Interdigital Space Research Articles

Evaluation of ‘In-Parlour Scoring’ (IPS) to Detect Lameness in Dairy Cows during Milking

The objective of this study was to evaluate the potential of ‘In-Parlour Scoring’ (IPS) as an alternative to locomotion scoring in herringbone, side-by-side, and tandem milking parlours in Austria. Between January and May 2023, a total of 990 observations were conducted on 495 cows across eleven Austrian dairy farms by two investigators working simultaneously but independently of each other. The observation criteria included shifting weight, claw conformation, and obvious disorders of the distal limb. Locomotion scoring was conducted on all cows within 24 h of assessment in the milking parlour using a scale of 1 to 5 (LCS 1: not lame; LCS 5: severely lame). Functional hoof trimming was performed within ten days after IPS. The following indicators were identified as useful for predicting lameness (LCS ≥ 3): shifting weight, abnormal weight distribution, swollen heel, hock joint or interdigital space, skin lesion on the lateral hock, claw position score, digital dermatitis lesions, short dorsal claw wall, and hyperextension of one claw. The reliability of the individual indicators for intra- and inter-rater assessment exhibited considerable variation ((weighted) kappa values: −0.0020–0.9651 and −0.0037–1.0, respectively). The specificity and sensitivity for the prediction of lame cows were calculated to be ≥ 96% and ≤ 24%, respectively. It was demonstrated that a one-time IPS has limited suitability for lameness assessment on Austrian dairy farms with herringbone, side-by-side, and tandem milking parlours.

Interaction of acoustic waves with spin waves using a GHz operating GaN/Si SAW device with a Ni/NiFeSi layer between its IDTs.

A two port surface acoustic wave (SAW) device was developed to be used for the control and excitation via spin waves (SW). The structure was manufactured using advanced nanolithography techniques, on GaN/Si, enabling fundamental Rayleigh interdigitated transducer (IDT) resonances in GHz frequency range. The ferromagnetic resonance of the magnetostrictive Ni/NiFeSi layer placed between the IDTs of the SAW device can be tuned to the SAW resonance frequency by magnetic fields. Using structures with finger and interdigit spacing of 170 nm and 100 nm, fundamental Rayleigh IDT resonance frequencies of 6.4 and 10.4 GHz have been obtained. Coupling of SAW to SW was demonstrated through transmission measurements at the fundamental Rayleigh frequencies in a magnetic field, μ0H from -280 to +280 mT, at different angles (θ) between the SAW propagation direction and the magnetic field direction. For the 6.4 GHz resonator a maximum decrease of about 1.2 dB occurred in |S21|, at μ0H = 30 mT and at θ = 45. Time-gated processing of the frequency domain raw data was used to remove the direct electromagnetic cross talk and triple transit effects. Nonreciprocity associated to the coupling was analyzed for the two SAW structures. The quantitative influence of the magnetic field strength on the phase of the transmission parameters is also presented.

BIOMECHANICAL VARIABLES OF THE FOOT IN SOUND RETICULATED GIRAFFES (GIRAFFA CAMELOPARDALIS RETICULATA) IN HUMAN CARE.

Lameness is an important veterinary and welfare concern for giraffes in human care. To date, there is limited information on the objective weight-bearing characteristics of the foot in giraffes, making evidence-based decisions for foot care and lameness treatment subjective. Eleven young-adult reticulated giraffes (Giraffa camelopardalis reticulata; median age, 3.5 yr [range, 13 mon-13 yr]), with no clinical lameness or visible hoof overgrowth when viewed from standing, voluntarily walked across a commercially available pressure-sensitive walkway. Footfalls were analyzed for force, pressure, surface area, and impulse from each foot. The weight-bearing claw was also determined based on pressure in both the front and hind limbs. The data obtained suggest that the main weight-bearing claw is the lateral claw in both the forelimbs and the hind limbs the majority of the time, but is inconsistent. The forelimbs also had greater values for all biomechanical variables than the hind limbs. The higher force and pressure suggest that giraffe forelimbs are subjected to greater biomechanical stress than the hind limbs. The relative maximum force from front limbs to hind limbs was 59:41. For these clinically sound giraffes, the center of force was consistently located in the interdigital space approximately equidistant from the toe and heel correlating with the center of mass of the limb. Furthermore, foot strikes occurred in a heel-first pattern. A pressure-sensitive walkway was well tolerated by all animals in the study and may be used in future research to help further elucidate factors that contribute to lameness in giraffes.

