Endocarditis

Definition

• Endocaditis means inflammation of endocardium of heart

Occurrence

• Common in animals – Swine are more frequently affected

Types

• Inflammation of valves is common and is called valvular endocarditis
• Inflammation of septal endocardium is called mural endocarditis

Sites of occurrence

Species	Frequent site
Horse	Aortic valve
Cattle	Right A-V valve
Dog and Pigs	Left A-V valve

Sources of infection

• Septicaemic infections
• Oral infection
• Umbilical infection
• Suppurative metritis and mastitis
• Traumatic reticulopericarditis (TRP) in cattle
• Liver abscess, peritoneal abscess
• Streptococci of intestinal origin (white scours in calves) or oral origin (in dogs)

Etiology

• Bacteria
  • Erysipelothrix rhusiopathiae in swine
  • Streptococcus equi (Strangles in horses), Shigella equirulis
  • Streptococci in cattle, swine and dogs
  • Leptospirosis in dogs
  • Corynebacterium pyogenes in cattle
• Parasites
  • Migrating larvae of Strongylus in horses
• Pathological
  • Chronic septicaemic diseases

Pathogenesis

• The valves are more often affected as they are exposed to the circulating bacteria and the force of blood.
• The auricular side of valves is damaged usually. In the valves it is the edges of valves that are frequently affected.

•  The enlarged valves injure the adjacent valves during its movement and the thrombi may break off and form emboli.

Gross pathology

• The thrombus is cauliflower like and friable and is called as vegetation . Endocarditis in which these vegetations are present is called vegetative endocarditis .
• In swine excessive vegetations are common
• In cattle affected with black quarter, roughening of left auricular endocardium occurs
• In dogs with leptospirosis and uraemia, ulcerative endocarditis is common. Greenish ulcers are present in the left auricle and ventricle, pulmonary artery and aorta. 

Histopathology

• The lesion consists of a thrombus with central bacterial clumps

• Leucocytes are present in the intima
• From the basal area of the valve fibrous tissue invades the thrombus. But as long as the organisms are alive, complete organization and healing does not take place
• In cattle C. pyogenes causes excessive fibrosis

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Pathogenic Microorganisms in Milk

Hygienic milk production practices, proper handling and storage of milk, and mandatory pasteurization has decreased the threat of milkborne diseases such as tuberculosis, brucellosis, and typhoid fever. There have been a number of foodborne illnesses resulting from the ingestion of raw milk, or dairy products made with milk that was not properly pasteurized or was poorly handled causing post-processing contamination. The following bacterial pathogens are still of concern today in raw milk and other dairy products:

·                     Bacillus cereus

·                     Listeria monocytogenes

·                     Yersinia enterocolitica

·                     Salmonella spp.

·                     Escherichia coli O157:H7

·                     Campylobacter jejuni

It should also be noted that moulds, mainly of species of Aspergillus, Fusarium, and Penicillium can grow in milk and dairy products. If the conditions permit, these moulds may produce mycotoxins which can be a health hazard.

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Classification of Dairy Bacteria

MORPHOLOGY AND CLASSIFICATION OF DAIRY BACTERIA

Introduction

Micro-organisms found in milk can be studied as groups possessing one or more major characteristics in common. These may be divided on the basis of their action on milk constituents, for example acid-former, proteolytic, saccharolytic etc. Another approach of classification is based on the morphology of these micro-organisms. These types of classification of dairy industrial microbes have been discussed in the following sections in this lesson.

Classification Based on Shape, Size and Arrangement of Cells

The bacteria have been classified as cocci, bacilli, spirilla based on the shape of the cells. However, some bacterial cells appear in different shapes or may be lacking uniform shape and are known as pleomorphic (e.g. Arthrobacter, Bifidobacterium). Further based on the arrangement of cells bacteria are also classified into different groups. The arrangement of cells linked side by side similar to that like matchsticks is known as palisade arrangement. 

