Tortoises belong to the order Testudines, and their shell, composed of the carapace and plastron, protects internal organs and represents a unique evolutionary adaptation. The shell is a rigid structure of bony plates connected to the spine and ribs, requiring a specific approach to diagnosing and treating injuries. The most common injuries in terrestrial tortoises include traffic accidents, dog bites, and thermal injuries. Shell fractures can be simple or complex and are often accompanied by injuries to internal organs. Diagnostic procedures rely on imaging methods such as radiography, CT scans, and ultrasound, while laboratory analyses assess the general health status. Surgical treatment methods include wound management with thorough irrigation using sterile solutions, debridement of necrotic tissue, and application of antimicrobial agents. Shell fixation is performed using techniques such as screws, wires, epoxy, and bone plates, ensuring fracture stability and protection of internal structures. Vacuum therapy accelerates healing and reduces recovery time, especially for wounds with significant tissue loss. Limb fracture stabilisation involves external fixators, intramedullary pins, and special mini-plates, tailored to the specific fracture types. A combination of techniques is used to maximise stability in complex fractures and improve the healing process. Each phase of treatment, from initial stabilisation to final postoperative care, is crucial for the successful recovery and preservation of functionality in terrestrial tortoises. Special attention is given to adapting environmental conditions, including optimal temperature and humidity, to ensure tissue regeneration and overall health. This review aims to describe the specific anatomy of the land turtles, the most common injuries, methods of diagnosing injuries, and surgical treatment techniques depending on the type of injury.

The Dilemma of Dog Bite Wounds: Primary versus Delayed Closure.

The Renaissance Wound Man: Parallels with today's understanding of wound repair.

Introduction Injuries sustained by animals are now common. A review of cases shows that injuries usually manifest as penetrating injuries, lacerations, crushing and tissue rupture. These can lead to severe complications, including infection, deformity, zoonotic diseases and, in extreme cases, death. Materials and Methods From January 2020 to February 2025, 981 patients were admitted to Balıkesir University Health Practice and Research Hospital due to animal-related injuries. A detailed investigation was performed. The investigation analysed demographic data, animal-related injury mechanisms, trauma sites, plastic surgery interventions, patient outcomes and complications. A decision tree model was constructed to identify predictors of complication risk among patients who underwent surgery following an animal bite. Results The patient sample’s demographics: 54.2% female, 45.8% male. The most common reasons for admission: dog (83.9%), cat (9.0%), rodent (5.4%). The most prevalent intervention is primary suturing, accounting for 55.05% of cases. Patients who were referred to the Plastic Surgery Department constituted 14.07% of the total. 62.1% of these patients were discharged, while 24.8% were admitted to hospital. The mean duration of hospitalisation for dog, cat, rodent and equine bite patients is 4, 2, 6 and 7 days respectively. Patients were observed at the outpatient clinic two, four, four and six times on average. Conclusion The risk predictive model shows that antibiotic therapy, animal type and injury location can predict complications. Older age and lack of vaccination were also identified as risk factors. This helps clinicians to make more informed decisions.

Pediatric dog bite-related injuries are a significant public health concern. Dog bite-related injuries frequently involve the craniofacial complex and may carry psychosocial sequelae. We compared clinical characteristics of craniofacial versus non-craniofacial injuries and assessed caregiver perspectives on prevention and mental health needs. Pediatric patients with a history of dog bite-related injuries were identified in the medical record. Caregivers were contacted to complete a survey to assess their perspectives on injury prevention and mental health needs. Patient demographics and injury characteristics were collected. Group comparisons used χ2/Fisher's exact tests and Mann-Whitney U tests. Independent associations were assessed using multivariable logistic regression. Of 458 pediatric patients identified, 225 caregivers completed follow-up calls, and 125 completed the survey. Among respondents, 111/225 (51.6%) injuries were craniofacial. Compared with non-craniofacial injuries, craniofacial cases involved younger age at injury (median 5 [IQR 3-7] versus 8.5 [4-11] years, P<0.001), deeper/complex wounds (P<0.001), and a greater need for surgical intervention (13.8% versus 1.8%, P<0.001). Among surveyed caregivers (n=125), 72% endorsed the need for better safe-pet-ownership education, 63.2% believed education could have prevented the incident, and 83.2% believed mental health services should be offered; however, only 4/125 (3.2%) reported post-bite mental health​​​​ care for their child. Craniofacial dog bites in children are associated with younger age, more severe wounds, and higher procedural needs. Despite strong parental support, few children received post-bite psychological care. Our findings identify that caregivers support psychological services and found that utilization was rare. Implementing trauma-informed screen-and-refer pathways and targeted prevention education may address unmet needs.

