Uterine Prolapse in a Sheep and its Management: A Case Report

It is simply an eversion of the uterus which turns inside out as t passes through the vagina. Prolapse of the uterus generally occurs immediately after or a few hours of parturation when the cervix is open and the uterus lacks tone (Hanie, 2006). Post partum uterine prolapse occurs in all large animal species. It is most common in the cow and ewe, less common in the doe goat and rare in the mare. In sheep, the condition is usually seen in mature females in the last trimester of pregnancy. Predisposing factors include increased intra-abdominal pressure associated with increased size of the pregnant uterus, intra-abdominal fat, or rumen distention superimposed upon relaxation and softening of the pelvic girdle and associated soft-tissue structures in the pelvic canal and perineum. The prolapse is visible as a large mass protruding from the vulva, often hanging down below the animal’s hock. The placenta may likely be retained during this period (Roberts, 1982). Animals with uterine prolapse treated promptly recovers without complication while delay treatment could result in death of the animal in a matter of hour or so from internal hemorrhage caused by the weight of the organ which tears the mesovarium and artery (Noakes et al., 2001). Success of treatment depends on the type of case, the duration of the case, the degree of damage and contamination

Ultrastructural alterations of renal tissue in a male patient with Fabry’s disease

Background: Fabry’s disease is an X-linked lipid storage disorder due to deficient lysosomal alpha galactosidase A.Case Presentation: Kidney biopsy was done on a 19 year old male patient with complaint of acroparesthesia, maculopapular skin lesions and cornea verticillata. Kidney biopsy tissue was processed and examined by electron microscopy. Changes were inclusion bodies in the cytoplasm of the renal cells. These inclusions were osmophilic with concentric lamellation of clear and dark layers, showing onion skin appearance. The podocytes were mostly affected and some of the foot processes were fused. Cross-sections of collagen fibers were also evident, indicating fibrosis.Conclusion: The ultra-structure of the kidney clearly showed the intra-cytoplasmic glycosphingolipid accumulation in renal cells, responsible for progressive decline in renal function which could lead to kidney failure. The final diagnosis of Fabry’s disease was confirmed. In the present case-study, electron microscopy proved to be a valuable diagnostic aid.Keywords: Fabry’s disease, Male patient, Ultra-structural alteration

Artemia resources in salt water lakes in Gonbad Area

A strain of parthenogenetic artemia was distinguished in Shoor and Incheh lakes in Golestan province, situated south east of the Caspian Sea. Its maximum frequency was measured 942.5 and 2426.7 individuals per cubic meters during May in Shoor and Incheh lakes respectively. Gyrosigma, Nitzschia, Chroococcus and Oscillatoria were the most aboundant genera of phytoplankton. Cl^- and SO_4 had highest concentrations among anions

Changes of digestive enzymes activity in common carp (Cyprinus carpio) during larval ontogeny

This study was aimed to gain knowledge on the ontogeny of digestive enzymes in common carp larvae at the governmental Warm Water Fish Aquaculture Center of Shahid Rajaee in Sari, Mazandaran, Iran. The ontogenetic development of pancreatic (trypsin, chymotrypsin, lipase and α-amylase) and intestinal (alkaline phosphatase and aminopeptidase-N) enzymes were assessed in common carp larvae from first feeding (3 days post hatching) to 33 days post hatching (dph). The larvae started to feed on rotifers at day 3 to day 7. Feeding on a commercial diet was started from day-8 onwards. Specific trypsin and chymotrypsin activities feed with rotifer were 0.011 U/mg protein and 0.003 U/mg protein at day 7, respectively; then the specific activities feed with dry food reached a maximum level at 33 dph (0.028 U/mg protein and 0.028 U/mg protein, respectively) (P<0.05) compared to live prey. The elevated alkaline proteases activity can be related to adaptation of larvae to digest protein content in the food. Specific lipase activity was 0.0006 U/mg protein at 7 dph; then the activity feed with dry food reached a maximum level at 15 dph (0.0011 U/mg protein) (P<0.05) compared to live prey. Specific α-amylase activity feed with rotifer was 85.86 U/mg protein on the 7 dph; consequently, its specific activity reached a maximum level at 15 dph (128.77 U/mg protein) (P<0.05). Specific alkaline phosphatase and aminopeptidase N activities feed with rotifer were 6 U/mg protein and 0.0106 U/mg protein at day 7, respectively; then the specific activities feed with dry food reached a maximum level at 33 dph (28.66 U/mg protein and 0.58 U/mg protein, respectively) (P<0.05) compared to live prey

Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

Changes in growth and amino acid composition of Rutilus frisii kutum during larval development