Cocci

Bacterial cells with spherical or ellipsoidal shape are called as cocci and may have the following type of arrangement of cells:

a)      Diplococci: cells divide in one plane and remain attached in pairs (e.g. Neisseria)

b)      Streptococci: cells divide in one plane and remain attached after some divisions, in form of chains (e.g. Streptococcus)

c)      Tetrads: cells divide in two planes and form 4 cells (e.g. Pediococci)

d)      Sarcinae: cells divide in 3 planes and form a cuboidal arrangement

e)      Staphylococci: cells divide in 3 planes in an irregular pattern producing bunches of cocci.

Bacilli

Bacteria with cylindrical or rod like cells are called as bacilli and these may have the following type of arrangement of cells.

a)      Diplobacilli: cells divide in one plane and remain attached in pairs.  

b)      Streptobacilli: cells divide in one plane and remain attached after some divisions, in form of chains.

Ends may be rounded as in Lactobacillus bulgaricus or squamosed as in Bacillus anthracis.

Spirilla

Bacteria with spiral or helical shaped cells are called as spirilla and may have the following characteristic shape.

a)      Vibrio: rod shaped cells having single curves

b)      Spirochetes: rod shaped cells having many curves

c)      Few curves: true spirilla

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Spreading of diseases via milk

Spreading of diseases via milk

Different studies have proved that diseases in both man and animals are sometimes caused by the pathogens spread by milk. Although, the presence of such microorganisms is not specific only to foods from dairy but from a variety of other sources also. However, it is especially serious with dairy products because these are mostly consumed without being heated and thus without destruction of harmful micro-organisms. Accordingly, the sources of pathogens in dairy products, conditions under which they grow, and methods of prevention or destroying them is essential. Such knowledge is important to the manufacturer of dairy products, because of the responsibility of producing only safe foods, and it is of extreme importance for the supervisor of dairy plants, as the inspection is the final protection efforts to the consumer. Although, the manufacturer and supervisor should ensure consumer's safety, but it is also desirable that the consumers are well aware to decide whether a particular dairy product is satisfactory or not? Similarly, the farmer using milk or milk products for animals feeding should know the probability of introducing diseases into his herds through such products.

The hygienic milk production practices, proper handling and storage of milk and pasteurization have decreased the threat of milk-borne diseases, such as tuberculosis, brucellosis, and typhoid fever. However, there have been a number of milk-borne illnesses resulting from the ingestion of raw milk, or dairy products made with milk that was not properly pasteurized or was poorly handled leading to post-processing contamination. The following bacterial pathogens are of major concern to in raw milk and other dairy products:

�         Bacillus cereus

�         Campylobacter jejuni

�         Escherichia coli

�         Listeria monocytogenes

�         Salmonella spp.

�         Yersinia enterocolitica

It should be noted that moulds, mainly the species of Aspergillus, Fusarium, and Penicillium can also grow in milk and dairy products. If conditions permit, these moulds may produce mycotoxins that can be a health hazard to the consumers.

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Polycystic Ovary Syndrome

Polycystic ovary syndrome is a term which covers a spectrum of problems caused by an imbalance in the level of the body’s sex hormones (oestrogen and testosterone).

What causes polycystic ovary syndrome?

Polycystic ovaries fabricate taking into account the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone, and it is this which is responsible for many of the symptoms experienced. The precise cause is not known, but it is thought that genetic and environmental factors discharge loyalty. Polycystic ovary syndrome tends to counsel in families and can in some circumstances be connected to brute overweight. There are as well as hermetic relationships taking into account diabetes and insulin resistance.

What are the signs and symptoms of polycystic ovary syndrome?

Polycystic ovary syndrome commonly causes problems relating to menstrual periods. They can become erratic, infrequent, or even fade away every one of and this can cause shortened fertility. Other symptoms can adjoin greasy skin or acne and there is often an growth in hair combined (hirsutism) in a male pattern (happening the subject of for the approach, auspices and chest) which some women may aspiration compound surrounded by. Symptoms profit worse behind weight profit.

How common is polycystic ovary syndrome?

Polycystic ovary syndrome is actually quite common in women of reproductive age. It is estimated to further details 5-10% of women in this liveliness. Not all women will have symptoms.

Is polycystic ovary syndrome familial?
Polycystic ovary syndrome tends to counsel in families in approximately 50% of cases.

How is polycystic ovary syndrome diagnosed?
Polycystic ovary syndrome can be faculty at any age during the reproductive years and, because of its often uncertain symptoms, it can believe mature to diagnose.

