Operative management of non-elective incisional hernia reduces readmission in a national database.

PURPOSE: The aim of this project was to compare patient characteristics, overall efficacy, and readmission events following operative vs non-operative management modalities of non-elective patients presenting with symptomatic incisional hernias. METHODS: This study is a retrospective study of patients and patient demographics that presented as non-elective hospitalizations with symptomatic incisional hernia. Analysis of patients and characteristics utilized the National Readmission Database from 2010 to Q3 of 2015, delineating patient factors and outcomes following operative or non-operative management of hernias. RESULTS: A total of 14,137 patients met inclusion criteria for our study. The majority of patients were treated operatively rather than non-operatively (79 vs. 21%) on their non-elective admission for incisional hernia. Those undergoing surgical management were younger (56 vs 61 years, p < 0.01), we more often of male gender (69 vs 64%, p < 0.01), and had fewer comorbidities (1.92 vs 2.97, p < 0.01) and chronic conditions (0.45 vs 2.68, p < 0.01). Patients managed operatively had a significantly lower readmission rate when compared to patients managed non-operatively (6.6 vs 14.3%, p < 0.01). However, non-operative management was associated with a shorter length of stay (3 vs 4 days, p < 0.01). Of patients who were initially medically managed and had to be readmitted, a further 61% underwent surgical treatment on their readmission. CONCLUSION: In this nationwide study, patients with non-elective admissions for incisional hernia were mostly managed surgically. Those managed operatively had lower rates of readmission when compared to non-operative management. Initial non-operative management was associated with a shorter length of stay and a lower cost to the patient. The results of this study support operative management of symptomatic incisional hernia.

Surgical and non-surgical treatment of inguinal hernia during non-elective admissions in the Nationwide Readmissions Database.

INTRODUCTION: Inguinal hernia repair is one of the most common surgical operations, yet the optimal treatment strategy remains undefined. Treatment of symptomatic inguinal hernias include both surgical and non-surgical approaches. The objective of this study was to determine differences in population, readmission rates, and costs between operative and non-operative approaches for patients admitted non-electively for an inguinal hernia in a national dataset. In addition, we sought to define the baseline characteristics of the two groups and identify potential predictive factors in the non-surgically managed subgroup who were readmitted and treated operatively within 90 days of their first visit. METHODS: This study was a retrospective review of data from the Nationwide Readmissions Database (NRD) from 2010 to 2014. Patients above age 18 who were admitted non-electively for a primary diagnosis of inguinal hernia were included. Patients whose length of stay was < 1% or > 95% percentile or died during the initial visit were excluded. Readmissions within 90 days of the initial visit were flagged. Patients were classified according to initial management strategy: operative versus non-operative. Demographic, clinical, and organizational characteristics were compared between the two cohorts. RESULTS: 14,249 patients met inclusion criteria and were operative (n = 8996, 63.13%) and non-operative (n = 5255, 36.88%) cohorts. When comparing the two groups, readmission rate was lower (0.49% for surgical, 1.78% for non-surgical, p < 0.01), mean length of stay (LOS) longer (3.27 [SE = 0.05] days for surgical, 2.76 days [SE = 0.06] for non-surgical, p < 0.01), and mean total cost higher ($9597 for surgical, $7167 for non-surgical, p < 0.01) in surgically treated patients. The non-surgical population was on average older (63.05 years for surgical, 64.52 years for non-surgical, p < 0.01) with more chronic conditions (3.57 for surgical, 4.05 for non-surgical, p < 0.01). Of the patients initially managed non-surgically, 1.78% (n = 91) were readmitted, and of them, 62.63% (n = 57) were readmitted and managed surgically within 90 days of initial admission (i.e., crossed over from watchful waiting to surgical treatment). Average number of chronic conditions (3.79 versus 4.03, p = 0.74), average number of comorbidities (2.26 versus 2.18, p = 0.87), and average total number of ICD-9 discharge codes (7.44 versus 8.23 p = 0.54 did not differ significantly between the operative versus non-operative sample of the readmitted population. The total cost ($5562.38 versus $8737.28, p = 0.01) was greater in the operative versus non-operative sample. CONCLUSION: Watchful-waiting strategy is the most common treatment approach in patients admitted non-electively for symptomatic inguinal hernia. Readmission after non-elective hospitalization for inguinal hernia is rare, but surgical intervention decreased the likelihood of readmission compared to non-operative management, while also increasing LOS and cost of care. Our data supports a patient centric approach to the management; non-surgical treatment is a viable temporary option even in symptomatic inguinal hernias, while surgical treatment may reduce the likelihood of future readmission.

