Doctors' Perceptions towards Domestic and Multinational Pharmaceutical Products: An Investigation from Developing Country Jashim Uddin Ahmed*, Md. Humayun Kabir Chowdhury**, Ishrat Jahan Synthia***, and Ishrat Sultana**** This exploratory study focuses on doctors' perception towards domestic and multinational phar-
C: lindsay farm newsletters cattle - winter 2013.wpd
A Housing OverviewNeil Fox and Will SheppardWith cattle coming inside over the winter, their management becomes more involved than when they areat grass and if you get it wrong you could potentially lose a lot of money. We thought it would be useful togive you a short guide on the type of cases we are commonly presented with affecting housed animalsand how to deal with them should they arise on your farm.
and should be stomach tubed until it will drink. Suitable productsinclude Effydral and Rehydion and the on-package instructions should be Infectious calf scour accounts for around 50% of all calf deaths in the UK followed carefully. For recumbent calves intravenous fluids are an and causes significant financial loss in both the beef and dairy industry.
option and when used in the right cases are extremely effective.
However, with the correct management and prompt, correct treatmentof cases it is an entirely preventable disease. The common scour Prevention of Infectious Scour pathogens are found in the environment on all farms and they can cause As with all disease prevention is better than cure and will also keep yourdisease in the correct circumstances. As well as having a scour affected accountant happier! Scour outbreaks occur following a build-up of animals will be dull and uninterested in feeding, often dehydrated and in infection particularly at the end of calving or in housing during thesevere or untreated cases become recumbent and die.
winter. Another significant factor in the development of scour is poorcolostrum intake of calves during the first six hours after birth which Treatment of Infectious Scour leads to poor immunity against the pathogens. By carrying out some of When you get a number of calves scouring at the same time it is likely the following preventative steps you can significantly reduce the risk of that it is more than just a milk scour, particularly if you are also seeing clinical cases of scour and calf deaths on your farm: sick calves showing the clinical signs above. Defining cause can be 1. Remove freshly calved cows and their calves to a separate pen important to direct treatment. A calf scour package at our lab will cost immediately post calving.
£15 plus VAT per calf and allows us to test for rotavirus, coronavirus, 2. Change fields/sheds used for calving every year or when you have E.coli K99 and cryptosporidium. Testing for salmonella (£9 plus VAT) and infection in that year.
coccidia (£7 plus VAT) may also be carried out and a vet should be 3. Ensure that each calf receives adequate colostrum during the first consulted prior to testing. Faecal samples for testing should be six hours of life (we recommend you give six pints in six hours if the collected from both sick and healthy calves before any treatment is calf is not suckling properly, ideally milked from its own mother).
4. If buying in calves then purchasing them from a known good source Symptomatic therapy is vital to the recovery of animals affected by will reduce the risk of poor colostral transfer.
scour, particularly those that are very sick. NSAIDs such as Metacam and 5. Clean out housing areas regularly and disinfect with a quaternary Finadyne will reduce inflammation of the intestines and reduce ammonium based disinfectant. If you manage calves in batches then discomfort. Fluid therapy is vital and should be carried out at least twice disinfect between batches.
a day orally in sick calves. If a calf will not drink, it must not go without Endell Veterinary Group, 49 Endless Street, Salisbury, Wiltshire, SP1 3UH • Tel: 01722 333291 Endell Veterinary Group is the trading name of Endell Veterinary Group Ltd., registered in England and Wales No. 08078309. Registered office: 49 Endless Street, Salisbury, Wiltshire, SP1 3UH.
6. Bed animals regularly with clean, dry bedding material.
back and rump. The selection of the right product should be discussed 7. Ensure an appropriate stocking density.
with a vet or with our Livestock Technician, poet and SQP Barry Ewens.
8. If Rotavirus or Coronavirus is diagnosed on-farm then you can vaccinate your cows pre-calving, but colostrum intake must be ensured for this to be effective.
Mites cause mange and there are a number of different mites thatcommonly cause problems in cattle. Mange is mainly a problem in cattle when they are housed and clinical signs are similar to those seen with Outbreaks of pneumonia can be extremely costly with the latest figures lice. Therefore, the areas affected and skin scrapes taken by a vet are suggesting that a single case costs £43 per treated animal and £29 per important to differentiate them. untreated animal in the group. Only 40% of these costs are attributed to Predilection Sites vet and medicine costs with the remaining 60% being made up of lost Neck, legs and tail head growth, deaths and labour.
