Dietary Intake and Milk Micronutrient Levels in Lactating Women with Full and Partial Breastfeeding

Background

Micronutrient intake and status in lactating women may impact micronutrient levels in milk.

Objectives

This study aimed to determine the micronutrient intake and status in lactating women, and their association with micronutrient levels in human milk.

Methods

Lactating women were enrolled at 4–6 months postpartum. A 24h food recall was examined and nutrient intakes were analyzed using INMUCAL software. Human milk samples were collected to analyze calcium, copper, iron, and zinc levels. Plasma zinc and serum ferritin levels were determined.

Results

Thirty-four women participated; 19 were classified as full breastfeeding and 15 as partial breastfeeding. Mean levels of calcium, copper, iron, and zinc in human milk were 243, 0.2, 0.2, and 1.56 mg/L, respectively. The prevalence of zinc deficiency (plasma zinc?<?10.7 µmol/L) was 11.8%. No lactating women had iron deficiency. Nutrient intakes were lower than the recommended amounts in 38%–70% of participants, and were not correlated with corresponding nutrient levels in human milk. Multiple linear regression showed significant association between zinc levels in human milk and plasma for lactating women with full breastfeeding (β?=?0.034, 95% confidence interval [0.003, 0.067], p?=?0.040).

Conclusions

Lactating women were at risk of micronutrient deficiency. There was an association between zinc levels in human milk and plasma of lactating women with full breastfeeding. As the nutritional status of lactating women influences the quality of human milk, we should encourage good nutrient intake for lactating women.

     

Outcomes of Direct Pulp Capping by Using Either ProRoot Mineral Trioxide Aggregate or Biodentine in Permanent Teeth with Carious Pulp Exposure in 6- to 18-Year-Old Patients: A Randomized Controlled Trial

Introduction

This study aimed to compare the success rates of direct pulp capping (DPC) by using either ProRoot Mineral Trioxide Aggregate (MTA) or Biodentine in the cariously exposed permanent teeth of 6- to 18-year-old patients. Gray discoloration was also evaluated.

Analysis of breast cancer susceptibility genes BRCA1 and BRCA2 in Thai familial and isolated early-onset breast and ovarian cancer

Here we report the study on BRCA1 and BRCA2 mutations in 12 Thai breast and/or ovarian cancer families and 6 early-onset breast or breast/ovarian cancer cases without a family history of cancer. Five distinct rare alterations were identified in each gene: four introducing premature stop codons, one in-frame deletion, two missense changes, two intronic alterations and one silent rare variant. The BRCA1 or BRCA2 truncating mutations were detected in four of seven patients with familial or personal history of breast and ovarian cancer, in one of four isolated early onset breast cancer cases and in none of seven breast cancer site specific families. The BRCA1 and BRCA2 mutation yield in Thai patients is consistent with that reported from Europe and North America in similar groups of patients, being particularly high in individuals with personal or family history of breast and ovarian cancer. The BRCA1 and BRCA2 alterations found in this series are different from those identified in other Asian studies, and all but two have never been reported before. We report at least three novel deleterious mutations, the BRCA1 3300delA, BRCA1 744ins20 and BRCA2 6382delT. One in-frame deletion was also found, the BRCA2 5527del9, which seggregated within family members of breast-only cancer patients and was thought to be a cancer-related mutation. BRCA1 3300delA and Asp67Glu alterations were detected each in at least two families and thus could represent founder mutations in Thais.     

Diabetic education,special consideration of oriental patients

The important of patient education program in the management of diabetes has been widely recognized. We studied to find out in general what the patients and their parents know about diabetes and their self-care by using a questionnaire. Then, the diabetic education was given by one-to-one basis to every patient. Thirty four insulin-dependent diabetes mellitus attended the diabetic the clinic at Siriraj Hospital, Bangkok age ranged from 4 to 22 years with peak age at 11 to 15 years. Male to female ratio was l:i. Majority came from low socioeconomic families. 23.5 percent were from separated families, one patient lived with neither her mother nor father. Only one patient had home glucose monitoring. Fourteen cases (41.2%) had been hospitalized with diabetic ketoacidosis (DKA) over the past year, however, there was no statistically significant difference between admission with DKA and low socioeconomic status. In addition to insulin, there were 8 patients taking herbs to cure diabetes. Only 6 patients were able to follow their meal plan and only one case ever used the food exchange list. Most patients accepted being diabetic and attended the clinic regularly mainly to get financial supports. The situation in our country is different from that in the western countries as the patients are low in literacy and socioeconomic status. A well-planned educational programme is essential to cater to the need to the oriental patients     