Benchmarking analysis of computer vision algorithms on edge devices for the real-time detection of digital dermatitis in dairy cows

Digital dermatitis (DD) is a bovine claw disease responsible for ulcerative lesions on the coronary band of the foot. It causes significant animal welfare and economic losses to the cattle industry. Early detection of DD can lead to prompt treatment and decrease lameness. Current detection and staging methods require a trained individual to evaluate the interdigital space on each foot for clinical signs of DD. Computer vision (CV), a type of artificial intelligence for image analysis, has demonstrated promising results on object detection tasks. However, farms require robust solutions that can be deployed in harsh conditions including dust, debris, humidity, precipitation, other equipment issues. The study aims to train, deploy, and benchmark DD detection models on edge devices. Images were collected from commercial dairy farms with the camera facing the interdigital space on the plantar surface of the foot. Images were scored for M-stages of DD by a trained investigator using the M-stage DD classification system. Models were trained to detect and score DD lesions and embedded on an edge device. The Tiny YOLOv4 model deployed on a CV specific integrated camera module connected to a single board computer achieved a mean average precision (mAP) of 0.895, an overall prediction accuracy of 0.873, and a Cohen’s kappa of 0.830 for agreement between the computer vision model and the trained investigator. The model reached a final inference speed of 40 frames per second (FPS) and ran stably without any interruptions. The CV model was able to detect DD lesions on an edge device with high performance and speed. The CV tool can be used for early detection and prompt treatment of DD in dairy cows. Real-time detection of DD on edge device will improve health outcomes, while simultaneously decreasing labor costs. We demonstrate that the deployed model can be a low-power and portable solution for real-time detection of DD on dairy farms. This result is a step towards applying CV algorithms to veterinary medicine and implementing real-time detection of health outcomes in precision farming.

Reconstruction of Total Hand Degloving Injury with Combined Free and Pedicled Flaps and Ilizarov Minifixator.

Total hand degloving injuries present a significant challenge in treatment, with no consensus yet on the optimal choice of flap for coverage. Functional reconstruction necessitates careful consideration of syndactyly release, particularly after flap coverage. A 64-year-old woman sustained a total hand degloving injury and underwent extensive reconstructive surgery. Initially, a free superficial circumflex iliac perforator flap was applied to the thumb, whereas pedicled groin and superficial inferior epigastric artery flaps were used for the remaining fingers. However, partial necrosis at the edges of the pedicled flaps necessitated the adduction of the fingers, followed by suturing the skin flaps closed. This led to the formation of adduction contractures, requiring careful release and skin flap extension for effective syndactyly release. Subsequently, the innovative use of an Ilizarov minifixator was used for the dual purpose of interdigital widening and elongation of the flap. At the 27-month follow-up, the patient demonstrated significant functional recovery of the hand and fingers, showing the effectiveness of this multifaceted surgical approach. Despite some residual flexion contractures, the patient regained the ability to write and perform pinching motions with the thumb and middle finger, expressing satisfaction with the surgical outcome. In conclusion, for a functional reconstruction of the thumb and fingers, the thumb and other fingers should be covered separately. When the fingers are in adduction and there is insufficient skin stock for syndactyly release, using an external fixator to expand the interdigital spaces before the syndactyly release proved to be effective.

