On the design of low modulus Ti-Nb-Au alloys for biomedical applications

Developing new low modulus structures is important for reducing the risk of aseptic loosening during loading of implant materials. However, an alloy that may also confer some advantage at preventing septic loosening could dramatically improve the outcomes for patients. Nevertheless, the predictive power of current models remains limited to common alloying additions. As such, this study considers the mechanical properties of a range of Ti-Nb-Au superelastic alloys to elucidate the composition range for which low modulus structures can be achieved. These modulus values are compared to other critical design parameters such as strain recovery and strength. It was found that Au additions are effective at suppressing the formation of the ω phase and allow alloys with lower moduli to be achieved. It was also shown that low β phase stability is critical for achieving the lowest modulus, and that this susceptibility to transform to a martensite may enable higher strengths to be achieved. However, this low β phase stability also limits the strain recovery that may be achieved meaning these two properties are not necessarily independently tuneable. These data provide important context for the design of new systems containing unusual alloying additions such as Au.

Amphibian Segmentation Clock Models Suggest How Large Genome and Cell Sizes Slow Developmental Rate

Evolutionary increases in genome size, cell volume, and nuclear volume have been observed across the tree of life, with positive correlations documented between all three traits. Developmental tempo slows as genomes, nuclei, and cells increase in size, yet the driving mechanisms are poorly understood. To bridge this gap, we use a mathematical model of the somitogenesis clock to link slowed developmental tempo with changes in intra-cellular gene expression kinetics induced by increasing genome size and nuclear volume. We adapt a well-known somitogenesis clock model to two model amphibian species that vary 10-fold in genome size: Xenopus laevis (3.1 Gb) and Ambystoma mexicanum (32 Gb). Based on simulations and backed by analytical derivations, we identify parameter changes originating from increased genome and nuclear size that slow gene expression kinetics. We simulate biological scenarios for which these parameter changes mathematically recapitulate slowed gene expression in A. mexicanum relative to X. laevis, and we consider scenarios for which additional alterations in gene product stability and chromatin packing are necessary. Results suggest that slowed degradation rates as well as changes induced by increasing nuclear volume and intron length, which remain relatively unexplored, are significant drivers of slowed developmental tempo.

Human papillomavirus related oropharyngeal cancer: identifying and quantifying topics of patient interest

OBJECTIVE

As the incidence of human papillomavirus related oropharyngeal cancer continues to rise, it is increasingly important for public understanding to keep pace. This study aimed to identify areas of patient interest and concern regarding human papillomavirus and oropharyngeal cancer.

METHOD

This study was a retrospective survey of search queries containing the keywords 'HPV cancer' between September 2015 and March 2021.

RESULTS

There was 3.5-fold more interest in human papillomavirus related oropharyngeal cancer (15 800 searches per month) compared with human papillomavirus related cervical cancer (4500 searches per month). Among searches referencing cancer appearance, 96.8 per cent pertained to the head and neck region (3050 searches per month). Among vaccination searches, 16 of 47 (34.0 per cent; 600 searches per month) referenced human papillomavirus vaccines as being a cause of cancer rather than preventing cancer.

CONCLUSION

The vast majority of online searches into human papillomavirus cancer pertain to the oropharynx. There are relatively few search queries on the topic of vaccination preventing human papillomavirus associated oropharyngeal cancer, which highlights the continued importance of patient education and awareness campaigns.

Hippocampus Segmentation-Based Alzheimer's Disease Diagnosis and Classification of MRI Images

Alzheimer's disease represents a neurological condition characterized by steady cognitive decline and eventual memory loss due to the death of brain cells. It is one of the most prominent dementia types observed in patients and which hence underlines the imminent need for potential methods to diagnose the disease early on. This work considers a novel approach by utilizing a reduced version of one of the datasets used in this work to achieve a considerably accurate prediction while also enabling quicker training. It leverages image segmentation to isolate the hippocampus region from brain MRI images and then strikes a comparison between models trained on the segmented portions and models trained on complete images. This research uses two datasets-4 classes of images from Kaggle and a popular OASIS 2 MRI and demographic dataset. A deep learning-based approach was adopted to train the Kaggle dataset to perform severity classification, and the hippocampus region segmented from a reduced version of the OASIS dataset was trained on supervised and ensemble learning algorithms to detect Alzheimer's disease. The metric used for the assessment of model performance is classification accuracy. A comparative analysis between the proposed approach and existing work was also performed, and it was observed that the proposed approach is effective in the early diagnosis of Alzheimer's disease.