Neck and loin area next to the tail Pneumonia is usually caused by respiratory viruses and bacteria with the Back, shoulders and tail head majority of pneumonia starting with a virus which damages the airwaydefences. This allows bacteria to invade and set up a bacterial infection As with lice, please consult with a vet or Barry if you are unsure what is in the lungs. Some bacteria, however, can cause pneumonia on their causing the problem or which product to use.
own (Pasteurella and Mycoplasma) often associated with stressfulevents such as weaning, transporting and changing temperatures.
RingwormThe ringworm vaccine Ringvac is off the market for the time being. It is Signs of pneumonia are an increased breathing rate, chesty cough, hoped that it will be available again in early 2014 and will sell at £2.37 increased temperature (39.5°C/103°F), rough coat, decreased appetite, plus VAT per dose. Ringworm presents as areas of hair loss and scabbing depressed look and occasionally animals found dead. If you suspect an that are not initially itchy, but can be if they become bacterially infected.
animal is starting to show signs of pneumonia then often simply taking The most common treatment is topical Imaverol, but various other its temperature can confirm your diagnosis.
things are rumoured to work including iodine and old engine oil! Treatment and Prevention of Pneumonia Ringworm spores can remain on the wood and bricks of sheds for Treatment for pneumonia invariably involves antibiotics, whether it be months and so disinfection may reduce the risk of infection. The to prevent a bacterial infection getting started or to cure a bacterial recommendation is to clean with a pressure washer and disinfect with a infection that has already established. Often we will advise you to give hot disinfectant (eg: benzalkonium chloride) or to creosote the wood.
an anti-inflammatory in conjunction with the antibiotics as these will help to decrease the animal's temperature and alleviate some of thepain caused by pneumonia. Studies have proven that giving anti- Animals that have been out at grass all summer and autumn may have inflammatories as well as antibiotics in cases of pneumonia can increase picked up endoparasites from the pasture including gut worms, lung feed intakes and minimise the reduction in weight gain.
worm and liver fluke. It is important to control these at housing so thatyou can maximise the growth and health of your animals over winter. There are many ways you can reduce the chance of pneumoniaoutbreaks occurring in the first place: First and Second Season GrazersThese animals will require worming at housing to control gut worms, 1. Have you controlled BVD? BVD affects the immune system making lungworm and liver fluke depending on what parasites you have infected animals more susceptible to other infections, including confirmed to be present on your farm. If you buy in store animals or fattening animals then you should treat for all three as you do not 2. Ensure all animals have a good start in life; getting good quality necessarily know the prevalence on the farm of origin.
colostrum at birth will boost the immune system.
3. Good nutrition will help with the immune defences of animals of all Treatment for gut worms and lungworm can be done easily with an avermectin based wormer (this will kill encysted Ostertagia larvae which 4. Correct stocking rates will reduce the risk of pneumonia (1.5m2 of can cause outbreaks of diarrhoea in the spring). This worming dose can floor space and 6-10m3 of air space per animal).
be given immediately at housing and does not need to be repeated over 5. Good ventilation will help remove pathogens, ammonia and water the winter or at turnout.
vapour from the air in the shed. Animals need lots of fresh air (but If you have confirmed liver fluke on your farm then you will need to not draughts), so be careful not to block up openings with sheets or treat for this using a triclabendazole based drench two weeks after bales as these will reduce air flow.
housing when any ingested fluke cysts have developed into susceptible 6. A clean dry bed will reduce the ammonia and humidity in the air, so larvae. You can use other flukicidal products but you will need to wait regular cleaning out and fresh bedding will improve health.
for six to twelve weeks post-housing depending on the product chosen.
7. Avoid mixing animals of different ages in the same air space, as If you are in any doubt about which products to use and when then pathogens will pass from the older animals to the more susceptible contact your vet for advice.
8. Consider vaccinating animals against respiratory pathogens.
Timing of dose post-housing to kill all liver fluke There are many vaccines available to protect against pneumonia in young animals. They all work against a different selection of the viruses and bacteria. They also vary in how long they last, so it is best to get advice from your vet as to which vaccine would be most appropriate to your farm. We can often take some blood samples from older animals towork out which of the viruses you have on your farm.
