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Though the proven- triculus and ventriculus can normally contain small stones purchase coumadin 2mg overnight delivery pulse pressure 47, gastric impaction from the consumption of foreign bodies is a common problem in ratites order 5 mg coumadin free shipping blood pressure j curve, par- ticularly in juvenile birds (Color 48 order coumadin 5mg fast delivery heart attack kit. In emus rected into the pouch causes a drumming sound in the female and a growling sound in the male discount 1mg coumadin mastercard arteria labialis superior. The presence of this expandable pouch may compli- cate inhalation anesthesia in mature emus. If posi- tive pressure ventilation is used to inflate the air sacs and ventilate the lungs, air may be directed into and thus inflate the pouch. Inflation of the pouch can be prevented by wrapping the lower neck with a self- adhesive bandage, taking care not to place excessive pressure on the major vessels of the neck. Proventriculus (p), ventriculus (v), duodenum (d), jejunum (j), ileum (i), ceca (c), rectum (r) and niche of these large grazing ungulates. Ratites have cloaca (cl) (courtesy of Murray Fowler, reprinted with permission19). The opening from the ventriculus to the duodenum is on the right side in all ratites. The small intestine is most important in the emu, in which it occupies most of the abdomen caudal to the ventricu- lus. In the ostrich and rhea, the elongated, well developed ceca, vis- ible immediately after entering the midline abdominal wall, course di- agonally from right to left in a caudal direction. The lumen of the ceca ap- pears sacculated as a result of spiral folds that increase the surface area in the organ and facilitate the fer- mentive digestion of fiber (Color 48. The large intestine of the ostrich is voluminous and occupies the caudal right abdomen (Figure 48. The long, large intestine is considered necessary to digest high-fiber food items. The gastroin- testinal transit time is slow in ostrich and rheas (36 hours) and much faster in emus (5 to 6 hours). Interestingly, emus produce a large portion of their energy through fermentation even though they have poorly developed ceca, a short colon and a rapid gastro- intestinal transit time. In the ostrich, the urodeum and co- prodeum are separated by a muscu- lar sphincter, making the ostrich the only bird that can urinate inde- pendent of defecation. The coprodeum is a large sac that may be covered by a dark tough membrane similar to koilin. There is no gallbladder in the ostrich, but this organ is present in the emu and rhea. As a hen reaches sexual maturity, the follicles begin to develop, so the ovary has many visible follicles of different sizes at any one time (see Color 29). Cranial division of the left kidney (k), left testicle (t) and left adrenal gland (a) (courtesy of Murray Fowler, reprinted with near the kidney. Male ratites have a phallus that serves to transport semen from the ejaculatory Ratites of both genders possess a genital prominence ducts in the cloaca of the male to the cloaca of the that extends from the ventral aspect of the cloaca. The phallus is shaped differently in ostrich, This prominence may be visualized or palpated to emu and rhea; however, the function is the same, and 25 determine the gender of any aged individual. Venipuncture can be performed using the jugular, brachial and medial metatarsal veins. The right jugular vein is larger than the left as in other avian species and is a convenient site for venipuncture or placement of intravenous catheters (Figure 48. The brachial vein is inaccessible in the reduced wings of the cassowary and emu, but is well developed in the large wings of the ostrich and can be easily accessed. The medial metatarsal vein is readily ac- cessible in sedated or immobilized adult ratites and in unsedated chicks. The medial metatarsal vein generally is not used in standing adults due to the potential for being kicked. The medial metatar- sal vein is a common preference for intravenous catheterization of chicks (Figure 48. Catheters should be secured in place using tissue adhesive followed by a light bandage. The can be collected from the oviduct of adult hens (see cross sectional view of the reproductive organ is also provided. Abdominocentesis can be performed on proctodeum 2) phallus 3) clitoris and 4) genital eminence (modified birds with clinical signs suggestive of intestinal tor- with permission from Murray Fowler19). A lubricated gloved finger is device for use for abdominocentesis in ratites (see used to expose the cranio-ventral aspect of the cloaca. The male ostrich chick has a phallus that is conical Oral medications are relatively simple to administer in cross section, contains a palpable core of fibroelas- by orogastric tube to chicks or tractable adults. Occa- tic tissue and is characterized by the presence of a sional feedings can be provided by placing an equine seminal groove. By