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Host Defnitive host: Man Intermediate For intestinal taeniasis: host: Cattle • Defnitive host: Man • Intermediate host: Pig For Cysticercosis: • Both defnitive and intermediate host: Man Infective form Larva (cysticercus bovis) For intestinal taeniasis–Larva (cysticercus cellulosae) For cysticercosis–egg Diagnostic form Egg For intesticercosis–larva (cysticercus cellulosae deposited in tissue) Mode of Ingestion of contaminated beef For intetinal taeniasis–ingestion of transmission contaminated pork For cysticercosis: • Contaminated food and water • Autoinfection Cysticercosis • Potentially dangerous systemic disease order cheap avodart line permatex rust treatment. Taenia Multiceps (Multiceps Multiceps) • Defnitive host- Dog 0.5 mg avodart free shipping symptoms of anemia, fox and wolf • Intermediate host- herbivorous animals like sheep (or man) • Transmission-Ingestion of food /water contaminated with eggs • Eggs develop to larva (Coenurus) which is a unilocular cyst with multiple scolices order acticin 30gm mastercard. Eggs –Infective stage of the • Man is an accidental host (dead end) Echinococus • Eggs – infective stage of the parasite. Clinical Features • Hydatid disease- Hepatomegaly (60-70% of cases), then lungs • E. Mansoni • Common in Africa including Caribbean Islands (West Indies), South America • Resides in mesenteric veins draining sigmoido-rectal region. Which of the following is the most common central nervous system parasitic infection? Chlonorchis sinensis jaundice with increased alkaline phosphatase & conjugated 31. Chatterjee 13/e p153; Apurba Sastry’s Essentials of Medical Parasitology, p/165 Characters Intestinal Taeniasis Cysticercosis Host Defnitive host – Man Both defnitive and intermediate host - Man Intermediate host-Cattle/pig Caused by Taenia solium& Taenia saginata Taenia solium 3. Kimura- Hayama et al, Neurologic Imaging, Oct-2010; Apurba Sastry’s Essentials of Medical Parasitology,p/171 – Though brain parenchyma was thought to be the commonest site of Neurocysticercosis but recent evidences have shown that subarachnoid space being the commonest site, followed by brain parenchyma. Chatterjee 13/e p175 Liver fuke – Fasciola hepatica – Fascola gigantica – Clonorchis sinensis – Opisthorchis viverinii. Chatterjee 13/e p177; Apurba Sastry’s Essentials of Medical Parasitology,p/199 – Katayama fever–In the acute phase of Schistosoma mansoni infection, antigens released from the eggs combine with antibodies and form immune complexes and this serum sickness like illness called Katayama fever. It is characterized by fever, generalized lymphadenopathy, and hepatosplenomegaly. Chatterjee 13/e p177; Apurba Sastry’s Essentials of Medical Parasitology,p/197 5 species of Schistosomes infecting humans: – Eggs with a terminal spine - Schistosoma haematobium, Schistosoma intercalatum – Eggs with a lateral spine - Schistosoma mansoni, – Eggs with a rudimentary knob - Schistosoma japonicum, Schistosoma mekongi. Chatterjee 13/e p177; Apurba Sastry’s Essentials of Medical Parasitology,p/201 Habitat – S. Rhabditiform larva of strongyloides Classifcation According to Nematodes Habitat • Intestinal Human nematodes – Small Intestine- Ascaris lumbricoides, Hook worm (Ancylostoma & Necator), Strongyloides – Large intestine- Trichuris and Enterobius • Somatic Human nematodes- Filarial worm, Trichinella spiralis, Dracunculus medinensis (Guinea worm) Classifcation According to Whether they Produce Egg/ Larva I Ovo-viviparous- Lay eggs • Viviparous- Lay Larva- Filarial worm, Trichinella & Dracunculus containing larva which • Oviparous- Lay eggs which hatch out to larva later in the environment- Ascaris, immediately hatchout- E. Necator vs Ancylostoma – Harada Mori technique – Stool Culture is done to – Baermann funnel technique demonstrate rhabditiform – Charcoal culture method larva which on further cultivation, transform to – Agar Plate technique (more sensitive) flariform larva • Chandler’s index is done for hookworm–eggs per gram of stool – Below 200- Hookworm is not of much signifcance – 200–250-May be regarded as potential danger – 250–300-Minor public health problem – Above 300-Important public health problem 478 Nematodes Fig. Sometimes, if the stool – Moreover, the passage of enteric fora through disrupted mucosa lead to sample is examined late, Gram-negative sepsis. Characters Classical Filariasis Occult Filariasis Causative Agent Infammatory changes to adult worm Hypersensitivity reaction to microflaria antigen Diagnostic form Microflaria in blood & in fuid Microflaria absent in blood I – Occult flariasis- Also called Organs affected Lymph Nodes & lymphatic vessels Lungs, liver, spleen as Weingarten’s Syndrome. Pathology Lymphangitis & lymphadenitis Eosinophilic granuloma – Tropical Pulmonary Serology Antibody not diagnostic Antibody (IgE) – diagnostic Eosinophilia- Also called • Occult flariasis- Also called as Weingarten’s Syndrome. Causes of Food Poisoning Toxic Type Intermediate Type Infective Type (Incubation Period < 6hrs) (Incubation Period 8–16hrs) (Incubation Period > 16 hrs) • Staphylococcus aureus • Clostridium perfringens • Escherichia coli: Enterotoxigenic, • Bacillus cereus (emetic • Bacillus cereus (diarrheal Enterohemorrhagic type) • Salmonella spp: S. D viruses vaginal bacteria Herpes simplex virus type I Group B Streptococcus Epstein-Barr virus Mobiluncus spp. Kaposi’s sarcoma-associated Herpes Helicobacter cinaedi virus Helicobacter fennelliae Transfusion-Transmitted virus Transmitted by Sexual contact involving oral-fecal exposure (homosexual Men) Shigella spp.