Matrix stiffness induces epithelial-mesenchymal transition and promotes chemoresistance in pancreatic cancer cells.

Increased matrix rigidity associated with the fibrotic reaction is documented to stimulate intracellular signalling pathways that promote cancer cell survival and tumour growth. Pancreatic cancer is one of the stiffest of all human solid carcinomas and is characterised by a remarkable desmoplastic reaction. Here we use mouse models, genetically engineered to recapitulate human pancreatic cancer, and several pancreatic cancer cell lines as a model to investigate the effect of matrix stiffness in epithelial-mesenchymal transition (EMT) and resistance to chemotherapeutics. We found that recapitulation of the fibrotic rigidities found in pancreatic cancer tissues promote elements of EMT, including increases in vimentin expression, decreases in E-cadherin expression, nuclear localisation of ß-catenin, YAP and TAZ and changes in cell shape towards a mesenchymal phenotype. We also report that stiffness induces chemoresistance to paclitaxel, but not to gemcitabine, both commonly used therapeutics, suggesting that environmental rigidity underlies an aspect of chemoresistance.

Effects of calcium soap of rice bran oil fatty acids supplementation alone and with DL-α-tocopherol acetate in lamb diets on performance, digestibility, ruminal parameters and meat quality.

Thirty-six Malpura lambs (28 day old and 6.7 ± 0.25 kg BW) were distributed equally in three groups having six males and six female. They were ad libitum fed individually three different experimental diets containing calcium soap of fatty acids (CA-FA) at 0 (T1 ) and 40 (T2 and T3 ) g/kg concentrate up to six months of age. Animals in T3 were supplemented additionally with 40 mg DL-α-tocopherol acetate/kg of concentrate. The roughage moiety included ad libitum dry Prosopis cineraria and fresh Azadirachata indica leaves. All the lambs were allowed to suckle from their dam up to weaning (90 day of age). Supplementation of Ca-FA improved weight gain and feed conversion ratio during both pre- (28-90 days) and post-weaning (91-180 days) phases; however, no effect of DL-α-tocopherol was observed. Metabolic parameters during post-weaning phase revealed non-significant effect on digestibility but improved nitrogen balance in the test groups. The effect on biochemical attributes did not show any significant alteration in ruminal parameters, blood biochemicals and urinary purine derivatives. Carcass traits revealed higher (p < 0.05) dressing yield and loin eye area with Ca-FA supplementation. The value of thiobarbituric reactive substances for nuggets prepared from frozen carcasses revealed significant (p < 0.05) reduction in T3 compared to the other dietary groups. Fatty acid profile of adipose tissue revealed higher (p < 0.001) 9-octadecanoic, 9-12-octadecadienoic, polyunsaturated fatty acids (PUFA), higher ratio of PUFA/saturated fatty acids (SFA), ω-6/ω-3 and lower SFA in Ca-FA-supplemented groups. It is concluded that supplementation of 40 g/kg calcium soap prepared from industrial grade rice bran oil in lamb ration provided additional energy intake, improved N utilization, gain and feed conversion ratio besides improving dressing yield and meat quality with CLA enriched fatty acid profile. DL-α-tocopherol acetate when supplemented at 40 mg/kg feed reduced lipid oxidation of meat products thus improving its keeping quality.

Effect of milk replacer and rumen inert fat on growth and reproduction of Malpura ram lambs.

