By T. Gunnar. Eastern Kentucky University. 2018.

It should be noted that any factor (infectious or however purchase 5mg lexapro overnight delivery, surgery should not be considered until all noninfectious) that damages the epidermal collar can other therapeutic modalities have failed to resolve result in a gross lesion resembling that induced by the lesions over a six-month treatment period generic lexapro 10mg otc. Techniques that are discussed in the lay literature discount 5 mg lexapro fast delivery, including dietary additives and careful selection of Lesions should be evaluated regularly (generally on breeding stock, are probably futile. Good hygiene is a weekly basis) to determine if prescribed therapy is advisable, and birds should be purchased from effective. Poxvirus can cause skin lesions in most avian species and may retard wound healing. Uncomplicated le- sions are characterized by the formation of nodules on the unfeathered skin. Skin lesions should be kept clean and dry to prevent secondary bacterial or fun- Specific Etiologies of gal infections (see Chapter 32). Generalized Dermatopathies Cutaneous papillomas may occur on the head, neck, beak commissure, feet or uropygial glands. Some of these lesions have been associated with papil- Viral Diseases lomavirus or herpesvirus while others are of undeter- mined etiology. Dermatologic lesions may oc- “feather dusters,” and adenoviral folliculitis has been cur with poxvirus, papillomavirus and herpesvirus reported in lovebirds (see Chapter 32). The ally attack birds causing characteristic hyperemic disease progression can be acute or chronic depending swellings (Color 24. The likelihood of a bird being stung can be reduced by removing uneaten soft foods (particularly fruits) from the enclosure and destroying wasp nests found near the aviary. Flies, mosquitoes and gnats can cause severe derma- titis on the face, feet and legs, particularly in birds raised in warm coastal areas (see Color 26). Lesions are most common in Amazon parrots and macaws, but can occur in any species. The flies that commonly parasitize cattle and deer can induce small bleeding ulcers on the unfeathered areas of the body (Color 24. Topical application of antibiotic and steroid lotions or creams Bacterial and Fungal Diseases can be used to reduce swollen or hyperemic lesions. There have been remarkably few studies on the bac- Ant bites also may cause localized necrosis that re- terial flora of the avian skin other than in poultry sults in defects in the webs of the feet in waterfowl 39 and birds of prey. Some helminths and mites can cause more attention, and several surveys on the fungal dermatitis (see Chapter 36). In one A sarcoptid mite infection was described in a Grey- study, 6000 fungi were recovered from the feathers, cheeked Parakeet with feather loss and flaking skin nests, pellets, droppings and organs of 92 species of free-ranging birds. Severe pyogranulomatous dermatitis was associated with a sarcoptic mite in- were potential pathogens and a number were kerat- fection in a Green-winged Macaw. Control of ectoparasites, genic bacteria or may provide appropriate nutrients for competitive autochthonous flora. Only those parasiticidal agents that are fungal infections of facial skin are usually secondary licensed or recommended for use in birds should be to trauma or possibly a contact dermatitis. Avian applied, and such therapy must be accompanied by skin abscesses are rare but can be found following other measures to exclude the parasites. In subtropical and tropical areas, the sticktight flea (Echidnophaga gallinacea) can be a problem on Although frequently discussed, documented cases of many species of birds. The pulp can be large numbers may attach to the skin of the head, examined for the presence of bacteria by making especially around the eyes, and cause anemia (see impression smears or by culturing the pulp cavity Color 8). Bacterial pathogens that have been topical application of a pyrethrin-based product. The birds in these cases responded favorably to fungicidal therapy, suggest- ing that the fungus was involved in the feather pick- ing behavior. Malnutrition, particularly hypovitaminosis A, is suggested by the smoothing of the normally papil- lary surface of the plantar surface of the feet (see Color 8). The pulp cavity of birds with thistype of presentation should the sheath on the developing feather is retained, always be examined cytologically, and cultures should be submit- resulting in a bird that appears to have an excess ted for bacterial and fungal isolation. The precise effects that mal- nutrition and organopathy (particularly hepatopa- thy) have on the quality and pigmentation of feathers cus spp. The importance of staphylococci in the occur- age in birds fed marginal diets and with hepatopa- rence of these lesions has not been defined. The feather geons experiencing severe feather picking and self- barbs were not connected properly, making the vanes appear like mutilation problems. The bird was placed on a formulated diet and from a lovebird, Penicillum chrysogenum from a par- molting activity started within several weeks. The etiology of these lesions was not determined, but the bird responded to bandaging, a diet change, frequent exposure to sunlight and keeping the wounds clean with dilute chlorhexidine solution. Further, many generalized topical drying agents and antibiotics may be effective feather abnormalities will resolve when a bird is therapy. Biop- sies should always be performed on proliferative, Many minor scratches and cuts (that are not caused chronic skin lesions to determine if they are neoplas- by animal bites) require no medical attention, espe- tic in origin. If a severe wound occurs, the feathers Giardiasis and hypovitaminosis E seem to be associ- can be trimmed or pulled from the periphery of a ated with ulcerative dermatitis in lovebirds and lesion to prevent the accumulation of necrotic debris. The precise nutrients that Most companion and aviary birds do not pick at skin may be missing in the diet have not beendefined, but injuries (see Chapter 16).