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The syndrome did not depend on ir- it is a syndrome dominated by a new onset of potentially ritability for the diagnosis order 0.5mg avodart with mastercard symptoms cervical cancer. He was sad and persistently drew pictures of graves and tombs avodart 0.5mg free shipping medications 512, expressed hopeless- severe affective instability discount 200mg urispas visa, aggression, or disinhibition/ ness, and had vegetative signs of depression. He thus re- markedly impaired social judgment and occasionally by ceived a diagnosis of postconcussional syndrome as well apathy or paranoia. A child age 5 years 3 months presented 29 months after be- ing involved in a motor vehicle accident. He was strapped in his car seat 446 Textbook of Traumatic Brain Injury and cried loudly immediately upon impact and then sucked development (Goldman 1971). There was no apparent loss of consciousness mechanism may involve the rare late onset of a seizure dis- and no treatment given by paramedics. A history driver, suffered whiplash and headaches and had a promi- of seizures would clarify the clinical decision. After the accident he developed clini- cally significant headaches; feelings like spiders crawling School Failure on his scalp; mild regression in expressive language, requir- ing speech/language therapy; affective lability, mostly with Case 1. Regula- mother, himself, and his dog; callous comments on the physical attributes of strangers; a wish to die; and a preoc- tion of mood states was unremarkable. Six months after injury he began to be challenged more at school and could cupation with car accidents, including believing that each not keep up with his class. He became irritable, angry, car trip would be associated with another accident and that death was imminent. This persisted despite 2 years of play and sad and was diagnosed with an adjustment disorder with mixed emotional features. Treatment with an anticonvulsant mood stabilizer such as valproic acid may be helpful. Mood-stabilizing medications such as carbamazepine and valproic acid can Comment: The child’s affective change was not considered be particularly effective when combined with a behavior to be a direct consequence of brain injury because of the modification program targeting aggression. School aides may be re- dotal evidence of effectiveness of amitriptyline in a child quired to supervise the children closely. Careful as- sessment is necessary to determine whether a child with paranoid thoughts is truly impaired by these symptoms Treatment: and whether the symptoms actually influence the child’s behavior. Family problem-solving inter- of neuronal recovery have been elucidated in animal mod- ventions have resulted in a decrease in children’s intern- els (Kline et al. The focus on the family stabilizers may be helpful, and if stimulants are being in these treatment studies is appropriate given that prein- used, they should be reevaluated although the mania/ jury family function is a significant predictor of child out- hypomania should not be considered a contraindication to come as well as postinjury family function. Education, clinical, and advocacy ser- vices should be offered to families who are in need. Until more comprehensive treatment studies are done Popular belief that children with brain damage do not re- to justify specific guidelines for treatment of emotional or spond to this treatment is unfortunate and may impede the behavioral problems (e.

