Foot-and-mouth disease-associated myocarditis is age dependent in suckling calves.

Myocarditis is considered a fatal form of foot-and-mouth disease (FMD) in suckling calves. In the present study, a total of 17 calves under 4 months of age and suspected clinically for FMD were examined for clinical lesions, respiratory rate, heart rate, and heart rhythm. Lesion samples, saliva, nasal swabs, and whole blood were collected from suspected calves and subjected to Sandwich ELISA and reverse transcription multiplex polymerase chain reaction (RT-mPCR) for detection and serotyping of FMD virus (FMDV). The samples were found to be positive for FMDV serotype "O". Myocarditis was suspected in 6 calves based on tachypnoea, tachycardia, and gallop rhythm. Serum aspartate aminotransferase (AST), creatinine kinase myocardial band (CK-MB) and lactate dehydrogenase (LDH), and cardiac troponins (cTnI) were measured. Mean serum AST, cTn-I and LDH were significantly higher (P < 0.001) in < 2 months old FMD-infected calves showing clinical signs suggestive of myocarditis (264.833 ± 4.16; 11.650 ± 0.34 and 1213.33 ± 29.06) than those without myocarditis (< 2 months old: 110.00 ± 0.00, 0.06 ± 0.00, 1050.00 ± 0.00; > 2 months < 4 months: 83.00 ± 3.00, 0.05 ± 0.02, 1159.00 ± 27.63) and healthy control groups (< 2 months old: 67.50 ± 3.10, 0.047 ± 0.01, 1120.00 ± 31.62; > 2 months < 4 months: 72.83 ± 2.09, 0.47 ± 0.00, 1160.00 ± 18.44). However, mean serum CK-MB did not differ significantly amongst the groups. Four calves under 2 months old died and a necropsy revealed the presence of a pathognomic gross lesion of the myocardial form of FMD known as "tigroid heart". Histopathology confirmed myocarditis. This study also reports the relevance of clinical and histopathological findings and biochemical markers in diagnosing FMD-related myocarditis in suckling calves.

Evaluation of different antigenic preparations against necrotic enteritis in broiler birds using a novel Clostridium perfringens type G strain.

OBJECTIVE: Keeping in view, the constraints faced by the Indian broiler industry with lack of a suitable vaccine against Necrotic Enteritis (NE), a study has been proposed to explore the prevalence and detail characterization of C. perfringens type G in NE suspected broiler chicken in the process of suitable vaccine development. METHODS: Intestinal scrapings/faecal contents of NE suspected broiler chickens were screened to establish the prevalence of C.perfringens type G in broiler birds. A most pathogenic, highly resistant type G isolate of C. perfringens, bearing both tpeL and gapC gene was selected for preparation of three different vaccine formulations, and to evaluate their immunogenic potential in broiler birds. RESULTS: Screening of clinical samples of NE suspected broiler birds revealed C. perfringens type G, bearing gapC gene in 51.22% samples, of which 47.62% revealed tpeL gene. Seven of the tpeLpos type G isolates were comparatively more pathogenic for mice, of which, one exhibited multidrug resistance towards ciprofloxacin, norfloxacin, tetracycline and levofloxacin. The sonicated supernatant (SS) prepared from the selected tpeL and gapC positive isolate could maintain a significantly higher protective IgG response than toxoid and bacterin preparation from the 21st to 28thday of age in immunized birds. CONCLUSION: The additional TpeL toxin in C. perfringens type G has been proved to be an additional key biological factor in the pathogenesis of NE in broiler chickens. Considering the release of more immunogenic proteins, the SS proved to be a better immunogenic preparation against NE with a multiple immunization dose.

Regulatory Requirements for Quality Control of Unani Medicines.