comparison, the clitoris in the stomach tube directly into the proventriculus; how- hen is laterally compressed, soft and lacks the semi- ever, to perform gastric lavage or supply sustained nal groove. The clitoris of the adult female remains enteral nutrition, an equine stomach tube is passed approximately one to two centimeters in length (Fig- through an esophagostomy incision and is sutured ure 48. The tube is most easily placed by introduc- male is approximately three to five centimeters in ing it orally into the esophagus, making an incision length and is readily detected on the ventral wall of over the cranial end of the tube and retracting it back the cloaca by palpation. These birds (blebs) and contamination of the shell with are best managed by surgically removing sand and debris. The chick on the left is se- The skin has been removed from the abdo- verely edematous, which in other avian men of a three-day-old emu chick to better species can be caused by excessive humid- visualize the infected yolk sac. Volvulus of the The chick on the left has a distended abdo- small intestines was caused by rotation of men caused by the retention of an infected the yolk sac. The bird on the right has a small, sac and distal portion of the small intes- tucked abdomen secondary to starvation. Aortic rupture of unknown etiology in a six-month-old female ostrich that died Color 48. The site where the aneurysm Uric acid deposits in the eyelid of a rhea formed between the intima and media of that died from renal failure. A of uric acid were also noted on the tongue, copper deficiency has been discussed as a thoracic and cervical vertebrae, heart, ven- possible cause of this lesion. The phallus is firm, conical in shape, curves to the left and has a prominent seminal groove. It has been suggested that this site may be inappropriate for the administration of nephrotoxic or renally ex- creted drugs because of the renal portal system. However, in one study involving the clearance of aminoglycoside, there was no difference in plasma levels when the drug was given in the posterior or anterior portions of the body. Adult Bird Management insurance company requirements for identification and provide unmistakable identification for record keeping purposes. Identification Nutrition It is suggested that all ratites be permanently iden- Numerous pelleted rations are commercially avail- tified. Most of these are locally produced dramatically illustrated by a case in which an ostrich and are highly variable in content and quality.

Silymarin not only prevents the depletion of glutathione induced by alcohol and other toxic chemicals but also has been shown to increase the level of glutathione in the liver by up to 35% generic 2 mg coumadin mastercard pulse pressure fluid responsiveness. In human studies quality 5 mg coumadin blood pressure medication used to treat adhd, silymarin has been shown to have positive effects in treating liver diseases of various kinds buy discount coumadin 1 mg line blood pressure medication not working, including cirrhosis generic 1mg coumadin visa blood pressure monitor chart printable, chronic hepatitis, fatty infiltration of the liver (from chemicals or alcohol), and inflammation of the bile duct. Fasting Fasting is often used as a detoxification method, as it is one of the quickest ways to increase elimination of wastes and enhance the body’s healing processes. Fasting is defined as abstinence from all food and drink except water for a specific period of time, usually for a therapeutic or religious purpose. Although therapeutic fasting is probably one of the oldest known therapies, it has been largely ignored by the medical community despite the fact that significant scientific research on fasting exists in the medical literature. Numerous medical journals have carried articles on the use of fasting in the treatment of obesity, chemical poisoning, rheumatoid arthritis, allergies, psoriasis, eczema, thrombophlebitis, leg ulcers, irritable bowel syndrome, impaired or deranged appetite, bronchial asthma, depression, neurosis, and schizophrenia. One of the most significant studies regarding fasting and detoxification appeared in the American Journal of Industrial Medicine in 1984. All patients reported improvement in symptoms, and some observed “dramatic” relief, after undergoing 7- to 10-day fasts. If you elect to try a fast, we strongly advise supporting detoxification reactions while fasting, especially if you are carrying a particularly heavy toxic load or have a long history of exposure to fat- soluble toxins like pesticides. The reason is that during a fast, stored toxins in our fat cells are released into the system. Longer fasts require strict medical supervision at an inpatient facility, while a short fast can usually be conducted at home. For a three-day juice fast, each day you will consume three or four 8–12-fl-oz juice meals spread throughout the day. Drinking fresh juice for cleansing reduces some