Improvement in litter quality and leg health by nutritional modification in growing turkeys

Pododermatitis (FPD) is a contact dermatitis commonly observed in poultry, primarily affecting the surface of the footpad and the hock joint, and causes poor welfare and economic losses when severe. Most reported field outbreaks of FPD have been associated with poor litter conditions. There are three important aspects of litter condition associated with incidences of FPD and hock burns (HB) i.e. increased litter moisture, greasy or capped litter as well as high ammonia (NH3) content. Therefore maintaining litter quality and more specifically the moisture content is essential if conditions such FPD and HB are to be controlled. Poor litter condition is caused by an interaction between management, nutrition and intestinal health. In terms of nutrition, dietary density i.e. energy and protein concentrations are important factors in terms of determining litter quality and incidences of FPD, because of the effect that they exert on water intake. Four experiments were used to investigate the effects of nutritional modifications on water intake (WI) and excretion by turkeys. In the first experiment explored the effect of different dietary nutrient concentrations supplemented with and without phytase on WI and excretion. It was noted that excreta moisture content was reduced (P0.05) on the cumulative WI. Water output (g/g of weight gain) was higher (P0.05). In the next two experiments floor-pen studies were used to examine the effects of nutrient density and dietary protein concentration (ranging from 77 to 120% of BUT breed recommendation) on litter quality parameters and, therefore, on leg health conditions. In one study the energy and protein ratio were kept constant whereas in the second the protein concentration changed while the energy remained constant (100% of breed requirement). Growth performance parameters were determined for each study which was conducted from 4 to 20 weeks of age. When birds were fed diets in which the energy and protein ratio remained constant the high protein/energy diets resulted in a lower WI and litter moisture content when compared to group fed diet containing lower concentrations of protein/energy (P0.05) of treatment on FPD. Birds fed diets containing a higher than the recommended dietary protein concentration (constant energy concentration) had a higher WI and litter moisture content when compared to group fed diets containing the low nutrient density diets (P<0.001). Likewise, litter pH and NH3 concentration and prevalence of HB and FPD were higher where birds were fed the higher than recommended protein concentration diets. The final experiment was designed to establish the relative importance of protein and potassium in determining WI and excretion. There were six treatments based on three diets containing either 77, 100 and 120% of the dietary protein recommended by the breeder. Each diet was then split into two and one of the two diets was supplemented with K2CO3 to give a K+ concentration of 16.5 g/kg of diet. The remaining diet of the pair was left unsupplemented (ie contained only naturally occurring potassium). It was noted that birds fed with diet containing higher dietary protein concentration had higher WI and moisture output (MO) when compared to group fed diet containing lower dietary protein concentration (P<0.001). The effect within diets containing the same CP and standardised K+ was marginally insignificant (P=0.065) in terms of WI. Whereas birds fed diets containing naturally occurring K+ only had approximately 10% less (P<0.05) MO compared to these fed diets containing the standardised concentration of K+. While recognising that factors such as non-starch polysaccharides (NSP), indigestible fat and trypsin inhibitor could not be excluded totally, it was concluded, on the basis of the experiments conducted, that dietary protein (as provided by soybean meal) was primarily responsible for the higher WI and hence excretion. This then ultimately produces unacceptable litter quality and results in leg health problems in turkeys. To prevent excessive water intake and reduce litter moisture content there should be a correct balance between dietary energy and protein levels. Feeding turkeys lower ideal protein diets containing higher apparent metabolisable energy ratio crude protein (AME:CP) may help to improve the amino acid digestibility and ionic balance and, therefore, litter quality and this will help to decrease leg health problems such as footpad dermatitis and hock burn

Impact of Learning & Market Orientation on Business Performance & Innovation: The Mediating Role of Business Resilience & CRM effectiveness

This study discussed the mediating role of business resilience and customer relationship management effectiveness (CRMe) in the context of learning and market orientation, business innovation and business performance. Structural Equation Modelling was used to test the model with a sample size of 390 respondents from tourism ministry, travel agencies and hotels. The outcome of the study confirms that business resilience and customer relationship management effectiveness significantly mediates the relationship resulting into enhanced business performance and innovation. Keywords: Learning and Market Orientation, Business Resilience, CRM Effectiveness, Innovation &amp; Business Performanc

Carotid Intima Media Thickness Percentiles for Pakistani Population

Carotid artery intima media thickness estimation is a well-established way of cardio vascular disease evaluation. The purpose of this cross-sectional study was to develop normal carotid intima media thickness percentile values for a Pakistani cohort. Data was collected at the Departments of Radiology and Family Medicine, The Aga Khan University Hospital, Karachi, from April 2014 to August 2015. High frequency ultrasound of carotid was done in 257 patients [97 male (38%), 160 female (62%)] without any known carotid artery disease. Reference ranges (90% range between 5th and 95th centiles) were constructed for each common carotid and internal carotid artery measurement and displayed in graph form. The mean difference was found in left common carotid artery (0.55 ±0.13) and left internal carotid artery thickness (0.50 ±0.10) significant at p=0.031 and p=0.014, respectively. The IMTpercentile graphs developed in this study for internal and common carotid arteries are exclusive for this population and can be used to assess vascular health from ultrasound measurements