Knowledge, Attitude, and Practices Regarding Management of Dog Bite among Victims in Rural Area of District Ambala, Haryana

Auricular amputations are rare injuries, particularly in children, and most published literature reports complete ear amputations rather than partial defects. We present a case of a paediatric patient who sustained a partial amputation of the right ear from a dog bite. This was treated with single vessel microvascular arteriovenous replantation without venous repair. The ear survived with excellent cosmetic outcome at 8 months. This case highlights the feasibility of single vessel replantation in paediatric partial ear injuries and adds to the limited published experience of such cases.

Rabies remains a serious public health concern, as dog bites account for the majority of human cases. In this study, we develop a comprehensive mathematical model to investigate the dynamics of rabies transmission by incorporating two key intervention strategies: an asymptotic class (\(P\)) and a booster vaccination class (\(B\)). The basic reproduction number (\(R_0\)) is derived as a threshold parameter that governs whether the disease spreads or dies out, based on a system of nonlinear differential equations. A sensitivity analysis of \(R_0\) is conducted to identify the most influential parameters affecting disease transmission. The results indicate that the transmission rate (\(\beta\)) has a significant impact on \(R_0\), emphasizing the importance of reducing contact between susceptible and infected populations. Stability analysis of both the disease-free and endemic equilibria reveals that the disease can be eradicated when \(R_0 &lt; 1\), whereas it persists when \(R_0 &gt; 1\). Numerical simulations, performed using the classical Runge–Kutta method, illustrate the comparative effects of vaccination and treatment interventions. The results demonstrate that the inclusion of the booster vaccination class (\(B\)) substantially reduces the number of infected individuals compared to the scenario without vaccination. Moreover, the therapeutic class (\(P\)) further accelerates recovery and alleviates the overall disease burden. Analysis of varying transmission rates (\(\beta\)) shows that higher values lead to a rapid rise in infection levels, underscoring the necessity for effective intervention strategies in high-contact environments. Overall, the model highlights that integrating booster vaccination and treatment measures within rabies control programs can significantly decrease disease prevalence. The findings of this study provide valuable insights for public health authorities aiming to design efficient strategies for the control and eventual eradication of rabies.

Rabies is a zoonotic disease of global public health importance which accounts for 59,000 human deaths annually. In India, about 60million stray or free ranging dogs are found in the country posing a significant risk of increase in incidences of dog bite and transmission of rabies. The aim of this study was to assess the burden of dog bites and associated healthcare seeking behavior for rabies post-exposure prophylaxis in North and South Shahdara municipal zones of Delhi, India. A cross-sectional study was conducted between the period of May 2023 to November 2024 in North and South Shahdara municipal zones of Delhi. Data was collected using a semi-structured, pretested and prevalidated interviewer administered schedule from family members of selected five types of residential settlements. Total of 800 families were interviewed. The overall annual incidence of dog bites was 25.5 per 1000 population and it ranged from 15.9 in Planned Colony to 32.1 in Jhuggi Jhopri Cluster. Around three fourth (75.5%) of the total dog bite cases reported in the last one year were by stray dogs. Category III dog bites were more common across all settlements, comprising 67/102 (65.7%) of the total cases. Category II dog bites had a higher odds of receiving rabies Post-Exposure Prophylaxis (PEP) as per national guidelines compared to those with Category III dog bites (OR: 5.54, 95% CI: 2.25, 13.66). Dog bite incidence in Delhi was high and varied across type of settlements. More emphasis should be placed on mass dog vaccination and animal birth control measures in areas with high incidence of dog bites. Despite good anti-rabies vaccine uptake, the shortfall in rabies immunoglobulin (RIG) administration for high risk Category III bites highlights the need for periodic training of health workers.

