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The present study aimed to clarify the alternations in alpha-fetoprotein (AFP), phosphorus (Ph), calcium (Ca), and metabolic hormones (Growth hormones (GH), insulin, and thyroid gland hormones) in singleton, twin, and triplet pregnancy in goats. Animals were examined for pregnancy ultrasonographically during mid-pregnancy (6-14 weeks of gestation), and were classified conferring to litter size into singleton (n =55), twin (n=25) and triple (n=6) pregnancy, and non-pregnant status (n=64). Blood samples (5 ml) were collected before ultrasound examination and serum was separated for analysis of alpha-fetoprotein, phosphorus, calcium, and GH, insulin, T3, and T4. The current data showed that the fetal numbers markedly influenced AFP, Ph, Ca, GH, insulin, T3 levels, but did not affect T4 and Ph/Ca ratio. AFP levels were higher in twin (P< 0.05) and triple (P< 0.001) bearing does than in non-pregnant does (56.00±5.00 and 87.00±1.90 vs 3.80±.051 ng/ml). Phosphorus and Ca levels declined with pregnancy, with the substantial decreased in multiple feti compared with non-pregnant does. Growth hormone imminently raised in twine and triple fetuses than non-pregnant does. Insulin levels elevated in triple compared to non- pregnant and singleton (P< 0.005). Serum free T3 levels were lower in single and twin bearing does than non-pregnancy. In conclusion, fetal number markedly influenced the dam metabolic profile and mineral homostatis through altering AFP and metabolic hormones levels during pregnancy in goats.

This study aimed to (1) identify the status of reproductive tract of repeat-breeder heifers (RBH) ultrasonography, as well as (2) determinethe variations in steroid hormones, oxidative stress biomarkers, and cell-free RNA in serum.These culled animals from400 heifers at the breeding stationwere examined ultrasonography, and whole blood samples were collected. Theultrasonic diagnosed heifers as paraovarian cyst (POC, n=18) associated with genital pathological conditionswere compared with groups of control heifers at follicular(n=6), luteal (n=6), and early pregnant (n=10). The POC appeared as anechoic circumscribed masses located nearby, but separated from the ovary. Follicular number, corpus luteum size, serum cell-free RNA, and ovarian steroids were not affected by POC, although dominant follicle size tended to be lower (P= 0.069)in POC withCL absence (POC-CL). Heifers with POC-CLhad lower MDA levels than pregnant ones. Buffaloes that had POC in the presence of CL (POC+CL) were found to have higher SOD activity than luteal and pregnant cases. Total serum proteinslevels recorded lower valuesin POC+CL compared to that in follicular phase. There was a significant positive relationship between POCsize, and GPx activity and CL size, but negative correlations with dominate follicles size. The POC might interfere with ovarian function, via alterations in antioxidant levels.

Apparently healthy mares with conception failure or embryonic loss may have subclinical endometritis (SE). Our objective was to document evidence of systemic immune responses against SE in mares. In apparently healthy (control) mares as well as those with chronic endometritis (ChE) or subacute suppurative endometritis (SSE), both considered classes of SE, serum concentrations of cytokines (IL-1β, IL-6, IL-10 and TNF-α), chemokines (IL-8), acute phase protein (SAA), and plasma concentrations of prostaglandins (PGF2α and PGE2) were measured using validated enzyme linked immunoassays (EIA). Mixed-breed mares of known reproductive history, were used. Based on an endometrial cytological examination, mares were allocated into the following groups: healthy (control), ChE, and SSE (12, 26 and 11 mares, respectively). Serum concentrations of IL-6, IL-8 and IL-10 and plasma PGF2α concentrations were increased (P

