Anorectal malformations in low and middle-income countries- spectrum, burden and management.

The clinical presentation, diagnosis and management of anorectal malformation has been well described in the literature, however the experience with these conditions in low-and middle-income countries is often shaped in unique ways due to the social, cultural and economic factors at work in these regions. This leads to adaptation of modifications in management options for these babies that usually present as delayed cases with added poor prognostic factors like sepsis leading to need for emergency resuscitation and overall increased morbidity and mortality. This article explores the anomaly from a global surgery lens and outlines the spectrum of the anomaly, burden faced in the resource constrained environment and the management options adopted for successful management under the available circumstances.

Comparative transcriptome analysis during tuberous stem formation in Kohlrabi (B. oleracea var. gongylodes) at early growth periods (seedling stages).

Tuberous stem of kohlrabi is an important agronomic trait, however, the molecular basis of tuberization is poorly understood. To elucidate the tuberization mechanism, we conducted a comparative transcriptomic analysis between kohlrabi and broccoli at 10 and 20 days after germination (DAG) as tuberous stem initiated between these time points. A total of 5580 and 2866 differentially expressed transcripts (DETs) were identified between genotypes (kohlrabi vs. broccoli) and growth stages (10 DAG vs. 20 DAG), respectively, and most of the DETs were down-regulated in kohlrabi. Gene ontology (GO) and KEGG pathway enrichment analyses showed that the DETs between genotypes are involved in cell wall loosening and expansion, cell cycle and division, carbohydrate metabolism, hormone transport, hormone signal transduction and in several transcription factors. The DETs identified in those categories may directly/indirectly relate to the initiation and development of tuberous stem in kohlrabi. In addition, the expression pattern of the hormone synthesis related DETs coincided with the endogenous IAA, IAAsp, GA, ABA, and tZ profiles in kohlrabi and broccoli seedlings, that were revealed in our phytohormone analysis. This is the first report on comparative transcriptome analysis for tuberous stem formation in kohlrabi at early growth periods. The resulting data could provide significant insights into the molecular mechanism underlying tuberous stem development in kohlrabi as well as in other tuberous organ forming crops.

Metals extraction processes from electronic waste: constraints and opportunities.

The skyrocketing demand and progressive technology have increased our dependency on electrical and electronic devices. However, the life span of these devices has been shortened because of rapid scientific expansions. Hence, massive volumes of electronic waste (e-waste) is generating day by day. Nevertheless, the ongoing management of e-waste has emerged as a major threat to sustainable economic development worldwide. In general, e-waste contains several toxic substances such as metals, plastics, and refractory oxides. Metals, particularly lead, mercury, nickel, cadmium, and copper along with some valuable metals such as rare earth metals, platinum group elements, alkaline and radioactive metal are very common; which can be extracted before disposing of the e-waste for reuse. In addition, many of these metals are hazardous. Therefore, e-waste management is an essential issue. In this study, we critically have reviewed the existing extraction processes and compared among different processes such as physical, biological, supercritical fluid technologies, pyro and hydrometallurgical, and hybrid methods used for metals extraction from e-waste. The review indicates that although each method has particular merits but hybrid methods are eco-friendlier with extraction efficiency > 90%. This study also provides insight into the technical challenges to the practical realization of metals extraction from e-waste sources.

Topical Pilocarpine Formulation for Diagnosis of Cystic Fibrosis.

Cystic fibrosis is diagnosed in infants by estimating the levels of chloride ions present in the sweat induced by iontophoresis of pilocarpine solution. Elevated levels of chloride (≥60 mMol/L) in sweat are indicative of cystic fibrosis. However, the iontophoretic method of delivering pilocarpine is cumbersome and usually is associated with several side effects such as skin burn, skin rashes, erythema, and so forth. The objective of this study was therefore to develop a topical formulation that delivers adequate amount of pilocarpine. The drug delivery of formulation was compared with iontophoresis of aqueous solution of pilocarpine nitrate in vitro using porcine skin model. The pilocarpine levels in the skin exposed to topical pilocarpine solution under mild hyperthermia was 152.04 ± 52.23 µg/cm2 after 10 min of application, whereas it was 97.05 ± 27.93 µg/cm2 in the skin after 10 min of iontophoresis. The topical formulation was subjected to clinical evaluation to assess the efficacy of the product to induce sweat production. The average amount of the sweat secreted on application of topical formulation was found to be 77.28 ± 18.97 mg. Based on these results, it was found that the topical formulation was successful in delivering pilocarpine and to stimulate sweat secretion.