Koalas are an iconic Australian species now classified as nationally endangered due to habitat loss, predation, disease, and vehicle collisions. Yet, because of their nocturnal and arboreal nature, koala movement on the ground between trees remains poorly described. Ground visits are fraught with danger, with two-thirds of koala deaths occurring due to vehicle strikes and dog attacks. Quantifying these behaviours can provide insights for conservation efforts targeted to their time on the ground. To quantify detailed movement patterns, we collared nine koalas in a highly fragmented agricultural landscape with tri-axial accelerometers for 8.50 ± 1.17 days. Using an annotated dataset of observed behaviours, we trained Random Forest models to classify four main behavioural states: Motionless in Tree, Feeding & Grooming in Tree, Other Movement in Tree, and Walking. Koalas spent 57.5% ± 14.2% of their time moving in trees, 26.8% ± 13.5% motionless in trees, 15.6% ± 2.7% feeding and grooming, and only 0.2% ± 0.1% walking on the ground (around 3 min daily). Koalas walked most frequently between 2 am and 5 am. Our findings highlight a major discrepancy between mortality rates on the ground and frequency of ground time, indicating that focused mitigation during these infrequent events could yield disproportionately high conservation benefits.

Fatal dog attacks are rare but devastating events with significant public health, forensic, and legal implications. Italy lacks a centralized registry for such incidents, limiting the ability to monitor trends and implement preventive strategies. This retrospective study analyzes all verified fatal dog attacks in Italy from 2009 to 2025. Data were collected from national and regional media, cross-verified, and organized into a comprehensive database. Descriptive statistics, chi-square tests, logistic and Poisson regressions, and interaction analyses were performed to identify patterns in victim demographics, breed involvement, ownership status, and environmental context. A total of 54 fatal attacks were recorded, with an increasing trend observed in the last five years. Elderly individuals (≥65) and preschool-aged children (≤4) were the most affected groups. Molosser and bull-type breeds were implicated in 69% of cases, and 92.6% of attacks involved owned dogs-more than half belonging to the victim. Private settings accounted for 66.7% of incidents. Comparative analysis with U.S. data revealed similar demographic and breed-related patterns, but also highlighted Italy's lack of a centralized behavioral risk registry. Fatal dog attacks in Italy follow recurring and preventable patterns. The absence of a national database severely limits surveillance and intervention. A centralized behavioral risk registry, modeled on international systems, should be established to support early detection, policy development, and multidisciplinary collaboration.

Human rabies in Avignon, France, following exposure in Morocco, 2025.

Retrospective analysis of the clinical approach practiced in dog bite cases caused by Vipera latastei, Vipera seoanei and Vipera aspis.