of the side effects associated with a water fast such as light- headedness, tiredness, and headaches. While on a fresh juice fast, individuals typically experience an increased sense of well-being, renewed energy, clearer thought, and a sense of purity. Be sure to use vegetable juices (preferably fresh and organic), not fruit juice, as the high level of sugars in fruit juice can cause widely fluctuating blood sugar levels. Take a high-potency multiple vitamin and mineral formula to provide general support. Take a lipotropic formula to provide a daily dose of 1,000 mg choline and 1,000 mg methionine and/or cysteine. Take 1–2 tbsp of a fiber supplement at night before retiring, preferably a soluble fiber such as powdered psyllium seed husks, guar gum, or oat bran. If you are carrying a particularly heavy toxic load, take silymarin at a dosage of 70 to 210 mg three times per day. Other Tips on Fasting Although a short juice fast can be started at any time, it is best to begin on a weekend or during a period when adequate rest can be ensured. The more rest, the better the results, as energy can be directed toward healing instead of other body functions. Prepare for a fast by having only fresh fruits and vegetables as the last meal on the day before the fast begins. As noted above, have four 8- to 12-fl-oz glasses of fresh juice throughout the day. The quantity of water should be dictated by thirst, but it should be at least four 8-fl-oz glasses every day during the fast. Short walks and light stretching are useful, but heavy workouts tax the system and inhibit repair and elimination. Body temperature usually drops during a fast, as do blood pressure, pulse, and respiratory rate—all measures of the slowing of the body’s metabolic rate. When it is time to break your fast, reintroduce solid foods gradually by limiting portions. It is also a good idea to eat slowly, chew thoroughly, and eat foods at room temperature. Digestion and Elimination Introduction If we are to gain the nutritional benefits from foods, they must be properly digested, absorbed, and eliminated. Fortunately, the human digestive system is quite efficient in extracting the necessary nutrients from foods. The major functions of the gastrointestinal system are to break down and absorb nutrients. It consists of the gastrointestinal tract and its appendage organs, such as salivary glands, the liver and gallbladder, and the pancreas. The mechanical processes of digestion are brought about by grinding and crushing the food mass and mixing it with digestive juices during propulsion through the digestive tract. The active compounds in the digestive juices are primarily hydrochloric acid and enzymes. Chewing food thoroughly is the first step toward getting the most from the food you eat. Chewing signals other components of the digestive system to get ready to go to work; it also allows food to mix with saliva. Saliva contains the enzyme salivary amylase to break down starch molecules into smaller sugars. Once the food has been chewed, it is transported through the esophagus into the stomach. The stomach churns and gyrates to promote the mixing of the food with its digestive secretions, including hydrochloric acid and the enzyme pepsin. If hydrochloric acid secretion is insufficient or inhibited, proper protein digestion will not occur. It takes chyme approximately two to four hours to make its way through the 21-foot-long small intestine. The small intestine is divided into three segments: the duodenum is the first 10 to 12 inches, the jejunum is the middle portion and is about 8 feet long, and the ileum is about 12 feet long. The small intestine participates in all aspects of digestion, absorption, and transport of ingested materials. It secretes a variety of digestive and protective substances as well as receives the secretions of the pancreas, liver, and gallbladder. Absorption of minerals occurs predominately in the duodenum; absorption of water-soluble vitamins, carbohydrates, and protein occurs primarily in the jejunum; and the ileum absorbs fat- soluble vitamins, fat, cholesterol, and bile salts. Diseases involving the small intestine often result in malabsorption syndromes characterized by multiple nutrient deficiencies. Examples of common causes of malabsorption include celiac disease (gluten intolerance), food allergy or intolerance, intestinal infections, and Crohn’s disease. The Pancreas The pancreas produces enzymes that are required for the digestion and absorption of food. The proteases secreted by the pancreas (trypsin, chymotrypsin, and carboxypeptidase) function in digestion by breaking down protein molecules into single amino acids. Incomplete digestion of proteins creates a number of problems for the body, including the development of allergies and formation of toxic substances during putrefaction (the breakdown of protein by bacteria). As well as being necessary for protein digestion, proteases serve several other important functions.