Genetic Variability and Antibacterial Sensitivity of Dichelobacter nodosus and Fusobacterium necrophorum Infection in Sheep Sulaimani Province, Kurdistan Region, Iraq

Footrot is a significant health problem in ruminants, especially sheep, caused by the bacteria Dichelobacter nodosus and Fusobacterium necrophorum. Infected animals may become lame and lose body condition. The aim of this study was to investigate whether sheep had mixed infections with D. nodosus and F. necrophorum, the global genetic relationships of both target genes (lktA and 16S rRNA genes) with different reference genes, and the degree of genetic heterogeneity between the standard serogroups of D. nodosus were studied. In addition, to detect the antibacterial sensitivity against these two pathogens. One hundred and seventy-five sheep interdigital spaces were investigated (2016-2022). The D. nodosus field isolate (Dn Sul/016-KY399851) showed 96% compatibility with other global isolates (NR_104942/USA, JN008724/India, and DQ016290/Sweden) when its 16S rRNA sequence was compared to some reference genes. The local isolate (Fn Sul/016- KY399852) and other IktA gene strains from other nations (FJ230831/New Zealand, JX678872/Australia, JX648295/India) were compared, and the results showed 99% and 96% identity. Additionally, within the multiple sequence alignment, a single nucleotide variation at position 389 (CA) was seen in the partial lktA sequence when compared to the field isolate (Fn Sul/16-KY399852). This modification corresponds to a switch at residue 130 from alanine (Ala) to glutamic acid (Glu). This study showed the initial molecular identification of D. nodosus and F. necrophorum from sheep with footrot in the Iraqi province of Sulaimani‎‎‎‎‎.

Comparative analysis of computer vision algorithms for the real-time detection of digital dermatitis in dairy cows

Digital dermatitis (DD) is a bovine claw disease responsible for ulcerative lesions on the planar aspect of the hoof. DD is associated with massive herd outbreaks of lameness and influences cattle welfare and production. Early detection of DD can lead to prompt treatment and decrease lameness. Computer vision (CV) provides a unique opportunity to improve early detection. The study aims to train and compare applications for the real-time detection of DD in dairy cows. Eight CV models were trained for detection and scoring, compared using performance metrics and inference time, and the best model was automated for real-time detection using images and video. Images were collected from commercial dairy farms while facing the interdigital space on the plantar surface of the foot. Images were scored for M-stages of DD by a trained investigator using the M-stage DD classification system with distinct labels for hyperkeratosis (H) and proliferations (P). Two sets of images were compiled: the first dataset (Dataset 1) containing 1,177 M0/M4H and 1,050 M2/M2P images and the second dataset (Dataset 2) containing 240 M0, 17 M2, 51 M2P, 114 M4H, and 108 M4P images. Models were trained to detect and score DD lesions and compared for precision, recall, and mean average precision (mAP) in addition to inference time in frame per second (FPS). Seven of the nine CV models performed well compared to the ground truth of labeled images using Dataset 1. The six models, Faster R-CNN, Cascade R-CNN, YOLOv3, Tiny YOLOv3, YOLOv4, Tiny YOLOv4, and YOLOv5s achieved an mAP between 0.964 and 0.998, whereas the other two models, SSD and SSD Lite, yielded an mAP of 0.371 and 0.387 respectively. Overall, YOLOv4, Tiny YOLOv4, and YOLOv5s outperformed all other models with almost perfect precision, perfect recall, and a higher mAP. Tiny YOLOv4 outperformed all other models with respect to inference time at 333 FPS, followed by YOLOv5s at 133 FPS and YOLOv4 at 65 FPS. YOLOv4 and Tiny YOLOv4 performed better than YOLOv5s compared to the ground truth using Dataset 2. YOLOv4 and Tiny YOLOv4 yielded a similar mAP of 0.896 and 0.895, respectively. However, Tiny YOLOv4 achieved both higher precision and recall compared to YOLOv4. Finally, Tiny YOLOv4 was able to detect DD lesions on a commercial dairy farm with high performance and speed. The proposed CV tool can be used for early detection and prompt treatment of DD in dairy cows. This result is a step towards applying CV algorithms to veterinary medicine and implementing real-time DD detection on dairy farms.

Morton's Metatarsalgia: The Current State of the Issue

A typical complaint with Morton's neuroma is a burning paroxysmal pain in the area of the plantar surface of the metatarsal bones with irradiation into the III interdigital space, which forces the patient to take off his shoes and massage the foot in the most inappropriate situations. Given that women are mostly ill, clinical manifestations reduce the quality of life of patients, limit their daily professional and work activities. The paper presents the etiology, pathogenesis and clinical picture of this disease, diagnostic features. A radical method of treatment is surgery, which is relatively simple in technique and consists in dissecting the tissues that compress the nerve and creating optimal conditions for the nerve trunk, preventing its subsequent traumatization.