Multicenter Study of 342 Anorectal Malformation Patients: Age, Gender, Krickenbeck Subtypes, and Associated Anomalies.

INTRODUCTION: Published studies based on Krickenbeck classification of anorectal malformations (ARMs) are still insufficient to assess the global as well as regional relative incidence of different ARM subtypes, gender distribution, and associated anomalies. The primary purpose of this study was to provide an estimate of those in Global Initiative for Children's Surgery (GICS) research group. MATERIALS AND METHODS: We collected ARM data prospectively for 1 year from four institutes of different geographic locations. A total of 342 patients were included in this study (195, 126, 11, and 10 from Bangladesh, Iran, Papua New Guinea, and Oxford, United Kingdom, respectively). RESULTS: Overall male to female ratio was 1:1. The most frequent ARM subtype was perineal fistula (23.7% = 81/342). About 48.5% (166/342) patients had at least one associated anomaly. Cardiac and genitourinary systems were the most commonly affected systems, 31.6% (108/342) and 18.4% (63/342), respectively. These organ-systems were followed by anomalies of vertebral/spinal (9.9% = 34/342), musculoskeletal (4.4% = 15/342), and gastrointestinal/abdominal (3.2% = 11/342) systems. Rectovesical fistula had the highest percentage (96.4% = 27/28) of associated anomalies. About 18.1% (62/342) patients had multiple anomalies. ARMs (both isolated and with associated anomalies) occurred equally in males and females. Comparison between patients from Bangladesh and Iran showed differences in relative incidence in ARM subtypes. In addition, Iranian patient group had higher percentage of associated anomalies compared with Bangladeshi (73 vs. 35.4%). CONCLUSION: Our study provides important insights about ARM subtypes, gender distribution and associated anomalies based on Krickenbeck classification especially from Bangladesh and Iran.

Allele specific DNA marker for fusarium resistance gene FocBo1 in Brassica oleracea.

The fusarium yellows resistance (YR) gene FocBo1 was previously identified and the DNA markers were developed to assist the breeding of YR cultivars in Brassica oleracea. However, the further analysis revealed discrepancies between the phenotypes and the genotypes predicted by those DNA markers in cabbage commercial cultivars. Since this discrepancy seemed to be due to unknown susceptible alleles of focbo1, we sequenced the gene in 19 accessions to determine the sequence variations between alleles and found that there were two resistant FocBo1 alleles and six susceptible alleles in the investigated population. The newly designed PCR markers detected three mutations in the susceptible alleles that generate premature termination codons. These were shown to accurately distinguish resistant and susceptible alleles in more than 200 accessions of B. oleracea inbred lines and cultivars. The study revealed that the locus is represented by 37.2% resistant and 62.8% susceptible alleles within seventy-eight commercial cultivars. Structural analysis of the gene revealed that a part of the allelic variation comes from intragenic recombination between alleles. Our results enable a more precise prediction of the phenotype by marker assisted selection, promoting the production of YR cultivars in B. oleracea.

Echocardiographic study of healthy Indian Spitz dogs with normal reference ranges for the breed.

AIM: The present study was aimed to determine the normal reference values of M-mode echocardiographic measurements in healthy Indian Spitz dogs and evaluate the influence of gender and body weight on these measurements. MATERIALS AND METHODS: M-mode echocardiography was performed in twenty-four clinically healthy conscious Indian Spitz dogs, aged 3-5 years and weighing 7-18 kg. Measurements were made from the right parasternal long axis left ventricular outflow tract view of the heart. The parameters recorded were: Left ventricular internal dimension, interventricular septal thickness and left ventricular posterior wall thickness during diastole and systole, left atrial diameter, aortic root diameter, left ventricular systolic functional parameters, and indices and mitral valve parameters. RESULTS: M-mode echocardiographic measurements in healthy Indian Spitz dogs were standardized. Gender had no influence on echocardiographic measurements except mitral valve excursion amplitude and time interval between onset and end of mitral valve closure, which were significantly (p<0.05) higher in females than males. Left ventricular internal dimension at end-diastole, left ventricular internal dimension at end-systole, left ventricular posterior wall dimension at end-systole, end-diastolic volume, end-systolic volume, stroke volume, cardiac output, left ventricular ejection time, and mitral valve excursion amplitude correlated significantly (p<0.05) with body weight in Indian Spitz dogs. CONCLUSION: Data obtained in the present study can be used as breed-specific reference values for cardiac disease diagnosis as well as for future studies in Indian Spitz dogs.