The objective of this study was to assess the effects of milk replacer and rumen inert fat on growth, testicular development, puberty, semen production and sperm motion characteristics of ram lambs reared under intensive management in semi-arid climatic conditions. Seven-day-old male lambs of Malpura breed (n=20) were divided equally into two groups. Up to weaning, the lambs in G1 group (control) were fed concentrate, green khejri (Prosopis cineraria) leaves and cowpea (Vigna unguiculata) hay along with suckling of dams, whereas lambs in G2 group were fed reconstituted milk at 17 g/lamb per day for the 1st week and at 34 g/lamb per day from 2nd week in addition to the feed inputs given in G1. During post weaning, lambs in the G1 group were given control concentrate, whereas in G2 the control concentrate supplemented with 40 g rumen inert fat per kg of feed was offered along with dry pala (Zizyphus nummularia) and ardu (Ailanthus excelsa) leaves. BWs of lambs were recorded weekly up to 6 months of age. Ram lambs of both the groups were trained for semen collection at a weekly interval from the age of 5 months and simultaneously testicular measurements were recorded fortnightly. The feeding of milk replacer and rumen inert fat had positive (P<0.05) effects on BW, testicular length, testicular volume, semen volume, sperm concentration, mass motility, % motility, % rapid, medium or slow motile spermatozoa. However, no significant effect was observed on testicular breadth, scrotal circumference, age of puberty, sperm velocities and other CASA-derived parameters. The results of this study indicate that higher plane of nutrition in the form of milk-replacer feeding during preweaning and rumen inert fat-supplemented feed during the postweaning period to growing ram lambs enhances their growth, testicular development and semen quality.

Mutant p53 enhances MET trafficking and signalling to drive cell scattering and invasion.

Tumour-derived mutant p53 proteins promote invasion, in part, by enhancing Rab coupling protein (RCP)-dependent receptor recycling. Here we identified MET as an RCP-binding protein and showed that mutant p53 promoted MET recycling. Mutant p53-expressing cells were more sensitive to hepatocyte growth factor, the ligand for MET, leading to enhanced MET signalling, invasion and cell scattering that was dependent on both MET and RCP. In cells expressing the p53 family member TAp63, inhibition of TAp63 also lead to cell scattering and MET-dependent invasion. However, in cells that express very low levels of TAp63, the ability of mutant p53 to promote MET-dependent cell scattering was independent of TAp63. Taken together, our data show that mutant p53 can enhance MET signalling to promote cell scattering and invasion through both TAp63-dependent and -independent mechanisms. MET has a predominant role in metastatic progression and the identification of mechanisms through which mutations in p53 can drive MET signalling may help to identify and direct therapy.

Growth performance of lambs fed diet supplemented with rice bran oil as such or as calcium soap.

Forty two Malpura lambs (21 d old) were divided into three groups of 14 each consisting of 8 females and 6 males. Lambs were allowed to suckle their respective dams twice daily up to weaning (13 wks) and offered free choice concentrate and roughage in a cafeteria system. The lambs in control group were fed conventional concentrate mixture, in RBO group concentrate mixture fortified with 4% industrial grade rice bran oil and in Ca-soap rice bran oil (as in RBO group) was supplemented in the form of calcium soap. The concentrate intake decreased(p≤0.05) in RBO group as a result total dry matter, crude protein and metabolizable energy intake decreased compared to control whereas Ca-soap prepared from the same rice bran oil stimulated the concentrate intake leading to higher total dry matter, crude protein and energy intakes. The digestibility of dry matter (p≤0.05), organic matter (p≤0.05) and crude protein (p≤0.05) was higher in RBO group followed by Ca-soap and control whereas no effect was observed for ether extract digestibility. Higher cholesterol (p≤0.05) content was recorded in serum of oil supplemented groups (RBO and Ca-soap) while no effect was recorded for other blood parameters. Rice bran oil as such adversely affected and reduced the body weight gain (p≤0.001) of lambs in comparison to control whereas the Ca-soap of rice bran oil improved body weight gain and feed conversion efficiency in lambs. Fat supplementation decreased total volatile fatty acids (p≤0.05) and individual volatile fatty acid concentration which increased at 4 h post feeding. Fat supplementation also reduced (p≤0.05) total protozoa count. Ca-soap of rice bran oil improved pre slaughter weight (p≤0.05) and hot carcass weight (p≤0.05). It is concluded from the study that rice bran oil in the form of calcium soap at 40 g/kg of concentrate improved growth, feed conversion efficiency and carcass quality as compared to rice bran oil as such and control groups.

Re-alimentation strategy to manoeuvre body condition and carcass characteristics in cull ewes.