BackgroundDog-mediated rabies disproportionately affects marginalised and socioeconomically disadvantaged communities. Tea estate (TE) communities in India exemplify one such vulnerable population. Despite their vulnerability, limited research has explored rabies epidemiology within TE settings. This retrospective study uses secondary data to evaluate the incidence of dog bite and their determinants amongst the TE communities in the Udalguri district of Assam state of India.MethodsSecondary data from 17 to 29 months (January 2022 to May 2024) were retrieved from the hospitals and dispensaries of 11 TE of Udalguri district, Assam. The collected information included dog-bite victims’ demographics and adherence to post-exposure prophylaxis (PEP). Data were analysed using R software, employing descriptive statistics, chi-square tests, odds ratios and mixed-effect logistic regression. Administrative approval was obtained prior to data collection.ResultsA cumulative annual incidence of 11.8 bites per 1,000 individuals was recorded across 11 TE in Udalguri. Children aged ≤15 years accounted for 35% of cases, and dependents were the most affected occupational group (32%). Most exposures involved dogs (66%), and 76% of incidents were bites. Less than half (43%) of victims completed the full PEP regimen of five doses, although 71% received at least three doses. Chi-square analysis indicated that males and children aged ≤ 15 years were more likely to be bitten by dogs compared to other animals than females and the older residents. Children aged ≤ 15 years and non-workers had higher odds of receiving any PEP, while females and children aged ≤ 15 years are more likely to receive at least three doses. In multivariable analysis, females were less likely than males to be bitten by dogs compared to other animals (aOR = 0.4, 95% CI: 0.3–0.7), older individuals had higher odds of completing PEP (aOR = 1.8, 95% CI: 1.2–2.8), and children (≤15 years) were more likely to receive at least three doses of PEP (aOR = 1.9, 95% CI: 1.1–3.3). Temporal analysis showed no clear seasonal pattern, although spikes were observed during winter and monsoon months.ConclusionThis retrospective study contributes to build the foundation for community-based approach to control dog-mediated rabies in TE by highlighting key epidemiological patterns, demographic vulnerabilities and limitations of the existing intervention implementation delivery among TE communities. We recommend further in-depth investigations to inform the context specific interventions designed to address the unique vulnerabilities, thereby reducing the risk of rabies specifically in tea -estate populations.

Background: Rabies is a fatal yet preventable zoonosis. In Saudi Arabia, uneven surveillance and limited public awareness may delay post-exposure prophylaxis (PEP). In Makkah, where residents regularly encounter free-roaming dogs, knowledge gaps could elevate exposure risks. Objectives: This study aims to assess public knowledge, attitudes, and post-bite practices regarding rabies, including wound washing and access to PEP among adult residents of the Makkah Region, and to examine associations with pet dog ownership. Methods: A cross-sectional survey was conducted in the Makkah Region (March–June 2025). An online validated bilingual questionnaire targeted residents ≥ 18 years via social media. Descriptive statistics, chi-square tests, 95% confidence intervals, and binomial logistic regression were applied in IBM SPSS v26; p < 0.05 was significant. Results: Of 523 respondents, 91.8% lived in Makkah city, 52.8% were female, and the age distribution was 18–24 years (44.2%), 25–34 years (35.6%), 35–44 years (12.0%), and ≥45 years (8.2%). Pet dog ownership was rare (1.9%), yet 39.4% reported stray dogs in their communities. Overall, 60.6% knew what rabies is and 63.7% knew it is vaccine-preventable, but 52.2% wrongly believed that transmission occurs only via dog bites. Hospitals (79.7%) and health centers (79.2%) were the most cited vaccination sites; social media was the dominant information source (74.6%). No significant association was found between pet ownership and rabies awareness (all p > 0.05). In multivariable regression (n = 509), adequate rabies knowledge increased the odds of an appropriate intended response (AOR 1.85, 95% CI: 1.27–2.68). Participants aged 30–40 years and those >50 years had significantly lower odds (AOR 0.45, 95% CI: 0.24–0.85 and AOR 0.23, 95% CI: 0.09–0.56, respectively). Conclusions: Despite moderate awareness, critical misconceptions and inconsistent first aid intentions persist. Priority actions include clear, locally adapted education on immediate wound washing and prompt PEP, standardized bite management pathways across facilities, reliable access to vaccines and immunoglobulin, and targeted social media micro-campaigns. By identifying public misconceptions, knowledge gaps, and preferred communication channels, this study provides baseline evidence to guide community awareness programs, intersectoral collaboration, and One Health-based surveillance essential for Saudi Arabia’s progress toward the global “Zero rabies by 2030” goal.