The leaves base was cordately with a deep order coumadin 5 mg fast delivery hypertension patient teaching, narrow sinus and the twining petioles were present coumadin 5mg line blood pressure chart online. The flowers were purplish brown 5 mg coumadin amex xopenex arrhythmia, base globose buy coumadin 1mg line arteria en ingles, tube shortly funnel-shaped with mouth obique trumpet- shaped gradually passing into the short oblong obtuse glabrous purple brownish lip. In microscopical study, the leaves were dorsiventral type and anomocytic type of stomata. The papillose of leaves were confined in lower surface and more rarely occur on both sides. In addition, the dried powdered of the leaves and rhizome was also investigated for their standardization use in medicine. The microscopical studies were examined with the microscope by literature of (Wallis, 1967 and Trease and Evans, 1978). Phytochemical investigation revealed that the twelve tests constituents were present except cyanogenic glycoside was absent. According to the physicochemical examination, the samples were more soluble in water, moderately soluble in ethanol and methanol. Phytochemical and physicochemical investigation by the methods of British Pharmacopeia, 1968. In elemental analysis of leaves and rhizome of Aristolochia roxburghiana Klotzsch. It was found that Calcium (Ca), Potassium (K), Sulfur (S) and Iron (Fe) were found as principal elements and Chlorine (Cl) was moderately presented in leaves only. Antimicrobial activities with six micro-organisms were also tested by using pet-ether (60ºC-80ºC), chloroform, water,ethanol, methanol, ethyl acetate extract and acetone extracts. The rhizomes extracts showed more activity than the leaves extracts of Aristolochia roxburghiana Klotzsch. Isolated total acid, chloramphenicol and tetracycline were tested against six microorganisms for their antimicrobial activites by using agar well diffusion method according to Cruickshank, (1975). The acute toxicity test was carried out with aqueous extract and 70% ethanolic extracts of rhizome on albino mice. They were observes that these extracts did not show any visible symptoms of toxicity even with the maximum permissible dose of 7g/kg. Antidiarrhoeal activity of 70% ethanolic extract of Aristolochia roxburghiana Klotzsch. The collected plants were studied and identified with the help of literature using morphological characters. It is a medical herb, with simple, palmate leaves having 5 lobes, the lamina reniform in shape. The present work deals with the histological characters of the leaves, petioles, fruits and seeds of the species Benincasa hispida (Thunb. The fruits having massive mesocarp which was heterogeneous in structure with thick-walled sclerehymatous layer in the outer part of pericarp (fruit wall) and the seed coat (or) testa having sclerenchymatous layer as inner seed coat cells were the principal structure features. Qualitative analysis were concerned with the determination of presence or absence of phytochemical in the pulp and seeds of Benincasa hispida (Thunb. The investigation of these tests confirmed with the presence of alkaloids, glycosides, amino acids, tannin are present in both pulp and seeds. The physicochemical characterization of the dried fruits pulp and seeds were carried out. In solubility test, fruits pulp was more soluble in water than the seeds but less soluble in petroleum ether than the seeds. Whereas, 5 elements were found in seeds in which potassium elements were more abundant than the others. Thef antimicrobial activities of crude extracts were carried out by using various solvents such as petroleum ether, chloroform, acetone, ethyl acetate, ethanol and distilled water. Among the six different extracts, the ethanolic extract of fruits showed high antimicrobial activities on Bacillus pumalis, Bacillus subtilis, Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Staphyococcus aureus. In acute toxicity test, no lethality and toxic effect of the mice were observed up to 14 days, even with the maximal permissible dose of 9g/kg of ethanolic extracts. Therefore, it can be observed that these extracts were free from acute toxic or harmful effect for the mice. The appreciable antipyretic effect noticed at 50mg/kg was slightly comparable to standard drug paracetamol. Therefore, the results showed that the 70% ethanolic extract of Benincasa hispida (Thunb. Inflorescences axillary, clusters 2-4 flowered, white and fragrant, fruits loculicidal capsule, 1-3 lobed and seed 1-3. Tanniniferous