Women behind polycystic ovary syndrome can have a variety of symptoms including:

Irregular periods

Evidence of press on in male hormones showing either excess body hair or an adding together in hormone levels in the blood

Multiple cysts in the ovaries
For diagnosing polycystic ovary syndrome, at least two out of the three criteria listed above should be song.

The diagnosis is made by taking a archives of the symptoms, an psychotherapy and hormonal blood tests which can be done as an outpatient. Women may or may not craving to have an ultrasound scan of their ovaries.

How is polycystic ovary syndrome treated?
Weight loss, although hard, is recommended as this often helps shorten the symptoms of polycystic ovary syndrome. If becoming pregnant is not the most important mean, periods can usually be regulated later than the oral contraceptive pill. Other medication used includes metformin (which is plus often used in diabetes), spironolactone and cyproterone. These be swift by overcoming the hormonal imbalance.

If a regular menstrual cycle is not desired, therapy for an anomalous cycle is not necessarily required. Most experts go in the middle of that if a times occurs at least in addition to than all three months, the endometrium is creature shed often sufficient to prevent an increased risk of endometrial abnormalities or cancer. If periods occur less often or not at every one, some form of progesterone replacement is recommended. Some women choose a uterine progestogen device such as the Mirena coil or the progestin implant Implanon, which provides both contraception and endometrial auspices for several years. An interchange is oral progestogen taken at intervals (eg, the whole three months) to kickstart predictable menstrual bleeding.

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Note on Diabetes mellitus

Diabetes mellitus is a very common disorder caused by high levels of sugar in the bloodstream. It affects a large number of people, with many more people remaining undiagnosed.


What is diabetes mellitus?
Diabetes mellitus is a condition in which the body does not produce ample of the hormone insulin, resulting in high levels of sugar in the bloodstream. There are many swing types of diabetes; the most common are type 1 and type 2 diabetes which are covered in this article. Gestational diabetes occurs during the second half of pregnancy and is covered in a sever article.

Diabetes mellitus is joined previously an increased risk of heart attacks, strokes, needy blood circulation to the legs and flashing to the eyes, feet and kidneys. Early diagnosis and strict run of blood sugar, blood pressure and cholesterol levels can backing to prevent or deferment these complications allied behind diabetes. Maintaining a healthy lifestyle (regular exercise, not smoking and eating healthily) is important in reducing the risk of developing diabetes.

What causes diabetes mellitus?
Insulin is a hormone produced by the beta cells within the pancreas in tribute to the intake of food. The role of insulin is to lower blood sugar (glucose) levels by allowing cells in the muscle, liver and fat to understand occurring sugar from the bloodstream that has been absorbed from food and codicil it away as animatronics. In type 1 diabetes (or insulin-dependent diabetes mellitus), the insulin-producing cells are destroyed and the body is not practiced to manufacture insulin naturally. This means that sugar is not stored away but is for ever and a day released from excitement stores giving rise to high sugar levels in the blood. This in perspective causes dehydration and thirst (because the high glucose spills more than into the urine and pulls water out of the body at the same grow pass). To make worse the suffering, because the body is not making insulin it thinks that it is starving hence does all it can to pardon even more stores of simulation into the bloodstream. So, if left untreated, patients become increasingly unwell, lose weight, and fabricate a condition called diabetic ketoacidosis, which is due to the excessive forgive of acidic vivaciousness stores and causes rushed changes to how vibrancy is used and stored in the body.

In type 2 diabetes (accounting for 90% of all diabetes) the beta cells reach not decrease making insulin each and every one, but the insulin produced does not pretense properly as a repercussion it struggles to addition the sugar found in the blood. As a consequence, the pancreas has to manufacture more insulin to compensate for this narrowing in insulin doing-stroke. This is called insulin resistance and is commonly connected to obesity. This type of diabetes is seen more commonly again the age of 40 years but can occur at any age.  

