Evaluation of transrectal examination of cervical diameter by palpation in dairy cows

The objective of the study was to evaluate the reliability of a manual assessment of cervical diameter through palpation. In an in vivo trial, 64 Holstein-Friesian cows between 2 and 5d in milk (DIM) and between 21 and 27 DIM were examined by transrectal palpation by 3 investigators. For calculation of sensitivity and specificity, ultrasound-generated measurements were used as reference standard; a cervix >7.5 cm was categorized as large. The Pearson coefficient of correlation between the results of the 3 investigators and ultrasound-generated measurements was moderate (r=0.71, 0.74, and 0.51). The estimates generated by palpation by the 3 different investigators did not differ and were similar to measurements obtained by ultrasound. The coefficient of variation (CV) between the investigators and ultrasound was high (20.9, 18.7, and 32.0%). The mean difference between the investigators and the ultrasound was 0.60 cm (95% confidence interval: -2.4 to 3.6). Sensitivity was 28.6, 42.9, and 42.9%, and specificity was 100, 96.2, and 92.6% for the ability of the 3 investigators, respectively, to detect the 7.5-cm cutoff by palpation. Overall sensitivity and specificity for all 3 investigators, considering ultrasound as the reference, were 37.5 and 96.2%, respectively. In vitro, 24 wooden cylinders were used to represent cervical diameter and to examine the reliability, as well as sensitivity and specificity, of manual assessment of different diameters. The Pearson coefficient of correlation between the results of the investigators (n=11) and the actual diameters of the cylinders was 0.78. The CV between the investigators and the cylinders was 27.8%. The variation in the results was greater for cylinders with a larger diameter (3.5-cm diameter: mean ± standard deviation = 2.6 ± 0.9 cm; 10.5-cm diameter: mean ± standard deviation = 13.2 ± 4.0 cm). The estimate obtained by palpation for the 7.5-cm cylinder was 7.4 ± 2.1cm. Sensitivity was 79.4% and specificity 92.5%. After training one group of investigators, sensitivity and specificity improved to 85.9 and 94.4%, respectively. Transrectal palpation of the cervical diameter shows moderate repeatability and correlation and high variation between the investigators and the reference standards. Variability increased with larger diameters

Prescribing quality in patients with chronic diseases at primary and secondary health care facilities using prescription quality index tool

Background: Prescribing quality is a matter of major concern worldwide. This study was carried out to determine the quality of prescribing in chronic diseases at primary health care (PHC) and secondary health care (SHC) settings using the new prescription quality index (PQI) tool.Methods: A cross-sectional observational study was carried out at four PHC and two SHC facilities in Anand district of India. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33), and high quality (score 34-43) based on PQI total score. The internal consistency of PQI was measured using item total correlation and Cronbach’s α so as to validate it in our settings. Data were analyzed using Statistical Package for Social Science 20.Results: A total of 134 prescriptions were collected and evaluated for quality of prescribing. Mean age of patients was 60.6 ± 13.5 years. Mean PQI score was 23.60 ± 9.3 with 71.6% prescriptions being of poor quality. Quality of prescribing did not differ at PHC and SHC (P>0.05). Of 22 criteria, PQI score was strongly correlated with drug indication, drug effectiveness, evidence-based prescribing, unnecessary duplication, duration of therapy, and cost (P<0.01). PQI total score was negatively correlated to the number of drugs per prescription. Cronbach’s α for the entire 22 criteria were 0.90.Conclusion: PQI was found to be a reliable tool for assessment of prescribing quality in chronic diseases

Design of Lean to Roof Steel Trusses with Hollow Circular tube using IS 875 (part-III):2015 & IS 800:2007

At present, SP-38:1987 is available which provides design for lean to roof type trusses and pitch roof trusses. The design of lean to roof truss has been carried out as per IS 800:1984 IS 875 (Part-III):1964. Afterwards IS 800:1984 is revised in 2007, which is based on limit state method. Also, IS 875 (Part-III) is updated in 1987 and then in 2015 considering climate changes and economical parameters. Accordingly, study has been done to revise the design of trusses given in SP-38:1987. In the present study, design and comparison of lean to roof type truss with steel circular hollow tube section have been carried out using IS 875 (Part-III):2015 and IS 800:2007 limit state method using STAAD Pro. and their results compared with SP-38:1987 results. This study includes lean to roof truss system considering different parameters like span, spacing of truss, slope of roof and wind zones with all cases of wind load. At the end, a compiled report will be prepared, which will be helpful to design engineers to provide economic, easier, faster approach for designing of steel trusses