Adult cattle do not need worming as a routine for gut worms and Lice are common in housed cattle and treatment with an appropriate lungworm as they should have adequate immunity by this age.
ectoparasitic medication is indicated. The clinical signs seen with lice are If you have confirmed liver fluke then you must treat for this in the same itching, hair loss and skin damage. Sucking lice are usually found on the way that you treat youngstock (see note above).
head and neck and biting lice are usually found on the neck, shoulders,
NutritionSpring Calving Cows In order to ensure adequate nutrition of your animals it is important tobe sure of the quality of the forage that you are providing them with. As the quality of the forage produced on farm varies each year, an analysis Why did you get into the profession? of the forage will give you reassurance that it is adequate or give an Something I often ask myself! I wanted an outdoor job, as well as early warning of any deficiency that needs correcting. Body condition one that was science based, and since I had worked on farms for scoring (BCS) is an effective way to assess ration quality. You should most of the time I was at high school it seemed like the job with generally be aiming for a BCS of 3 around the time of weaning and 2.5 the best combination of my interests. It also gave me a good around the time of calving in spring calving herds. Remember to excuse to spend five years at University generally being continue to supplement any trace elements that have been deficient onyour land historically and consult a vet if you think that you may have a deficiency that has not previously been diagnosed.
Where have you worked before?My previous job was at Bristol University's dairy farm. In the Autumn Calving Cows evenings I also worked at the Vet School Bar, a classy In these cows you should be aiming for a BCS of 3 around the time of establishment serving refreshments to discerning future calving which will be reduced to around 2.5 around mating time. Good professionals after a hard day's studying! nutrition of these cows is important in getting them cycling again and What is the most amusing thing that's happened to you on back in calf. Loss of condition before housing can be difficult to reverse once cattle are housed. As for spring calving cows, feed analysis is a I got my hand bitten by a goat while looking in its mouth. It didn't useful tool for assessing nutrition of your herd and remember to seem funny at the time but in retrospect I can see why everybody supplement trace elements as required.
else was laughing- and it turned out there was nothing wrong with its teeth anyway! Don't forget your bulls! They have a hard life, so at the end of the What do you do with your spare time? mating season they tend to be in poorer body condition. A plentiful Normally I can be found either playing the piano, drinking posh supply of good quality feed that meets their nutritional requirements coffee or working on my old car. will help them recover. Any young bulls you have are still growing and Pepsi or Coca Cola? will need extra feeding to allow for growth on top of maintenance.
Don't overfeed your bulls, however, because if they become obese it Football or Rugby? can reduce their fertility and their ability to cover as many cows.
I love them both Maintaining live weight gain as the autumn grass becomes scarce and as calves are weaned is a challenge. These effects are compounded by the stress of weaning and mixing groups that occurs on housing. Creep Disbuds or Dehorns? feeding prior to weaning helps to acclimatise the rumen to the change in diet that comes with weaning. As with adult cattle, ensure that the quality of nutrition and trace element supplementation meets the requirements of the animals. It is important to provide enough troughspace for all animals in the group in order to maximise feed intakes. Themonitoring of live weight gains is a useful tool for assessing theadequacy of nutrition and a number of our farms are doing this. We are pleased to welcome Hannah Bradon to our Housing is a good time of year to run the cows through the crush and team of vets. Hannah joined us in November having get any feet trimmed that are looking a bit long. It is far better to trim graduated from the University of Liverpool. Hannah feet regularly than wait until they are long and curled when there is little grew up between her home on ‘The Wirral' and that a foot-trimmer or vet will be able to do. Do not forget to trim the Cumbria, spending much of her childhood helping bulls' feet over winter so that there won't be too much to do to them in out on farms, particularly at lambing time. At the spring before they are turned out with the cows. University Hannah did the farm animal elective witha focus on sheep medicine. Her main veterinary You may experience signs of digital dermatitis in housed beef animals, interests are infectious disease epidemiology and with large numbers of your herd appearing very lame with little to find control. She is particularly interested in herd and flock health planning in the hoof itself. If you suspect digital dermatitis or have confirmed it and cattle youngstock. Hannah is joining us to take on TB testing duties before then we can help you set up a simple foot-bathing regime to but is keen to get involved in other areas of the farm practice. Outside control it. There are other methods that can be used if foot-bathing is of work Hannah enjoys hill walking, climbing and running. Hannah also impractical and you should discuss these with your vet if you suspect a enjoys canoeing and spent time open-boating in Canada after digital dermatitis issue.
graduation. Having moved to the south west, Hannah is looking forwardto getting out and about on farms and exploring the local area.