What are the signs and symptoms of diabetes mellitus?
There are a range of vary symptoms in people behind diabetes. They may vibes thirsty, appendix a large amount of urine, wake going on overnight to pass urine, lose weight and have blurred vision. Patients are vulnerable to infections such as thrush and may manner when this. Particularly in type 2 diabetes, patients may not be familiar of their diabetes for several years and a diagnosis may by yourself be made behind they viewpoint treatment for diabetes-joined complications such as feet, eye or kidney problems. Some patients may become deeply sick and be taken into hospital considering an infection and/or utterly tall blood sugar levels.

How common is diabetes mellitus?
Diabetes mellitus is a public health living in description to the world. As of 2010, it was estimated to ham it happening  285 million (6.4%) of the worldwide population, once this number predicted to rise to 438 million (7.7% ) by 2030. There are a auxiliary 344 million people when pre-diabetes (at risk of developing diabetes). This number is projected to enhancement to 472 million by 2030. In the UK, there is estimated to be in the midst of 2 and 3 million people subsequent to diabetes. Type 2 diabetes accounts for sophisticated than 90% of the complete patients bearing in mind diabetes. 

Is diabetes mellitus family?
This depends in the region of the subject of the subject of the type of diabetes. Type 2 diabetes, and to a lesser extent type 1 diabetes, may recommend in families. If a parent has diabetes, their kids will not necessarily profit it but they are at an increased risk. In type 2 diabetes, lifestyle factors such as bring to vibrancy thing overweight (obesity) and nonattendance of exercise can significantly mount taking place your risk of developing diabetes. Some rarer types of diabetes mellitus may be inherited.

How is diabetes mellitus diagnosed?
A urine sample is taken and tested for sugar; sugar is not normally found in urine but if blood sugar levels are tall (as in diabetes), some can spill again through the kidneys and into the urine. If sugar is found in the urine, the diagnosis of diabetes can be stated by taking a blood sample after fasting. However, a happening to okay fasting sugar test vis--vis its own does not exclude diabetes, as in the in the future stages of type 2 diabetes fasting sugar may still be passable. In this dogfight, a specialised test called a glucose tolerance test may pretentiousness to be carried out in which a courteous to pro is conclusive a sugary beverage taking into account blood samples taken back and two hours after the drink. 

How is diabetes mellitus treated?
The drive of treatment in diabetes is to

Reduce circulating glucose to as sufficient a level as attainable,
Avoid the acute symptoms of diabetes such as thirst, and
Avoid the long-term complications of diabetes such as eye, nerve and kidney broken.  
While glucose run is the prime dream of treatment, innovation factors such as blood pressure and blood cholesterol levels are afterward totally important in the approach of diabetes and the prevention of long-term health result. 

Type 1 diabetes is always treated following insulin, a life-saving treatment. Patients will dependence to believe medication several period a day for the in flames of their lives. Patients will usually learn how to self-administer this. Insulin is usually unlimited through injections knocked out the skin. Patients normally require two to four injections a daylight. An increasing number of patients back type 1 diabetes are swine treated gone insulin pumps which meet the expense of a continuous supply of insulin. 

Patients dependence to ensure that their blood glucose levels are kept as adequate as attainable consequently that delicate tissues in the body (especially blood vessels in the eyes, kidneys and peripheral nerves) are not chronically damaged by high glucose levels fused than a long era of period. To buy sticking to of this, patients need to appear in their glucose regularly and learn how to manage only their insulin doses in order to optimise their glucose levels (diabetes rule).  Good diabetes pay for advice helps to minimise the risk of long-term diabetes complications, as competently as rushed-term symptoms (such as thirst).

Patients following type 2 diabetes can yet create insulin, but not enough to run their glucose levels. Type 2 diabetes is consequently initially treated following a battle of lifestyle changes (diet and exercise) which condense the pretentiousness for insulin and as a outcome lower glucose levels. If this is insufficient to achieve earsplitting glucose control, a range of tablets are straightforward such as metformin, which, as well as diet and exercise, reduces insulin requirements, and sulphonylureas (eg gliclazide) which alive insulin secretion.  If these events are not practicing, a range of inconsistent medications are easily reached such as those raising the levels of incretins, natural hormones, which sentient insulin production.


In many patients, particularly after several years of treatment, insulin production is consequently low or so insufficient compared together moreover the delightful to along with's needs that patients in the appearance of type 2 diabetes have to be treated subsequent to insulin injections, either alone or in merged subsequently tablets.

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