Estudio de los factores de riesgo de la presencia de los nevus interdigitales de los pies

Background and objectivesNo studies focused on counting the interdigital acquired melanocytic nevi (AMN) of the foot (IDNf) have ever been conducted. Therefore, our objective was to study the relationship between the presence of IDNf and the total number of AMN in the feet and the rest of the body, the racial phenotypic characteristics, and other risk factors for melanoma. Material and methodsWe conducted a cross-sectional observational study with 255 patients ≥18 years old who attended our Dermatology Unit from September 2020 through February 2021, and included all AMN ≥1mm from the feet and ≥2mm from the rest of the bod. The association between the variables was studied using univariate and multivariate logistic regression models. ResultsThe presence of IDNf was significantly and independently associated with the presence of plantar AMN and body counts ≥50 AMN. However, no significant differences were observed regarding sex, age, personal history of melanoma, presence of nevi on the dorsum of the foot, history of sunburn or UV rays, or racial phenotypic characteristics. ConclusionsThe presence of IDNf is associated with a higher count of plantar nevi and total AMN in the body, meaning that interdigital spaces of the foot—anatomical expansions of the sole and other possibly genetic causes—could be responsible for the number of AMN found in this location, as these regions are not photoexposed.

Correlation of lesion severity with bacterial changes in Treponeme-Associated Hoof Disease from free-roaming wild elk (Cervus canadensis)

BackgroundTreponeme-Associated Hoof Disease (TAHD) is a polybacterial, multifactorial disease affecting free-ranging wild elk (Cervus canadensis) in the Pacific Northwest. Previous studies have indicated a bacterial etiology similar to digital dermatitis in livestock, including isolation of Treponema species from lesions. The lesions appear to progress rapidly from ulcerative areas in the interdigital space or along the coronary band to severe, ulcerative, necrotic, proliferative lesions under-running the hoof wall, perforating the sole, and contributing to hoof elongation, deformity, and overgrowth. Eventually the lesions undermine the laminal structure leading to sloughing of the hoof horn capsule. The objective of this study was to characterize the bacterial communities associated with hoof lesions, which were categorized into 5 stages or disease grade severities, with 0 being unaffected tissue and 4 being sloughed hoof capsule. We also wanted to determine if the etiology of TAHD through morphological changes was dominated by Treponema, as observed in hoof diseases in livestock.ResultsThe bacterial 16S rRNA gene was sequenced from 66 hoof skin biopsy samples representing 5 lesion grades from samples collected by Washington Department of Fish and Wildlife as part of a voluntary hunter program. Analysis of the relative abundance of bacterial sequences showed that lesions were dominated by members of the bacterial phyla Proteobacteria, Firmicutes, Spirochaetes, Bacteroidetes and Actinobacteria. In lesion samples, members of the genus Treponema, Porphyromonas, and Mycoplasma increased with lesion severity. Association analysis indicated frequent identification of Treponema with Porphyromonas, Bacteroides and other anaerobic Gram-positive cocci.ConclusionsThe bacterial 16S rRNA gene sequencing confirmed the presence of Treponema species at all stages of TAHD lesions, treponeme specie-specific PCR and histopathology, indicating that the morphological changes are a continual progression of disease severity with similar bacterial communities. Association and abundance of these other pathogenic genera within lesions may mean synergistic role with Treponema in hoof disease pathogenesis. Characterizing bacteria involved in lesion development, and their persistence during disease progression, provides evidence for science-based management decisions in TAHD infected elk populations.

