Effect of dietary chitosan supplementation on productive and physiological performance parameters of growing New Zealand white rabbits.

This study aimed to investigate the effects of dietary chitosan supplementation on the growth performance, carcass traits, and some physiological parameters of weaned New Zealand White rabbits (NZW). Sixty-four NZWs were randomly distributed into four dietary experimental groups (n = 16) and fed a basal diet ad libitum for eight weeks: under Egyptian conditions. The basal diet without chitosan served as the control group, while the other three groups were fed diets containing 0.2, 0.4 and 0.6 g chitosan/kg diet. We observed significant (P ≤ 0.05) differences among chitosan treatments. Specifically, groups supplemented with chitosan in their diets had significantly (P ≤ 0.05) higher final body weight and weight gain, as well as an improved feed conversion ratio compared to the control group. Rabbits fed chitosan at 0.2 g/kg diet performed the best in growth traits compared to other treatment groups. Rabbits fed chitosan at 0.4 g/kg diet had significantly (P ≤ 0.05) higher levels of total protein in their blood than in the control group. However, levels did not differ significantly from that in the 0.2 group. Likewise, the highest (P ≤ 0.05) levels of glucose and HDL concentrations were detected in rabbits fed chitosan at a 0.2 g/kg diet. All chitosan-supplemented groups (especially at 0.2 g/kg diet) had higher economic efficiency and relative profit levels than the control group. Moreover, morphometric evaluations of the small intestine revealed higher villi number and crypt depth values in chitosan-treated animals compared to the control group. We conclude that using chitosan at levels of 0.2 or 0.4 g/kg diet can effectively improve the body weight gain, feed conversion ratio and economic efficiency, as well as the overall health status of NZW under Egyptian conditions.

Sexual behaviour response, testicular development and semen quality of New Zealand white rabbit bucks as influenced by dietary chitosan.

The present study was conducted to determine the effects of dietary chitosan supplementation on sexual behaviour responses, testicular development, and semen quality traits of New Zealand White (NZW) rabbit bucks. Twenty-four 5-week-old rabbit bucks were used in this experiment. Animals were grouped into four equal experimental groups: the control group was fed only on a basal diet, whereas the other groups were fed the basal diet supplemented with three levels of chitosan at 0.2, 0.4, or 0.6 g/kg, respectively. Also, bucks that received chitosan at 0.2 and 0.4 g/kg had a significantly earlier time of sexual libido (p ≤ .05) and had significantly higher ejaculate volume and sperm concentration than other groups (p ≤ .001). Furthermore, basic and sexual behaviours were significantly improved in bucks fed chitosan at 0.2 and 0.4 g/kg compared with other groups. Therefore, it could be concluded that using chitosan at 0.2 and 0.4 g/kg enhanced sexual behaviour, improved semen quality, and reproductive efficiency in the NZW rabbit bucks.

Early correction of malunited supracondylar humerus fractures in young children.

INTRODUCTION: Supracondylar fracture malunion usually results in cubitus varus deformity. The long-standing unsightly deformity causes psychological stress to the child and his/her parents in addition to biomechanical disturbances and functional disorders in the affected elbow. The optimal timing of corrective osteotomy is not well-established in the literature. The present study aimed to report the results of early correction of cubitus varus deformity using a simple technique and to focus on the timing of early correction after supracondylar fracture malunion. PATIENTS AND METHODS: Thirty consecutive patients treated for recent cubitus varus deformity after malunited supracondylar fractures, in the period between January 2012 and August 2017, were retrospectively reviewed. All patients had early surgical correction of the deformity within one year after the initial injury. In patients who presented with maluniting supracondylar fracture, the fracture was splinted until union was achieved, then active exercises were encouraged until elbow ROM was regained. The deformity was then corrected with a lateral closing wedge (LCW) osteotomy and fixed with two lateral and one medial wire. RESULTS: All the osteotomies united. All the deformities were corrected. The humerus-elbow-wrist (HEW) angle significantly improved compared to the pre-operative values (p<0.001). All patients achieved satisfactory results at the final evaluation. Twenty-six patients (86.7%) achieved excellent results while four patients (13.3%) achieved good results. CONCLUSION: Early correction of cubitus varus deformity avoids the psychological stress of the long-standing unsightly deformity to the young child and his/her family. It also avoids the delayed biomechanical and functional disturbances to the affected elbow. The LCW osteotomy and the three-wires fixation technique are simple and effective to correct the deformity and maintain the correction.

