a melhoria nas respostas do sistema imunológico é importante, no sentido de aumentar a resistência contra patógenos. As ervas estão entre os suplementos que podem substituir os antibióticos na dieta com o objetivo de melhorar as respostas imunes humoral e celular. Objetivo: o presente estudo avaliou o uso potencial da Aloe vera (Aloe barbadensis Miller) e Vitamina E como imunoestimulantes sobre as respostas imunes humoral e celular em frangos de corte. Métodos: frangos de corte foram aleatoriamente distribuídos em 3 tratamentos, conforme a dieta: controle (dieta basal + sem aditivos), dieta basal + 1% de gel Aloe vera na água de bebida e dieta basal + 100 mg/Kg de vitamina E na dieta. Títulos de anticorpos contra células sanguíneas vermelhas de ovelha e o vírus da doença de Newcastle foram utilizados para avaliar a resposta imune humoral. A resposta imune celular foi avaliada através do teste da fitohemaglutinina-P. Resultados: o maior título de anticorpos contra células sanguíneas vermelhas de ovelha, aos 28 e 38 dias, e a maior resposta à injeção de fitohemaglutinina-P, aos 38 dias, foram observados no grupo recebendo o gel de Aloe vera (p0,05). Além disso, o maior título de anticorpos contra o vírus da doença de Newcastle foi observado aos 25 e 35 dias no grupo que recebeu vitamina E sem diferença com o grupo que recebeu gel Aloe vera (p>0,05). Conclusão: em geral, nossos resultados indicam que tanto o gel Aloe vera quanto a vitamina E, podem ser utilizados para aumentar as respostas imune humoral e celular em frangos de corte, enquanto que o gel Aloe vera (adicionado à água de bebida) pode ser utilizado como um imunoestimulante em frangos.Resumen Antecedentes: en la industria avícola, es particularmente importante mejorar el rendimiento del sistema inmune con el objetivo de incrementar la resistencia contra patógenos. Las plantas están dentro de los suplementos alimenticios que podrían reemplazar a los antibióticos con el propósito de mejorar la respuesta inmune humoral y celular en aves. Objetivo: el presente estudio evaluó el potencial del Aloe vera (Aloe barbadensis Miller) y la vitamina E como inmunoestimulantes sobre la respuesta inmune humoral y celular en pollos de engorde. Métodos: los pollos de engorde fueron asignados aleatoriamente a tres tratamientos (dietas): un control negativo (dieta base sin aditivo), dieta base + 1% de gel de Aloe vera en el agua de bebida, y una dieta base + 100 mg/Kg de vitamina E en el alimento. Se usó la titulación de anticuerpos contra glóbulos rojos de oveja y contra la enfermedad viral Newcastle para examinar la respuesta inmune humoral. La respuesta inmune celular fue evaluada usando las pruebas de fitohemaglutinina-P. Resultados: el mayor nivel de titulación de anticuerpos contra glóbulos rojos de oveja en los días de experimentación 28 y 38, y la mayor respuesta a la inyección de fitohemaglutinina-P en el día 38 se observó en el grupo del gel de Aloe vera (p0,05). Además, el más alto nivel de anticuerpos contra la enfermedad viral Newcastle fue obtenida en los días 25 y 35 en el grupo que recibió vitamina E, sin diferencia significativa con respecto al grupo con gel de Aloe vera (p>0,05). Conclusión: en general, nuestros resultados demuestran que tanto el gel de Aloe vera como la vitamina E pueden mejorar la respuesta inmune humoral y celular en pollos de engorde, mientras que el gel de Aloe vera (agregado al agua) puede usarse como un inmunoestimulante en pollos de engorde

Molecular Mechanisms of Obesity-Induced Osteoporosis and Muscle Atrophy

Obesity and osteoporosis are two alarming health disorders prominent among middle and old age populations, and the numbers of those affected by these two disorders are increasing. It is estimated that more than 600 million adults are obese and over 200 million people have osteoporosis worldwide. Interestingly, both of these abnormalities share some common features including a genetic predisposition, and a common origin: bone marrow mesenchymal stromal cells. Obesity is characterized by the expression of leptin, adiponectin, interleukin 6 (IL-6), interleukin 10 (IL-10), monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), macrophage colony stimulating factor (M-CSF), growth hormone (GH), parathyroid hormone (PTH), angiotensin II (Ang II), 5-hydroxy-tryptamine (5-HT), Advance glycation end products (AGE), and myostatin, which exert their effects by modulating the signaling pathways within bone and muscle. Chemical messengers (eg. TNF-α, IL-6, AGE, leptins) that are upregulated or downregulated as a result of obesity have been shown to act as negative regulators of osteoblasts, osteocytes and muscles, as well as positive regulators of osteoclasts. These additive effects of obesity ultimately increase the risk for osteoporosis and muscle atrophy. The aim of this review is to identify the potential cellular mechanisms through which obesity may facilitate osteoporosis, muscle atrophy and bone fractures