This study aimed at evaluating the litter size influence on fetal growth (marked by biparietal diameter), steroid hormones (estradiol and progesterone), oxidative stress markers [Total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), Glutathione peroxidase (GPx), and malondialdehyde (MDA)], total proteins, and serum-free RNA. Goats (n=150) were blood sampled and assessed ultrasonographically during the mid-stage of pregnancy (6th to 14th week) and were classified into non-pregnant (n=64), single (n= 55) twine (n= 25), and triple (n= 6) pregnancy according to a number of feti. The correlation coefficient of caprine fetal growth was R² = 0.9609, 0.9418, and, 0.928 in single, twin, and triple feti, respectively. The area under the curve of the fetal growth was 286.2, 282.1, and 263.4 for single, twin, and triple caprine fetuses. The mean reduction rate in fetal growth compared to singleton pregnancy was 1.65±1.03 and 8.32±2.41 % in twine and triple feti, respectively. Estradiol significantly (P< 0.05) decreased, while progesterone (P< 0.01) and serum-free RNA (P< 0.001) increased in pregnant animals compared to non-pregnant. TAC and MDA increased in multiple pregnancies compared to non-pregnancy in association with the decrease of SOD and catalase activities. GPx activity and total proteins substantially decreased in triple pregnancy than non-pregnancy. Cell-free RNA negatively correlated with estradiol, CAT, GPx, and total proteins, and positively correlated with P4, TAC, and MDA. In conclusion, litter size greatly impacted fetal growth, maternal steroids, and serum-free RNA, and preload to oxidative stressmediated health disorders in pregnant goats.

SummaryThis study aimed to compare the expression of genes regulating follicles development, survival and steroid hormones secretion in oocytes and granulosa cells (GCs) and study the correlation between their expression and follicular fluid (FF) levels of progesterone (P4) in pregnant and non-pregnant camels. In total, 138 ovarian pairs from slaughtered camels were used. Gene expression and hormonal assay were determined using real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The obtained results revealed that the number of follicles (3–8 mm) was significantly (P < 0.05) lower in pregnant, compared with non-pregnant, camels. P4 level in the FF was significantly (P < 0.05) higher in pregnant, compared with non-pregnant, camels. However, no significant (P > 0.05) difference was noticed in the oestradiol (E2) level. STAR, PTEN, IGF1 and BCL2 mRNA levels were significantly higher in GCs and significantly lower in oocytes of pregnant, compared with non-pregnant, camels. However, follicle-stimulating hormone receptor (FSHR) mRNA level was significantly lower in GCs and oocytes, and the BMP15 mRNA level was significantly lower in oocytes of pregnant, compared with non-pregnant, camels. P4 level in FF was positively correlated with STAR, PTEN, IGF1 and BCL2 mRNA levels in GCs and negatively correlated with BMP15 mRNA levels in oocytes and FSHR mRNA levels in GCs and oocytes of pregnant camels. It could be concluded that pregnancy-induced variations in oocytes and GC expression of BMP15, IGF1, FSHR, STAR, BCL2, and PTEN genes might be associated with a decrease in the number of follicles and an increase in the FF level of P4.

Fresh semen from fifty bulls was evaluated for ejaculate volume, individual motility, concentration, lives sperm and abnormalities as well as acrosome integrity. Bulls were classified according to semen motility into two groups; good and poor. DNA was extracted from semen of both groups, then the PCR followed by single-strand conformation polymorphism (SSCP) techniques were performed for mutation detection in gonadotropin releasing hormone receptor (GnRHR) gene through multiple sequence alignment. The results showed that the percentages of sperm motility, sperm concentration and live sperm, were significantly higher in good than poor semen quality bulls. However, semen volume, percentage of acrosome integrity and abnormalities did not differ between good and poor. The PCR amplification of 240-bp fragment and the results of SSCP appeared a genetic polymorphism with two patterns. Pattern I was seen in all good bulls, with incidence of 100%. Pattern II appeared only in poor semen quality bulls with a frequency of 31.25%. The sequence analysis of the PCR product for the two patterns showed two single nucleotide polymorphisms (SNPs) as a transversion base substitution mutation at positions 20 (T/A) and 193 (A/T). The GnRHR gene could be used as a genetic marker related to semen quality in buffalo due to the good semen bulls had a unique pattern.