Improvement in body condition and carcass traits through nutritional intervention was studied in cull ewes. Sixty-eight adult non-productive Malpura ewes (average body weight 26.7 ± 0.33 kg) were randomly divided into four equal groups: G0 maintained on free grazing for 8 h on protected natural rangeland with ad libitum guar (Cyamopsis tetragonoloba) straw (GS) after grazing; G1, G2 and G3 fed with supplemental concentrate at the rate of 250 g, 2.5% of live weight (LW) and ad libitum, respectively. The experiment was continued for 90 days and daily feed intake, weekly LW and body condition score (BCS) were recorded. Intake and digestibility of nutrients were assessed by indicator method. Rumen fermentation attributes and blood biochemical profile were studied to assess the dietary effects and animals were slaughtered at the end of experiment for evaluation of carcass characteristics. Higher dry matter (DM) intake and improvement in plane of nutrition was observed in G2 and G3 with a higher LW gain (LWG) and improvement in BCS than in G0. The digestibility of DM, organic matter, CP, ADF and cellulose was higher (P < 0.05) in G2 and G3 than in G0. A lower ruminal pH and ammonia N but higher total N and trichloroacetic acid-precipitable N, an increase in holotrichs, spirotrichs and total protozoa population, increase in haemoglobin but decrease in serum total cholesterol and non-esterified fatty acids were observed in high-concentrate-fed groups. Carcass attributes revealed increase (P < 0.05) in empty LW, dressing yield, eye muscle area, subcutaneous and intramuscular fat, decrease in shear force value and higher (P < 0.05) protein content in Longissimus dorsi muscle in test groups than in the control. Above all, the G2 animals had better rumen environment and blood biochemical attributes and consumed more feed with enhanced digestibility that supported higher LWG at better feed conversion efficiency, improvement in BCS and carcass quality. Thus, re-alimentation of cull ewes with challenged feeding of concentrate at 2.5% of LW on a basal roughage diet for a period of 3 months may have promise for better economic return to the farmers with possibly meeting quality mutton for human consumption.

Effect of concentrate supplementation on performance, ovarian response, and some biochemical profile of Malpura ewes.

Effect of feed flushing on ovulation rate was investigated during the autumn seasons on 24 adult Malpura ewes (BW 34.8 ± 0.58 kg and age 4-7 years) equally divided into two groups. Ewes in G1 (group 1) were grazed 8-10 h daily on Cenchrus ciliaris pasture interspersed with seasonal shrub. In addition to grazing, concentrate was provided at 1.5% of BW to the animals in G2 (group 2) for a period of 35 days. Estrus was synchronized by a double injection schedule of PGF(2α) at 0 and 10 days of the experiment and detected by parading aproned rams at 6 h intervals. Blood samples were collected at weekly interval during the estrous cycle. A rumen fermentation study was conducted on day 23 of the experiment at 0 and 4 h post-concentrate feeding. Ovarian responses in terms of number of corpora lutea and large follicles was examined on all the ewes by laparoscopy after 3 to 6 days of each estrus and were found to be similar in both the groups. Hemoglobin and packed cell volume, total protein, albumin, and globulin were similar among the groups. Concentration of plasma glucose (12 and 22 days) was higher (P < 0.05) in G2 vis-à-vis control. Plasma urea was higher (P < 0.01) in the control than G2. Rumen liquor pH, concentration of total N, TCA-ppt N, NH(3)-N, and TVFA were significantly higher (P < 0.01) in G2 than the control. Thus, it can be concluded that concentrate supplementation in ewes prior to mating (flushing) did not enhance ovulation response during the autumn season.

Haematology, blood biochemistry and tissue histopathology of lambs maintained on diets containing an insect controlling protein (Cry1Ac) in Bt-cottonseed.