Amelioration of fly annoyance in dairy cattle by using illuminated fly traps

Blood-sucking and biting flies are a significant source of annoyance to warm-blooded animals. Behavioural changes in animals may include attempts to pursue, remove or avoid the disturbance caused by the fly by means of body movement. In the presesnt study the behaviour during a 10 min period in each four-hour interval i.e. 1 AM, 5 AM, 9 AM, 1 PM, 5 PM and 9 PM was analysed and noted for inclusion in the ethogram. The cows with light trap (treatment) were compared with those without light traps (control) to study the effectivenss of the fly trap in reducing annoyance in cattle. All the seven avaoidance behaviours were counted such as head movement, ear shaking, tail movement, skin twitching, licking, kicking on belly and restlessness and were recorded by scan method. The results of this study indicated that the incidence of all the seven fly avoidance behaviours were significantly higher (p<0.01) in the control group. It could also be concluded that the occurance of all the behaviours in the control group at 1 PM were significantly high followed by 5 PM. The findings of the study suggest that fly activity in dairy farms was high during the afternoon hours followed by evening time and illuminated fly traps could be used effectively in controlling flies, so that the fly avoidance behavior by cattle was reduced on dairy farms.

Seroprevalence to common infectious abortifacient and infertility causing agents in the dairy herds of India

BACKGROUND

Information on the prevalence of infectious agents in dairy farms forms the basis for formulating a suitable control strategy; especially in endemic situations.

AIMS

A cross-sectional study was undertaken to determine the prevalence of six economically important bovine diseases, causing reproductive disorders including bovine abortion in organized dairy herds in India.

METHODS

A total of 1,075 animals (cattle and buffaloes) from 09 dairy farms were screened by ELISA tests.

RESULTS

Bovine viral diarrhoea (BVD) was the most prevalent (56.5%) disease followed by infectious bovine rhinotracheitis (IBR) (45.4%). Prevalence of Q-fever (5.4%) and neosporosis (6.1%) were less on the farms. Although 16.3% of the samples turned positive for brucellosis, the contribution of calf-hood vaccination (B. abortus S19 vaccine) to the prevalence of antibodies cannot be ruled out. The overall prevalence of bovine anaplasmosis, known to cause sporadic abortions in dairy herds, was 34.1% in the 9 farms with a prevalence of less than 20% in 5 farms. Infection of multiple abortifacient (seroprevalence to more than two pathogens) was recorded in 56.8% of animals. A very strong association was observed between BVD and brucellosis (Odds ratio 14.2; P<0.001). Further, a positive association was also seen between seroprevalence of IBR and anaplasmosis, and neosporosis and Q fever (P<0.05).

CONCLUSION

Viral diseases were found to be more common in the dairy herds than bacterial and protozoan diseases. Increased susceptibility of IBR seropositive cows to other bacterial and viral infections was observed.

Effectiveness of livestock delivery services of dairy cooperatives of Kerala state

The present study aimed to know the effectiveness of livestock services delivered by the veterinarians working under state regional cooperative milk producers’ union (SRCMPU) and farmers views on these services. An ex-post-facto research design was adopted for the study. A total of fifteen veterinarians working under SRCMPU, Kerala, and thirty livestock farmers dependent on SRCMPU for the livestock services were selected. Data collection was done through using structured interview schedule method. The result from the study revealed that majority of the veterinarians and livestock farmers perceived curative services (60.00% and 46.66%), production services (53.33% and 63.33%), preventive services (53.34% and 56.66%), extension services (60.00% and 50.00%) and miscellaneous services (60.00% and 60.00%) as average. About satisfaction level, majority of the livestock farmers had medium level of satisfaction towards curative services (66.66%), production services (43.33%), preventive services (60.00%), extension services (50.00%) and miscellaneous services (60.00%). It is concluded from the result that there is need to improve the quality of livestock services from both veterinarians and farmers point of view. It is the need of hour to analyze and interpret the current scenario of service delivery systems of state regional cooperative milk producers’ union through assessing the constraints perceived by them in livestock service delivery.

