MICROFILARIOSIS ASSOCIATED WITH EPISTAXSIS IN A SHE BUFFALO

ABSTRACT The present communication reports a case of microfilariosis in a she buffalo with an unusual sign of epistaxis and its successful clinical management. A she buffalo in its 3 rd lactation was brought to the clinic with a history of profuse bilateral nasal bleeding and swollen udder in the right quarters, reduced appetite and dullness for 4 days. No response to therapy was observed even after 3 days of treatment. The signs aggravated further with haemogalactia, pale conjunctival mucous membranes and edema of the brisket region. Examination of wet blood film revealed no haemoprotozoans. Whole blood examination by modified Knott's method revealed the presence of filarial worms. Hematological examination by standard techniques (Benjamin, 2001) revealed hemoglobin 6 g/dl, PCV 20%, polymorphs 38%, lymphocytes 57%, eosinophils 5%, basophils 0% and monocytes 0%. To alleviate the signs of anemia, blood transfusion was undertaken as a supportive therapy. Blood was collected in 3.8% sodium citrate bottles from healthy donor buffaloes after cross matching and was transfused on the same day 10 ml/kg with continuous monitoring of the patient. On the day following, blood transfusion Inj. Ivermectin was administered 200 μg/kg body weight subcutaneously. Supportive therapy includes intramuscular administration of Inj. Iron dextran 10 ml/day for 3 days and oral haematinic mixture for 10 days

The identification of biophysical parameters which reflect skin status following mechanical and chemical insults

Background : Skin is constantly exposed to mechanical and chemical insults, in the form of prolonged loading, overhydration or exposure to irritants. An array of non-invasive biophysical tools has been adopted to monitor the changes in skin response. The present study aims to identify a set of robust parameters sensitive to mechanical and chemical challenges to skin integrity. Materials and methods: Eleven healthy participants were recruited to evaluate the skin response following mechanical loading, tape-stripping, overhydration and chemical irritation. Forearm skin responses were recorded at baseline and at three time points following the insult. Measurements included transepidermal water loss, sub-epidermal moisture, erythema and laser Doppler imaging. Thresholds were informed by basal values and the sensitivity of parameters to detect skin changes was evaluated. Results: High degree of variability in skin response was observed with selected biophysical parameters, such as sub-epidermal moisture, laser Doppler imaging and erythema, even in the absence of an applied insult. Temporal skin response revealed distinct response profiles during each evoked insult. Indeed, the sensitivity of the biophysical parameters was influenced by the threshold values and time point of measurement. Some statistically significant correlations were determined between the biophysical parameters.Conclusion: The study revealed that thresholds derived from single biophysical parameters were limited in detecting skin changes following insults. A complementary evaluation using combined parameters has the potential to provide a more sensitive assessment. Further research is required to identify robust biophysical parameters, to aid the early detection of skin damage in clinical settings. <br/

Dataset for the biophysical parameter study to support article &quot;The identification of biophysical parameters which reflect skin status following mechanical and chemical insults&quot;

Dataset to support article &quot;The identification of biophysical parameters which reflect skin status following mechanical and chemical insults&quot; in Clin Physiol Funct Imaging. 10.1111/cpf.12707 </span

Spatial and temporal changes in biophysical skin parameters over a category I pressure ulcer

In acute care facilities, the detection of pressure ulcers (PUs) relies on visual and manual examination of the patient's skin, which has been reported to be inconsistent and may lead to misdiagnosis. In skin and wound research, various biophysical parameters have been extensively employed to monitor changes in skin health. Nonetheless, the transition of these measures into care settings as part of a routine clinical assessment has been limited. This study was designed to examine the spatial and temporal changes in skin biophysical parameters over the site of a category I PU, in a cohort of hospitalised patients. Thirty patients, each presenting with a category I PU, were enrolled in the study. Skin integrity was assessed at the PU-compromised site and two adjacent areas (5 and 10 cm away). Data was collected over three sessions to examine both temporal differences and longitudinal changes. Skin integrity was assessed using two biophysical parameters, namely, transepidermal water loss (TEWL) and stratum corneum (SC) hydration. In addition, the influence of intrinsic factors, namely, incontinence and mobility status, on the parameters was evaluated. TEWL values at the sites compromised by PU were statistically significantly greater (P &lt;.001) than corresponding values at the adjacent control sites at 5 and 10 cm, which were consistent with a normative range (&lt;20 g/h/m 2). By contrast, SC hydration values did not reveal clear distinctions between the three sites, with high inter-patient variation detected at the sites. Nevertheless, individual profiles were consistent across the three sessions, and the PU site was observed to be either abnormally dry or overhydrated in different individuals. No consistent temporal trend in either parameter was evident. However, intrinsic factors were shown to influence the parameters, with females, bedridden and incontinent patients presenting significantly higher TEWL and SC hydration values (P &lt;.05). TEWL was able to identify differences in skin responses at skin sites compromised with a category I PU when compared to healthy adjacent skin sites. Accordingly, this parameter could be included in the clinical assessment for the identification of PU risk. Further studies are required to elucidate the role of hydration and skin barrier function in the development of PUs and their ability to monitor temporal changes in skin integrity. </p

Inflammatory biomarkers in sebum for identifying skin damage in patients with a stage I pressure ulcer in the pelvic region: a single centre observational, longitudinal cohort study with elderly patients

Pressure Ulcers (PU) are a major burden for affected patients and healthcare providers. Current detection methods involve visual assessments of the skin by healthcare professionals. This has been shown to be subjective and unreliable, with challenges associated with identifying erythema in darker colour skin. Although there exists a number of promising non-invasive biophysical techniques such as ultrasound, capacitance measurements, and thermography, the present study focuses on directly measuring the changes in the inflammatory status of the skin and underlying tissues. Therefore, in this study, we aim to analyse inflammatory cytokines collected through non-invasive sampling techniques to detect early signs of skin damage. Thirty hospitalised patients presenting with Stage I PU were recruited to evaluate the inflammatory response of skin at the site of damage and an adjacent healthy control site. Sebutapes were collected over three sessions to investigate the temporal changes in the inflammatory response. The panel of cytokines investigated included high-abundance cytokines, namely, IL-1α and IL-1RA, and low abundance cytokines; IL-6, IL-8, TNF-α, INF-γ, IL-33, IL-1β and G-CSF. Spatial and temporal differences between sites were assessed and thresholds were used to determine the sensitivity and specificity of each biomarker. The results suggest significant (P &lt; .05) spatial changes in the inflammatory response, with upregulation of IL-1α, IL-8, and G-CSF as well as down-regulation of IL-1RA over the Stage I PU compared with the adjacent control site. There were no significant temporal differences between the three sessions. Selected cytokines, namely, IL-1α, IL-1RA, IL-8, G-CSF, and the ratio IL-1α/IL-1RA offered clear delineation in the classification of healthy and Stage-I PU skin sites, with receiver operating characteristic curves demonstrating high sensitivity and specificity. There were limited influences of intrinsic and extrinsic factors on the biomarker response. Inflammatory markers provided a high level of discrimination between the sites presenting with Stage I PU and an adjacent healthy skin site, in a cohort of elderly inpatients. Indeed, the ratio of IL-1α to IL-1RA provided the highest sensitivity and specificity, indicative that inflammatory homeostasis is affected at the PU site. There was a marginal influence of intrinsic and extrinsic factors, demonstrating the localised effects of the inflammation. Further studies are required to investigate the potential of inflammatory cytokines incorporated within Point of Care technologies, to support routine clinical use.</p