Supplementation of maturation media with antioxidant (bulk form) improves oocyte maturation. However, the influence of adding antioxidant (nano-particles) on oocyte maturation is not well known. We aimed to evaluate the effect of selenium nano-particles (SeNP) and bulk selenium (Se) on buffalo oocytes maturation, in terms nuclear maturation and molecular level. Oocytes were distributed into four groups; 1st group was control, 2nd group was supplied with Se (10 ng/ml), 3rd and 4th groups were supplied with 1 µg/ml SeNP (67 nm), and SeNP (40 nm), respectively. Matured oocytes were fixed and stained to determine nuclear maturation. Oocytes and COC after IVM were stored at − 80 °C, for RNA isolation and qRT-PCR for selected genes. The Se and seNP (40 nm) had a positive effect on oocytes nuclear maturation rates. Apoptosis-related cysteine peptidase (CASP3) was reduced in all supplemented groups. Anti-Mullerian hormone (AMH) was up-regulated in oocytes supplemented with SeNP (40 nm). In COC, AMH increased in group supplemented with SeNP (67 nm). In oocytes, phospholipase A2 group III (PLA2G3) decreased in all supplemented groups. While in COC, PLA2G3increased in group supplied with Se. In COC, luteinizing hormone/choriogonadotropin receptor (LHCGR) increased in groups supplied with Se or SeNP (40 nm).Glutathione peroxidase 4 (GPX4) increased in all supplemented groups, in oocytes and COC. In oocytes, superoxide dismutase (SOD) was up-regulated in supplemented groups {Se and SeNP (67 nm)}.The DNA methyltransferase (DNMT) in oocytes was reduced in supplemented groups. In oocytes, the POU class 5 homeobox 1 (OCT4) increased in all supplemented groups. In COC, the OCT4 was over-expressed in group supplemented with SeNP (40 nm). Selenium supplementation in bulk or nano-particle improved in vitro buffalo oocytes maturation, viaup-regulation of antioxidant defense and development competence genes. SeNP (smaller size, 40 nm) induced higher expression of antioxidant gene.

A better understanding of the molecular mechanisms in granulosa cells (GC) is warranted, during different follicular and luteal developmental stages in buffalo cows. We aimed to (I) study the expression of selected genes in GC during follicular and luteal phases, (II) evaluate correlations between GC gene expression and steroid concentrations {17-beta estradiol (E2) and progesterone (P4)} in follicular fluid (FF), and (III) study effect of ovarian status on follicular population as well as follicular size frequency. Ovaries were collected in pairs from buffaloes (n = 178). Ovaries bearing corpus luteum (CL) were subdivided into hemorrhagic, developing, mature, and albicans. Follicles from luteal groups were classified only into small (

Cryptosporidium is an apicomplexan parasite of human and animals and is considered as an important co-factor in neonatal diarrhea. In this study, an explant culture was used as an in vitro model of buffalo intestine to evaluate the effect of Moringa leaves extract on Cryptosporidium parvum (C. parvum) oocysts using light and scanning electron microscopy and measuring IFN-γ, IL-12 and IL-14 in the culture supernatants. C. parvum oocysts were collected from naturally-infected calf feces, isolated, excysted and then co-inoculated with ileal tissue explants culture medium. The prepared Moringa leaves extract was then introduced to the infected tissues in the concentrations of 100 mg/ml and 300 mg/ml. After 24 h, tissues were collected and processed for light and scanning electron microscopy. Also, culture supernatants were collected for cytokines measurement. C. parvum parasitophorous vacuoles were found attached to the surface of tissue in Cryptosporidium-infected ileal tissue explants. High magnification imaging of ileal tissue explants using scanning electron microscopy showed that Moringa leaves extracts had a great effect on Cryptosporidium-infected ileal tissue explants. There was a high significant (P

Objective: To evaluate the teratogenic effects of clarithromycin on developing rabbit.Design: Randomized controlled study.Animals: Twenty one female New Zealand rabbits. Procedure: The pregnant female rabbits (21) were allocated into 4 groups. Control group (G1) (6 rabbits) received placebo. Other groups received clarithromycin (at a dose of 30 mg/kg b.wt orally) for ten days during the first stage (group2, n=6), the second stage (group3, n=6) or the third stage (group 4, n=3) of pregnancy. Three rabbits from each group were slaughtered on 20th and 30th days of pregnancy. Teratogenic effects were evaluated morphologically and histopathologically. Results: The therapeutic dose of clarithromycin exhibited morphological malformations, significant decrease (P≤0.05) in viable foeti mean, the mean values of the body weight and the fetal crown-rump length. However there was significant increase (P≤0.05) in dead foeti, fetal resorption rate, pre and post-implantation death in different stages of pregnancy. Visceral fetal abnormalities revealed dilatation of lateral ventricles of brain, thickening of the ventricular wall of the heart, and slight unilateral or bilateral widening of the renal pelvis. Skeleton fetal malformations showed incomplete ossification of 5th sternipri with absence of last ribs. Histopathological examination confirm teratogenic effects of clarithromycin. Conclusion and clinical relevance: The use of clarithromycin during pregnancy should be prohibited.