Traumatic Composite Bone and Soft Tissue Loss of the Leg: Region-Specific Classification and Treatment Algorithm.

BACKGROUND: The management of traumatic composite bone and soft tissue loss (TCBSTL) requires a classification system and decision-making algorithm for the purpose of description, prognosis and choice of treatment method. PATIENTS AND METHODS: between the year 2000 and 2017 a series of 254 cases of TCBSTL were treated using distraction histogenesis and external fixation techniques. The tissue loss was due to either the initial injury or debridement of infection. Adjunctive procedures included split thickness skin grafting and ICBG when indicated. A classification system was designed by the author. The classification is based on factors that influence management and prognosis; (1) stability of the host bone (intact tibia or a well-fixed fracture), (2) presence or absence of infection in the fracture site, (3) size of bone defect, and (4) contamination (infection) of the medullary cavity. A flowchart and decision-making algorithm was subsequently developed. RESULTS: Ilizarov external fixator was used in all cases. Ten cases (4%) had combined Masquelet - Ilizarov technique. One hundred seventy five cases (68.9%) had gradual distraction-compression (GDC) technique; while 79 cases (31.1%) had acute shortening and re-lengthening (ASRL) technique. Seventy-two cases (28.3%) had autogenous iliac crest bone graft (ICBG). All cases (100%) had complete clinical and radiological fracture union. All patients completed the follow up that ranged from 24 to 118 months (mean 43.3 ± 23). The results were satisfactory in 212 cases (83.5%) and unsatisfactory in 42 (16.5%) cases due to residual leg length discrepancy, joint stiffness, and persistent pain. DISCUSSION: the proposed classification is simple, applicable, recallable and includes most scenarios of reconstructable TCBSTL. The classification provides a basis for communication, description and evaluation of such cases. The algorithm, based on our classification, provides a guideline for management without over/under treatment.

Effect of dietary inclusion of sugar syrup on production performance, egg quality and blood biochemical parameters in laying hens.

The effects of dietary inclusion of sugar syrup on quality of egg, cholesterol level, production performance, serum total protein and blood biochemical parameters were evaluated in laying hens. A total of 300 commercial Lohmann LSL hens (30 weeks of age) were randomly distributed into 3 dietary treatments which consisted of a normal corn diet containing corn-soy and 2 diets containing 5% and 10% sugar syrup. Each treatment was replicated 5 times (n = 20). Egg production, feed intake, body weight and egg weight of laying hens fed different diets were recorded. The experiment lasted for 20 weeks. The Haugh unit scores of hens fed diets with sugar syrup were significantly increased (P < 0.05) compared with the control treatment. The sugar syrup had no significant effect on liver enzymes, total protein, blood glucose and creatinine in all treatments. The eggs laid by hens fed sugar syrup diets had lower cholesterol level (P < 0.05) compared with those laid by hens fed the control diet. Electrophoresis analysis showed that comparable electrophoretic patterns were noticed between serum proteins of treatment groups. From the results, it can be concluded that sugar syrup diets and corn diets have similar effects on feed intake, body weight, production of eggs and blood biochemical parameters in layer hens, which suggests sugar syrup can be used as an energy source for replacing part of corn in poultry layer diets.

Distal humerus fractures nonunion with elbow stiffness in working adults: Can triple tension band technique and Lambda Plate(®) be a standby solution?