cells with yellowith brown content scattered throughout the lamina, various sizes of astrosclereids and calcium rosettes are abundant in the leaves and fruits. The plant materials were dried at room temperature for 7 days and then crushed and powdered by using grinding mill and stored in air-tight bottle for further use. Plant materials were preliminary studied for photochemical and physicochemical tests. Potassium and calcium were major constituent and lead, Arsenic and Cadium were present but their contents were lower than the toxic level. In addition, the plant extracts were prepared by various solvents such as methanol, ethanol, pet-ether and ethyl acetate. These extracts were tested with six types of microorganisms by using agar-well diffusion method in vitro. Furthermore, the acute toxicity studies of caffeine was perform by using albino mice and harmful effect was observed up to 0. Caffeine treated rats showed significant reduction in Malondialdehyde levels than carbon tetrachloride treated hepatotoxic rats. The morphology and taxonomy of this plant have been studied by using the standard methods used in Botany Department of Yangon University. To study the microscopical characters the free-hand sections of fresh plant materials as well as the dried powdered drugs were prepared. In transverse section of the rhizome, the vascular bundles are scattered, collateral and closed. Using grinding mill the rhizome also is thoroughly powdered and phytochemical and physicochemical tests were conducted. The presence of glycosides and flavonoids were mostly common in the phytochemical investigation of the powdered rhizomes. So, cyaniding, kaempferol and quercetin were extrated and isolated by selective solubility method. The plant extract was prepared from powdered rhizomes by using polar and non-polar solvents.

Acid-fast rods are found distributed throughout the parenchyma of infected organs purchase 5 mg coumadin fast delivery prehypertension and chronic kidney disease. An infected liver or Clinical Disease spleen may be only swollen or may show necrotic foci In some bird species the clinical course is atypical buy 5mg coumadin otc blood pressure chart old, or even general induration discount coumadin 2mg amex hypertension signs and symptoms treatment. In pigeons generic 1mg coumadin otc arteria coronaria derecha, liver lesions and acid-fast rods have been detected more or less may resemble Trichomonas abscesses. This is particularly the case with small greasy tumor-like swellings like those seen in leuk- Passeriformes, especially the Hooded Siskin. The lungs, particularly of cal signs associated with mycobacteriosis are highly geese, weaver finches (genera Queleopsis, Quelea and variable. Imma- characterized by the occurrence of clubbed villa con- ture individuals frequently develop subclinical condi- taining acid-fast rods in the intestinal mucosa. Intermittent switching lameness may occur as sions may also occur in glands of Lieberkühn, with a result of painful lesions in the bone marrow. These clini- fluent epithelioid cells in affected organs is sugges- cal changes are particularly common in Falconifor- tive of an M. Skin over the affected joint generally consist of epithelioid cells or multinu- is often thickened and ulcerated. Tubercle formation cleated giant cells (mostly the foreign body type, only in the skin is rare, but when it is present, pinpoint to rarely the Langhans type) and occasionally contain pigeon egg-sized nodules filled with yellow fibrinous lymphocytes and plasma cells. Granulomas may be seen ing quantities can be demonstrated in the affected within the conjunctival sac, at the angle of the beak, epithelioid or multinucleated giant cells. Acid-fast around the external auditory canal and in the oro- rods may also be noted in tissues in the absence of pharynx. Greater Rhea free acid-fast rods in the proventriculus or jejunal frequently develop granulomas in the upper phar- villi without an inflammatory response. The tuberculin test (aller- avium infections frequently induce depletion of lym- genic test) and the slide agglutination test (serologic phocytes in the spleen (particularly the white pulp) test) have both been used in birds with some success. Depletion of the splenic false-negative results, particularly in early and late lymphocytes and lymph follicles may induce an im- stages of the disease and is no longer recommended. The slide agglutination test requires fresh plasma or serum and is evaluated against a bank of antigens