Organic Discussion Group Last month some of the farm vetsgrew moustaches in aid of We are planning to set up an Organic Discussion Group for organic Movember, a charity raising dairy, beef and sheep farmers. A first meeting is planned for late funds and awareness for men's January, covering "The science behind organic animal husbandry and prostate and testicular cancer. To animal health standards". If you are interested in going on our find out more about Movember or mailing list for this, please let us know and we will send you an invite donate, please visit: http://uk.movember.com/team/1085777 as soon as the date and location are finalised.
Worming Cows?Peter Plate It has come to our attention that representatives from a pharmaceutical company have been visiting dairies in the area and taking bulk milk samples to test for Ostertagia (abomasal worm)antibodies. On producing a positive result, farmers have then been advised to worm their entireherd with an avermectin based pour-on and told that doing so could increase yield by two litres per It was Christmas in the cowshed cow per day.
Not a single cow could sleep We would like to take this opportunity to explain why taking such action based on such a test Every eye was tightly shut would be poor clinical practice based on bad science.
Trying not to peep First, it is important to understand a bit about the parasite. Ostertagia ostertagii is an abomasal roundworm, which follows a direct lifecycle between cattle and the pasture. Larvae are eaten and They heard carols from the village develop to adults living in the glands of the abomasum. This takes around three weeks, after which As the snow began to fall the adults produce eggs which are excreted in the faeces. As with most gastrointestinal round- All believing this year worms, contamination of the pasture with larvae increases steadily throughout the spring and early Santa at last would call summer, resulting in peak numbers of larvae in Autumn and September. This has the potential to With no pillowcase or stocking cause clinical disease through protein loss and acidifying the blood. The parasite also has the To hang up on their beds capability to undergo hypobiosis, essentially ‘hibernating' in the abomasal wall, through the winter, Each cow had found a bucket only to reemerge ‘en-masse' in the spring.
And hung that up instead However, illness caused by ostertagia is not a disease we see in adult cattle. The reasoning for They wrote a note to Santa this is that after a well-managed first grazing season, cattle develop immunity to Ostertagia and This year to hedge their bets should not require further routine treatments for clinical reasons. The stock most at risk areanimals in their first grazing season. Autumn calving heifers which have had a long summer out at They've never sent him one before grass may also be held back by worms. Hopefully, most farms have a worming protocol in place for Maybe that's why he forgets their first season grazers. This is an important part of your health plan, as correct control of Daisy wanted ribbons to tie around her tail Ostertagia during the first grazing season is what ensures that a strong and healthy natural For Clarabelle a summer hat immunity develops to protect them as adults. Your worming protocol for these animals should be Annie wanted one as well designed with regard to the period of risk, clinical picture and, if necessary, faecal egg counts.
For greedy Gert a hay bale Further to this, diagnosis of parasitic disease should not be based solely on an antibody test.
One to eat all on her own The presence of antibodies to a disease only indicates that the animal has, at some stage in the And a poster for Huff Heifer grazing season, been exposed to the foreign parasite or pathogen. With this in mind, many adult Of her favourite band.Bullzone cows would probably be antibody positive for Ostertagia and a positive bulk milk sample really haslimited diagnostic value. Also, with ever increasing pressure on the responsible use of Well in the mornings early hours anthelmintics, treating cattle unnecessarily contravenes the guidelines set outspecifically to delay They heard the jingle bell of sleigh the onset of resistance to our wormers (COWS - Control of worms sustainably, jointly published by They saw the red nosed Rudolph EBLEX and Dairy Co). These guidelines specifically advise against treating adult cattle for production Santa was on his way! enhancement as well as blanket herd treatments, as both can favour the spread of anthelmintic Imagine their disappointment When they saw it wasn't him In summary, worming adult cattle is an exercise used in controlling fluke and sometimes Who they thought was Santa Claus lungworm- however, in most cases treatment should not be necessary for Ostertagia or other Was in fact the herdsman, Jim gutworms. A well-considered sustainable worming protocol for your grazing youngstock will setthem up for life; don't be coerced into spending your hard earned money treating a problem that The jingling that they heard Not a sleigh bell sound at all If you are still not conviced, a very recent study from Canada quantified the treatment effect to But the chink of crystal glasses only about half a litre per cow in infected animals. (Vanderstichel et al 2013). He'd won in the Christmas draw And the nose so bright of Rudolph Not what they'd come to think But the rosey glow of a herdsman's nose Who'd had too much to drink Santa again had passed them by A fact most found hard to take But seeing as it was Christmas Jim gave each a scoop more cake While milking he sang Silent Night To get them in the mood Though he was slurring somewhat And the words were rather rude But when they got back to the cowshed They let out excited squeals So where does the 2 litre figure come from? The study quoted in the glossy brochure (Reist et For each bucket had a carrot in al 2002) was done in 1998 in a closed valley in Switzerland - which was also endemically infected And a box of Just Brazils with warble fly! The product used (eprinomectin), kills warble flies as well as worms. Warble flies Santa Claus had really been were eradicated from the UK 23 years ago. The paper concludes that it is impossible to quantify He'd not forgot at all how much of the effect is due to killing warble flies and how much is due to killing worms. The It must have been like Daisy said glossy brochure does not mention warble flies at all. They were his last port of call.