Epidemiological characteristics of Hirschsprung's disease (HSCR): Results of a case series of fifty patients from Bangladesh.

BACKGROUND: The epidemiology of Hirschsprung's disease (HSCR) in Bangladesh has never been studied. The aim of this study was to determine the epidemiological characteristics of HSCR in Bangladesh. METHODS: Data from fifty patients were collected prospectively from two hospitals in Chittagong, Bangladesh. RESULTS: The rate of consanguinity (16%) among parents of HSCR patients was higher than that of the general population (10%). Maternal age at the time of birth of the affected child was ≤30years in all cases except one. No association was found between parents' occupation and HSCR. No patient was born preterm and only three patients (6%) had low birth weight. Nine patients (18%) had associated anomalies. We found coexistence of bilateral accessory tragi and ankyloglossia in one patient, and coexistence of rectal duplication cyst in another. Neither anomaly had been previously reported in HSCR patients. CONCLUSIONS: Our study suggests that consanguinity might increase the risk of HSCR whereas advanced maternal age does not. HSCR patients were found more likely to born at term and with normal birth weight. The coexistence of HSCR with previously unreported anomalies highlights the diversity of conditions that can co-occur with HSCR. LEVELS OF EVIDENCE: IV.

Vertebral scale system to measure heart size in thoracic radiographs of Indian Spitz, Labrador retriever and Mongrel dogs.

AIM: To establish reference values of vertebral heart score (VHS) in Indian Spitz, Labrador retriever, and Mongrel dogs; to assess applicability of VHS in these three dog breeds; to determine if breed, recumbency side, gender, body weight, and thoracic depth (TD) to thoracic width (TW) ratio has an influence on the VHS measurement in these dog breeds. MATERIALS AND METHODS: A total of 60, client owned, clinically healthy Indian Spitz (n=20, mean age = 4.25±2.15 years, body weight = 11.87±2.7 kg), Labrador retriever (n=20, mean age = 4.75±1.91 years, body weight = 27.31±5.43 kg), and Mongrel dogs (n=20, mean age = 4.25±1.52 years, body weight = 16.25±3.99 kg), having no radiological and clinical signs of cardiovascular or pulmonary disease were included in the study. All dogs were restrained manually and left lateral (LL) and right lateral (RL) radiographic views were obtained. The size of heart in lateral radiographs was calculated using VHS method. Besides, the TD, TW and TD: TW were calculated to determine the type of thoracic conformation in the dog breeds. In addition to this, the effect of breed, side of recumbency, gender, body weight, and TD to TW ratio on the calculation of VHS was determined. RESULTS: VHS was calculated in all the animals of the breeds. VHS in Spitz and Labrador retriever was significantly (p<0.0001, p<0.0001, respectively) >9.7±0.5 v. RL and LL VHS in Mongrel dog was significantly (p<0.037) >9.7±0.5 v. Significant (p<0.05) differences in the VHS were observed among Spitz, Labrador retriever and Mongrel dogs, being higher for Labrador retriever followed by Spitz and Mongrel dogs. VHS in RL recumbency was significantly (p<0.001) greater than VHS in LL recumbency in all three breeds. LL and RL VHS correlated significantly with each other in Spitz (r=0.58; p=0.02), Labrador retriever (r=0.87; p<0.0001), and Mongrel dogs (r=0.93; p<0.0001). Significant (p<0.05) differences in the TD and TW were observed among Spitz, Labrador retriever, and Mongrel dogs. Non-significant effect of gender, body weight, and TD to TW ratio on the VHS measurement was observed in each dog breed. CONCLUSION: Breed-specific VHS reference ranges should be used for the objective measurement of heart size in dogs. Furthermore, the radiographic view should also be taken into consideration to avoid any erroneous interpretation of cardiac enlargement in dogs.