BACKGROUND: Distal humerus fracture nonunion and associated elbow stiffness are two intermingled orthopaedic challenges for working adults. This prospective study aimed to evaluate the short-term results of the triple tension band and Lambda plate in managing both problems. METHODS: The study included fourteen cases. The mean age was 35.7 ± 8.5 years (range 25-49). Eight cases were males. Initial management was conservative in three cases. Three cases had a history of infected nonunion. Eight cases had initially OTA type C injuries and six cases had type A injuries. All cases had olecranon osteotomy, triple tension band, Lambda plating, and autogenous bone grafting. Five cases had ulnar nerve anterior transposition. Evaluation of the cases was objectively via Mayo Elbow Performance (MEP) score and subjectively through Disabilities of the Arm, Shoulder and Hand (DASH) score. RESULTS: The average follow-up period was 23.7 ± 5.3 months. All cases had a solid bony union in a mean of 16.4 ± 2.1 weeks and the final range of motion averaged 100 ± 19.6°. MEP and DASH scores had significant improvement at the final follow-up periods (P = 0.001). Cases with transposed ulnar nerve had significantly less MEP scores (P = 0.028) and more DASH scores (P = 0.013). CONCLUSIONS: The prescribed technique could be a good alternative to the known traditional methods with the advantages of: good exposure for arthrolysis; rigid and stable internal fixation even with low bone quality or small-sized distal fragments; and secure early rehabilitation.

Standalone percutaneous transiliac plating of vertically unstable sacral fractures: outcomes, complications, and recommendations.

PURPOSE: The aim of this study is to evaluate results of a standalone percutaneous posterior plating of the vertically unstable sacral fractures, to analyze the influencing factors, to discuss encountered complications, and to express the related recommendations. METHODS: Forty two cases were included; all of them had type C vertical sacral fractures; and 16 cases had associated nerve roots injury. Subcutaneous 3.5-mm reconstruction plate was used in all cases, through vertical incisions in 28 cases and transverse incisions in 14 cases. Hannover pelvic outcome scoring system was implemented for results evaluation. RESULTS: The mean follow-up period was 22.1 ± 7.5 months; the mean operative time was 43.3 ± 7 min; the mean surgical incision length was 4.6 ± 1.1 cm. 14 cases had excellent scores, 16 cases had good scores, 6 cases had fair scores, and 6 cases had poor scores. Younger age groups had significantly better outcome (P = 0.015), whereas the comminuted sacrum had significantly worse score (P = 0.041). Final residual posterior displacements significantly improved (P = 0.001) in comparison to the initial displacement. The nerve roots injury had final significant recovery (P = 0.012). Transverse skin incisions had subjectively significant satisfaction (P = 0.017). CONCLUSIONS: Percutaneous 3.5-mm reconstruction plate is a good alternative to percutaneous iliosacral screws in vertically unstable sacral fractures; especially in the presence of contraindication to the latter. It is simple procedure with minimal incisions; short operative time; less radiological exposure; good mechanical stability; and less iatrogenic injuries.

Midterm results of Ilizarov hip reconstruction for late sequelae of childhood septic arthritis.

The management of hip instability as a consequence of septic arthritis in childhood is difficult. Ilizarov hip reconstruction is a double-level femoral osteotomy with the objective of eliminating hip instability, through a proximal valgus-extension-derotation osteotomy and a distal varization-lengthening osteotomy for mechanical axis correction and equalization limb length. Ilizarov hip reconstruction was performed for 16 adult patients with complaints of hip pain, leg-length discrepancy, limping, reduced activity and limited abduction of the hip as a result of childhood septic arthritis. Their ages ranged from 19 to 32 years (mean 23.2 ± 4.2). Ilizarov external fixator was used in all cases. At the time of last follow-up that ranged from 60 to 132 months (mean 85.6 ± 23.5), the Harris hip score (HHS) showed excellent functional outcome in two cases (12.50 %), good in 13 cases (81.25 %) and fair in one case (6.25 %). There was no poor functional outcome in any case. Preoperatively, the mean HHS was 56.18 points, and at the time of last follow-up, it improved to a mean of 84.62 points. Pain subsided in all patients, the Trendelenburg sign became negative in all but three (19 %) patients, no patient had limb-length discrepancy, and the alignment of the extremity was reestablished in all cases. No additional operations were required. Ilizarov hip reconstruction is a valuable and durable solution for the late sequelae of childhood septic arthritis of the hip presenting in adult patients.