This experiment assessed the effect of feeding genetically modified cottonseed (Bt) containing an insect controlling protein (Cry1Ac) on haematology, blood biochemistry and histopathology of lambs. Haemato-biochemicals were estimated at periodic intervals, and histopathology at termination of experiment. Thirty three weaner lambs were fed a composite feed mixture (CFM) ad libitum individually, in three groups for 123 days. The isonitrogenous CFM had roughage (Perl Millet Stover) and concentrate ratio of 350:650. Diet fed to control lambs contained groundnut oil meal as protein source while other two groups received diet containing either whole cottonseed (N-Bt) or Bt-cottonseed (Bt-CS). Daily feed intake and average daily gain were similar among lambs of three groups. Lambs fed N-Bt diet had higher (p < 0.05) serum protein and globulin compared to control and Bt diets, while albumin content was higher (p = 0.018) in Bt diet fed lambs. Serum urea and creatinin content, alkaline phosphatase (ALP) and serum glutamate pyruvic transaminase (SGPT) activities were not different among lamb groups, while urea and creatinin content and ALP activities increased linearly (p < 0.001) with increased feeding period. Blood haemoglobin (Hb), haematocrit (Hc), white blood cells (WBC), mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) ranged from 11.1% to 11.2%, 31.8% to 32.8%, 7.0 to 8.3 (× 10(3) /µl), 19.1 to 22.5 fl and 33.2% to 35.5%, respectively, were similar among lamb groups. Erythrocyte sedimentation rate (ESR) (p = 0.008) and red blood cell counts (p = 0.006) were higher in Bt diet fed lambs. Control and N-Bt diet fed lambs had mild fatty infiltration in liver and/or micro-calculi in renal cortex, and such lesions were not seen in Bt diet fed lambs. Growth, haemato-biochemical and histopathology did not change by Bt-CS feeding in growing lamb. However, before recommending the use of Bt-CS in routine feed formulations prolonged feeding experiments of Bt-cotton seed require.

Effect of different feeding regimes on pre-weaning growth rumen fermentation and its influence on post-weaning performance of lambs.

Influence of pre-weaning live weight on post-weaning growth performance was assessed on thirty-nine 15-day-old Indian native lambs, randomly fed in three equal groups until 180 days of age. During pre-weaning phase lambs were maintained under feeding regimen of grazing (C-0; Control), grazing and ad lib creep mixture supplementation (C-AL) or grazing, with ad lib creep mixture and milk replacer supplementation (C-ALMR). Lambs were allowed to suckle respective dam in morning and evening till 90 days of age, and fed ad lib green leaves of Ailanthus excelsa after grazing. After weaning all lambs were maintained on grazing and ad lib finisher concentrates supplementation. Pre-weaning performance of lambs in terms of weaning weight (17.2 kg), average daily gain (ADG; 154 g) and feed conversion ratio 3.73 was higher (p < 0.01) in C-ALMR lambs but total gain and ADG were similar among three groups during post-weaning phase. However, improved pre-weaning plane of nutrition and growth rate increased (p < 0.01) finishing weight (FW) of lambs in C-AL, 33 kg and C-ALMR, 32 kg. Dry matter intake was significantly (p < 0.01) higher in C-AL and C-ALMR lambs due to combined effect of feeding. Rumen pH was lowest (p = 0.049) in C-AL lambs. Rumen ciliate protozoa population (10(4)/ml) decreased in C-ALMR lambs (4.3) but increased in C-AL lambs (50.0) more so in C-0 Lambs (19.8). Concentrate feeding of C-AL lamb improved nutrient digestibility. Lambs of C-0 group consumed more DM during post-weaning phase that improved growth performance, while nutrient digestibility was not affected by pre-weaning nutrition. Thus, pre-weaning nutrition has significant influence on FW, however influence of milk replacer feeding on lamb growth need further studies.

Effect of different liquid cultures of live yeast strains on performance, ruminal fermentation and microbial protein synthesis in lambs.