A Novel Case of Bifacial Diplegia Variant of Guillain-Barré Syndrome Following Janssen COVID-19 Vaccination

Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating disorder which attacks the peripheral nervous system. Antecedent infection or vaccine administration are known to precipitate the onset of this disorder. Its typical presentation leads to a symmetric, rapidly progressive, ascending paresis with associated sensory deficits and impaired reflexes. We present a rare case of a bi-facial diplegia variant of GBS, within four weeks of the COVID-19 vaccination. Due to its chronology, clinical manifestations, and cerebrospinal fluid (CSF) findings, we propose this case to be a rare complication of the COVID-19 vaccination.

A rare case of gliomatosis cerebri lurking beneath the shadows of a stroke mimic

Gliomatosis cerebri (GC) is a diffuse infiltrative neoplastic glial process with a devastating prognosis. Considering its rarity, unpredictable clinical manifestations, and lack of characteristic radiographic features, GC is a difficult diagnosis that is quite often delayed. In this report, we present a case of a 61-year-old man with a history of chronic alcohol abuse and atrial fibrillation who presented with right arm weakness initially presumed to be from an acute ischemic stroke. GC was not diagnosed until six months after initial symptoms and diagnosis was indicated when considering the neurocognitive findings in conjunction with suggestive radiographic findings. The presence of a rapid, expansile lesion in the cortex, corpus callosum, and infratentorial structures with mild parenchymal enlargement, as shown in our case, is more revealing of an invasive entity typical of GC rather than an ischemic process and other pathologies. This case demonstrates the fatal challenges of its prompt recognition and the therapeutic limitations for those patients presenting with advanced symptoms at the time of diagnosis. Recognizing GC in cases with such rapid multilobe clinical features with similar diffusely invasive patterns of growth on imaging can avoid a delay in diagnosis and improve patient quality of life.

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2

BACKGROUND

The literature on neurological manifestations in COVID-19 patients has been rapidly increasing with the pandemic. However, data on CNS inflammatory disorders in COVID-19 are still evolving. We performed a literature review of CNS inflammatory disorders associated with coronavirus disease-2019 (COVID-19).

METHODS

We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords; "SARS-CoV-2 and neurological complication", "SARS-CoV-2 and CNS Complication" looking for reports of transverse myelitis, longitudinally extensive transverse myelitis, neuromyelitis optica, myelitis, Myelin Oligodendrocyte Glycoprotein Antibody Disorder (MOGAD), Acute Disseminated Encephalomyelitis (ADEM), Acute Hemorrhagic Necrotizing Encephalitis/Acute Hemorrhagic Leukoencephalitis (AHNE/AHLE), Cytotoxic lesion of the Corpus Callosum/Mild Encephalopathy Reversible Splenium Lesion(CLOCC/MERS) and Optic neuritis published between December 01, 2019 and March 15, 2021.

RESULTS

Our literature search revealed 43 patients meeting the diagnosis of myelitis, including Transverse Myelitis, ADEM, AHNE/AHLE or CLOCC/MERS and Optic neuritis. Acute myelitis was most commonly associated with non-severe COVID-19 and all reported cases of AHNE/AHLE had severe COVID-19 infection. Based on IDSA/ATS criteria of either requiring vasopressor for septic shock or mechanical ventilation, 49% (n = 18) patients were considered to have a severe COVID infection. There were 7 (n = 19%) fatalities.

CONCLUSION

To our knowledge, this is among the first reviews that includes the clinical features, neuroimaging, CSF findings and outcomes in COVID-19-associated CNS inflammatory disorders. Our observational review study reveals that although rare, myelitis, ADEM, AHNE and CLOCC can be associated with COVID-19 infection. Further studies using MRI imaging and CSF analysis in early diagnosis and intervention of these disorders are warranted.

