Comparative Evaluation Of Conventional Method And Staple Suture Technique For Intestinal Aanastomosis In Dogs
Material type: Book ; Format:
Publisher: 2013 Dissertation note: Intestinal resection and anastomosis is frequently essential during abdominal surgeries. Indications for intestinal resection are malignancy, inflammation, stricture formation, injuries and ischemia. Several surgical situations necessitate the resection of intestinal segments and the formation of consistent anastomoses. Conventionally, a large diversity of suture materials has been used to make hand-sewn anastomoses. Surgical stapler was made for the first time at the beginning of 20th century but its use remained limited in gastrointestinal surgery. Currently, stapled anastomoses is an essential part of the majority of the gastrointestinal surgeries. The simple-interrupted, single-layer, approximating technique, in which absorbable monofilament suture material is used, is presently believed to be the technique of choice for end-to-end bowel anastomosis. This procedure is mostly used in gastrointestinal surgeries with comparatively lesser complications. Intestinal anastomosis with skin staples was started by military surgeons for the soldiers suffering from bowel trauma caused by gunfire. In this technique, stainless steel skin staples were used to create a seromuscular intestinal anastomoses. There are several types of staplers available in markets, e.g. circular ligators, clip appliers, endoscopic staplers etc. The circular stapler is a disposable anastomotic instrument that places a round, double staggered row of titanium staples connecting intervening tissues. It can generate an end-to-end, end-to-side, or side-to-side anastomosis. This round stapler is available with a variety of staple line diameters to be used according to need. In current years, there has been a large shift from hand-sewn method towards the use of intestinal stapler in gastrointestinal surgery. They present a possible reduction in operational timing and are easy to learn and use than for hand-sewn method. So, staplers are very popular in the trainee. This research project was tested on 12 mongrel dogs divided randomly into two different groups (A and B). Each group comprised of 6 dogs. Conventional hand-sewn method of end-to-end anastomosis was applied on group A and stapled anastomosis was made in the dogs of group B. Two surgical techniques were applied for end to end anastomosis of jejunum. In group-A conventional hand-sewn anastomosis technique was applied. In this method a piece of jejunum was removed and then anatomosed with simple interrupted, single-layer, approximating technique. The absorbable, monofilament suture material was applied manually. This is currently considered the method of choice for end-to-end intestinal anastomosis in small animal surgery. This technique is well described and has been used throughout the canine gastrointestinal tract with a relatively low complication rate. In group-B a circular mechanical stapler was used to construct anastomosis. In this method a piece of jejunum was removed and end-to-end anatomosis was made using a mechanical stapler. Comparison of both techniques was made on the basis of clinical parameters (temperature, pulse, respiration, vomiting, diarrhea and blood in feces), radiographic evaluation, exploratory laparotomy, change in lumen diameter and duration of surgical procedure. There is a significant difference in change in diameter within each group before and after surgery but there is no significant difference in change in diameter or stenosis formation between these two groups. There is a significant difference in the duration of operation; stapled group significantly requires an average of 10 minutes less than conventional hand-sewn method. Conclusively it was inferred that there is no significant difference in change in diameter between stapled group and hand sewn group but the anastomosis construction time is shorter in stapled group. Stapled anastomosis is safe and faster technique than hand-sewn method. The prevalence of low complication rate makes it all the more ideal for application in routine practices.
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Molecular Diagnosis And Therapeutic Trials Against Bovine Fasciolosis In And Around Okara
Material type: Book ; Literary form:
Publisher: 2015 Dissertation note: Agriculture sector plays a pivotal role in the economy of Pakistan. At present it
participates 11.4% to GDP. Agriculture provides 45% employment to labour of our country
and contributes in the development of other sectors of the economy. The livestock sector
occupies a distinguishing position in the National Agenda of economic development. It
provides net source of foreign income. In the history livestock has been dominated by small
holders to meet their needs of milk, food safety and cash earnings on daily basis. Besides,
livestock is considered a source of employment generation at rural level. It plays an important
role in poverty mitigation and keeps in elevating the socio-economic situation of our rural
commonalities. Livestock share approximately 55.4 percent to the agricultural value added
and 11.9 percent to national GDP during 2013-14. Anonymous (2013-14).