Background and Objectives: Although preventable, rabies represents a significant public health problem. An important part of prevention is the surveillance of people exposed to potentially rabid animals, carried out in the anti-rabies clinics of all public health institutes in Croatia. We aimed to analyze the burden of human animal-bite injuries, patient/biting animal characteristics, and the uptake of anti-rabies post-exposure prophylaxis (PEP). Material and Methods: This retrospective study used medical records data ranging from 2015 to 2024 for all patients in the anti-rabies clinics in Split-Dalmatia County, Croatia. Results: A total of 4105 patients reported contact with a potentially rabid animal. The majority of examined people (52.6%) were working-aged adults (20-60 years). The largest proportion of reported injuries were recorded on the lower limbs (34.9%) and hands/fingers (32.3%). No contact with a proven rabid animal was recorded. PEP was received by 37.7% of those examined. Although dog exposure (68.9%) most frequently led to post-exposure care-seeking, PEP was most common after rodent (91.2%) and bat (87.5%) exposures. Conclusions: Improving public health education is the most effective method of preventing dog bites and thus reducing bite injuries. Promoting responsible dog ownership and behavior around animals, as well as avoiding contact with unfamiliar animals, would likely reduce the need for PEP. The results of this study can also be used in planning health resources, primarily the availability of rabies vaccine and immunoglobulin. In addition, they emphasize the importance of rabies prevention and the continued implementation of all preventive measures in collaboration between the human and animal health sectors. This research may be useful to future public health policies for the control of zoonotic infectious diseases, especially from a "One Health" perspective.

Rabies is almost universally fatal, with survival being extremely rare. An 8-year-old girl sustained a category III dog bite and received incomplete postexposure prophylaxis without immunoglobulin. Two months later, she developed hydrophobia, aerophobia, seizures, and altered sensorium, with clinical and MRI findings consistent with rabies encephalitis. She was discharged against medical advice and received alternative treatment with physiotherapy for nearly 1.5 years. Presenting with increasing seizure frequency, she underwent PET-CT whole body and brain, which showed cerebral and cerebellar atrophy with encephalitic changes. To our best knowledge, this is the first case of PET-CT findings in rabies encephalitis.

Background: India is endemic for rabies, the most dreaded complication of animal bites which accounts for 35-40% of the world’s rabies cases. The Anti-Rabies Vaccine (ARV) is the only proven way to prevent deaths due to rabies; however, its compliance is still a matter of concern. This study was conducted with objectives to (1) generate the epidemiological profile of dog bite cases and (2) assess the determinants of ARV compliance. Methodology: A prospective study was conducted at a Primary Health Centre (PHC), also the RHTC of a medical college in Ahmedabad, Gujarat. All consecutive incident cases of animal bite registered at RHTC between May-Dec 2023 were included and followed for 60 days (post-bite). All cases, whether ARV compliant or not were approached by home visits or telephonic meetings. Data were collected using a pre-designed semi-structured questionnaire. Results: There were 221 cases of dog bites. Most involved were stray dogs 175 (79.2%). Bites occurred more in public places (75.1%), during the evening and early night hours, accounting for 42.5% of cases with a peak during September-November (45.2%). As for the treatment-seeking pattern, 40.7% did not do anything at home. Maximum cases were from category II 58.4%, followed by 30.3% and 11.3% cases from categories I and III. ARV was indicated in 196 cases; 121 (61.7%) of them fully complied with ARV. Reasons for non/poor compliance were feeling cured, being out of the station, and a lack of specific reasons. Important compliance determinants were the occupation of the case and the status of the animal vaccination. Conclusion: Only 61.7% of cases had complete ARV compliance, highlighting compliance issues and the necessity of community-based awareness campaigns that emphasize wound care and ARV schedule completion.