So far the intimate link between serum microRNA (miRNA) and uterine inflammation in mares is unknown. We aimed (I) to investigate expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 (II) and to measure concentrations of interleukin 6 (IL-6), and prostaglandins (PGF2α and PGE2) in serum of mares with healthy and abnormal uterine status (endometritis). This study was conducted on 80 Arabian mares: young (4–7 years), and old (8–14 years). Mares were divided into 48 sub-fertile (endometritis) and 32 fertile (control) at stud farms. Serum was collected for measuring IL-6, PGF2α, and PGE2, as well as miRNA isolation and qRT-PCR. Concentrations of IL-6, PGE2, and PGF2α were higher in mares with endometritis compared to control. Age of mares had a remarkable effect on IL-6, PGE2, and PGF2α concentrations. Relative abundance of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 was higher in both young and old mares with endometritis. We noticed that eca-miR-155, eca-miR-223, eca-miR-200a, and eca-miR-205 revealed higher expression level in old than young mares with endometritis. This is the first study that has revealed the changes in cell free miRNA and serum inflammatory mediators during endometritis, and these findings could be used for a better understanding the pathophysiology mechanisms of endometritis in equine.

Background: So far the intimate link between serum microRNA (miRNA) and uterine inflammation in mares is unknown. We aimed (I) to investigate the expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 (II) and to measure the concentrations of interleukin 6 (IL-6), and prostaglandins (PGF2α& PGE2) in serum of Arabian mares with healthy and abnormal uterine status (endometritis).Methods and Results: This study was conducted on 80 Arabian mares; young (4-7 years), and old (8-14 years). These animals were divided into 48 sub-fertile including 16 young and 32 old mares suspected of endometritis and 32 fertile as control (24 young and 8 old) at stud farms. Serum samples were collected for measuring IL-6, PGF2α, and PGE2 concentrations, as well as serum miRNA isolation and qRT-PCR. Serum concentrations of IL-6, PGE2, and PGF2α were higher (P≤0.001) in mares with endometritis (young and old) compared to the control ones. Age of mares had a remarkable effect(0.001≤P≤0.01) onIL-6, PGE2, and PGF2αconcentrations. The relative abundance of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 was higher (P≤0.001) in both young and old mares with endometritis. We noticed that eca-miR-155, eca-miR-223, eca-miR-200a, and eca-miR-205 revealed higher (0.001≤P≤0.01) expression level in old than young mares with endometritis. Conclusions: To the best of our knowledge, this is the first study revealed that serum miRNA and serum inflammatory mediators (IL-6, PGE2, and PGF2α) could be used as non-invasive gold standard biomarkers, and therefore might be served as an important additional diagnostic tool for endometritis in Arabian mares.

We aimed (I) to simulate an in vivo milieu, through establishing an in vitro paradigm to study sperm-oviductal interactions using different segments of oviduct, as well as different incubation media, and (II) to investigate spatial changes of oviductal gene expression. Two experiments were designed; one was to investigate the yield of oviduct aggregates from different oviduct segments; in the second experiment, we observed effects of different incubation media on sperm-oviductal binding. Oviduct cell pellets before (control) and after sperm binding were collected for RNA isolation and gene expression. Isthmus resulted in a higher aggregate yield and possessed the highest affinity towards spermatozoa. The different segments of oviduct showed clear changes in gene expression after sperm binding. TALP medium promoted formation of a higher number of oviduct aggregates towards spermatozoa. Different media resulted in profound alterations in isthmus gene expression. Collectively, isthmus segment in TALP media showed the highest binding affinity to spermatozoa. At the molecular level, our in vitro model was successful for simulation in vivo milieu. Thus, our findings could be used as a simple tool to gain more insights into the molecular regulation of sperm movement, selection and affinity for oviductal binding in buffaloes.