Hybrid grafting of post-traumatic bone defects using ß-tricalcium phosphate and demineralized bone matrix.

OBJECTIVES: Management of post-traumatic bone defects continues to be a substantial clinical challenge in orthopaedic trauma. This retrospective study evaluates the results of primary hybrid grafting of residual bone defects or voids, in displaced and comminuted long-bone fractures treated by plate fixation, using ß-tricalcium phosphate and demineralized bone matrix. MATERIALS AND METHODS: Fifty-four patients having 62 fractures were included. Their mean age was 40.7±10.7 years; femoral and tibial fractures were the commonest (70.9%) in this study. Eight fractures (12.9%) were open injuries; 13 fractures had critical-sized defects that averaged 3.4±0.9 cm. Cortical bone defects occurred in 51 cases, and cancellous bone voids in eleven. Eleven patients (20%) were polytraumatized. Tobramycin powder was added to the graft in all open fractures. The functional outcome was evaluated according to a modified Karlström and Olerud criteria. RESULTS: All fractures (100%) had solid union without any implant failure. There was a significant delayed union (P<0.001) in all critical-sized defects. The mean healing time showed a highly significant difference (P<0.001) between closed and open fractures. The functional outcome was excellent in 28 fractures, good in 21 fractures, fair in nine fractures and poor in four fractures. CONCLUSIONS: We believe that the ideal bone graft substitute for all situations does not exist; however, this hybrid grafting is a very good alternative to autogenous grafts especially in polytraumatized patients and when massive bone grafting is needed to reconstruct more than one bone in absence of segmental defects.

Refractory osteitis condensans ilii: outcome of a novel mini-invasive surgical approach.

PURPOSE: Osteitis condensans Ilii (OCI) is an orthopaedic mystery until now and the refractory type poses a great challenge in its management. Surgical resection and sacroiliac arthrodesis are major procedures with no guarantee of success for an unknown disease entity with a normal sacroiliac joint. The aim of this retrospective study was to evaluate results of a novel mini-invasive surgical approach for the refractory type after failure of conservative management. MATERIALS AND METHODS: Fourteen females were included with an average age 35.5 ± 5.8 years. Nine cases were multiparous and five were nulliparous. The pathology was bilateral in all cases; however, seven cases suffered bilateral symptoms, while seven cases had only unilateral complaints. Preoperative computed tomography was mandatory. All cases had three to five percutaneous iliac core decompressions through a cannulated drill bit. The Bath ankylosing spondylitis functional index (BASFI) was used for functional outcome evaluation. RESULTS: The mean follow up was 23.3 ± 4.1 months. The mean BASFI improved from 3.7 ± 0.6 preoperatively to 1.3 ± 0.2 during follow up (P = <0.001). There was a significant improvement with the four drillings over five decompression drillings (P = 0.011). Sacral side sclerosis was associated significantly (P = 0.009) with less improvement. No relapse or substantial complications were encountered. CONCLUSIONS: This novel approach can be of great benefit for refractory OCI cases with almost no added morbidity or complications. It has advantages of the mini-invasive techniques in addition to sparing the physiological functions of the affected sacroiliac joints.

Neglected neck femur fractures in adolescents and young adults: factors predicting the surgical outcome.