Traumatic auricular amputations present a unique surgical challenge, particularly in cases where microsurgical anastomosis is not feasible due to vessel damage or absence. Traditional reconstruction techniques often yield suboptimal aesthetic or functional results. The pocket technique, as described by Sexton and Mladick, has shown promise in such scenarios, particularly in partial auricular amputations. We report a case of a 52-year-old Caucasian male who presented with traumatic amputation of the cranial third of the auricle following a dog bite. The injury was classified as grade III according to the modified Laskin and Donohue grading system. Owing to the absence of suitable vessels for microsurgical repair, a two-stage reconstruction using a novel modification of the pocket technique was performed. In the first stage, under general anesthesia, the skin was carefully dissected from the amputated auricular cartilage, which was then cleaned, debrided, and sutured to the remaining auricle using an "8"-pattern suture technique. A retroauricular advancement flap, adapted from Mladick's method, was utilized to create a vascularized pocket for the cartilage. After 2 months, the auricle was elevated from the mastoid, and a full-thickness skin graft was applied to cover the defect. A galea advancement flap, based on the posterior branches of the superficial temporal artery, was harvested to provide vascular support and refine the auricular contour. This case demonstrates the successful application of a modified pocket technique that synergistically integrates principles from Sexton and Mladick's approaches. The result was a well-perfused, anatomically contoured, and aesthetically pleasing auricular reconstruction without the need for microsurgical anastomosis. This technique represents a viable reconstructive alternative in select cases of partial auricular amputation where vessel quality or availability is compromised.

Large nasal defects after dog bites are a complex problem, the solution of which is possible provided that the optimal choice of skin graft and professional performance of surgical intervention are carried out as soon as possible after the injury. Aim. To determine the feasibility of using a rotational paramedian full-thickness forehead flap for the reconstruction of nasal defects after a dog bite. Material and Methods. Over the course of six years (2017-2023), 6 victims with bite wounds on the nose were brought to Lviv regional hospital for war veterans and victims of repression named after Yurii Lypa in Lviv by ambulance, 4-7 hours after receiving the injury. All patients were male, aged 22 to 51 years. Due to the lack of documented information on vaccinations, all patients received passive tetanus prophylaxis. In accordance with current guidelines, animal bites have been reported to the appropriate services. The primary surgical treatment of the wound was carefully performed (washing with isotonic sodium chloride solution, removal of blood clots, non-viable tissue parts, decontamination of the skin with soap solution and aqueous iodine), which created the opportunity to inspect the wound to its full depth. No bone or cartilage damage was found in any case, but the soft tissue defect was significant. All victims underwent surgery during the first day of their stay in the clinic under endotracheal anesthesia. The duration of the intervention is 91-210 minutes. The administration of broad-spectrum antibiotics was started before surgery and continued for 5-7 days. The postoperative period was without complications. Graft engraftment was achieved in every case. The cosmetic final result did not cause any concerns in all patients. Results. The patients underwent classical two-stage surgical treatment. The first plastic surgery was performed with a paramedian forehead flap. The choice of donor site was determined by the proximity of the forehead skin to the color and texture of the nose. In addition, the edges of the forehead skin after graft extraction, being mobilized by sharp and blunt methods, can be sutured without tension. We consider the determination of a graft of sufficient size and shape (not larger and in no case smaller) to be a difficult part of the operation. We consider tissue tension to be an unacceptable mistake that can lead to tissue necrosis, suppuration, and therefore an unsatisfactory cosmetic result. After thorough hemostasis, the wounds were closed with knotted sutures (Prolene 4-5.0). The second stage of soft tissue rhinoplasty was the excision of the feeding pedicle on day 30-35. Discussion. A dog bite is one of the most common types of animal bites. It accounts for between 26.8% and 56.5% of head and neck injuries. About 1-2% of bite patients require hospitalization. The most common bite site on the head and neck is the upper lip - 37.8%, the nose - about 20.6%. Surgery using a forehead flap takes less time, does not limit the patient's mobility after surgery, and does not restrict food intake, unlike reconstructive surgeries in which flaps from other parts of the body, such as the forearm (Italian plastic), are used to close soft tissue defects in the nose, which takes more time than forehead surgery, limits the patient's body movements for a certain period after surgery, and requires more stages to achieve a good aesthetic appearance. In summary, the surgeon reconstructing the nose after a dog bite should consider the possibility of using a frontal flap as a key surgical method. Conclusion. Bite wounds to the nose vary in shape, size, and depth of the defect. Reconstruction of large soft tissue nasal defects after dog bites with a frontal rotational graft gives good long-term results if performed professionally.