for Diagnosis the different serovars; there are cross-reactions be- The demonstration of acid-fast rods in tissues or on tween the different serovars. Unfortunately, only se- cytologic preparations is suggestive of mycobacte- rovar 2 antigen is commercially available. False-negative staining can occur by not ob- mate the probability of an acute disease process, taining an adequate sample. The demonstration of serotitration (using the Gruber-Widal scheme) is pos- acid-fast rods in the feces has been suggested as a sible. Only titers greater than 1:64 are considered useful diagnostic tool in subclinical birds. Psittaciformes may exhibit a cyclic reduc- present in the feces can interfere with test results, tion in titer and mycobacterial excretion, which may and samples should be processed with one of the lead to an incorrect suspicion that natural healing or sputum solvents used in human medicine before a successful therapy has occurred. The most consistent results can be obtained has been tested to distinguish between M. Treatment and Control The clinician must differentiate between pathogenic Several treatment modalities have been discussed and nonpathogenic strains of mycobacteria, both of for birds with M. In general, non- infected birds is not recommended because: pathogenic strains are wider and are not granular. Recent information re- vealed that ethambutol, while ineffective, does Culture is required to make a distinct diagnosis. Endoscopy (with biop- appropriate method of treatment for infected hu- sies) can be used for diagnosis in cases of advanced mans. Birds that are definitively diagnosed (biopsy of af- Biopsy is required to differentiate between mycobac- fected tissue with histopathology and culture) with terial and fungal granulomas, which radiographi- M. Birds that remain negative (also not Pathogenesis shedding the agent with the feces) and are in good E. There are when food is scarce and energy requirements are currently no absolute means of control. Most affected birds die during the bacteremic fecal examinations of all new additions during the phase of an infection. However, transmission is probably dependent on in- Clinical Disease and Pathology herent resistance, the immune status of the person E. If in question, the frequency of exposure and the num- clinical signs occur, they may include lethargy, weak- ber of bacteria per exposure. In the Marabou Stork, infec- present, they are generally characterized by the for- tions have been characterized by inflammation and mation of benign localized granulomas of the dermis, necrosis of the cutaneous adnexa of the neck. The liver and spleen are friable and discolored affected dermis looks granulomatous and may even (red to black). Clinical changes associated with this form of disease Infected birds should be euthanatized. The Diagnosis strain in question was sensitive to all common tuber- Diagnosis is confirmed by isolating E. As in most bacterial diseases, cell-mediated immunity is Erysipelothrix rhusiopathiae can induce an acute-to- more important in resolving infections than the de- subacute septicemic disease. Thus, serologic commonly discussed in ducks and geese but can occa- methods of diagnosis are of little value. Survivability in moist may sensitize the birds and potentiate chronic dis- soil and in the water of shallow lakes and ponds, even ease. Flock control can best be implemented through salt and seawater, is particularly high. The motility of listeria is dependent on the ambient temperature to which it is exposed. Acute disease is characterized by bacteremia pro- gressing to death within one to two days. There is little information on Clinical disease is usually associated with sporadic the pathogenicity of these Listeria spp. Pathogenesis Histologically, infections are characterized by degen- erative lesions, without a cellular response, in the Clostridium spp. The Diagnosis ability of clostridia to colonize the intestines appears A confirmed diagnosis requires the isolation of L. Newcastle dis- by using a culture alone is usually not possible, and ease virus can induce ulcers called “boutons” that clostridial organisms are considered to be opportun- resemble those induced by Clostridium. Following colonization, pathogenic clostridia produce exotoxins, which then induce clini- Gangrenous Dermatitis cal lesions or death. These organ- It is best to discuss clostridial infections by grouping isms can directly colonize damaged skin.

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