Clinical Characteristics and Outcomes of COVID-19 in West Virginia

This study examines the clinical characteristics, outcomes and types of management in SARS-CoV-2 infected patients, in the hospitals affiliated with West Virginia University. We included patients from West Virginia with SARS-CoV-2 infection between 15 April to 30 December 2020. Descriptive analysis was performed to summarize the characteristics of patients. Regression analyses were performed to assess the association between baseline characteristics and outcomes. Of 1742 patients, the mean age was 47.5 years (±22.7) and 54% of patients were female. Only 459 patients (26.3%) reported at least one baseline symptom, of which shortness of breath was most common. More than half had at least one comorbidity, with hypertension being the most common. There were 131 severe cases (7.5%), and 84 patients (4.8%) died despite treatment. The mean overall length of hospital stay was 2.6 days (±6.9). Age, male sex, and comorbidities were independent predictors of outcomes. In this study of patients with SARS-CoV-2 infection from West Virginia, older patients with underlying co-morbidities had poor outcomes, and the in-hospital mortality was similar to the national average.

458 Patient Willingness to Undergo Elective Orthopaedic Surgery in Relation to the COVID-19 Outbreak

Objective

To determine patients’ willingness to undergo elective orthopaedic surgery during the COVID-19 pandemic.

Method

4 groups of patients were chosen based on type of surgery. A telephone survey was conducted, including questions on diagnosis, symptom duration, pain severity, co-morbidities, anxiety levels for COVID-19 and surgery. Patients were given the conditions for surgery and asked whether they would undergo surgery, have the operation carried out by another consultant and any factors that would increase their confidence.

Results

Of 200 patients, 156 participated (78%). 78.2% were willing to undergo surgery. There was a statistically significant difference in willingness between age groups 40-49 (100%) and 80 + (58.3%). Differences in willingness between surgery types, BOA risk class, sex, symptom duration and pain scores, were not statistically significant.

Patients unwilling to undergo surgery reported statistically higher anxiety scores for health (4.39) and surgery (4.62) compared to the willing group (2.89 and 2.71 respectively). Patients’ main concern was contracting COVID (35.2%).

Conclusions

Our study demonstrated that the majority of patients were willing to undergo surgery. This can be used to inform strategies for resuming elective surgeries. It has also highlighted several areas in patient perception that warrant further investigation and the importance of enhanced consent on the specific risks.

A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

BACKGROUND

Limited literature exists on Cerebrospinal fluid (CSF) findings in COVID-19 patients with neurological symptoms. In this review, we conducted a descriptive analysis of CSF findings in patients with COVID-19 to understand prognosis and explore therapeutic options.

METHODS

We searched PubMed, Google Scholar, and Scopus databases using the keywords "SARS-CoV-2 in cerebrospinal fluid" and "SARS-CoV-2 and CNS Complications"" for reports of CSF findings in COVID-19 related neurological manifestations. Descriptive analyses were conducted to observe the CSF protein and cell counts based on age, gender, severity, fatality of COVID-19, and whether central (CNS) or peripheral nervous system (PNS) was associated.

RESULTS

A total of 113 patients were identified from 67 studies. Of these, 7 patients (6.2%) were fatal COVID-19 cases and 35 patients (31%) were considered severe COVID-19 cases. CSF protein was elevated in 100% (7/7) of the fatal cases with an average of 61.28 mg/dl and in 65.0% (52/80) in non-fatal cases with an average 56.73 mg/dl. CSF protein levels were elevated in 74.5% (38/51) patients with non-severe COVID-19 and 68.6% (24/35) in those with a severe COVID-19 infection. CSF cell count was increased in 43% of fatal cases, 25.7% severe cases, and 29.4% of non-severe cases.

CONCLUSION

Our analysis showed that the most common CSF findings situation in COVID-19 infection is elevated protein with, very occasionally, mild lymphocyte predominant pleocytosis. Further studies to elucidate the pathophysiology of neurological complications in COVID-19 are recommended.