Compliance with pharmacopeial standards is mandatory to ensure the quality, safety, and efficacy of medicines. In India, allopathy, Ayurveda, Siddha, Unani, and homeopathy are the recognized systems of medicine and come under the provisions of different regulations. Promulgation of the "Drugs and Cosmetics Act, 1940" and the rules thereunder provide a regulatory framework for medicines of all of these systems and also prescribe "Pharmacopoeia and Formularies" for regulatory quality standards. Unlike in many other countries, the Act prescribes independent pharmacopeias for each system of medicine. The Unani Pharmacopoeia of India (UPI) and the National Formulary of Unani Medicine are the regulatory compendia for quality standards and manufacturing of Unani medicines, respectively. The Pharmacopoeia consists of Part I (single drugs) and Part II (formulations). Unani medicines are presented as classical or patent and proprietary formulations prepared using single ingredients or multiple ingredients of plant, animal, mineral, and/or metal origin. UPI Part I is published in six volumes comprising 298 monographs on Unani drugs derived from plants (single drugs). Part II is published in three volumes encompassing formulations, standard operating procedures, and quality standards for 150 classical formulations of Unani medicines, which are chosen from the National Formularies of Unani Medicine. The National Formulary of Unani Medicine is published in six parts comprising 1229 formulations of Unani medicines. Each monograph of the Pharmacopoeia provides specific analytical parameters and limits (standards) to ensure the quality of drugs or medicines. This communication reviews the UPI, the National Formulary of Unani Medicine, regulatory quality standards (parameters), and analytical techniques adopted for pharmacopeial standards of Unani drugs and medicines.

Total Knee Arthroplasty in a Diagnosed Case of Deep Vein Thrombosis - Our Experience and Review of Literature.

INTRODUCTION: Deep vein thrombosis (DVT) following total knee arthroplasty (TKA) and its associated complication, pulmonary thromboembolism (PTE) remains a challenge for orthopedic surgeons. There are wide ranges of predisposing factors which are both patient specific as well as procedure associated, responsible for DVT. PTE is a well-known fatal complication of DVT which may be life-threatening. Medical management and early mobilization are necessary for the management of DVT. Fatal PTE can be prevented by implantation of inferior vena cava (IVC) filter in at risk patients. CASE REPORT: We are presenting a rare case report of 75-year-old female with severe osteoarthritis of the left knee with DVT of the left lower limb in which TKA was done in a prediagnosed case of DVT. IVC filter placement was done before TKA for prevention of fatal PTE, and medical management was done for DVT. CONCLUSION: Prevention of fatal thromboembolism is of prime importance in the management of DVT. This can be achieved by implanting IVC filter. TKA is necessary for early pain free mobilization of the patient, which prevents progression of DVT and early recovery. IVC filter placement prevents fatal thromboembolism. Hence, treatment of both osteoarthritis of knee by TKA and DVT can be done simultaneously.

Functional outcome after primary hemiarthroplasty in three or four part proximal humerus fracture: A short term followup.

BACKGROUND: Several modalities of treatment are being used for the management of proximal humerus fractures. Primary hemiarthroplasty in proximal humerus fracture is indicated in three or four part fracture or fracture dislocations. It is also indicated if fracture involves a large area of articular cartilage loss and viability of head is doubtful. We studied the functional outcome of hemiarthroplasty in comminuted proximal humerus fracture. MATERIALS AND METHODS: 29 patients of three or four part proximal humerus fractures, (according to Neer's classification) who underwent primary shoulder hemiarthroplasty were included in this retrospective study. 20 patients were of more than 55 years of age. Functional evaluation based on Constant score and radiological assessment by periodic X-rays were done. All patients were operated in a 'beach chair position'. The lesser and greater tuberosities were dissected with their tendinous attachments and were later reattached to the proximal humerus for stability of the prosthesis. Cemented prosthesis was used in all cases. RESULTS: Three patients died and two patients were lost to followup during the course of the study, so 24 patients were finally included in the study. Mean Constant score was 56.62 (range 42.5-65.5) after mean followup of 18.28 months (range 12-24 months). Mean anterior elevation was 118.2° (range 75°-150°) and mean active abduction was 102°(range 50°-135°). Nineteen patients (79.16%) were satisfied about their functional outcome. Proximal migration of tuberosity was present in four patients. These patients had decreased abduction with impingement. One patient had higher placement of prosthesis and one patient had radiolucency at bone cement interface. There were no heterotopic ossification, dislocation, superficial, or deep infection. CONCLUSION: This study showed that hemiarthroplasty in a grossly comminuted proximal humerus fracture is a viable alternative to osteosynthesis. Tuberosity healing plays a main role in good range of motion and better functional outcome after shoulder hemiarthroplasty.

