Background: Submucous cleft palate is characterized by muscular diastasis of the velum in the presence of intact mucosa with variable combinations of bifid uvula and hard palatal defect. Submucous cleft palate is indicated as a separate entity in most previous classifications but it has never been properly classified on an anatomical basis. Objectives: To revise the Smith-modified Kernahan ‘Y’ classification of cleft lip and palate deformities, and to describe the different anatomical subtypes of submucous cleft palate. Methods: The present study was conducted in Hayatabad Medical Complex, Abasin Hospital and Aman Hospital Peshawar, Pakistan, from November 2010 to December 2011. All patients who presented to the outpatient departments with cleft lip and palate, with the exception of previously operated cases, were included. All cases were described according to the Smith-modified Kernahan ‘Y’ classification and the authors' revised Smith-modified Kernahan ‘Y’ classification. All of the data were organized and analyzed using SPSS version 17 (IBM Corporation, USA). Results: A total of 163 cases of cleft lip and palate deformities were studied, of which 59.5% were male and 40.5% were female. Smith modification of the Kernahan ‘Y’ classification completely described the cleft deformities in 93.9% of patients. However, while the Kernahan ‘Y’ classification represented the submucous cleft palate, it did not describe its different anatomical subtypes in 6.13% of patients. The revised Smith-modified Kernahan ‘Y’ classification completely described the cleft deformities of the entire study population, including the different submucous cleft palate patients. Discussion: The Smith alphanumeric modification of the Kernahan ‘Y’ classification of cleft lip and palate came into existence after a long search and a series of modifications over the past century. This classification system describes the cleft region, site of the cleft, degree of the cleft, rare and asymmetrical clefts, and are computer database friendly. However, this classification did not describe the different anatomical subtypes of submucous cleft palate that have variable relationships with velopharyngeal insufficiency. Conclusion: The revised Smith-modified Kernahan ‘Y’ classification described in the present study can describe all types of cleft lip and palate deformities in addition to the different types of submucous cleft palate deformities.

Objective Pentavalent vaccine has been introduced in Pakistan against tetanus, diphtheria, Haemophilus influenzae type B (HiB), pertussis, and hepatitis B virus. Methods This study was designed to determine protection against diphtheria, tetanus, and HiB in children of age 18 to 24 months from community which had received all three doses of pentavalent vaccine. Results Overall, 97% were having immunity against HiB, 97% against tetanus, and 88% against diphtheria. Our study showed that children aged 18 to 24 months in Pakistan have high level of protection against HiB and tetanus. However, the protection for diphtheria was low in 40% of children which could be improved by adding a booster dose of diphtheria. Conclusion By increasing the vaccine coverage among children, the burden of these diseases can be reduced in the future.

This study determined the interaction between soybean hulls (SHs) and enzymes (β-mannanase) to improve the sustainability and efficacy of feeding programs for laying hens during peak production while ensuring the best health and efficiency. In a completely randomized design (CRD), 200 golden-brown hens were fed for four weeks (33 to 36 weeks) and randomly distributed into four groups, each containing four replicates of ten birds, with one group receiving a control diet (P0) and the others receiving diets that contained four combinations of SHs and enzymes (ENZs). e.g., 3% SHs and 0.02 g/kg ENZs (P1), 3% SHs and 0.03 g/kg ENZs (P2), 9% SHs and 0.02 g/kg ENZs (P3), and 9% SHs and 0.03 g/kg ENZs (P4). Although most egg quality measures remained similar, the P2 group showed enhanced (p = 0.630) egg weight, albumen weight, and height. Moreover, the P2 group improved gut (p < 0.05) shape by increasing villus width, height, crypt depth, and surface area throughout intestinal sections, while the P4 group markedly improved total cholesterol and LDL (p = 0.022) levels. The P1, P2, and P4 groups exhibited a significant enhancement in dry matter (p = 0.022) and crude fiber (p = 0.046) digestibility, while the P2 group demonstrated superior crude protein digestibility (p = 0.032), and the P1 and P2 groups showed increased crude fat digestibility compared to the other groups. In conclusion, adding 3% of SHs and 30 mg/kg of ENZs (β-mannanase) to the feed may help laying hens, enhance gut health and some egg quality indices, and decrease blood cholesterol and LDL levels without compromising nutrient digestibility.