Relevance and Clinical Significance of Magnetic Resonance Imaging of Neurological Manifestations in COVID-19: A Systematic Review of Case Reports and Case Series

We performed a systematic literature review of neuroimaging, predominantly focusing on magnetic resonance imaging (MRI) findings associated with neurological manifestations of coronavirus disease-2019 (COVID-19). We screened articles from PubMed, Google Scholar and Scopus, looking for reports that would potentially have neuroimaging findings in patients with COVID-19. Data analysis was performed with patient-based data based on the availability of clinical characteristics and outcomes for each individual patient from the studies. Chi square and Wilcoxon rank-sum tests were used to report COVID-19 severity and outcomes based on neurological imaging indicators and pathophysiology. A total of 171 patients with COVID-19 having neurological complications, from 134 studies, were identified in our review. The most common neuroimaging finding was ischemic stroke (62, 36.2%) cases, followed by CNS inflammatory disorder (44, 25.7%), and hemorrhagic stroke (41, 24.0%). Around 51% of all the fatal COVID-19 cases had an ischemic stroke. Among patients with ischemic stroke, the mean age of those who suffered from COVID-19 infection was 57.5 years (SD = 15.4) whereas it was 50.7 years (SD = 15.1) among those without stroke/other diagnosis. Fatality was more common in patients with ischemic stroke compared to those with other diagnosis (40% vs. 22%, p = 0.011). The most frequently published neuroimaging findings in patients with COVID-19 were ischemic stroke, CNS inflammatory disorder, and hemorrhagic disorder. In those studies, ischemic stroke was associated with fatality, and was more frequently seen in older patients. Based on our findings, early usage of MRI in COVID-19 patients may be recommended.

Multiple embolic stroke on magnetic resonance imaging of the brain in a COVID-19 case with persistent encephalopathy

The pulmonary manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) are well known. The literature on neurological manifestations and complications in patients with COVID-19 has been increasing but is still sparse. At present, there are only a few reported case reports and clinical studies on neurological manifestations of COVID-19, of which ischemic stroke is one of the most common ones. Coagulopathy and vascular endothelial dysfunction have been proposed as the complications of COVID-19 which can ultimately lead to ischemic stroke. In this case report, we present a case of multifocal ischemic stroke in a patient with COVID-19. This patient had persistent encephalopathy and dysarthria after recovering from hypoxic respiratory failure and subsequently developed ischemic stroke in multiple vascular territories during hospital admission.

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Hypercoagulopathy and vascular endothelial dysfunction have been proposed as complications of COVID 19 which can lead to stroke.

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Diagnoses of stroke in critically ill patients hospitalized with COVID-19 using MRI brain can be challenging due to multiple factors.

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Patient with COVID-19 with stroke in multiple vascular territories after he had persistent encephalopathy and dysarthria.

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MRI brain is more sensitive and specific modality to detect brain tissue that has been damaged by an ischemic stroke than a CT head.

Multiple anthelmintic resistance in gastrointestinal nematodes of Caprines on Mountain Research Centre for Sheep and Goat at Kashmir Valley, India

The study was conducted to evaluate the status of anthelmintic resistance in Gastro-Intestinal Nematodes (GINs) of goats at an organized farm located in Kashmir, as there is no report of resistance against these parasites of goats from this temperate region, although it has been reported worldwide including India. Caprines reared at this farm exhibited reduced efficacy to multiple anthelmintics following treatments with Fenbendazole (FBZ), Closantel and Ivermectin (IVM) in Faecal Egg Count Reduction Test (FECRT). The results suggested that the overall efficacy was highest for IVM at 83.5% and 90.0% on 7^th and 14^th day post-treatment, respectively and least for FBZ at 44.3% and 62.5%, respectively, whereas the corresponding figures for closantel were 68.3% and 86.2%, respectively. The pre-treatment faecal culture revealed Haemonchus contortus, Teladorsagia circumcincta and Trichostrongylus colubriformis as predominant strongyles, however, in post-treatment samples, only H. contortus was observed. Further, the infective larvae were subjected to Allele specific PCR (AS-PCR) for accurate diagnosis of BZ resistance. The AS-PCR revealed 52% of H. contortus were homozygous resistant (rr) and 17% were heterozygous (rS) on day “0” before treatment and 100% homozygous resistant (rr) on 7th day post treatment. In both T. colubriformis and T. circumcincta, 100% population was homozygous susceptible (SS) at day “0” before treatment. The overall frequency of resistant (r) allele for H. contortus was 60.5% and for susceptible allele (s) was 39.5%. For T. colubriformis and T. circumcincta the frequency of susceptible allele (s) was 100%. The survey indicated that the GINs of goats on the farm have developed multiple anthelmintic resistance to FBZ, closantel and IVM and the condition is alarming in the farm. Moreover surveillance studies about status of anthelmintic resistance in other farms (Govternment as well as Private) of Kashmir valley should be carried out at large scale to develop effective and sustainable control strategies against GI Nematodes.