“Morton’s Neuroma” — Term Etymology: A Review

Background. The urgency of the problem is explained by a high morbidity rate and the need to verify the diagnosis with related specialists (ultrasound physicians, radiologists, trauma surgeons, pathologists), as well as by significant difficulties in patient routing and high probability of primary referral to neurologists, neurosurgeons, and general practitioners. In modern Russian literature, neuromas of all interdigital spaces are identified with Morton’s neuroma.
 Aim of the review was to determine the accuracy of modern medical terminology, in particular of the term «Morton’s neuroma», to reveal the spectrum of eponyms unacceptable for communication with related specialists and patients, to fill the historical gap and to attract the scientific medical community to discussion on this topic.
 Methods. We identified 40 articles on this topic published from 1845 to 2022. The search was performed in PubMed/MEDLINE and eLIBRARY databases.
 Results. Evolution, history, and etymology of several terms used for intermetatarsal neuroma are covered in the study, based on the analysis of literature sources. It has been found that a number of eponyms used to designate neuromas are historically inaccurate. In addition, we have discovered that the reports of «nerve fibrosis» were encountered prior to the introduction of the term «neuroma». However, most authors have popularized the nominal term «Morton’s neuromas».
 Conclusions. An obvious contradiction between the etiopathogenesis of neuroma and the term itself can be confusing for clinicians and diagnosticians. In our opinion, the disease known nowadays as «Morton’s neuroma» should be named «fibrosis of the plantar nerve of the third toe», and the name terms denoting the number of the corresponding interdigital space should be replaced by the number of the corresponding common plantar digital nerve.

Gram-Negative Toe Web Infections.

Gram-negative bacterial toe web infection (GNTWI) is a common dermatologic condition affecting the interdigital spaces. The clinical presentation ranges from mild erythema to exudative maceration of the web spaces that may extend to in other areas of the foot and lead to cellulitis in severe cases. Pseudomonas aeruginosa is the most commonly identified etiologic agent. Occlusive and humid environments, pre-existing dermatologic conditions, and fungal infections increase the risk of developing GNTWI. GNTWI has a broad differential diagnosis including erythrasma, tinea pedis, pitted keratolysis, eczematous dermatitis, and malignancies. Diagnosis is performed using bacterial and fungal cultures. There is a lack of a standardized treatment regimen for GNTWI. While GNTWI is fairly common, it may still be under-recognized by dermatologists due to the limited medical literature. This article presents a review of GNTWI, its clinical features, epidemiologic factors, etiologic agents, predisposing factors, diagnostic methods, and therapeutic options.

Instrumental and clinical diagnosis of interdigital Morton neuroma

Background: Interdigital neuroma is one of the most common diseases in foot surgery. It is a common cause of metatarsalgia leading to debilitating pain. At the same time, the diagnosis of neuroma can be a difficult task for an orthopedic surgeon due to the complex anatomy of the forefoot and a large number of soft-tissue and bone structures. Besides, the existing manual testing methods are not pathognomonic specifically for neuroma. The clinical symptoms and history, as well as a physical exam and instrumental evidence are important in assessing and grading the disease. However, there are no recommendations in the modern Russian literature regarding the need for routine visualization of neuroma. The reproducibility of the study, the absence of ionizing radiation and the possibility of obtaining a second opinion, as well as high sensitivity makes magnetic resonance imaging an important diagnostic tool in the diagnosis of neuroma. Aim: To evaluate the importance of the anamnesis and complaints and the sensitivity of clinical tests and magnetic resonance imaging of the foot in the diagnosis of interdigital neuromas. Methods: The study presents a retrospective analysis of the medical histories and outpatient records of 28 patients (8 men and 20 women) treated at the EMC ECSTO in the period from 2017 to 2022. The examination was performed according to a standardized protocol: collection of complaints and anamnesis, palpation, manual testing, including Mulder's click test. As a part of examination, magnetic resonance imaging of the foot was performed for all the patients. The average patient’s age at the time of the surgical treatment was 45 years. The resection of a part of the affected nerve with the subsequent histological examination was considered a gold standard for the treatment and verification of interdigital neuromas. In all the cases, the histopathological study confirmed the diagnosis. Results: The sensitivity of magnetic resonance imaging in the diagnosis of interdigital neuromas was 86%, the sensitivity of the Mulder test was 61%. Pain during the palpation of the affected interdigital space was determined in 100% of cases. Conclusion: The combination of a manual examination and magnetic resonance imaging, along with the analysis of complaints and anamnesis makes it possible to diagnose Morton's neuroma in most cases.