Three yeast strains, Kluyveromyces marximanus NRRL-3234 (KM), Saccharomyces cerevisiae NCDC-42 (SC) and Saccharomyces uvarum ATCC-9080 (SU), and a mixed culture (1:1:1 ratio) were evaluated for their value as probiotics in lamb feeding in two experiment. In experiment I and II, 20 and 30 pre-weaner lambs were fed for 63 and 60 days in two and three equal groups respectively. All lambs were offered ad libitum a creep mixture and Zizyphus nummularia leaves, and yeasts were dosed orally. In experiment I, one group received no yeast, the other of the mixed culture (1.5-2 x 10(10) live cells/ml). In experiment II, yeast cultivation was modified yielding 1.5-2 x 10(13) live cells/ml. Lambs of the three experimental groups received 1 ml/kg live weight of one of the individual yeasts. Feed intake did not differ among groups of both experiments with the exception of SC-supplemented lambs in experiment II which showed a trend to higher intakes per kg metabolic body weight and in percentage of body weight when compared with KM- and SU-supplemented lambs. Supplementation of the mixed yeast culture had no effect on intakes of digestible crude protein and metabolisable energy, nutrient digestibility, nitrogen balance and rumen fermentation characteristics (pH, ammonia, volatile fatty acid concentration, protozoa count) and urinary allantoin as an indicator of microbial protein synthesis. The same was true for comparisons in experiment II except ciliate protozoa counts, which showed a trend to be the highest with SU and the lowest with SC. The results of present study show that the response of lambs to supplemented live yeast cultures is inconsistent, as it lacked to have an effect in the present study, and that differences among strains were small, even when supplemented at a much higher live cell count.

Growth, haematology, blood constituents and immunological status of lambs fed graded levels of animal feed grade damaged wheat as substitute of maize.

The aim of this study was to explore possibilities of utilization of animal feed grade damaged wheat (ADW) in lamb feeding, and assess the effect of ADW and its aflatoxin on intake, growth, haematology, blood biochemical constituents and immunological status. The ADW is a slightly mouldy feed resource, which is not suitable for human consumption. The experimental ADW contained dry matter (DM) 964, organic matter 974, crude protein 153, cellulose 205 and lignin 24, and starch 732 g/kg DM. ADW also contained aflatoxin B1 50 microg/kg due to mould infestation. Thirty-five weaner lambs (90 +/- 15 days of age and 16.1 +/- 0.82 kg body weight) in a randomized design were fed for 91 days on one of four composite feed mixtures (roughage to concentrate ratio of 25:75) containing 0, 118, 235, 353 or 470 g/kg ADW, which replaced equal amounts of maize and at these inclusion levels ADW replaced 0%, 25%, 50%, 75% and 100% maize in lamb diets respectively. Dry matter intake (DMI) was similar in different level of ADW fed lambs but ADW inclusion linearly (p = 0.016) reduced DMI. Average daily gain (g/day) was higher (p = 0.038) in lambs fed 353 g ADW diet. Haematological attributes viz. WBC, haemoglobin (Hb) and mean corpuscular volume did not affect by ADW feeding whereas it increased haematocrit, mean cell Hb and decreased neutrophil, RBC counts and mean cell Hb concentration. Blood glucose and urea-N increased whereas albumin and protein level reduced by ADW feeding. ADW feeding of lambs did not affect serum IgG level. The activities of serum aspartate aminotransferase, alkaline phosphates and acid phosphates were not affected, whereas alanine aminotransferase increased linearly (p = 0.001) with increasing levels of ADW. It is concluded that ADW containing aflatoxin B1 50 microg/kg DM can safely be incorporated in growing lamb feeding up to 353 g/kg diet without affecting growth and cellular immunity, however ADW may induce a transient alteration of hepatic enzymatic activities. Further aflatoxin content of the diet should be kept within permissible limits of respective country.

Socio-demographic characteristics of children infested with scabies in densely populated communities of residential madrashas (Islamic education institutes) in Dhaka, Bangladesh.

BACKGROUND: Outbreaks of scabies in institutions and the socio-economic consequences have not been reported from overpopulated countries such as Bangladesh. STUDY DESIGN: A community-based study among children from six residential Islamic education institutes (madrashas) in Dhaka. Multistage random sampling was used. OBJECTIVES: To study the socio-economic profile, water-sanitation facilities, personal hygiene and living conditions of these children. METHODOLOGY: Direct interviews were used to collect the data and clinical check up was performed in all children. RESULTS: In total, 492 children received clinical check-ups; 92.5% were boys (mean age: 11.2+/-2.4 years). 63.4% of fathers and 98.5% of mothers were either illiterate or had only received primary education, 55.1% of fathers were in low-paid labouring jobs, and 99% of mothers were housewives. Of the 98% of children who had scabies, 71% had been re-infected (96% during the winter). Randomly assigned anti-scabies drugs revealed an average cure rate of 85.5%. Seventy-four percent of children were living in poorly ventilated buildings with overcrowded sleeping arrangements. They had poor personal hygiene: 21% shared towels; 8% shared undergarments; 30% shared bed linen; and 81% kept their used clothes on a communal line or shelf. Sanitation was also poor: 39% bathed infrequently, although 97% carried out mandatory ablution. Most children (61%) washed their clothes (including undergarments) two or three times a fortnight, 35% did so every 2-3 days, and 3.7% washed their clothes on alternative days. Disease severity and re-infection were associated with infrequent washing of clothes (P<0.001) and bed linen (P<0.001), overcrowded sleeping arrangements (P<0.001) and infrequent bathing (P<0.001) with soap (P<0.001). This was further related to household income (P<0.001 for both). CONCLUSION: The study findings have potentially dangerous implications for public health. Immediate attention should be given to developing a sustainable long-term intervention programme to combat scabies hyperendemicity, and to save thousands of children from impending complications.

