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Very low birth weight (VLBW) neonates present a high risk of metabolic bone disease (MBD). Our main objective was to determine the easiest way to make an early diagnosis of this disease by identifying surrogate biomarkers before any radiological signs occurred. We conducted in our NICU a 6-month observational prospective study, with inclusion of all singleton VLBW neonates. We collected clinical and biological data, and nutritional intakes during hospitalization. We defined biological MBD (bMBD) as alkaline phosphatase (ALP) levels superior to 600 UI/L at day of life 30 (DOL30) and performed a case-control analysis. Nine out of 30 patients (30%) exhibited bMBD. All have extremely low birth weight and were significantly younger in gestational age (GA) and smaller at birth. There was no statistically significant difference in nutritional intake between bMBD and control groups. In the bMBD group, phosphatemia was lower since DOL3. ALP was already significantly higher at DOL15, and way beyond normal range., Conclusions: Our results showed that even the strict respect of nutritional guidelines cannot completely prevent bMBD in high-risk patients and suggest that an early screening from DOL15, with ALP levels greater than 500 UI/L, could be sufficient for detection of upcoming MBD., What Is Known: • Metabolic bone disease of prematurity (MBD) definition is not consensual, but biological changes appear earlier than radiological signs of rickets. • MBD management relies on biological evidence. Treatment is based on phosphate and/or calcium and calcitriol supplementation., What Is New: • Studying phosphocalcic biological assessment in very low birth weight neonates, we showed respect of nutritional guidelines could not protect from biological MBD. • Increase in alkaline phosphatase (ALP), about 500 UI/l at day of life 15, could be a biomarker of MBD with no need of X-ray evaluation and sufficient to begin a treatment to prevent osteopenia., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

A consistently high level of stallion fertility plays an economically important role in modern horse breeding. To better understand the factors affecting variation in stallion fertility, we have performed a statistical analysis study on some breeding factors: year of breeding, stud farm, age of the stallion, number of covered mares per stallion, reproduction methods, and age of the mare. This work was conducted on 94 purebred Arabian stallions in four different regions of Tunisia. The results showed an increase in the number of stallions during the study period, ranging from 11.33% in 2011 to 13.29% in 2018. Sidi Thabet's stud farm contained the highest number of purebred Arabian stallions. The majority of stallions were between 15 and 21 years old and had covered 1 to 20 mares; 95.19% of stallions were used in natural mating (Nat); 50.36% had low fertility, 17.69% had medium fertility, and 32.3% had excellent fertility according to fertility standards. Depending on the year and stud, there was a variation in fertility per cycle (FERPCE) and end-of-season fertility (FERPSE) of the stallions. The highest average FERPCE and FERPSE values were obtained using artificial insemination with fresh semen (AIF). Analysis of FERPCE and FERPSE showed that the model used in our study explained 40.21% of total variability observations for FERPCE and 42.1% for FERPSE. The used statistical model showed that the breeding year, the stud, the age of the stallion, the number of covered mares by stallions and the method of reproduction significantly affected both FERPCE and FERPSE (with p = 0.001). Low to moderate heritability estimations for FERPCE (h s 2 = 0.08) and FERPSE (h es 2 = 0.36) were obtained.

Despite obstetric and pediatric progress, twin pregnancy still represents nowadays a high-risk situation for both pregnancy and childbirth. It still remains a distressing situation for the obstetric team. The aim of this study was to describe the practice of twin pregnancy deliveries in the obstetrics and gynecology department of Sousse, the maternal and fetal prognosis and to analyze the factors that may influence it. A descriptive, retrospective study of twin pregnancies births was conducted over a period of two years. We included twin pregnancies that have reached at least 28 weeks of amenorrhea (SA) and women having a twin pregnancy complicated by fetal death in utero. Women with a twin pregnancy who gave birth before 28 weeks were excluded. Bi-chorionic bi-amniotic pregnancies represented 67% of cases, compared with only 11.5% of mono-chorial bi-amniotic pregnancies and 3% of mono-chorial mono-amniotic pregnancies. A total of 52 patients have scheduled caesareans. Spontaneous labor was noticed in 304 cases, and was initiated in 43 cases. A total of 178 women gave birth by vaginal delivery (44.6%) and 215 by cesarean (53.9%). The cesarean rate for the second twin was 1.5%. When the delivery was vaginal, 19 cases of complications were observed (10.7%). We analyzed the Apgar score of both the first and the second twin according to the mode of delivery. There was no statistically significant difference in the Apgar score between the two delivery routes. Perinatal morbidity and mortality is higher for the second twin than for the first twin. Maternal morbidity was higher in vaginal delivery than cesarean delivery. There are no significant differences in the Apgar score according to whether the infants were born by vaginal delivery or by caesarean., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Chekib Zedini et al.)