We review the child-friendly and family-centered approaches to conducting pediatric sleep studies. While the majority of sleep laboratories are geared toward adults, there is a need and opportunity to offer pediatric services. Sleep laboratories that can accommodate children are better positioned to attract a broad range of new referrals. In this chapter, we discuss indications for pediatric polysomnography (PSG), implementation of a family-centered approach, how to prepare a sleep lab for children, engaging children and families with the PSG procedure, and pediatric-specific strategies for success and delivery of high-quality care. Experience and evidence-based recommendations about policies and procedures; equipment and sensors; atmosphere, staff training, and the importance of preparation are also included. With these tools and strategies for success, a sleep laboratory can provide “best practice” care for the pediatric patient and optimize patient experience.

STUDY OBJECTIVES: Because existing data investigating obstructive sleep apnea (OSA) and insulin resistance (IR) are inconsistent, we examine OSA and IR in a pediatric obesity clinic. METHODS: Children (2–18 years) in the obesity clinic (2013–2017) undergoing polysomnography (PSG), anthropometric measurements, and fasting laboratory tests were included. Linear regression assessed OSA defined by the obstructive apnea-hypopnea index (oAHI) with the homeostatic model assessment of insulin resistance (HOMA-IR). Secondary aims assessed oxygen desaturation index (ODI) and age interactions with HOMA-IR. Logistic regression models and receiver operating characteristic analysis were performed to investigate optimal oAHI and ODI cutoffs relative to HOMA-IR ≥ 3. RESULTS: Eighty children were included (mean age, 11.4 ± 4.0 years; 56% female; 46% Caucasian; median body mass index [BMI], 34.6 kg/m(2) [interquartile ratio, 29.9–40.1], median BMI z-score, 2.5 [interquartile ratio, 2.3–2.8); 46% with oAHI ≥ 5 events/h. HOMA-IR was higher in the OSA group (oAHI ≥ 5 events/h): 5 vs 3.8 (P = .034). After adjustment for sex, race, and BMI z-score, oAHI ≥ 5 events/h retained significance with HOMA-IR (P = .041). HOMA-IR increased in older children (age ≥ 12 years) when adjusting for waist circumference z-score and waist-height ratio (statistical interaction, P = .020 and .034, respectively). Receiver operating characteristic showed optimal cut points of oAHI and ODI for predicting significant IR 4.9 (area under the curve, 0.70; 95% confidence interval, 0.57–0.83; sensitivity, 0.76; specificity, 0.66) and 4.6 (area under the curve, 0.68; 95% confidence interval, 0.55–0.80; sensitivity, 0.70; specificity, 0.67), respectively. CONCLUSIONS: In a clinic-based pediatric cohort with obesity, OSA is associated with increased IR even after adjusting for confounders including obesity defined by the BMI z-score. Age ≥ 12 years was associated with AHI relative to IR after adjustment for waist circumference z-score and waist-height ratio. Significant IR could be discriminated by oAHI ≥ 4.9 with moderate sensitivity/specificity. Future studies are needed to verify these findings. CITATION: Siriwat R, Wang L, Shah V, Mehra R, Ibrahim S. Obstructive sleep apnea and insulin resistance in children with obesity. J Clin Sleep Med. 2020;16(7):1081–1090.

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.

Ameloblastic carcinoma (AC) is an extremely rare malignant odontogenic tumour arising from odontogenic epithelium. It was classified into primary type and secondary type. A previous study revealed that primary ameloblastic carcinoma cases were associated with more favourable prognosis than secondary cases. The aim of the present work was: to report the clinical, histopathological, immunohistochemical, and ploidy status, and therapeutic details of four cases of primary AC, and to review the literature with regard to clinical, follow-up, prognosis, histopathological, and immunohistochemical information of primary AC. The Medline database was searched using the term ameloblastic carcinoma and primary type. The review of English literature revealed that primary ameloblastic carcinoma favours the posterior mandible with profound male predilection and appears as an ill-defined radiolucency. Metastasis and invasion are more likely to occur in maxillary cases. The treatment of choice is wide surgical resection with or without cervical lymph node dissection. Adjuvant postoperative radiotherapy is beneficial in incomplete resection cases and advanced soft tissue invasion. The most specific diagnostic methods of AC, as concluded from review, are α-SMA in epithelial cells in conjunction with Ki-67 index value and SPF more than 11.5%.