Prevalence of childhood obesity and overweight in Bangladesh: findings from a countrywide epidemiological study.

BACKGROUND: Obesity has been declared an epidemic in many high income countries. In low income countries, the coexistence of obesity and underweight makes the situation more grievous. The priority is to explore the overall pictures of body weight status in low income countries and countries that are in transitional phase. Through this country wide cross sectional study we would like to capture the current body weight status among the school aged children, both in urban and rural areas in Bangladesh. METHODS: We conducted a countrywide cross sectional study, from June to September 2009. By random sampling, we selected 10,135 students from 6 to 15 years from both the urban and rural schools. We categorized the students into overweight, obese and underweight by using the values for age and sex at +1SD, +2SD and -2 SD of Z scores of BMI respectively. RESULTS: We observed among 6 to 15 year olds from both the urban and rural areas 3.5% were obese, 9.5% were overweight and 17.6% were underweight. The proportion of obese and overweight students were greater among the students from urban schools (5.6%, 10.6%) compared to the students from rural schools (1.2%, 8.6%) (RD = 4.3, 95% CI = 3.6, 5.0; RD = 2.0, 95% CI = 0.1, 3.1). The proportion of underweight students were lower in the urban schools (16.1%) compared to the rural schools (19.2%) (RD = -3.1; 95% CI = -4.6, -1.6) CONCLUSIONS: The rate of obesity and overweight is alarming among school aged children in Bangladesh. Overweight and underweight are coexisting which needs special attention to minimize the dual burden.

Reference values of six-limb-lead electrocardiogram in conscious Labrador retriever dogs.

Breed-wise standard electrocardiographic values in dogs have been reported as there is variation in body and chest conformation, which limits the application of data of one breed for other breed. Labrador retrievers being originated from hunting dogs, their electrocardiogram (ECG) values might be different from standard normal range of other dog breeds. So, the purpose of the present study was to determine the standard ECG of Labrador retrievers and to check effect of body weight, gender and breed upon different ECG parameters. Six-lead ECGs, three bipolar standard limb leads (I, II and III) and three augmented unipolar limb leads (aVR, aVL and aVF), were taken from 24 Labrador retrievers positioned in right lateral recumbency without any chemical restraint. Amplitude and duration of P wave and QRS complex, PR interval, QT interval and mean electrical axis and heart rate were measured in each recording. Non-significant effect of gender and body weight was seen on all the ECG waves. Deep Q waves in Leads I, II and aVF and variation in relation to QRS pattern were noted. It was concluded that retrievers had a specific shape of QRS complex which must be considered when evaluating a patient suspected of having cardiac disease. However, amplitude and durations of different ECG waves in all the six leads were statistically not affected by gender or body weight.

Cloacal malformation variants in male.

OBJECTIVE: The published surgical literatures have referred only to females as having cloacal defects and the incidence in males is not well established. As during embryogenesis, both sexes have to pass through the stage of a cloaca, there is every chance of development of cloacal anomalies in males also. Here, we are presenting our experience of male cloacal malformations. METHODS: We identified four cases of male cloaca by reviewing medical records of all anorectal malformation (ARM) patients treated at our institution in the past 19 years. Time of presentation, clinical, radiological, cystoscopic and operative findings, and outcomes were analysed. RESULTS: Out of 1,837 patients, we identified four cases (0.2 %) of male cloacal variants. All presented after 45 days (range 46 days to 28 years). Three of them had proximal hypospadias, two had a vaginal remnant and cystoscopic evaluation showed the length of the common channel ranged from 0.5 to 8 cm. One patient died of multiple anomalies and the other patients are doing well following reconstruction. CONCLUSION: None of the male cloacal patients presented in the neonatal period, proximal hypospadias was the common external genital abnormality and half of them had a vagina. Surgical outcome was satisfactory. The scarcity of reported cases of this group is a subject of further research.

Laparoscopic submucosal appendectomy for difficult and adherent cases: a novel technique to minimize complications.