Periprosthetic fractures after total knee arthroplasty.

PURPOSE: To evaluate outcome in 20 patients treated for periprosthetic fractures after total knee arthroplasty (TKA). METHODS: Records of 14 women and 6 men aged 45 to 85 (mean, 67) years who underwent operative (n=18) or conservative (n=2) treatment for periprosthetic fractures of the supracondylar femur (n=15), patella (n=3), and tibia (n=2) following minor falls (n=18) or high-velocity injury (n=2) were reviewed. The mean time from TKA to fracture was 43 (range, 14-98) months. Of the 15 supracondylar femoral fractures, 2 were managed with immobilisation in a long leg cast, 11 with internal fixation using locked compression plating, and 2 with revision arthroplasty. All 3 patellar fractures were managed with tension band wiring. Both tibial fractures were managed with revision arthroplasty. Radiographic and functional outcomes (the Knee Society scores) were assessed. RESULTS: The mean follow-up was 35 (range, 24-48) months. All fractures healed after a mean of 15 (range, 12-38) weeks. One patient had delayed union. Postoperative alignment was satisfactory in all patients except one (with 5º varus). The mean tibiofemoral angle was 4º valgus. The mean range of motion was 98.5º. The mean Knee Society knee score was 85 (range, 75-89) and the functional score was 76 (range, 70-85). No patient had implant failure, loss of reduction, deep infection, deep vein thrombosis, or pulmonary embolism. CONCLUSION: The locked compression plate is effective in managing periprosthetic femoral fractures. Periprosthetic patellar and tibial fractures are uncommon. The latter often warrant revision arthroplasty owing to the loose implant.

Ligament reconstruction/advancement for management of instability due to ligament insufficiency during total knee arthroplasty: a viable alternative to constrained implant.

BACKGROUND: We aimed to assess the results of ligament reconstruction/advancement for the management of ligament insufficiency during total knee arthroplasty. METHOD: We retrospectively reviewed the results of ligament reconstruction/advancement for management of instability due to ligament insufficiency during total knee arthroplasty (TKA). Between January 2001 and January 2008 collateral ligament reconstruction/advancement was done in 15 patients. Wherever ligament advancement was not possible (mid-substance tear) ligament reconstruction was done using the hamstring tendon. Knee society scores were calculated and Kaplan-Meier survival analysis was done. RESULTS: Average follow-up was 6.2 years. No patient developed instability until the last follow-up, except one patient who required revision due to instability at six years after primary surgery. CONCLUSION: We concluded from this study that ligament reconstruction/advancement during TKA is a viable option to address instability due to ligament insufficiency.

Bilateral Total Hip Arthroplasty in 20 Years Old Female with Neglected Developmental Dysplasia of Hip.

INTRODUCTION: Management of developmental dysplasia of hip in adult is challenging problem. Management protocols are not well defined in terms of operative technique. Patient may present very late. Usually they consult orthopaedic surgeons when osteoarthritic changes set in, leading to pain. Operative management is difficult because of difficult exposure, altered anatomy of soft tissue structures, hypoplastic femoral medullary canal and shallow and atypical acetabulum filled with soft tissues. Femoral head is up-ridden with contracted Abductors which resists reduction of femoral head into acetabulum. Altered anatomy of neurovascular structures also pose a risk of being injured during surgery. CASE REPORT: Here we are presenting a case of bilateral total hip arthroplasty in 20 years old female with developmental dysplasia of hip and sharing our experience of its operative management. CONCLUSION: We concluded from this case study that total hip arthroplasty in developmental dysplasia of hip is technically demanding but gives good functional and clinical result. For getting functionally good result contracted soft tissues around joint need special attention.