Spectrum of tardive syndromes: clinical recognition and management

Tardive syndrome (TS) refers to a group of delayed onset disorders characterised by abnormal movements and caused by dopamine receptor blocking agents (DRBAs). Classical tardive dyskinesia is a specific type of oro-buccal-lingual dyskinesia. However, TS may exist in other forms--for example, stereotypy, dystonia, and akathisia--and frequently occur in combination. The onset typically is insidious and after reaching its maximum severity it often stabilises. Frequently reported risk factors are age, dose and duration of neuroleptic exposure, the use of conventional DRBAs, and co-existing mood disorders. This review highlights the broad spectrum of TS, not limited to classical tardive dyskinesia, as well as the clues for its recognition. Despite challenges in the treatment of TS, dictated by the different phenomenology, severity of TS and the need for ongoing neuroleptic treatment, the authors provide evidence based recommendations for patient management, which is not restricted to only withdrawal of the offending neuroleptics or the selection of an alternative medication, such as clozapine. In a minority of cases with significant functional disability, symptomatic or suppressive treatments should be considered. Recently, there has been a resurgence of stereotactic pallidal surgery for the treatment of TS. Although the efficacy of both pallidotomy and pallidal deep brain stimulation in dystonia has been encouraging, the evidence is still limited.     

The second outbreak of trichinellosis caused by Trichinella papuae in Thailand

A human trichinellosis outbreak caused by Trichinella papuae occurred in the Uthai Thani Province of Thailand in September 2007. A total of 34 villagers suffering at least one of the symptoms suggestive of trichinellosis, or those who were asymptomatic but had a history of ingesting raw wild pig meat, were enrolled in the study. Twenty-two villagers had ingested undercooked pork from a hunted wild pig (Sus scrofa). One patient with a severe clinical picture was hospitalised and more than 80 non-encapsulated larvae were detected in the muscle biopsy. The larvae were identified as T. papuae by molecular analyses of the mitochondrial cytochrome c oxidase subunit I (COI) gene and the expansion segment 5 (ES5) of the large subunit rRNA. Of the 34 suspected cases, 27 agreed to be subjected to haematological and serological tests. Immunoblot analysis using crude antigens from T. spiralis muscle larvae revealed anti-Trichinella IgG in 20 of the 26 serum samples (1 serum sample could not be analysed). All infected people were successfully treated with mebendazole; the one patient with severe symptomatology was treated successfully with prednisolone.     

Human papillomavirus infection and lymphoma incidence using cervical conization as a surrogate marker: a Danish nationwide cohort study

Persistent human papillomavirus (HPV) infection may promote carcinogenesis by hyperactivation of the immune system. We, therefore, explored the associations between HPV infection and risk of Hodgkin and non‐Hodgkin lymphoma in a nationwide cohort study using conization as a surrogate marker. We identified all Danish women who underwent conization between 1978 and 2011. We computed standardized incidence ratios and 95% confidence intervals for Hodgkin and non‐Hodgkin lymphoma based on national cancer incidence rates. Among 87 435 women who underwent conization, we noted an increased incidence of Hodgkin (standardized incidence ratio 1.48, 95% confidence interval 1.05–2.02) but only a slight increase for non‐Hodgkin lymphoma (standardized incidence ratio 1.10, 95% confidence interval 0.97–1.25). As measured by conization, HPV infection is associated with an increased risk of lymphoma. This association may be attributable to a chronic immune activation induced by persistent HPV infection and/or failure of the immune system both to clear HPV infection and to control lymphoma development. Copyright © 2015 John Wiley & Sons, Ltd.     

The Efficacy of Topical 0.1% Adapalene Gel for Use in the Treatment of Childhood Acanthosis Nigricans: A Pilot Study

Background:

Vitiligo is one of the disorder that has social impact. Both skin and mucous membrane show depigmentation in vitiligo. Depigmentation in oral cavity can be more easily observed and the patient can be given awareness regarding the condition if they are unaware of vitiligo elsewhere in their body and can be guided for treatment.

Aim and objectives:

The aim of this study is to determine the frequency of occurrence of oral mucosal vitiligo in vitiligo patients and to determine the most commonly involved oral mucosal site.

Materials and methods:

The study sample included 100 vitiligo patients. The patients of all age groups and both genders were included. Vitiligo patients associated with systemic conditions such as thyroid disorders, juvenile diabetes mellitus, pernicious anemia, Addison''s disease were excluded in this study.

Results:

Out of 100 vitiligo patients 44 % male and 56% were female. The oral presentation of vitiligo in this study showed depigmentation of buccal mucosa in 5% of patients, labial mucosa in 5% of patients, palate in 8% of patients, gingiva in 2% of patients and alveolar mucosa 1%. Depigmentation of lip was seen in 42% of patients. Lip involvement refers to depigmentation of both the lips or either lip. Also vermilion border involvement was noted in majority of cases. In some cases, the depigmentation of lip extended to the facial skin also.

Conclusion:

In this study 55 patients out of 100 patients showed depigmentation in the oral cavity. Lip involvement was most common in this study showing about 42% of patients. Intraoral mucosal involvement was found in 21% of patients. Among intraoral mucosal site palate was common followed by buccal and labial mucosa, gingiva. Two patients had lip pigmentation as the only manifestation without any depigmentation in the skin.