Significance of third trimester ultrasound in detecting congenital abnormalities of kidney and urinary tract-a prospective study

INTRODUCTION

Antenatal hydronephrosis is defined as dilatation of the renal pelvis with or without dilatation of calyces in the developing fetus. Although second trimester scan is more sensitive in detecting congenital abnormalities of kidney and urinary tract (CAKUT), it has been suggested that the third trimester scan is more predictive of postnatal outcome.

OBJECTIVES

This study aims to determine the incidence of antenatal hydronephrosis at our institution and the significance of third trimester scan in detecting CAKUT postnatally.

STUDY DESIGN

It is a prospective observational study. During the 3-year study period from June 2013 to May 2016, all cases of antenatal hydronephrosis, defined as renal pelvic diameter (RPD) ≥4 mm in the second trimester and ≥7 mm in the third trimester scan, diagnosed in the fetal medicine unit of our hospital, were included and were followed up postnatally for 6 months.

RESULTS

In the fetal medicine unit, 32,443 women were screened for anomalies, and hydronephrosis was detected in 269 cases. Incidence of antenatal hydronephrosis was observed to be 0.83% in our institution. In second trimester scan, of 80 cases with the left hydronephrosis, only 22 (27.5%) had postnatal CAKUT and of 70 cases with the right hydronephrosis, 18 (25.7%) had CAKUT. In the third trimester scan, it was observed that with RPD >10 mm, on the left side hydronephrosis, 87% had CAKUT on postnatal scan, and 85% with the right hydronephrosis had CAKUT.

CONCLUSION

Sixty percent cases of hydronephrosis detected in the second trimester scan resolve in utero. In the third trimester scan with RPD <10 mm, the possibility of postnatal CAKUT is 23%, whereas if RPD is > 10 mm, then the possibility of postnatal CAKUT is 86%.

Isolation and analysis of the molecular epidemiology and zoonotic significance of Mycobacterium tuberculosis in domestic and wildlife ruminants from three states in India

The majority of tuberculosis cases in ruminants are caused by Mycobacterium bovis (MB). However, in this study, the authors reported the isolation of Mycobacterium tuberculosis (MT) from bovine milk, nasal swabs and post-mortem tissue samples (n = 841) collected from cattle and buffaloes in the states of Telangana, Maharashtra and Gujarat in India in the period from 2010 to 2015. The isolates (n = 7) were confirmed as Mycobacterium due to their growth characteristics and colony morphology in a commercial liquid medium Mycobacterial Growth Indicator Tube (MGIT)™ employing the BD BACTEC™ MGIT™ 960 system and the Löwenstein-Jensen (LJ) medium supplemented with glycerol but not with sodium pyruvate, and BD-DIFCO™ Middlebrook 7H10 agar containing oleic albumin dextrose catalase (OADC). These isolates were initially identified as members of the M. tuberculosis complex (MTC) using a commercial nested polymerase chain reaction (PCR) kit based on the IS6110 MTC specific nucleotide sequence. The isolates were confirmed as MT using three commercial line probe assay kits, were further genotyped, and the spoligotypes identified were of East African Indian (EAI) 3_IND, EAI5, Central-Asian (CAS) 1_DELHI, U and T1 lineages. Two MT isolates from one antelope (Antilope cervipara) andone gazelle (Gazella bennettii) from Gujarat, which were identified previously, were spoligotyped during this study and identified as belonging to EAI3_IND and EAI5 lineages, respectively. The epidemiological significance and zoonotic implications of regional presence and documentation of the same or two differents poligotypes in different species within the family Bovidae as well as humans is discussed.