Another option is a proprietary product called Amerigel order lexapro 10mg otc, a topical ointment featuring an oak extract (Quercus rubra) that contains quercitannic acid purchase 10mg lexapro with visa, catechin cheap lexapro 5 mg mastercard, ellagitannin, and proanthocyanidin, readily absorbed into damaged skin. Foot Ulcers Lack of blood supply, poor wound healing, and peripheral neuropathy are key factors in the development of diabetic foot ulcers. Key strategies in prevention and treatment are proper foot care (including care of nails and calluses), preferably by a podiatrist; regular examination of the feet by a physician; avoidance of injury; avoidance of tobacco in any form; and methods to improve local circulation. Proper foot care includes keeping the feet clean, dry, and warm and wearing well-fitting shoes. Tobacco use in any form constricts the peripheral blood vessels and can lead to more serious peripheral vascular disease with severe arterial blockages. Circulation can be improved by exercising regularly, avoiding sitting cross-legged or in other positions that compromise circulation, and massaging the feet lightly upward. Ginkgo biloba or grape seed extract can also be used to support optimal circulation. Type 2 is usually the end result of many years of chronic metabolic insult, and although it is treatable with the natural approach presented here, resolving it will take persistence. The first step in the therapy of either type 1 or type 2 is a thorough diagnostic workup. Diet, environment, and lifestyle need to be carefully studied to rule out any exposure to agents that may be inducing glucose intolerance. Then a diet, exercise, and supplement program that meets your personal needs must be developed. For maximum efficacy, ideal body weight must be achieved (see the chapter “Obesity and Weight Management”). It is important to recognize that as the natural therapies described in this chapter take effect, drug dosages must be altered, and so a good working relationship with the prescribing doctor is required. The ultimate goal is to reestablish normal blood sugar control and prevent the development of (or ameliorate) the complications of diabetes. Diet The optimal diet detailed in the chapter “A Health-Promoting Diet” is clearly the diet of choice. A low-glycemic diet rich in high-fiber foods should be stressed, and sources of healthful fats should be ingested. Nutritional Supplements for Type 1 Diabetes The recommended supplementation program depends on the existing degree of blood glucose control, as indicated by self-monitored blood glucose and A1C levels. The green tea extract should have a polyphenol content of >90% and be decaffeinated. If you are already at Level 2, the next step is to add a prescription medication (either an oral hypoglycemic drug or insulin). However, it may also be the first suggestion of a serious underlying disease or infection. Severe bloody diarrhea, diarrhea in a child less than six years of age, or diarrhea that lasts more than three days should not be taken lightly; its cause must be determined and it must be treated appropriately. Osmotic diarrhea is caused by an excess of water-soluble molecules in the stool, which results in increased fluid retention. Secretory diarrhea results from excessive secretion of ions into the bowel, with the same result of excessive water retention in the stools. Exudative diarrhea is usually due to infections and inflammatory bowel diseases, resulting in abnormal intestinal permeability and intestinal loss of serum proteins, blood, mucus, and pus. Frequent small, painful evacuations are usually a result of disease in the rectum or at the end of the colon. Inadequate-contact diarrhea is the result of inadequate contact between the intestinal contents and the absorbing surfaces, resulting in inadequate absorption. Viruses are the most common cause of infectious diarrhea, accounting for at least 75% of cases. Viruses are suspected when vomiting is prominent, the incubation period is longer than 14 hours, and the entire illness is over in less than 72 hours. A virus is likely to be the cause if there are no warning signs of bacterial infection (such as high fever, bloody diarrhea, severe abdominal pain, or more than six stools in 24 hours) and there are no epidemiological clues from the history (i. One of the most common causes of viral gastroenteritis, especially in children, is rotavirus. It can be an extremely serious infection, especially in developing countries, where it is estimated to cause more than 800,000 annual deaths among young children. Besides infectious diarrhea, common causes of chronic diarrhea include lactose intolerance, food allergies, celiac disease (gluten sensitivity), and inflammatory bowel disease (Crohn’s disease and ulcerative colitis). Lactose intolerance is due to a deficiency in the enzyme lactase, responsible for digesting the lactose found in dairy products; it is common worldwide. It has been estimated that 70 to 90% of adults of Asian, black, American Indian, and Mediterranean ancestry lack this enzyme. The frequency of deficiency is 10 to 15% among adults of northern and western European descent. While almost all infants are able to digest milk and other dairy products, many children lose their lactase enzyme by three to seven years of age. Symptoms range from minor abdominal discomfort and bloating to severe diarrhea in response to even small amounts of lactose.