Parasitism is one of the major problems lowering livestock productivity round the
earth Vercruysse and Claerebout et al. (2001). The significance of helminthes infections is
increased manifold in developing countries like Pakistan where 65.2% population is rural
(Population Census Organization (2007) depending upon livestock for their incomes and
where parasitism acts as a serious trouble for livestock economy Chaudhry et al. (1984).
Among helminthes infections, fasciolosis commonly called as liver fluke disease is of vital
importance due to its wider spectrum of ultimate hosts Rondelaud et al. (2001) causing acute
and chronic infections Sampaio-Silva et al. (1996). The disease is primarily caused by
Fasciola hepatica and Fasciola gigantica Soulsby et al. (1987). Fasciolosis is a parasitic liver
infection of wild and domestic ruminants caused by genus Fasciola, which has worldwide
distribution Soulsby et al. (1986). Fasciolosis causes economic losses as a result of
mortalities, abortions, retard growth, reduced milk and meat production, condemnation of
infected liver and emaciated carcasses and cost of animal treatment Gracey and Collins et al.
(1992). Fasciolosis caused by F. hepatica is a cause of important economic losses in
ruminants. The disease is widely spread throughout in Africa, Asia and the Pacific. Although
mostly a problem of young stock, the disease is also found in older animals where it
adversely affects health, growth rate and development. Apart from its great veterinary
importance throughout the world, fasciolosis caused by both F. hepatica and F. gigantica has
recently been shown to be a re-emerging and wide spread zoonosis affecting a number of
human populations Mas-Coma and Bargues et al. (1997); Esteban et al. (2003).
Prevalence of fasciolosis infestation in buffaloes is 49.01%. The infestation of
fasciolosis was optimal from January to September, while least during October to December.
Fecal samples indicated F. hepatica prevalence 65%. Whereas prevalence of F. gigantica
was observed higher in adult cattle as compared to cattle calves by fecal egg counts Khalil et
al. (2009). 4% Buffalo calves infested with trematodes. Availability of intermediate host and
the grazing habits of the final host determines the epidemiology and seasonal pattern of
infection with trematodes Pfukenyi et al. (2005); Bhutto et al. (2002). The life cycle of F.
hepatica includes many stages which develop in the environment or the intermediate host.
Metacercariae which is the infective stage encysted and ingested by grazing herbivores.
Temperature and rainfall are the important factors affecting the life cycle and the prevalence
of F. hepatica infection McCann et al. (2010). Many studies revealed that F. hepatica is
endemic in buffaloes, cattle, goats, sheep and humans in Pakistan Ijaz et al. (2009); Iqbal et
al. (2007); Khan et al. (2010) and Qureshi et al. (2005).
Fasciolosis is the disease by which about 250 million sheep and 300 million cattle are
potentially affected worldwide Boray et al. (2005), and more significantly infects all
ruminants Iqbal et al. (2007). F. hepatica and F. gigantica are the two liver flukes commonly
reported to cause fasciolosis in ruminants Walker et al. (2008). Infected cattle can exhibit
poor weight gain and dairy cattle have lower milk yield, and possibly metabolic diseases
Mason et al. (2004). Losses due to fasciolosis in the United Kingdom and Ireland alone are
more than ￡18 million a year Mulcahy and Dalton et al. (2001); €52 million a year or €299
per infected animal in Sweden Schweitzer et al. (2005); 0.26 million USD annual due to
fasciolosis associated liver condemnations in cattle slaughtered in Kenya Kithuka et al.