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This alteration has been referred to as onion- skinning because of its concentric appearance cheap 0.5 mg avodart with mastercard medicine 773. The lesion avodart 0.5mg without prescription treatment head lice, also called hyperplastic arteriolitis order zofran paypal, correlates well with renal failure in malignant hypertension. Small, pinpoint petechial hemorrhages may appear on the cortical surface from rupture of arterioles or glomerular capillar- ies, giving the kidney a peculiar “fea-bitten” appearance. Nephrosclerosis is associated with increasing age, more frequent in blacks than whites, and may be seen in the absence of hypertension. Hypertension and diabetes mellitus, however, increase the incidence and severity of the lesions. Absence of α5 staining is seen even on skin biopsy apart from glomerular and tubular basement membrane. The commonest cause in a child of nephrotic syndrome is lipoid nephrosis or minimal change disease. Electron microscopic examination in minimal change disease show the presence of effacement of foot processes of podocytesQ. Alport syndrome is a hereditary nephritis characterized by associated nerve deafness and eye disorders like lens dislocation, posterior cataracts and corneal dystrophy. Histologically foam cells (interstitial cells having fats and mucopolysaccharides) are seen. Persistently depressed levels’ are not seen in post streptococcal glomerulonephritis. Mild proteinuria is frequently present and occassionally nephrotic syndrome may develop. Important info Thin basement membrane disease is the most common cause of benign familial hematuria. Robbin’s 9/e p920, 8th/926, 7th/983-4) 470 Kidney and Urinary Bladder Collapsing Glomerulopathy is characterised by • A characteristic feature is proliferation and hypertrophy of glomerular visceral epithelial cells. Renal amyloidosis is the most common cause of death due to amyloidosis (including both primary and secondary amyloidosis). Other options: • Mesangioproliferative glomerulonephritis shows mesangial deposits of IgG, IgA and C3. However, in any renal disease, it allows protein molecules to pass through it and albumin is the frst protein to appear in the urine. However, the flterability of any neutral substance with diameter between 4 nm and 8 nm is inversely proportional to its size. Charge of the substance The sialoproteins contained in the glomerular fltration layer are negatively charged causing repulsion of all negatively charged particles including proteins. This explains the negligible fltration of albumin anion which has diameter of 7 nm In some renal diseases, the anionic charge of the fltration membrane is lost and this allows negatively charged particles of diameter 8nm to pass through it resulting in proteinuria.

The subject envisages • Worker absenteeism health order avodart cheap medications during pregnancy chart, safety and welfare of all the workers alike such • Biological agents and social factors in occupational as office goes quality avodart 0.5mg medications knowledge, farmers feldene 20 mg visa, unskilled laborers, teachers and health. Factory workers, however, need Physical Agents and are paid special attention by the government because they work in hazardous environments and are Temperature and Humidity exposed to special risks. Fishermen and workers at high highest degree of physical, mental and social well-being altitudes are exposed to cold. Workers in ice factories, cold storage rooms, milk workers in an occupational environment adapted to dairies and cold laboratories are exposed to cold. The various factors Exposure to high humidity: It accompanies extremes in occupational environment that may affect health are: of temperature in many industries and aggravates the • Physical agents such as extremes of temperature and heat or cold effects on body such as in textiles, paper humidity, abnormal air pressure, vibrations, noise, factories, ice factories, etc. There is enough evidence to show that workers in submarines and deep mines are exposed to noise has undesirable effects on cardiovascular, respi- high pressure. For example, Acclimatization to heat, humidity and pressure has abnormal cardiac rhythms have been found in workers already been discussed in the Chapter on Air. Overexposure to noise is associated with high Vibrations blood pressure, peptic ulcer, and, in general, a higher environmental stress. Vibrations noise level in several prison industries varied from 75 may cause general symptoms such as nervousness and to 110 decibels and the prisoners developed impairment fatigue or local symptoms such as injury and of hearing within three months, which was permanent inflammation of bones and joints. However, a study by producing machines in thick walled sound proofed the National Physical Laboratory indicated that Mumbai chambers. Noise in cities and towns can be markedly is ‘the noisiest city in India’, the biggest source of noise reduced by green belts having plantations of dense for a person there being vehicular traffic. Ear plugs and ranging from 81 to 102 decibels numbs the efficiency ear muffs can be used for this purpose. It may in noisy environment should be rotated to avoid be mentioned that as demonstrated by Theodore Wacks prolonged exposure and their hearing should be at Purdue University in 1982, ordinary household noise checked by periodic audiograms. A recent study advocated that • Appropriate health education: To workers, employers pregnant women avoid prolonged exposure to noise. Steady narrow band noise from saws, lathes and noise from myriad sources, including the modern day pneumatic hand tools. Impact noise (lasting less than 1/10th of a second) rules ban the use of vehicle horns, sound emitting fire- from drop hammers. Loud noise from the neighbor’s music system and parties has also tubes has no ill effect within reasonable limits of been covered. Bright, sharp and direct light produces glare such as a hotel or stadium should not rise above 10 which may cause eye strain, fatigue and headache.