A total of 138 pairs of slaughterhouse ovaries were collected from pregnant (n = 46) and non-pregnant (n = 92) she-camels. Oocytes (n = 150) and related granulosa cells (GCs) were retrieved from the growing follicles (3–8 mm) to study the effect of pregnancy status on the expression pattern of genes regulating follicles population and follicular fluid (FF) levels of estrogen (E2) and progesterone (P4). The mRNA fold changes of STAR, PTEN, and BCL2 genes were greater (p

This preliminary study investigated the tolerability and efficacy of a novel mattress technology-the Sound-To-Sleep (STS) system-in the treatment of sleep problems in children with autism.After screening, 45 children, ages 2.5 to 12.9 years, were randomized to order of mattress technology use (On-Off vs. Off-On). Treatment conditions (On vs. Off) lasted two weeks with immediate crossover. Tolerability, including study discontinuation and parent-report of mattress tolerance and ease of use, was tracked throughout the study. Efficacy assessments were obtained at baseline, prior to crossover, and end of study and included measures of autism traits, other psychopathology symptoms, sensory abnormalities, communication difficulties, quality of life, sleep diary parameters, and single-blinded actigraphy-derived sleep parameters. Statistical analyses evaluated differences in tolerability and efficacy when the STS system was on versus off.STS system use was well tolerated (n = 2, 4.4% dropout) and resulted in parent-reported sleep quality improvements (STS off mean = 4.3, 95% CI = 4.05-4.54 vs. on mean = 4.9, 95%CI = 4.67-5.14). The technology was described by parents as very easy to use and child tolerance was rated as good. Parent-diary outcomes indicated improvements in falling asleep and reduced daytime challenging behavior. Actigraphy-derived sleep parameters indicated improved sleep duration and sleep efficiency. Improvements in child and family quality of life were identified on parent questionnaires.A future large sample phase 2 trial of the STS system is warranted and would benefit from extended study duration, an objective primary efficacy outcome, and careful attention to methodological issues that promote compliance with the intervention and study procedures.

This chapter illustrates the impact of sleep disorders in pregnancy by demonstrating a case of obstructive sleep apnea (OSA) associated with preeclampsia. Maternal-fetal health complications are well documented in association with maternal OSA. OSA in pregnancy is a risk for preeclampsia, eclampsia, gestational hypertension, and gestational diabetes mellitus. A growing body of literature supports the importance of detection and diagnosis of OSA in pregnant women. Pregnancy-related complications may be mitigated by OSA treatment. Treatment with continuous PAP therapy is well tolerated in pregnancy and can be offered during pregnancy. Further investigation is needed to understand the effects of treatment on outcomes in pregnancy.

Introduction Narcolepsy is a central disorder of hypersomnia with a bimodal peak incidence at ages 15 and 35. Onset in early childhood has been reported, but rarely under the age of 5. We present a case of Narcolepsy Type 1 in a 2.5-year-old with dropping spells. Report of case(s) A 2.5-year-old African American healthy male presented with acute onset sudden drops, unsteady gait, and staring spells. These episodes lasted a few seconds, occurred multiple times a day, and were associated with eye fluttering and dysarthric speech. History was notable for increased daytime sleep/sleep attacks, disrupted nocturnal sleep with confusional arousals, nightmares and sleepwalking, weight gain and mood instability with aggressive behavior. No preceding head injury or illness. Physical examination demonstrated frequent atonic episodes with loss of deep tendon reflexes. A clinical suspicion of myoclonic/atonic epilepsy prompted video- electroencephalogram (EEG) which showed frequent bursts of generalized intermittent slowing representative of NREM 1 sleep lasting several seconds. Magnetic resonance imaging of the brain and infectious workup was unremarkable. Cerebrospinal fluid (CSF) Orexin was Conclusion This case demonstrates an unusual presentation of Narcolepsy Type 1 in a toddler initially thought to have epilepsy. Video-EEG and low CSF orexin led to the diagnosis. His age, severity of cataplexy, mood changes, and parental concerns made treatment challenging. Furthermore, this case highlights the importance of early recognition of Narcolepsy in young children to provide appropriate treatment during critical developmental stages. Support (if any)

Background: Nitric oxide (NO) is a potent vasodilator synthesized by the vascular endothelium. It has been reported that endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphism is associated with coronary artery disease (CAD). Methodology: In this study, we investigated Glu298Asp eNOS polymorphism and serum NO in a group of 146 age-matched male subjects; 77 patients with coronary artery disease (CAD) classified according to the severity of coronary insufficiency and 69 normal male controls. Results: The obtained frequencies of the eNOS Glu298Asp genotypes for the CAD subjects were GG (54.5%), GT (31.20%), and TT (14.3%). The allele distributions of G and T were 70.1 and 29.9%, respectively. In the control group, the genotype frequencies were 53.6% for GG, 36.2% for GT, and 10.2% for TT, and the frequencies of the G and T alleles were 71.7% and 28.3%, respectively. There were no significant differences in genotype and allele frequencies between the CAD patients and the control group. The mean serum NO levels in CAD patients was significantly higher than that of healthy subjects (p=0.0139). Conclusion: No significant association was detected when CAD severity, genotypes and NO serum levels were correlated.