Disturbing the exudates covering these le- of the skin are generally void of normal epithelium sions will induce severe bleeding effective lexapro 20 mg. Bollinger coalesce may prevent a bird from swallowing food or bodies are usually present in the neoplastic tissue but result in dyspnea (or asphyxiation) if the larynx is viable virus may not be demonstrated buy lexapro 20 mg visa. Oral lesions are frequently seen in Psittaci- moval of the skin tumors is an effective therapy order lexapro 20 mg line. Psittacinepoxvirus infections have been documented Cutaneous and diphtheroid lesions may occur in the in numerous South American parrots and parakeets. Coryza and ocular lesions are frequently the also occur in conjunction with either cutaneous or dominating clinical signs in the genus Amazona; diphtheritic forms of this disease. Ocular Septicemic Form: An acute onset of ruffled plumage, lesions begin as dry areas on the eyelid that become somnolence, cyanosis and anorexia characterize sep- crusty with exudate, sealing the lids closed. Most birds (mortality dary infections frequently cause keratitis, followed rates of 70-99%) die within three days of developing by ulceration, perforation of the globe, pano- clinical signs. Canarypox frequently caused by virulence factors and not differences in causes a desquamative pneumonia with occlusion of virus strains. Cutane- through the histologic demonstration of Bollinger ous lesions in raptorial birds from most regions are bodies in biopsy samples of suspect lesions. In contrast, cutane- ous lesions in Persian Gulf falcons were charac- Culture is usually necessary to document the sep- terized by inflammatory necrotic processes that in- ticemic or coryzal forms of the disease. Histopathology re- the feces of asymptomatic carriers that may be iden- vealed a distinct cribriform state, fresh hemorrhages tified by repeated culturing of feces. Serology is of in the white matter, mild inflammation of the menin- little value in diagnosing poxvirus infections. Poxvirus infections in lovebirds usually cause cuta- neous lesions although diphtheroid lesions (“wet Control pox”) have also been described. Skin lesions rarely Birds that recover from pox should be protected from erupt, and the affected skin appears dehydrated and further disease for at least eight months, but many brownish in color. The skin of the lower lid and of the facial ery, and only small amounts of humoral antibodies angular palpebra may be yellow-brown with palpable are produced. Taxon-specific vac- lent or fibrinous if secondary bacterial or fungal in- cines are available for only a few of the avian poxvi- fections occur. Canaries (and crosses) should be immunized with an appropri- Poxvirus infections in 10- to 60-day-old ostrich chicks ate vaccine. Only healthy flocks of these birds should are characterized by small vesicles containing yel- be vaccinated. Lesions become infected flock of canaries and other birds may result dry and form a scale within six to ten days of forming. A new or freshly sterilized needle must be used for each bird to prevent the vaccination procedure from spreading the virus. This method of Trauma Trichomoniasis vaccination causes the formation of a typical pox Trichophyton spp. Aspergillosis late with immunity, and vaccinated birds should be Pigeon herpesvirus inspected nine or ten days following vaccination to be Hypovitaminosis A certain that lesions have formed. Latently infected Determination of Flock Immunity following Cutaneous Vaccination378 birds can remain asymptomatic for years. Latently infected 70 birds may shed virions via the feces, 54 nasal discharge or desquamated skin (thereby endangering neighboring 36 birds) without developing clinical signs. Because humoral antibodies decrease with time, indi- vert in order to impart flock immunity is illustrated rect diagnosis of herpesvirus infections by detection in Figure 32. For example, the statistical limits for of antibodies may give false-negative results. Vaccination at 10-14 days old is recom- The Herpesviridae family is divided into three sub- mended in areas with high densities of mosquitoes. Replication occurs in the nu- a species), their respective subfamilies and the cur- cleus. Crossing over a host- or tissue-specific nal Pacheco’s disease virus has been lost). Herpesviruses primarily infect lymphatic tissue (either B- or T-cells), epithelial cells (skin, Transmission mucosa, hepatocytes) and nerve cells. Herpesviridae Transmission routes for avian herpesviruses in com- are considered a phylogenetic old group of viruses panion birds have not been thoroughly investigated. Vertical transmission has been confirmed only with It should be expected that more avian herpesviridae budgerigar herpesvirus and duck plague herpes- strains will be isolated, adding further confusion to virus. Epizootics result in high concentrations of vi- the already tangled classification system.