This study investigated the effects of the β-mannanase enzyme and soyhulls on production performance, economics, egg quality, hematology and serum biochemistry, nutrient digestibility, gut morphology, digesta viscosity, and excreta consistency in laying hens during the late peak production phase (37 to 40 weeks of age). Golden brown hens (RIR × Fayoumi; n = 200) were fed a control diet (no soyhulls or enzymes) and diets containing four combinations, i.e., 3% soyhulls with 20 mg/kg β-mannanase (D1), 3% soyhulls with 30 mg/kg β-mannanase (D2), 9% soyhulls with 20 mg/kg β-mannanase (D3), and 9% soyhulls with 30 mg/kg β-mannanase (D4), for four weeks in four replicates of 10 birds each. Overall, a significantly higher (p < 0.05) feed intake, weight gain, feed conversion ratio, and water intake were calculated in the D2 group as compared to the control and remaining combinations of soyhulls and β-mannanase. No mortality was recorded during the entire experiment. Economically, the D1 and D2 groups showed the best results as compared to the D3 and D4 groups. Egg quality parameters like egg weight, shell weight and shell thickness, yolk weight, albumen weight and height, and the Haugh unit remained unchanged (p > 0.05). Similarly, the D2 group showed significantly lower total cholesterol, LDL, and VLDL levels and enhanced gut morphology with greater villus width, height, crypt depth, and surface area across intestinal segments. Crude protein (CP), crude fiber (CF), crude fat, and ash digestibility were higher (p < 0.05) in the D1 and D2 groups compared to the control. Digesta viscosity, excreta consistency, and other egg quality parameters remained unaffected. In conclusion, the dietary inclusion of a combination of 3% soyhulls and 30 mg/kg β-mannanase may have potential benefits for laying hens by improving some production performance and egg quality indicators and economics, lowering blood cholesterol, LDL, and VLDL levels, enhancing nutrient digestibility, and improving gut morphology without affecting egg quality.

This study explored the potential of hemp seed cake (HSC) as an ingredient in broiler chicken diets. The assessment focused on production performance characteristics, carcass weight, dressing percentage (DP), and apparent nutrient retention to determine the overall impact of HSC on broiler performance. Three hundred male broiler chicks (Ross-308, one day old) were distributed into five groups with different percentages of HSC inclusion: 0% (HSC0), 5% (HSC5), 10% (HSC10), 15% (HSC15), and 20% (HSC20), using a completely randomized design (CRD) over 35 days. Each group comprised six replicates, with 10 chicks per replicate (pen). Feed intake (FI) was markedly elevated in the HSC10 group, but body weight gain (WG) and feed conversion ratio (FCR) were considerably enhanced in the HSC5 and HSC10 groups relative to the other groups (p<0.05). Carcass weight and DP were significantly higher in the HSC10 group compared with the other groups. The digestibility of dry matter (DM) and crude fiber (CF) was markedly enhanced in the HSC5 and HSC10 groups, whereas organic matter (OM), crude protein (CP), and apparent metabolizable energy (AME) were higher in the HSC10 group compared with the other groups (p<0.05). Furthermore, the HSC20 group had the lowest ash content compared with the other groups (p<0.05). These results indicate that the inclusion of HSC at 5-10% can enhance growth performance, carcass weight, dressing percentage, and nutrient digestibility in broilers, and thus is an economically viable protein source for poultry.

This study assessed the impact of four stocking densities (14.35, 10.76, 8.61, and 7.18 birds/m²) on the growth performance, carcass characteristics, hematological and serum biochemical indices, and economic efficiency of broilers raised in open-sided housing under natural heat stress (32-38 °C; relative humidity 65-80%). A total of 360 male chicks (Ross-308) were randomly allocated to four treatments, with six replicates of 15 birds each, in a completely randomized design over 35 days. Broilers raised at 8.61 and 7.18 birds/m² showed higher (p<0.05) feed intake and body weight gain than those raised at 14.35 and 10.76 birds/m². Feed conversion ratio was improved in birds provided 8.61 and 7.18 birds/m². Carcass characteristics and cut-up part yields were not significantly affected by stocking density. Hematological analysis revealed higher red blood cell count, hemoglobin, packed cell volume, lymphocyte percentage, and serum protein levels in birds reared at lower densities (8.61 and 7.18 birds/m²). Broilers kept at 14.35 birds/m² had higher levels of heterophils, heterophil-to-lymphocyte ratio, glucose, triglycerides, cholesterol, corticosterone, ALT, AST, and ALP. In terms of economics, 8.61 birds/m² produced the highest net profit and cost-benefit ratio, even though 7.18 birds/m² generated higher overall income. According to these results, under the environmental and management conditions of the present study, 8.61 birds/m² appeared to provide the most favorable balance between growth performance and economic return in broilers raised in open-sided housing during a hot season.