BACKGROUND: Recurrent appendicitis with the appendix tip in the subhepatic area and late presentations of perforated appendicitis sometimes test the skills of the surgeon. Because of dense adhesions and distorted anatomy, trying to do retrograde appendectomy or looking for the appendicular artery may lead to troublesome bleeding and injure the adjacent intestine. Submucosal appendectomy could be an answer in these situations. SUBJECTS AND METHODS: From October 7, 2005 to July 31, 2011, 1589 laparoscopic appendectomies were performed, of which 239 were recurrent or perforated or formed a mass. In 19 of these cases no plane could be established between the appendix and adjacent structures. So an incision was made on the anti-mesenteric wall of the appendix, and the mucosal sleeve was pulled out, leaving the muscular wall. The base was then ligated flush with the cecum and divided distally, leaving the muscular tube. Postoperative management was similar to usual appendectomies. RESULTS: Out of 19 cases 13 were male. Ages ranged from 3 to 14 years. Seven cases were perforated, and 12 were recurrent. Submucosal appendectomy was done in all these 19 cases. There was no intraoperative complication. Average operating time was 51 minutes. In 16 cases feeding was tolerated early, and 3 cases suffered from prolonged ileus. Average postoperative hospital stay was 3.47 ± 2.34 days. Follow-up ranged from 3 months to 5 years. Two cases reported occasional abdominal pain, which required re-admission. CONCLUSIONS: Submucosal appendectomy minimizes complications, obviates the need for conversion, and is a safe option for difficult cases during laparoscopy.

Management of male H-type anorectal malformations.

PURPOSE: H-type anorectal malformations (ARM) are extremely rare in males. Herein, we have described our experience of managing this variety. METHODS: From September 1993 to February 2009, seven boys with H-type ARM were managed in the Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh. Clinical features, operative procedures and outcomes were analyzed. RESULTS: Age ranged from 1 day to 4 years. The passage of meconium was seen in urine of four boys, through ectopic openings in the perineum in three boys. One patient had a round worm passing through an ectopic opening. Three boys' perineum showed meconium dots/streak along scrotal raphe. Anus was absent in all. Two patients had rectopenilurethral (RPU) and rectoscrotal (RS) fistula; two boys had anoscrotal and anoperineal fistula; one boy had pinhole anus with RS and RPU fistula. One boy had rectoperineal and RS fistula. One patient had rectobulbar urethral fistula with meconium filled chamber between the two hemiscrotum. Two boys had associated anomalies. Five boys had primary procedure with anterior sagittal approach-anoplasty (ASAP) and anorectoplasty (ASARP). Two patients had pelvic colostomy and ASARP in one and PSARP in one. One patient died postoperatively. One boy developed anal stenosis and needed redo. Five children have regular bowel movements and they are growing well. CONCLUSION: Thorough clinical examination may identify the anatomical variations of male H-type ARM, and for the treatment of which primary ASAP or ASARP gives good results.

Anovestibular fistula with normal anus.

PURPOSE: The purpose of the study was to review a rare anomaly of anorectal malformations in girls, congenital anovestibular fistula (AVF) with normal anus, over a 12-year period. MATERIALS AND METHODS: A total of 24 female patients of AVF with normal anus were treated in the Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh, from January 1994 to June 2006. Clinical features, operative findings, operative procedures, postoperative complications, and outcomes were analyzed. RESULTS: Age ranged from 1 day to 7 years (mean, 10.5 months). All 24 female patients presented with passage of stools through 2 perineal openings. In addition, vulvar abscesses were noted in 5 cases. Vestibular opening of the fistula was found behind the vagina in 18 patients, and the anal opening of the fistula was on the anterior anal wall above the dentate line in 20 cases. There were no associated abnormalities. After adequate bowel preparation, 22 patients underwent excision of the fistulous tract with reconstruction of anal wall without a diverting colostomy. All 5 patients with vulvar abscess experienced wound disruption and required reoperation. All 24 girls have normal bowel motions at follow-up. CONCLUSIONS: In the management of AVF with normal anus, primary repair without colostomy is a safe option. In cases of abscess or infection, definitive operation should be deferred until adequate healing is achieved.

Betel leaf in stoma care.