BACKGROUND: Neglected femoral neck fracture in young adults is an intriguing problem. This retrospective study tried to solve that challenge through open reduction, cannulated screw internal fixation, autogenous iliac bone and bone marrow grafting. METHODS: Thirty-six cases were studied; they were classified according to Sandhu et al.'s classification. Twenty cases were type I and 16 cases were type II fractures; the mean age was 26.8 years; fracture neglect averaged 44.6 days. Twenty cases had posterior comminution and 16 cases had anterior comminution. All cases had open reduction, cannulated screw internal fixation, autogenous iliac bone and bone marrow grafting. The Harris hip score and Matta et al. grading system were applied for functional and radiological evaluation, respectively. RESULTS: The average postoperative follow-up was 25.3 months; 94.4 % of the cases had solid union in a mean of 19.6 weeks. Functionally, the Harris hip score averaged 87.8 points. Nonunion, avascular necrosis and coxa vara complicated two, two and four cases, respectively. Fair and poor radiological results were related to coxa vara and avascular necrosis, respectively. Nonunion was significantly related to posterior comminution, type II neglected fracture, and a neglect of more than 45 days. Age groups more than 30 years old and postoperative neck-shaft angles <140° were significantly associated with late-onset radiological healing and nonunion. CONCLUSIONS: Cannulated screw osteosynthesis augmented by autogenous bone and bone marrow grafting is a simple, easy-to-perform surgical procedure with encouraging clinical outcomes for selected patients complaining of that difficult problem.

Displaced spinopelvic dissociation with sacral cauda equina syndrome: outcome of surgical decompression with a preliminary management algorithm.

INTRODUCTION: Displaced spinopelvic dissociation with cauda equina syndrome is still unclear challenging problem with multiple instabilities. This retrospective study tried to evaluate and analyze the results of surgical decompression and lumbopelvic fixation of these injuries. METHODS: Twenty-eight polytrauma patients with displaced spinopelvic dissociation and cauda equina syndrome were included. Preoperatively, they had thorough clinical, neurological, and radiological evaluation and classification. Operatively, they underwent primary, secondary, or tertiary decompression then spinopelvic fixation. Postoperatively, they were followed up for an average of 26 months. Hannover pelvic scoring system was applied for outcome evaluation. RESULTS: The mean age was 33.7 years; 17 cases were males and 11 were females. According to Roy-Camille, 13 cases had type II and 15 cases had type III injuries; cauda equina syndrome was incomplete in 17 cases and complete in 11 cases. Unilateral L5-S1 facet joint injury was detected in 13 cases; 14 cases had direct decompression (50 %) and 14 cases had indirect decompression (50 %). 19 patients (67.9 %) had excellent and good clinical outcome. Primary decompression had significantly increased the chances for neurological recovery (p = 0.024). Initial fracture kyphosis angles had a significant effect on neurological retrieval (p = 0.016). The mean of Gibbons score improved from 3.1 ± 0.83 preoperatively to 1.5 ± 0.84 at the end of follow-up with a highly significant impact (p = 0.001). CONCLUSIONS: Surgical decompression and lumbopelvic segmental fixation can enhance neurological recovery and combat any structural instabilities associated with the displaced spinopelvic dissociation injuries with a hopeful clinical results.

Improvement of growth and nitrogen utilization in sheep using sugar beet pulp treated with Trichoderma reesei or urea.

Twenty-five intact Barki lambs with mean body weight of 24.81 ± 0.16 kg were used to investigate the effect of including in the diet sugar beet pulp (SBP) treated biologically with Trichoderma reesei or chemically with urea 4 % on nutrients digestibility, growth performance, nitrogen (N) utilization, and hematological and biochemical parameters. Two experiments were conducted. In the growth experiment, five lambs were randomly assigned to one of five dietary treatments. Lambs were offered isonitrogenous and isoenergetic concentrate feed mixture containing on dry matter basis 0 % SBP (D0), 50 % SBP (D1), 50 % SBP treated with 4 % urea (D2), 50 % SBP treated with T. reesei (D3), and 25 % SPB treated with 4 % urea plus 25 % SPB treated with T. reesei (D4). In the metabolism experiment, five rams were used in a 5 × 5 Latin square design and housed in metabolism crates for 21 days. The present study showed that inclusion of SBP at the level of 50 % (D1) negatively affected diet digestibility coefficients of crude protein, crude fiber, and ether extract, in addition to average daily gain, feed conversion, and N utilization. However, treatment of SBP with urea (D2), T. reesei (D3), or the combination (D4) of both had improved (P < 0.05) these parameters with superiority of D3. Despite the significant differences in the tested hematological and biochemical parameters of lambs fed on biologically or chemically treated SBP diets, their levels remained within the physiological ranges which could indicate that treated SBP did not have any adverse effect on lambs' health.