Study of operative management of proximal humerus fracture treated with locking plates

Background: This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.Methods: 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.Results: Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union. Conclusions: Good functional outcome with Philos plate irrespective of fracture type was obtained

Measurement of fecal glucocorticoid metabolites and evaluation of udder characteristics to estimate stress after sudden dry-off in dairy cows with different milk yields

Sudden dry-off is an established management practice in the dairy industry. But milk yield has been increasing continuously during the last decades. There is no information whether the dry-off procedure, which often results in swollen and firm udders, causes stress, particularly in high-producing dairy cows. Therefore, we evaluated the effect of a sudden dry-off on extramammary udder pressure and the concentration of fecal glucocorticoid metabolites (i.e., 11,17-dioxoandrostane, 11,17-DOA) as an indirect stress parameter. Measurements were carried out within the last week before dry-off and until 9d after dry-off considering 3 groups of milk yield (i.e., low: <15 kg/d, medium: 15-20 kg/d, and high: >20 kg/d). Udder pressure increased in all yield groups after dry-off, peaked at d 2 after dry-off and decreased afterwards. Pressures were highest in high-yielding cows and lowest in low-yielding cows. But only in high-yielding cows was udder pressure after dry-off higher than before dry- off. Baseline 11,17-DOA concentrations depended on milk yield. They were highest in low-yielding (121.7 ± 33.3 ng/g) and lowest in high-yielding cows (71.1 ± 30.0 ng/g). After dry-off, 11,17-DOA increased in all yield groups and peaked at d 3. Whereas in medium- and high-yielding cows 11,17-DOA levels differed significantly from their respective baseline during the whole 9-d measuring period, low-yielding cows showed elevated 11,17-DOA levels only on d 3 after dry-off. However, especially the increase in 11,17-DOA after dry-off between the 3 yield groups was considerably different. Mean 11,17-DOA increase from baseline to d 3 was highest in high-yielding cows (129.1%) and considerably lower in low-yielding cows (40.1%). The highest fecal 11,17-DOA concentrations were measured on d 3 after dry-off, indicating that the stress was most intense on d 2, which is due to an 18-h time lag; at about the same time, udder pressure peaked. Our results showed a negligible effect of a sudden dry-off on low-yielding cows. High-yielding cows, however, faced high extramammary pressures and increased glucocorticoid production. Considering animal welfare aspects, a review of the current dry-off strategies might be warranted

Body temperature around induced estrus in dairy cows

The overall objective of this study was to study the influence of induced estrus on body temperature, comparing 5 distinct intervals around induced estrus and to determine the diurnal pattern from 4 ± 1 d before to 4 ± 1 d after induced estrus. Sixteen estrous cycles of 9 postpartum dairy cows were synchronized with 2 injections of PGF(2α), 10 d apart. After the second PGF(2α) injection on d 10, temperature loggers were inserted into the vaginal cavity for a 12 ± 1-d period. Two days later, a third dose of PGF(2α) was injected to induce estrus. After confirmation of a corpus luteum, loggers were removed on d 5 ± 1. Observation of estrus, rectal palpation, and ultrasound scanning to determine ovulation were carried out every 4 ± 1h, beginning at 12h after the third PGF(2α) injection. Blood samples from the vena coccygea mediana were collected twice daily from d 11 to 12 and every 4 ± 1h after the third PGF(2α) injection until ovulation. Vaginal temperature was recorded every 5 min and averaged to hourly means for the following 5 periods: 1) 48 h preceding the third PGF(2α) injection, 2) from the third PGF(2α) injection to first signs of estrus, 3) estrus to ovulation, 4) a 4-h interval in which ovulation occurred, and 5) a 96-h post-ovulation period. High body temperatures (39.0 ± 0.5 °C) and low progesterone (P4) concentrations (<0.5 ng/mL) were observed during estrus, whereas low body temperatures were observed from PGF(2α) injection to estrus (38.6 ± 0.3 °C) and around ovulation (38.5 ± 0.2 °C), respectively. An association between body temperature and serum P4 concentrations did not exist. However, P4 concentrations on d 11 and 12 were high (5.0 ± 1.5 ng/mL) and decreased (0.9 ± 0.2 ng/mL) after ovulation. Diurnal temperature rhythms were similar before and after estrus. Vaginal temperature before estrus (d 11 and 12) was slightly (0.1 °C) higher compared with the post-ovulation period