Film Retakes in Digital and Conventional Radiography

Objective: To determine the film-retake rates and causes in digital radiography comparison to conventional X-rays method. Study Design: Comparative study. Place and Duration of Study: Radiology Department, Aga Khan University Hospital, Karachi, from January 2004 to December 2006. Patients and Methods: X-rays of different body parts, conducted during the year 2004, with conventional radiography (n=170300), and in 2006 with digital radiography (n=174550), were included in this study. Measurements were done for number of X-rays re-take due to different quality control reasons for both the conventional and digital radiography. Quality control reasons included underexposure, overexposure, positioning errors, patient movements, portable X-rays, grid cutoff, and others (i.e. equipment related) due to which X-ray quality was questionable. Results were expressed in percentages. Results: A total of 9423 X-rays (5.5%) were repeated in conventional radiography (n=170300) due to underexposure (38%), overexposure (28.5%), positioning errors (25%), portable procedures (4%), patient movement (2%), grid cut-off (0.5%), and others (2%). Underexposure was the most frequently responsible factor for the X-ray repetition as compared to other factors (p\u3c0.001). In digital radiography (n=174550), 1464 X-rays (1%) needed to be repeated, which was significantly less in comparison to X-ray repetition in conventional method of radiography (5.5%) [p\u3c0.001]. In digital radiography, the most frequent factor for X-ray re-take was positioning error (435, 30%). Conclusion: Digital radiography is associated with significantly lesser number of re-take X-rays as compared to conventional radiography, hence minimizes the exposure of the patients to unnecessary radiations due to re-take X-rays. Positioning error remains a problem even in digital radiography, emphasizing training need for technologists

Amoebic liver abscess: Outcomes of percutaneous needle aspiration vs drain placement in paediatric population

Objective: To compare the effectiveness of percutaneous catheter drain placement with percutaneous needle aspiration in terms of hospital stay, time to resolution of symptoms and cost of intervention performed.Methods: The retrospective cohort study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with amoebic liver abscess from, January 2006 to December 2016 which was collected using non-probability purposeful sampling. Primary outcome included length of hospital stay, time to resolution of symptoms and cost of intervention. Secondary outcomes included development of complications, need for re-intervention and abscess resolution. SPSS 22 was used for data analysis. .Results: Of the 62 patients, 36(58%) underwent percutaneous needle aspiration Group A, and 26(42%) were treated with percutaneous catheter drain placement Group B. Both groups were malnourished and anaemic at presentation. Overall, 56(90.3%) patients had single abscess and 44(71%) had it in the right lobe. Mean duration of symptoms was less in Group B compared to Group A (11.2±4.5 versus 16.4±3.2 days). Mean abscess size was 6.13cm ± 9.75cm in Group A and 7.40cm ± 8.40cm in Group B. The mean length of hospital stay Group A was shorter than in Group B (p=0.047) with earlier resolution of symptoms (p=0.027).Conclusion: Both methods were found to be effective in treating amoebic liver abscess in children, but percutaneous needle aspiration was more effective

Staging of endometrial carcinoma by magnetic resonance imaging: correlation with surgery and histopathology

OBJECTIVE: To evaluate the accuracy of MRI in staging of endometrial carcinoma, and comparison with surgery and histopathological findings. METHODS: A one year prospective cross-sectional study was conducted from 10/3/2005 to 31/5/2006, at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty two patients with diagnosis of endometrial carcinoma, referred to radiology department for preoperative staging by MRI and had undergone surgery were included. RESULTS: MRI was found to be 79% sensitive, 85% specific and 80% accurate for staging endometrial carcinoma while PPV and NPV were 97% and 66% respectively. CONCLUSION: Magnetic resonance imaging is a good, safe, accurate and non invasive imaging modality in staging of endometrial carcinoma. It can be used as a first line radiological investigation in patients with endometrial carcinoma for treatment planning

Geographical Forwarding Methods in Vehicular Ad hoc Networks

Vehicular ad hoc networks are new and emerging technology and special class of mobile ad hoc networks that provide wireless communication between vehicles without any fixed infrastructure. Geographical routing has appeared as one of the most scalable and competent routing schemes for vehicular networks. A number of strategies have been proposed for forwarding the packets in geographical direction of the destination, where information of direct neighbors is gained through navigational services. Due to dynamically changing topologies and high mobility neighbor information become outdated. To address these common issues in network different types of forwarding strategies have been proposed. In this review paper, we concentrate on beaconless forwarding methods and their forwarding methods in detail

Carotid intima media thickness evaluation by ultrasound comparison amongst healthy, diabetic and hypertensive Pakistani patients

Objective: To compare carotid Intima media thickness and atherosclerosis burden amongst healthy, diabetic and hypertensive Pakistani patients.Methods: A cross-sectional study was carried out at the Department of radiology and family medicine, Aga Khan University Hospital Karachi from April 2014 to July 2015. Bilateral carotid ultrasound was done in 133 healthy adults, 65 hypertensive, 31 type-2 diabetic and 37 hypertensive with type-2 diabetes patients. Normal adults were matched for age and gender. Mean intimal media thickness was measured for common and internal carotid arteries. Presence or absence of atherosclerotic plaque was also identified. Height, weight, ethnicity, socioeconomic status and other risk factors were also assessed. Ultrasound findings were compared between healthy and diseased patients through statistical tests.Results: A total of 266 patients participated (Controls=133, Hypertensive=65, Diabetic=31, and Diabetes with Hypertension=37). There was no significant difference in the baseline characteristics between the four patients\u27 groups for age (p\u3e0.05) and gender (p\u3e0.05). The mean carotid intima media thickenss of right common carotid artery was significantly higher in patients with diabetes along with hypertension as compared to the control group (p=0.03). For (RICA) Right Internal Carotid Artery, (LCCA) Left Common Carotid Artery and (LICA) Left Internal Carotid Artery, there was a significantly higher thickness among patients with hypertension as compared to the control group with p=0.011, p=0.002, and p=0.039 respectively.Conclusion: Increased CIMT is most likely associated with underlying chronic diseases. Ultrasound is a non-invasive, easily available and useful modality for early detection and prevention of vascular atherosclerosis