Epidermophyton floccosum kao uzročnik Tinea pedis - prikaz slučaja

Tinea pedis or athlete's foot is a surface fungal epidermal infection caused by dermatophytic fungi of the species Trichophyton (T.) rubrum, T. mentagrophytes var. interdigitale, Epidermophyton floccosum or T. tonsurans. It occurs most often in adult men, rarely in women and children. It is estimated that at least 70% of all people have a fungal foot infection at least once in their lifetime. Case report: a 43-year-old male with a clinical picture of Tinea pedis was referred to the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" for laboratory diagnostics of the fungal infection of the right foot. In terms of patient history, he reported having dry, flaky changes to the skin of his right foot for two years, as well as erosion in the III and IV interdigital spaces of the foot. Due to itching, burning, and flaking of the skin on his feet, he reported to the attending physician who put him on betamethasone/gentamicin cream. The itching decreased, but the changes did not recede. Right foot toenails were not showing visible signs of infection. Direct microscopic examination of the right foot scrapings found micellar fibres and arthrospores, while culturing on dermatophyte-appropriate media allowed for the isolation of Epidermophyton floccosum. The isolate was identified based on microscopic morphology of the cultured organism, macroscopic appearance of the culture on dermatophyte isolation media, as well as using MALDI-TOF mass spectrometric diagnostics. Mycological confirmation of foot infection with the Epidermophyton floccosum fungus, with adequate treatment, reduces the risk of developing an onychomycosis, which is harder to treat.

Dermatite de Contato Alérgica Ocupacional a múltiplos agentes num Canalizador

Introduction Contact dermatitis can have an irritating or allergic background and are the most frequently encountered occupational dermatosis. Allergic Contact Dermatitis can be of occupational origin and most often affects the hands, wrists, and forearms. The occupational and clinical history is critical for its diagnosis. The relationship between the symptoms and work, identifying substances that may cause the dermatosis is important to perform epicutaneous tests. The initial stage of treatment consists of evicting the agent, which may include removing the worker from his workplace. Early and appropriate treatment is important to prevent further deterioration and persistence of skin lesions. Case Report 47-year-old man, a plumber for thirty years, and no relevant personal background. About seventeen years ago, he started erythematous, scaly, and fissured lesions on the dorsum of both hands and in the interdigital spaces, which he associated with his professional activity. Initially, he did not wear gloves when working with plastic pipes, glues, sealants, and other rubber and steel materials. With the appearance of the injuries, he began to use them, without improvement. However, he kept the injuries. Dermatology followed it, where it performed the first epicutaneous tests with positivity for the agent Isopropyl-N-Phenyl 4 Phenylenediamine, present in rubbers. Due to continued exposure to the agent present in his workplace, with consequent worsening of the skin lesions, he returned to the consultation. He carried out new epicutaneous tests that revealed new positivities: Paraphenylenediamine, Mixture of Thiurans and Colophony. These agents are present in his work, and the diagnosis of Occupational Allergic Contact Dermatitis was assumed. Discussion/ Conclusion Occupational Allergic Contact Dermatitis is associated with high personal and professional suffering, loss of earning capacity and decreased productivity. Given the multiplicity of sensitized agents, this case was a challenge for Occupational Health, as it was present in various work materials and protective equipment. In this case, it was not possible to leave the workplace, which was not the option accepted by the worker, so the management of the case involved minimizing contact, giving preference to other types of materials, by reducing the time and intensity of exposure, using safer individual protection material, as well as using inner cotton gloves and outer vinyl gloves, in addition to concomitant pharmacological treatment. This case is also positive for other agents due to cross-reactivity, as well as the multiplicity of reactions that was partly caused by the continuous injury to the skin. Keywords: Allergic Contact Dermatitis; Isopropyl-N-Phenyl 4 Phenylenediamine; Paraphenylenediamine; Tiurans; Colophony.