The present study investigated changes in growth and amino acid composition Kutum Rutilus frisii kutum during larval development. For this purpose, the periodic sampling from larvae obtained from breeders propagation was carried out at the fish aquaculture center of Shahid Rajaee in Sari. The samples were obtained at 1, 3, 7, 10, 15, 20, 25, 30, 35, 40 and 50 days after hatching (DAH). The result of larvae growth showed that mean initial and final length of Kutum (1 DAH, 50 DAH) were 8.47±0.02mm and 35.34±0.41mm, respectively. Initial and final weights were 4.02±0.01mg and 483.33±1.11mg, respectively. The composition of total amino acids of Kutum larvae changed significantly during ontogeny. High correlations were found between rotifers and dry food but correlations dry food was higher than that rotifer. No major imbalance was found in essential amino acids profile of the diet of fish larvae. Nevertheless, low correlation of rotifer to dry food in rotifer AA nutritional balances was less than dry food. During this study, methionine, lysine, arginine, threonine and histidine appeared to be limiting amino acids. These fatty acids showed the significant difference between the amino acid profile in larva and the diet

Laparoscopy and the impalpable testes: diagnosis, treatment options and the literature

Background: Laparoscopy is the best available tool and method to manage impalpable undescended testes; management of the impalpable testis often pose a significant diagnostic and therapeutic challenge to a surgeon. The aim of this work was to elucidate and present the sensitivity and the value of laparoscopy, as a surgeon’s tool, for the diagnosis and treatment of the impalpable testis.Methods: From November 2015 to December 2018, 56 patients with 60 impalpable testes were operated upon by laparoscopic approach by a single surgeon. One-stage Fowler-Stephens laparoscopic orchidopexy was performed in 14 cases, while two-stage Fowler-Stephens laparoscopic orchidopexy was performed in 16 cases and Vessel-Intact Laparoscopic Orchidopexy (VILO) was done in 22 cases. In 2 cases vessel and vas was entering through deep ring and inguinal orchidopexy was done. Blind ending vessel/vas was noticed in 4 cases (vanishing/absent testes). Laparoscopic orchidectomy was required in 2 patients for nubin. No case of disorder of sexual dysfunction was (DSD) was found.Results: Laparoscopy was successfully completed in all the cases. 34 testicles were impalpable on right side, 18 on left side and other 4 cases (8 testicles) were bilaterally impalpable. Laparoscopic orchidopexy was carried out for 36 testes at the same. 16 needed a staged procedure. Orchidectomy was done in 2 cases/testes. In 4 cases testes was absent/vanishing. In 2 cases testes was canalicular, standard inguinal orchidopexy was done. The mean operative time was 48 minutes. Patients were allowed oral fluids 6 hours of the operation and were discharged at one day after the procedure.  None of the patients had wound infection. Patients were followed up for a mean period of 12 months. At follow-up, all but one of the testes were well down in the bottom of the scrotum. In one patient, the testis was in a high scrotal position. All testes were of normal size, no atrophy was seen so far and no malignant change is suspected in any case so far. No severe morbidity or death was observed in our study.Conclusions: Laparoscopy offers surgeons a safe and reliable diagnostic and therapeutic option to patients with impalpable testes. No other imaging investigation is required, if well versed with basic laparoscopy. Intra-abdominal dissection allows more testes to be brought down to the scrotum. Even when open orchidopexy is being done for intra-canalicular testes in a child, it is advisable to be ready with laparoscopy if necessary, at the same time, in case open surgery fails to mobilize the testicular vessels adequately. The procedure is best viewed as laparoscopy-assisted; as Orchidopexy has to be done in a conventional manner

A Prospective Study of Internal Carotid Artery Plication During Carotid Endarterectomy: Early Clinical and Duplex Outcome

AbstractObjective: internal carotid artery (ICA) plication prevents kinking and secures the distal intimal step following carotid endarterectomy (CEA). The aims of this prospective study were to quantify the proportion of patients in whom plication might be beneficial and determine whether plication is associated with an increased incidence of early restenosis and a reduction in postoperative thromboembolic complications. Methods: analysis of a prospectively gathered computerised database. Results: between 1 November 1992 and 31 December 1997, 228 consecutive CEAs were performed in 213 patients, of which 84 (37%) in 79 patients were plicated. Sixty endarterectomy sites have been examined by duplex ultrasonography at a median of 5 (range 1–44) months postoperatively. No abnormality was detected in 52 (87%), six (10%) had restenosis of <50% and two (3%) restenosis of 50–75%. All were asymptomatic. Three patients (3.6%), one of whom died, had an intraoperative neurological event and one patient (1.2%) had a postoperative cerebral haemorrhage. No patient suffered ICA thromboembolism. During the same time period 144 non-plicated CEAs were performed in 134 patients. Of these, one (0.7%) had an intraoperative and five (3.5%) had a postoperative neurological event. Five of these six complications were due to ICA thromboembolism. There was no mortality in the non-plicated group. Conclusion: ICA plication can be used to prevent kinking, secure the distal intimal step, has not, to date, been associated with increased early restenosis rate and has avoided postoperative ICA thromboembolism