(2002). In Pakistan, 35697 USD (3141360 PKR) are reported in only one tehsil of Punjab
province, the Sargodha T.U. Rehman et al. (2013). While Fasciolosis is prevalent in whole
Punjab province of Pakistan but the marshy areas such as regions of Gujranwala, Lahore,
Multan, Faisalabad, Jhang, Muzaffargarh, Sheikhupura, and Sargodha are of major concern.
Fascioliasis in ruminants causes substantial economic losses, estimated at US$ 2
billion per annum worldwide, to rural agricultural communities and commercial animal
producers due to death of infected animals, condemnation of affected livers and production
losses associated with reduced feed conversion efficiency Urquhart et al. (1996); Spithill and
Dalton et al. (1998). In tropical countries, fascioliasis is prevalent up to 90% and is
considered the most important helminthes infection of cattle Spithill and Dalton et al. (1998).
Most important, human can also become infected with Fasciola spp. and the disease is
referred to as human fasciolosis. It is estimated that 2.4 million people in more than 60
countries are infected and the number of people at risk is more than 180 million throughout
the world Haseeb et al. (2002); Mas-Coma et al. (1999); Ishii et al. (2002). Khalil et al.
(2009) recorded 49.01% prevalence of fasciolosis infestation in buffaloes. He also observed
that optimum infestation was seen from January to September, while minimum during
October to December. Whereas Bhutto et al. (2002) recorded 4% buffalo calves infested with
Morphological identification of Fasciola species requires significant parasitological
skills and is not an accurate method of characterization, especially for the ‘intermediate’ form
Kendall et al. (1965); Lin et al. (2007); Le et al. (2008). Hence, different molecular tools have
been developed during the last decade for the accurate identification of Fasciola spp.
Marcilla et al. (2002); Velusamy et al. (2004); Cucher et al. (2006); Magalhaes et al. (2008);
Ai et al. (2010). Conventional techniques like fecal examination used for its diagnosis are not
comprehensive because of Species similarity in distribution in many countries of East and
North Africa, and Southeast and Central Asia, and are similar in egg morphology.
Coprological methods continue to be the most widely used approach for the detection and
quantification of Fasciola and other helminth eggs in laboratory animals, domestic and
sylvatic animals and humans Cringoli et al. (2004, 2010); Bergquist et al. (2009), with a more
recently developed method that is currently undergoing broad-scale validation the FLOTAC
techniques Cringoli et al. (2010) for the detection and quantification of F. hepatica eggs in
feces obtained from experimentally-infected rats before and after drug administration.
FLOTAC has been used successfully in the diagnosis of F. hepatica infections in naturallyinfected
sheep, which underwent treatment with standard Cringoli et al. (2006). However
PCR based diagnosis using specie-specific primers has been proved more accurate and
successful in diagnosis and distinction of Fasciola species Le TH et al. (2012). The molecular
technique such as PCR is used for the recognition of parasite. These molecular techniques are
largely accepted all over the world. These are more exact methods than traditional in
epidemiological studies Heckeroth and Tenter et al. (1999).
Herbal drugs have been used since ancient times to cure diseases and medicinal plants
have been used to treat fasciolosis among these Nigella sativa and Allium sativum have been
used to treat the worm infestation. No report of resistance development to plant anthelmintic
although many have been used in veterinary medicine for many years Ashaal et al. (2010);
Waller et al. (1995); Koko et al.(2000); Thienpont et al. (1979); Keiser et al. (2011). Herbal
(indigenous) drugs have been used since ancient times to cure diseases, and several medicinal
plants have been used to treat fasciolosis Satyavati et al. (1987). Among these, Nigella sativa
has been used to treat worm infestation Nadkrani et al. (1954; Said et al. (1969); Akhtar et al.
(1988). N. sativa can be used as a therapeutic agent against helminthes Khan et al. (2013).
Neem leaf powder can be used as therapeutic agent against gastrointestinal parasites of
camel, equine, cattle, buffalo and small ruminants Mehmood et al. (2013). Garlic powder can
also be used as herbal product against the gastrointestinal helminthes of livestock Ijaz et al.
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