Treatment of a patient with chronic causalgia after surgical removal of the neuroma in the second interdigital space

BACKGROUND: Mortons neuroma is a common pathology of the forefoot. Etiopathologically, this disease can be attributed to nerve fibrosis, not a tumor. We now have various therapeutic options for neuromas, the most frequent of which is traction neurectomy. Recurrent pain affects up to 35% of patients with traction neurectomy, and one-third have recurrent stump neuroma produced by the proliferation of fibrous scar tissue around the remaining nerve elements. Conservative treatment methods are more commonly used to treat recurrent neuromas and residual pain, but surgical therapy is required in some cases. Despite the relatively high prevalence, the treatment of such patients is a challenging task for orthopedic traumatologists.
 CLINICAL CASE DESCRIPTION: We show the effective treatment of a patient with stump neuroma and primary Mortons neuroma in two stages. The second interdigital space nerve was transposed, and the deep, transverse metatarsal ligament of the third interdigital space was dissected in the first stage. The second stage consists of removing the sensitive scar, resecting the plantar nerve of the third interdigital space, and performing a Weil osteotomy.
 CONCLUSION: Consistent use of conservative surgical procedures, appropriate revision of the subcutaneous nerve, and excision of a sensitive scar allows for a successful therapeutic outcome, pain alleviation, and the ability to wear normal shoes.

PREVALENCE AND ASSOCIATED FACTORS OF HUMAN SCABIES IN PRISONS IN DOSSO, NIGER

Scabies is a contagious, pruritic, cosmopolitan dermatosis, widespread especially in human communities, due to parasitism by a mite Sarcoptes scabiei var hominis A lack of hygiene and overcrowding inside the houses are favourable factors. The aim of our study was to determine the prevalence and factors associated with the occurrence of human scabies in the prison environment in Dosso (Niger). Prospective descriptive cross-sectional study conducted in November 2022 in the civil prison of Dosso on authorization of the prison administration. The collected data were sociodemographic characteristics, personal history of pruritus and its characteristics, risk factors related to hygiene and conditions of incarceration, examination performed by a dermatologist to look for clinical signs of scabies. The diagnosis was retained in any inmate presenting one or more elements at the interrogation and at the physical examination. Out of a total of 352 inmates, 43 (38 males and 5 females) had scabies, a prevalence of 12%. The average age was 33 with extremes of 18 and 62 years. Of the scabies patients, 9% reported a history of intense, sleepless pruritus prior to incarceration. Most of the inmates, 86%, were in cells with more than 20 inmates. Among those with scabies, 42% showered twice a day, 81% changed clothes after showering and 74% used soap regularly for washing. The topography of the lesions was external genitalia (37%), buttocks (21%), inner thighs (16%), interdigital spaces (9%), elbows (9%) and wrists (7%). The inmates were informed about the disease, treatment information was explained to them, and they attended a session on hygiene promotion. All cases of scabies detected were prescribed a local treatment based on benzyl benzoate lotion 25%. Human scabies is common in the prison environment in Dosso. Too often, scabies goes undetected and is confused with other pruritic dermatoses, such as eczema or atopic dermatitis. Prison medical staff should be trained in scabies in order to prevent scabies outbreaks. The authorities in the region should make the improvement of hygiene and detention conditions in prisons their priority.

Complex decongestive therapy in lymphedema: report from an Interdisciplinary Center

Lymphedema is a chronic and worsening disease due to an abnormal accumulation of liquids, with a high protein content in the interstitial space. The disease is characterized by an insufficient flow of lymphatic fluid, which manifests as edema, inflammation, and fibrosis, all the way up to the stiffening of the affected tissues. Because it's a chronic and increasing disease, the treatment is highly complex. The literature shows that the treatment must be multidisciplinary and it is necessary to combine multiple techniques, such as manual lymphatic drainage, mechanical lymphatic drainage, elasto-compressive bandages and other complementary techniques up to surgical treatment in the most advanced forms which are not responsive to physical therapy. Furthermore, the disease is characterized by episodes of cellulitis, that may lead to infectious complications because the lymphatic function becomes insufficient. A condition of local immunodeficiency is created due to the crucial role that the lymphatic system covers with immune defenses, therefore creates a fertile ground for infections caused by small skin wounds, insect bites, animal scratches, nail fungus, blood draws. Therefore, particular attention is paid to skin folds and interdigital spaces for which hygiene is necessary using neutral detergents, drying by dabbing, and applying emollient creams for skin hydration. Unfortunately, such practices of prevention and care are often underestimated. We provide education of the patient on self-care, such as the self-bandage and the correct application of the elasto-compressed stoking. For wrapping the bandage, it is advisable to wear a glove or a special sock. The multilayer bandages are used in the first decongestant phase while over time the elastic stocking is the best aid for the management of lymphedema. Our clinic is a referral center for diagnosis, treatment and surgical therapy, where patients come for surgical evaluation. Since 2016 we have systematically collected clinical data and volume evaluation of more than 600 cases affected by lymphedema and lipoedema of all stages. They have been treated with complex decongestive therapy for 4 hours a day, 15 consecutive days, subsequently a maintenance of once a week for 3 months, then once a month for 6 months. Of more than 600 patients treated, only 150 were submitted to surgery (lymphatic venous anastomosis, fasciotomy or liposuction, chylothorax and chyloperitoneal shunt, reconstructive plastic of external genitalia). Complex decongestive interdisciplinary therapy, when properly performed can stabilize the lymphedema patient situation, reducing the stage and ensuring a good quality of life.