Genetic background influences UPR but not PLP processing in the rumpshaker model of PMD/SPG2.

Mutations of the proteolipid protein gene (PLP1) cause Pelizaeus-Merzbacher disease (PMD) and Spastic paraplegia type 2 (SPG2). The rumpshaker mutation is associated with mild forms of PMD or SPG2 in man and the identical mutation occurs in mice, the phenotype depending on genetic background. The mild phenotype in C3H mice becomes a lethal disease when expressed on the C57BL/6 background. rumpshaker PLP is synthesised at a similar rate to wild type but is rapidly degraded by the proteasome. We show that the rates of synthesis, degradation and myelin incorporation of PLP/DM20 are similar in mutants on both backgrounds and therefore differences in PLP processing are unlikely to be the basis of the phenotypic variation. An unfolded protein response (UPR) is activated in rumpshaker. Whereas activation of CHOP correlates with phenotypic severity, we find no difference in the response of BiP and X-box protein1 (Xbp1) between the two strains.

Carcass traits of Kheri lambs maintained on different system of feeding management.

The study was conducted on 6-month-old finisher lambs of the Kheri breed raised under extensive range management (G1), grazing with ad libitum concentrate supplementation (G2) or intensive feeding (G3) to assess dressing yield, cutability of standard cuts, composition of the carcass and the efficiency of mutton production from the three defined systems. The weaning weight of the lambs in the three groups was similar while the finishing weight, total body weight gain in the experiment, average daily gain and the percent feed conversion efficiency were higher (P<0.01) in G2 and G3 than G1. The pre slaughter weight (PSW), empty live weight (ELW), hot carcass weight and hot carcass weight with edible offal was higher (P<0.01) in G2 and G3 fed on a high plane of nutrition than G1 raised under extensive range management. The dressing percent in terms of live weight (LW) and empty live weight (ELW) was also higher in G2 and G3 than G1. The loin eye area as an index of muscle growth was also higher in G2 and G3 than G1. Although the weights of standard cuts were generally higher in G2 and G3 due to higher PSW, as proportions of half carcass they were similar in the three groups, except the rack cut, which was higher in G2 and G3. The cut proportions pooled for the three groups averaged 33.2%, 12.3%, 13.3%, 24.9% and 16.3% of half carcass for leg, loin, rack, neck and shoulder and breast and fore shank, respectively. The depot fat (Caul and kidney fat) accretion was higher in G2 and G3 than G1. The composition of the half carcass indicated that lean percent was higher (P<0.01) in G1 and G2 than G3 while sub cutaneous and intra muscular fat content were generally higher (P<0.01) in G2 and G3 and KOH bone percent was higher (P<0.05) in G1 and G2 than G3. The results indicated that the growth performance was better, feed conversion efficiency, carcass yield and dressing percentage higher in lambs maintained under grazing with supplementation and intensive feeding than extensive range management. The carcass separable fat content was 8% under extensive range management while it was 12% and 16% in semi intensive and intensive system of feeding management indicating that the carcass was of acceptable quality. The loin eye area reflected the trends of pre slaughter weight and was higher in intensive and semi intensive than extensive range management.

Age at menopause, and knowledge of and attitudes to menopause, of women in Karachi, Pakistan.