BACKGROUND/PURPOSE: Construction of a stoma is a common procedure in pediatric surgical practice. For care of these stomas, commercially available devices such as ostomy bag, either disposable or of longer duration are usually used. These are expensive, particularly in countries like Bangladesh, and proper-sized ones are not always available. We have found an alternative for stoma care, betel leaf, which is suitable for Bangladeshis. We report the outcome of its use. METHODS: After construction of stoma, at first zinc oxide paste was applied on the peristomal skin. A betel leaf with shiny, smooth surface outwards and rough surface inwards was put over the stoma with a hole made in the center according to the size of stoma. Another intact leaf covers the stomal opening. When bowel movement occurs, the overlying intact leaf was removed and the fecal matter was washed away from both. The leaves were reused after cleaning. Leaves were changed every 2 to 3 days. From June 1998 to December 2005, in the department of pediatric surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh, a total of 623 patients had exteriorization of bowel. Of this total, 495 stomas were cared for with betel leaves and 128 with ostomy bags. RESULTS: Of 623 children, 287 had sigmoid colostomy, 211 had transverse colostomy, 105 had ileostomy, and 20 had jejunostomy. Of the 495 children under betel leaf stoma care, 13 patients (2.6%) developed skin excoriation. There were no allergic reactions. Of the 128 patients using ostomy bag, 52 (40.65%) had skin excoriation. Twenty-four (18.75%) children developed some allergic reactions to adhesive. Monthly costs for betel leaves were 15 cents (10 BDT), whereas ostomy bags cost about US$24. CONCLUSION: In the care of stoma, betel leaves are cheap, easy to handle, nonirritant, and nonallergic.

Congenital double anus with total colon duplication: a case report.

Cases of congenital double anus are very rare. The number of cases of hindgut duplication of all kinds is slightly higher, and some series include patients with genitourinary and genitalia duplications but with a single anus. However, double termination with tubular duplication is rarely heard of. We report on the case of a patient with 2 well-formed ani, total colon duplication, and 2 vaginas.

In vitro biomechanical properties of linear, circular, and hybrid external skeletal fixation devices for use in large ruminants.

OBJECTIVE: To report the biomechanical properties of 3 external skeletal fixation (ESF) devices for use in large ruminants. STUDY DESIGN: In vitro biomechanical testing of ESF constructs. SAMPLE POPULATION: Adult buffalo (weighing, 250-350 kg) tibiae (n=27). METHODS: ESF constructs (bilateral linear fixator [BLF], 4-ring circular external fixator [CEF], and hybrid fixator [HF]) were made using mild (low carbon) steel implants plated with nickel and cadaveric buffalo tibiae. After ESF application, a 1 cm mid-diaphyseal gap was created. Constructs were loaded to failure, on a materials testing machine, in axial compression (n=5/ESF type) and craniocaudal bending (n=3/ESF type). In addition, 3 CEF constructs were tested in intact tibiae under craniocaudal bending. RESULT: In compression, HF was the strongest and most rigid construct; yield load was significantly higher for HF than for BLF or CEF. Under bending, both CEF and HF had similar strength and modulus of elasticity. Strength for BLF was higher than CEF and HF, whereas the reverse was true for modulus of elasticity. CONCLUSIONS: ESF made from mild steel for use in large ruminants could withstand

Evaluation of two dynamic axial fixators for large ruminants.

OBJECTIVES: To evaluate healing of a radial osteotomy repaired by application of dynamic axial fixation devices (DAF) in large ruminants. STUDY DESIGN: In vivo study of bone healing after application of 2 DAF types. Model I had 2 sidebars, each with a central cylindrical cuff (internally threaded) with 2 detachable connecting rods telescoping within the cuff. Model II had 2 side bars with 2 moveable clamps with multiple holes. SAMPLE POPULATION: Bull calves (n=8; aged, 1.5-2.0 years; weighing, 175-250 kg). METHODS: A mid-diaphyseal radial osteotomy was repaired by use of a model I (n=4) or model II (n=4) DAF. Calves were monitored for weight bearing, stability of fixation, and radiographically for fracture reduction, alignment and healing at intervals for 6 months. Fixators were removed when there was radiographic evidence of healing. RESULTS: Both the fixators were well tolerated with free movement of adjacent joints. Fragment fixation was maintained until healing in all but 1 model I calf where failure occurred within 7 days. Model II DAF provided more rigid fixation as indicated by early full weight bearing and fracture healing with less callus formation. Functional recovery of repaired limbs occurred within 60 days in surviving calves. CONCLUSIONS: Both bilateral DAFs were easy to apply; however, the model II DAF provided better fixation. CLINICAL RELEVANCE: The model II DAF made of low carbon steel was economical and may be useful for treating long bone fractures in large ruminants.