Transmission and lesion progression of treponeme-associated hoof disease in captive elk (Cervus canadensis).

Treponeme-associated hoof disease (TAHD) is a debilitating disease of free-ranging elk (Cervus canadensis) in the northwestern U.S. While treponemes are associated with lesions, the etiology and transmissibility between elk are unknown. Our objective was to determine whether the disease can be environmentally transmitted to captive elk. Four individually housed treatment elk and 2 control elk were challenged with soil mixed with inoculum prepared from free-ranging elk hooves from TAHD-positive elk or autoclaved hooves from normal elk, respectively. The inoculum for each group was applied to the interdigital space and added to pre-existing soil in each pen. Eight challenges were conducted at 1-4-week intervals and lesion development was assessed during a 138-day challenge period that was followed by a 170-day monitoring period to document lesion progression. All treatment elk, but no control elk, developed gross and histologic lesions consistent with TAHD. Treponema phylotypes similar to those in bovine digital dermatitis in cattle were detected using 16S rRNA gene amplicon sequencing from lesions in all treatment elk, but no control elk, during the challenge period. Lesions progressed from ulcerations in the interdigital space to extensive ulceration and underrunning of the hoof capsule by 35 and 173 days following the initial inoculation, respectively. Lameness in treatment elk was correlated with lesion development (R = 0.702, p≤0.001), and activity of infected elk was reduced during the challenge (p≤0.001) and monitoring periods (p = 0.004). Body condition was significantly lower in treatment than control elk 168 days following the initial inoculation (p = 0.05) and at each individual elk's study endpoint (p = 0.006). Three of 4 treatment elk were euthanized when they reached humane endpoints, and one elk recovered. These results provide direct evidence that TAHD is a transmissible infectious disease in elk. As such, actions that reduce transmission risk can support disease management and prevention.

Incidence of hoof and leg injuries in dairy cow under different floor

Present study explored the effect of different floor on hoof health and leg injuries of crossbred dairy cow. Animals (n=24), were randomly assigned into four groups with different floor combination in covered and open area, viz. T0 (concrete and brick paved), T1 (concrete and sand), T2 (rubber mat and sand) and T3 (rubber mat and brick paved). Hoof and limb lesion scores were recorded as per the standard protocol during study period. White line lesion score did not differ significantly, however, sole lesion score and inter-digital space lesion score differed significantly between the groups. Both, sole and interdigital space lesion scores were greater in T0 group. Total hoof lesion score was different between the groups with highest value in T0 group. Month wise hoof lesion scores differedsignificantly in 5th and 6th month between treatments. Decreasing trend was noticed in T1 and T2 from 5th month onwards. In contrast, T0 showed increase in hoof lesion score. Knee lesion score and hock lesion score were different between treatments. Higher scores were found in cows housed in T0 group, while lower scores were noted in T1 group. Knee lesion score decreased in T1 and T2 groups 4th month onwards, however no change was seen in T0 and T3 group. Similar trend was also seen for hock lesion score. In conclusion, provision of sand bed floor in open area of loose house with or without rubber mat floor in covered area was found superior for improving animal welfare in terms of lesser hoof and limb injuries.