In vitro gossypol induced spermatozoa motility alterations in rabbits.

The objectives of the present study were to: (i) examine the in vitro dose response of rabbit spermatozoa motility to the antifertility agent gossypol (GOS) and (ii) determine whether filtered (FIL) and unfiltered (UNFIL) GOS differ in their magnitude of effect. Rabbit semen belonging to adult males (n = 5; 12-14 months) were cultured with UNFIL GOS and FIL GOS (5% solution) and subsequently diluted (1:1-7) for analysis using a Computer Assisted Semen Analyzer (CASA) system in 5 time periods (0, 60, 120, 180 and 360 minutes). At Time 0, no significant change in rabbit spermatozoa motility (MOT) and progressive motility (PROG) with GOS FIL was noted, while increases were observed with GOS UNFIL. At Time 60, weak changes were noted for MOT and PROG. After 120 minutes of culture with both GOS FIL and GOS UNFIL, MOT and PROG decreased significantly in some experimental groups. However, no differences were recorded for both the parameters at Times 180 and 360, with the exception of PROG in the GOS UNFIL category (groups A, B, E, F and G), where a significant decrease was noticed. Detailed evaluation of the distance and velocity parameters revealed reduction in all these studied markers after 60 and 120 minutes of in vitro culture with both GOS FIL and GOS UNFIL, indirectly confirming the PROG decrease. Straightness (STR), linearity (LIN), wobble (WOB), amplitude of lateral head displacement (ALH) and beat cross frequency (BCF) mostly remained unaltered at all time periods for GOS FIL, where as some minor alterations were noticed in GOS UNFIL category for STR, LIN, WOB, ALH and BCF parameters at Time 0, 60 and 120. The present study confirms the dose and time dependent alterations of rabbit spermatozoa motility parameters by GOS. The GOS dynamics in our experiment shows that rabbit spermatozoa as a biological material can indicate a GOS inhibition of motility. Obtained data for the first time indicates a higher immobilizing potential of unfiltered GOS in comparison to filtered GOS in its inhibitory action of spermatozoa motility parameters in rabbits.

Vertically unstable sacral fractures with neurological insult: outcomes of surgical decompression and reconstruction plate internal fixation.

During a 4-year period, 32 patients with type C unstable sacral fractures were treated in our university hospital. All patients had neurological deficits as a result of their sacral fracture. The average age was 31.2 (range 22-54) years and the average Hannover Polytrauma Score (PTS) was 24 (range 19-40) points. Twelve patients had zone I fracture, ten had zone II fracture and ten patients had comminuted fractures involving both zones. All patients underwent surgical decompression and reconstruction plate internal fixation. The average follow up period was 24.4 (range 19-47) months. Twenty-one patients (65.6%) had complete neurological recovery, eight patients (25%) had partial recovery and three patients (9.4%) had no recovery. The relationship between radiological and functional scores was evident but insignificant (P = 0.434). Significantly, the neurological recovery was less favourable in older age groups, pedestrian trauma, vertical shear injuries, comminuted fractures, fifth lumbar root involvement, very low motor power grades and in patients presenting late. Concerning complications, four patients (12.5%) had early infection and five patients (15.6%) had late urological problems and heterotopic ossification. Consequently, we conclude that patients undergoing very early surgical decompression and only reconstruction plate internal fixation can achieve safe early ambulation and better neurological, functional and radiological results.