Systematic review of the outcome of cemented versus uncemented total hip arthroplasty following pelvic irradiation

PURPOSE

The objective of this study is to evaluate the outcomes of total hip arthroplasty (THA) in patients with radiation-related changes to the bone, and specifically whether there is a difference in outcomes between cemented and uncemented acetabular components.

METHODS

A database search was performed to identify available studies reporting adults undergoing THA who have previously had pelvic irradiation. Data were extracted and analysed with respect to the use of cemented versus uncemented acetabular components. Statistical analysis was performed using the Chi-square test for independence.

RESULTS

The all-cause revision rate was 24% in the cemented THA group (27/111), compared with 15% of uncemented THAs (22/143) (p = 0.073). Revision for acetabular aseptic loosening occurred in 16% of cases (18/111) in the cemented group and 10% (15/143) in the uncemented group (p = 0.178). Acetabular aseptic loosening was reported in 24% of cemented THAs (27/111) and 14% of uncemented THAs (20/143), which was statistically significant (p = 0.035). Not all of these went on to have revision THA. The Incidence of prosthetic joint infection was similar in both groups.

CONCLUSION

Overall outcomes appear to be better for uncemented THAs in post-radiotherapy patients, with a significantly lower rate of aseptic loosening and an appreciable (but not statistically significant) reduction in revision rate. The best outcomes seem to be associated with the use of acetabular reinforcement across both cemented and uncemented groups, but further work is needed to evaluate this.

Immune response against subclinical haemonchosis in Himalayan hill goats

Haemonchosis commonly occurs as chronic and subclinical infection in small ruminants, and understanding of immunological response against subclinical haemonchosis is of paramount importance for designing and implementing effective control strategies. The present study was designed to evaluate immunological response during subclinical haemonchosis, experimentally established in goats. Sixteen 5-6 month-old helminth naive kids were randomly allocated into one of two groups, infected and uninfected; the infected group being infected per os with 250 Haemonchus contortus larvae per kg body weight. Faecal, blood and serum samples were collected every third day up to 30 days post-infection (DPI), thereafter weekly up to 58 DPI to record changes in faecal egg count (FEC), haemoglobin (Hb), packed cell volume (PCV), peripheral eosinophil percentage and immunological parameters, such as macrophage cytokine interleukin-12 (IL-12), Th1 cytokine (IFN-γ), Th2 cytokines (IL-4, 13, 25, 33) and immunoglobulins (IgG and IgE). Pre-patent period of H. contortus in the present study was 18 days and eggs per gram (EPG) peaked on 30 DPI. The total reduction in body weight gain in the infected group was 26 g per day when compared with uninfected animals. Hb (7.35 ± 0.34 g/dL in infected animals compared with 9.76 ± 0.67 in control animals) and PCV levels (22 ± 1.54 g/dL in infected animals compared with 29.2 ± 1.27 in control animals) decreased significantly up to 44 DPI in infected group (P = 0.000). IL-4, IL-13, IL-33, IgG and IgE showed significant increase in infected animals at different periods. IFN-γ, IL-12 and IL-25 did not show any significant changes barring a steep rise of IFN-γ on 27 DPI. A positive correlation was observed between IgE and IL-4 in subclinical haemonchosis. Of particular note was that all the major cytokines, such as IFN-γ (P = 0.000), IL-4 (P = 0.000), IL-13 (P = 0.009), and both IgG (P = 0.000) and IgE (P = 0.003), were observed at the lowest concentration on 24 DPI. The effect of infection was found to be significant on cytokines with a strong interaction with time. Taken together, the data suggest that Th2 immune response is predominating in subclinical haemonchosis. The economic loss in term of body weight gain due to subclinical haemonchosis was considerable.