McGraw-Hill generic lexapro 10 mg visa, New York buy lexapro 20 mg amex, pp 4 v (xlvii generic lexapro 5mg mastercard, rience with theophylline – relationship between dosage, 6338, 6140) serum concentration, and toxicity. J Toxicol Clin Toxicol 40:81 with formic acid recycling: a mechanism of active chloride 40. See Wegener granulomatosis Thrombocytopenia, 104, 105, 119, 187, 191, 219–223, Williams syndrome, 85, 176 225, 251 Winter’s formula, 154 . Worldwide, only an estimated ten to thirty percent of human health care is delivered by conventional, biomedically oriented practitioners. The remaining seventy to ninety percent ranges from self-care according to folk principles, to care given in an organized health care system based on traditional medicine. Likewise, in Myanmar health care system, the existence of traditional medicine along with allopathic medicines is well recognized. Myanmar traditional medicine dates back 2,000 years and is well accepted and widely used by the people throughout history. Burma Medical Research Institute since it was established in 1963 had started a program of research on traditional medicinal plants including laboratory screening tests on animal models of herbs with reputed pharmacological properties-such as anti-dysentery, bronchodilator, hypoglycemic effects. A research program for the standardization, pharmacological and toxicological evaluation of traditional drugs and herbal medicines was started in 1984 and Myanmar Traditional Medicine National Formulary has been compiled for 57 numbers of traditional medicine formulations, in each monograph including formulary, therapeutic uses, caution and dosage in Myanmar language. The Ministry of Health plays a pivotal role in the promotion and maintenance of health of the Myanmar people for ensuring their health and longevity. The ministry also encouraged research on traditional medicinal plants with the objectives of obtaining evidence-based traditional medicine drugs and exploring new traditional medicinal plants. Scientists from the Ministries of Health, Science and Technology and Education gather together to conduct research on traditional medicine and traditional plants during the past decades. An attempt has been made to consolidate all available data on traditional medicine research carried out at the Department of Medicine Research (Lower Myanmar) during the past five decades. In such cases, modifications have to be made and new subject headings have been added ie, species of plants as well as their local names. This bibliography will be of great assistance as a handy reference to traditional medicine practitioners and various researchers in the field of Myanmar Traditional Medicine. The action of Desmodium triquetrum (Lauk-thay-ywet) on the development of st Musca domestica. In Burma, Desmodium triquetrum (Lauk-thay-ywet) leaves are used to cover ngapi in the belief that this practice renders the ngapi free of fly larvae. Assuming that the larvae found in ngapi were those of Musca domestica, studies were initially made on the effect of Desmodium triquetrum leaves and extract on (1) eggs of M. Extracts tested had no action on the larve, but the leaf had a lethal effect on the majority of larvae within 24hours. The initial effects produced were a localisation of the larvae to part of the leaf, usually on the under surface, followed by an exudation of fluid. The mechanism by which the leaf produces the changes in the larvae has yet to be elucidated. The relative proportions of different kinds of fly larvae found in Nga-ngapi and Seinsa-ngapi were studied. Four different kinds of fly larvae were found in batches of Nga-ngapi and Seinsa-ngapi tested viz. Activation analysis of arsenic in 'Khun-hnit-par-shaung" Myanmar indigenous medicine. Sources of errors related to gamma attenuation and neutron self-shielding effects were studied. Mass-activity relation for arsenic was determined by gamma counting technique and checked against by both nuclear and chemical methods. Activities of some medicinal plants on Staphylococcus aureus isolated from patients with septic wound (Ana-pauk wound) attending Traditional Medicine Hospital, Yangon. Three medicinal plants: (Allium sativum-single clove garlic), leaves and seeds of Tama (Azadirachta indica) and Bizat (Eupatorium odoratum) leaves were selected to find out the antibacterial activity on 30 clinical isolates of Staphylococcus aureus. Wound swabs and pus samples were collected from patients with septic wound attending Traditional Medicine Hospital, Yangon from January to August, 2005. All extracts of three medicinal plants and fresh juice of Bizat leaves showed no antibacterial activity on Stphylococcus aureus. The findings of this study may be a scientific report for further development of a useful phytomedicine from garlic with specific antibacterial activity. The ingredients (24 plants) present in it were selected singly and tested for their antibacterial activities. A total of 35 strains of bacteria (Escherichia coli = 11; Staphylococcus aureus = 3; Salmonella species = 7; Shigella species = 4; Vibrio cholerae = 7 and one species each of Bacillus subtilis, Pseudomonas aeruginosa and Proteus morganii) were chosen for testing. Among the 23 plants tested, they were found to be active on one, two or more of the bacteria tested with different patterns. Mu Mu Sein Myint; May Aye Than; Yin Min Htun; Win Win Maw; Aye Myint Swe; San San Myint; Myint Myint Khine; Phyu Phyu Win. In acute toxicity test, it was found that there was no toxic symptom in albino mice at the dose of up to 4gm/kg body weight.