Background Clinical and subclinical endometritis are known to affect the fertility of dairy cows by inducing uterine inflammation. We hypothesized that clinical or subclinical endometritis could affect the fertility of cows by disturbing the molecular milieu of the uterine environment. Here we aimed to investigate the endometrial molecular signatures and pathways affected by clinical and subclinical endometritis. For this, Holstein Frisian cows at 42–60 days postpartum were classified as healthy (HE), subclinical endometritis (SE) or clinical endometritis (CE) based on veterinary clinical examination of the animals and histological evaluation the corresponding endometrial biopsies. Endometrial transcriptome and miRNome profile changes and associated molecular pathways induced by subclinical or clinical endometritis were then investigated using GeneChip® Bovine Genome Array and Exiqon microRNA PCR Human Panel arrays, respectively. The results were further validated in vitro using endometrial stromal and epithelial cells challenged with subclinical and clinical doses of lipopolysaccharide (LPS). Result Transcriptome profile analysis revealed altered expression level of 203 genes in CE compared to HE animals. Of these, 92 genes including PTHLH, INHBA, DAPL1 and SERPINA1 were significantly upregulated, whereas the expression level of 111 genes including MAOB, CXCR4, HSD11B and, BOLA, were significantly downregulated in CE compared to the HE animal group. However, in SE group, the expression patterns of only 28 genes were found to be significantly altered, of which 26 genes including PTHLH, INHBA, DAPL1, MAOB, CXCR4 and TGIF1 were common to the CE group. Gene annotation analysis indicated the immune system processes; G-protein coupled receptor signaling pathway and chemotaxis to be among the affected functions in endometritis animal groups. In addition, miRNA expression analysis indicated the dysregulation of 35 miRNAs including miR-608, miR-526b* and miR-1265 in CE animals and 102 miRNAs including let-7 family (let-7a, let-7c, let-7d, let-7d*, let-7e, let-7f, let-7i) in SE animals. Interestingly, 14 miRNAs including let-7e, miR-92b, miR-337-3p, let-7f and miR-145 were affected in both SE and CE animal groups. Further in vitro analysis of selected differentially expressed genes and miRNAs in endometrial stroma and epithelial cells challenged with SE and CE doses of LPS showed similar results to that of the array data generated using samples collected from SE and CE animals. Conclusion The results of this study unraveled endometrial transcriptome and miRNome profile alterations in cows affected by subclinical or clinical endometritis which may have a significant effect on the uterine homeostasis and uterine receptivity. Electronic supplementary material The online version of this article (doi:10.1186/s12864-016-2513-9) contains supplementary material, which is available to authorized users.

Accumulating data implicate obstructive sleep apnea (OSA) as a predisposing factor to the development of atrial fibrillation (AF), the latter representing the most common sustained cardiac arrhythmia. The postulated mechanisms leading to atrial arrhythmogenesis in OSA include alterations in intrathoracic pressures, intermittent hypoxemia, and autonomic nervous system fluctuations. Although these OSA-related pathophysiologic pathways may result in atrial structural and electrical remodeling, thereby predisposing to AF, there are data to suggest that the immediate influences of respiratory events may trigger arrhythmic events. This case demonstrates an immediate reversal of AF to normal sinus rhythm with optimal continuous positive airway pressure (CPAP) therapy in the background of severe OSA. These findings of immediate benefit of reversal of OSA pathophysiology on cardiac arrhythmia suggest OSA may have acute influences on cardiac electrophysiology.

The dynamic changes across pregnancy affect sleep and wakefulness producing sleep disturbances, which causes sleep disorders in some cases. This review will identify common sleep disorders in pregnancy, related maternal-fetal outcomes, pathophysiologic mechanisms, and potential therapies to guide clinicians in serving this population.