OBJECTIVES: The objectives of the study were to identify the average age at menopause in Karachi and to assess knowledge of and attitudes to the menopause among Pakistani women in different social strata. STUDY DESIGN: A population-based cross-sectional study of 960 women aged over 35 years was conducted. RESULTS: As insufficient data were available for 35 women, 925 interviews were analysed. There were 287 menopausal women, whose mean (SD) age at menopause was 47.1 (4.7) years (95% CI 46.8 to 47.6). Of these 287 women, 135 (47%) wanted their menses to continue and 235 (82%) had consulted a physician after the menopause. Of all 925 women, 58% knew the correct definition of the menopause, all had consulted a physician for various symptoms related to the menopause and 53% said that women should consult a physician premenopausally. Symptoms experienced by premenopausal women included lack of sleep (25%), fear of infertility (13%) and urinary incontinence (18%). The majority of the overall sample (52%) were sexually active. Of the sexually active women, 16% had marital problems, compared with 44% of sexually inactive women, and this difference was statistically significant (P < 0.0001). Source of knowledge about the menopause included relatives (35%), television (18%), neighbours (17%), friends (17%) and health-care providers (14%). CONCLUSIONS: Evidence-based information about the menopause should be provided for Pakistani women.

Carcass yield, composition and meat quality attributes of sheep and goat under semiarid conditions.

Carcass composition and meat quality attributes were compared in yearling sheep and goats. After weaning at 3 months of age, the animals were maintained under stall fed condition up to 1 year of age. Throughout the study, the animals were maintained on ad libitum complete feed (50:50 roughage and concentrate). The yearling sheep had higher (P<0.05) pre slaughter weight, hot carcass weight and dressing % than the goats. The muscular development as indicated by loin eye area was significantly (P<0.01) greater in sheep than goats. In general, total non-carcass fat contents were more in sheep than goats. Similarly, the dissected total fat of half carcass was also more (P<0.01) in sheep than the goats. Neck and shoulder portion was heavier (P<0.01) in goats than the sheep. Shear force value was greater (P<0.01) in goats (7.42 kg/cm(2)) than sheep (3. 74 kg/cm(2)). Goat meat had more (P<0.01) moisture and less fat than mutton. In sensory evaluation both the species were rated almost equal in overall palatability scores. The current study showed that dressing yield was higher in sheep than goats. But goat yielded leaner carcass which is desirable for the calorie concern consumers. It was also revealed that meat from goat carcasses was tougher than mutton.

Influence of ciliate protozoa on biochemical changes and hydrolytic enzyme profile in the rumen ecosystem.

AIMS: To assess the effect of presence or absence of rumen protozoa on fermentation characteristics and enzyme profile in growing lambs. METHODS AND RESULTS: Weaner lambs (G1, G2, G3, G4, G5 and G6 groups) were defaunated by oral administration of sodium laurel sulphate (at 8 g 100 kg(-1) body weight). The lambs of G4, G5 and G6 groups were refaunated. The roughage and concentrate ratio in the diet of G1 and G4, G2 and G5, and G3 and G6 were 50:50 (R1), 65:35 (R2) and 80:20 (R3), respectively. Daily dry matter intake was similar in defaunated and faunated lambs. However, digestibility of organic matter (OM), cellulose and gross energy were lower in defaunated lambs while crude protein (CP) digestibility was similar in both defaunated and faunated lambs. The rumen pH and NH3-N were lower (P < 0.01) while TVFA, total-N and TCA-ppt-N were higher (P < 0.01), in defaunated lambs. Ruminal activity of carboxymethyl cellulase was lower (P < 0.01) in defaunated lambs and amylase, xylanase, protease and urease were similar in faunated and defaunated lambs. Nutrient utilization, rumen metabolites and ciliate protozoal count were higher, whereas digestibility of fibre fractions was lower in high rather than low concentrate fed lambs. The rumen protozoa present before defaunation were B-type and the protozoa which re-established on refaunation were also B-type. CONCLUSIONS: Absence of ciliate protozoa decreased nutrient digestibility and increased ruminal TVFA and total-N with lower NH3-N concentration, indicating better energy and protein utilization in defaunated lambs. SIGNIFICANCE AND IMPACT OF THE STUDY: Defaunation improved energy and protein utilization in lambs.