So, what to do? If in doubt, get on the phone and speak to Barry, our SQP, or one of the vets, By Barry Ewens SQP about responsible and effective worming programmes. We continue to base our advice on best (Livestock Services & Sales) current evidence, and none of us is under any pressure to sell a product.
Traducido del Texto "Endodontics" de Arnaldo Castellucci MD, DDS Vol. 1. Primera Ed. 2.004 Traducción: Dr. Carlos Heilborn. Odontólogo. Especialista en Endodoncia. Asunción - Paraguay EL SÍNDROME DEL DIENTE FISURADO Uziel Blumenkranz S. DDS Si uno considera las varias quejas de los pacientes con diferentes formas de patología pulpar, por ej. sensibilidad al frío en la hiperemia o sensibilidad al calor en las pulpitis; o de patología peri apical, por ej. dolor desencadenado por presión en una periodontitis o absceso, uno puede concluir que éstos no pueden coexistir en el mismo diente. Mientras el paciente puede manifestar que el diente es sensible al calor, frío y presión, esto se debe generalmente a la condensación de síntomas de odontalgias previas. Sin embargo, existe un caso en el cual estos tres síntomas pueden originarse y coexistir en un mismo diente. Esto se conoce como el "síndrome del diente fisurado". Introducción Hasta el año 1.964 se han sugerido muchos nombres para esta condición. Pero fue Cameron quien introdujo el término "síndrome del diente fisurado", agregando que "el factor más importante para el diagnóstico del diente fisurado es el conocimiento de que estas fisuras suceden". Aunque se han escrito muchos artículos sobre este tema desde entonces, muchos pacientes con este síndrome están sin diagnóstico. Además existe una confusión en la literatura dental al respecto de los dientes diagnosticados con el "síndrome del diente fisurado" y aquellos fracturados como consecuencia de accidentes de procedimientos. Las fracturas de la última categoría han sido denominadas Fracturas Apicales Inducidas por Williams y fracturas radiculares verticales, por otros. Mientras que en ambos casos el la consecuencia en el diente puede ser la misma, la etiología es diferente. También es un hecho que mientras que la profesión dental se valga principalmente de las evaluaciones radiográficas, este síndrome no puede ser fácilmente identificado. Las fisuras se producen de mesial a distal, donde las películas radiográficas son incapaces de capturarlas. Por tanto, más y más dientes serán víctimas del "síndrome del diente fisurado". Aún así, si se detectan pueden ser salvados. Los dientes fisurados son muy difíciles de diagnosticar, especialmente si el dentista no los está buscando. En muchos casos, debido a la ignorancia por parte del dentista, el paciente es tildado de "paranoico", y es enviado a su casa con una prescripción de tranquilizantes. Es notable que en su estudio Cameron reportó que un paciente aquejado del síndrome del diente fisurado estaba siendo medicado con Tegretol debido a una posible neuralgia trigeminal y para otro se estaba considerando cirugía cerebral. Los dientes fisurados son un estadio intermedio de una serie de eventos que, si no se reconocen y no se tratan, culminarán con la extracción del diente. El diagnóstico y tratamiento precoces a menudo pueden prevenir molestias innecesarias y tratamientos más invasivos. Definición El "Síndrome del Diente Fisurado" se caracteriza por una fractura incompleta de un diente posterior con pulpa vital, la cual incluye dentina y posiblemente la pulpa dental. En un intento de expandir el dominio del síndrome, deben incluirse también en esta definición los dientes fisurados con necrosis pulpar y/o abscesos dentoalveolares. Un diente se considera "fisurado" cuando los potenciales segmentos de la fractura se mantienen intactos por una porción del diente a través del cual la fractura aún no se ha extendido. La "fisura" se refiere a una disrupción o interrupción de la continuidad de la