Introduction: Primordial odontogenic tumors are a rare recently described mixed odontogenic tumor composed histopathologically of dental papilla like tissue and enamel organ like tissue. Only nine cases have been documented worldwide and we are reporting the tenth case which is from Egypt. Clinical finding: A 2-year-old Egyptian boy that presented with an asymptomatic swelling of the mandible which appeared with multilocular radiolucency associated with an impacted developing tooth on a computerized tomography (CT) scan. Diagnoses, interventions, and outcomes: The lesion was excised and diagnosed as a primordial odontogenic tumor. The patient was followed up for two years with no recurrence. Conclusion: Differentiation of primordial odontogenic tumors from other odontogenic tumors, which resemble it histopathologically is crucial to avoid unnecessary aggressive treatment.

In the present study, we used an in vitro model to investigate the response of the oviduct with respect to inflammatory mediators and their regulatory microRNAs in case of bacterial infection and subsequent association with embryo survival. For this, we conducted two experiments. In the first experiment, cultured primary bovine oviductal cells (BOEC) were challenged with lipopolysaccharide (LPS) for 24h and the temporal expression pattern of inflammatory mediators and their regulatory microRNAs were measured at 0, 3, 6, 12, 24 and 48h after LPS treatment. Intriguingly, the temporal patterns of all miRNAs except miR-21 were significantly up-regulated at 6h after LPS treatment. Whereas, we observed significant overexpression of pro-inflammatory mediators as tumor necrosis factor alpha (TNFα) and interleukin-1 beta (IL1β) after LPS challenge for 24h. On the other hand, the expression level of essential elements like oviductal glycoprotein 1 (OVGP1) and insulin-like growth factor 2 (IGF2) was significantly decreased in challenged groups compared with control. Moreover, miR-155, miR-146a, miR-223, miR-21, miR-16 and miR-215 have shown a clear suppression in challenged group after LPS treatment. In the 2nd experiment there were four groups of blastocysts produced, namely embryo+LPS free media, embryo+LPS, BOEC+embryo and BOEC+embryo+LPS. The suboptimal oviduct environment due to LPS challenge is found to have a significant influence on the expression of inflammatory response genes (TNFα and CSF1), stress response genes (SOD and CAT), mitochondrial activity, reactive oxygen species (ROS) accumulation and apoptotic level either in cultured or co-cultured blastocysts. Collectively, LPS challenge led to aberrant changes in oviductal transcriptome profile, which could lead to a suboptimal environment for embryo development.

An impaired uterine environment triggered by the incidence of subclinical endometritis often compromises fertility in the bovine. The uterus is a dynamic organ with tight regulation of specific genes at the transcriptional and translational levels. Herein, we hypothesised that subclinical endometritis alters the expression of uterine microRNAs (miRNAs), which may result in the dysregulation of corresponding target genes and biological pathways. To test this hypothesis, we used a genome-wide RT2 (Exiqon, Vedbaek, Denmark) miRNA PCR array consisting of 354 miRNA primers and analysed miRNA expression in uterine cytobrush samples taken from cows with and without subclinical endometritis. The results revealed aberrant expression of 23 miRNAs in cows with subclinical endometritis compared with healthy cows. Furthermore, we designed an in vitro endometrial cell culture model challenged by lipopolysaccharide (LPS) to validate the differential regulation of miRNAs in cytobrush samples. Interestingly, we observed similar expression miRNA patterns in cytobrush samples taken from cows with or without subclinical endometritis and in vitro cultured endometrial cells challenged by LPS. To trace signalling pathways and biological functions potentially controlled by the aberrantly expressed miRNAs, we filtered high-ranking target genes from miRBase and analysed them using ingenuity pathway analysis. The gene networks, canonical pathways and biological functions strikingly converged to signalling pathways that mediate inflammatory responses, cellular proliferation, cell movement, the cell cycle and apoptosis in the bovine endometrium. In addition, expression analysis of key genes from the gene networks confirmed their presence and the potential regulation of these genes by uterine miRNAs. Furthermore, luciferase assay data substantiated the primary information from bioinformatic prediction that generated potential target genes for the dysregulated miRNAs in subclinical endometritis. Together, these data suggest the potential regulatory role of uterine miRNAs in the development and progression of bovine subclinical endometritis.