Echinococcosis is a parasitic disease of tapeworms of the Echinococcus type. The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. Less common forms include polycystic echinococcosis and unicystic echinococcosis. The disease often starts without symptoms and this may last for years.
Echinococcosis is a parasitic disease of tapeworms of the Echinococcus type. The two main types of the disease are cystic echinococcosis and alveolar echinococcosis. Less common forms include polycystic echinococcosis and unicystic echinococcosis. The disease often starts without symptoms and this may last for years.
The topic is highly useful for MBBS students.
Trichinella is a neamtode, The disease is called as Trichinellosis/Trichinosis. This topic will be explaining about Morphology of Trichinella, mode of transmission, life cycle ,clinical features, lab diagnosis, treatment and its prevention.
The convoluted filaria
It is common in parts of tropical African and central America
Habitat nodules in the subcutaneous tissue of man
Intermediate hos black fly simulium
Human become infected by bite of black fly which possession in its mouth the infective 3rd stage larvae
The adult worms live in deep fascia or in the subcutaneous tissue.
The females release actively motile, unsheathed microfilariae which migrate to the skin and eyes of infected subjects.
When a black fly again bites diseased human, the microfilariae migrate into thoracic muscles, they moult twice and develop into infective larvae.
The larvae migrate to the mouth parts of black fly where they transmitted to humans at next blood meal.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Clinically important cestodes pathogenic to man are:
Tenia solium (pork tapeworm), T. saginata (beef tapeworm), Diphyllobothrium lattum (fish or broad tapeworm), Hymenolepis nana (dwarf tapeworm) and Echinococcus granulosus and E. multilocularis (hydatid).
coccidian parasite is a very important topic for pg entrance........so every important point about it have been discussed in detail......take a look at it...
The topic is highly useful for MBBS students.
Trichinella is a neamtode, The disease is called as Trichinellosis/Trichinosis. This topic will be explaining about Morphology of Trichinella, mode of transmission, life cycle ,clinical features, lab diagnosis, treatment and its prevention.
The convoluted filaria
It is common in parts of tropical African and central America
Habitat nodules in the subcutaneous tissue of man
Intermediate hos black fly simulium
Human become infected by bite of black fly which possession in its mouth the infective 3rd stage larvae
The adult worms live in deep fascia or in the subcutaneous tissue.
The females release actively motile, unsheathed microfilariae which migrate to the skin and eyes of infected subjects.
When a black fly again bites diseased human, the microfilariae migrate into thoracic muscles, they moult twice and develop into infective larvae.
The larvae migrate to the mouth parts of black fly where they transmitted to humans at next blood meal.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Clinically important cestodes pathogenic to man are:
Tenia solium (pork tapeworm), T. saginata (beef tapeworm), Diphyllobothrium lattum (fish or broad tapeworm), Hymenolepis nana (dwarf tapeworm) and Echinococcus granulosus and E. multilocularis (hydatid).
coccidian parasite is a very important topic for pg entrance........so every important point about it have been discussed in detail......take a look at it...
„Lange Zeit wurde der Darm als eine periphere Struktur betrachtet, die mit zweitrangigen Funktionen beauftragt ist. Aber die Entdeckung von Aktivitäten, die mit der Koordination des emotionalen und immunologischen Zustandes verbunden sind, hat grundlegend dieses Denken geändert“ – erklärt Umberto Solimene von der Universität in Mailand, Direktor des Zentrums, Mitarbeiter der Weltgesundheitsorganisation (englisch World Health Organization, WHO) im Bereich der traditionellen Medizin” – “Tatsächlich finden wir im Bauch neuronales Gewebe”. In seinem Bestseller “The Second Brain”, stellt Professor Gershon Untersuchungen auf genetisch modifiezierte Versuchstiere vor, sowie auch invitro, die “die Existenz von Achse Bauch-Kopf gezeigt haben. Die Menge der Mitteilungen, die das Bauchgehirn zu dem Zentralhirn sendet, ist 90% von der Gesamtmenge”, behauptet der Forscher. Zum größten Teil handelt es sich um unbewußte Mitteilungen, die wir nur wahrnehmen, wenn sie sich in Alarmsignale umwandeln und Reaktionen von Unbehagen oder Krankheit hervorrufen.”
Wissenschaftliche Grundlagen – „Die Theorie von den beiden Gehirnen“ liegt auf einer soliden Grundlage – erklärt der Experte – Es ist genug zu bedenken, dass der Darm, ungeachtet dessen, dass er nur ein zehntel von den Neuronen des Gehirns besitzt, arbeitet autonom, hilft die Erinnerungen zu behalten, die mit Gefühlen verbunden sind und die eine grundlegende Rolle in der Übermittlung der Signale für Freude und Schmerz haben. Anders gesagt, der Darm ist der Platz, wo sich wirklich ein zweites Gehirn befindet. Und die Tatsache ist nicht zufällig, dass die Darmzellen – fügt Gershon hinzu – stellen 95% vom Serotonin her – der Neurotransmitter des Wohlstandes.“
PHD IS ENDEMIC IRAQ. CXR IS THE CHIEF DIAGNOSTIC MODALITY. CONSIDER DIFFERENTIAL DIAGNOSES. PREVENTION IS ACHIEVABLE.SURGERY IS STILL THE MAIN TREATMENT.ALWAYS TRY TO PRESERVE LUNG TISSUE. LUNG RESECTION IS DONE SPORADICALLY FOR CERTAIN INDICATIONS. SEARCH FOR CNS AND PA CYSTS IN PATIENTS WITH DISSEMINATED HYDATIDOSIS.
It is about the cancer initiation, progression, metastasis and angiogenesis. In addition to that viruses responsible for the cancer. oncogenes- protooncogenes, factors responsible for cancer, treatment, cell signaling mechanisms involved.
Strategies Novartis can use to GROW from a Billion Dollar Company to a Trillion Dollar Company like Alphabet Inc
Novartis is a leading healthcare company which is situated in Switzerland and uses digital technologies and innovative science to come up with transformative ways of treatment in areas of great medicinal needs. This article explains what Novartis strategies and what they should employ so that they can rise from a billion dollar company to a trillion dollar company like the Google Alphabet Inc.
Novartis was formed in March 1996 by the merging of pharmaceutical and agrochemical divisions of Ciba-Geigy and Sandoz companies. Thanks to the merging of the two companies, Novartis is one of the biggest pharmaceutical companies in the world. Novartis is one of the largest companies which achieved a great milestone within a few decades. Novartis as a whole is divided into three major divisions: Sandoz (generics), Innovative Medicines and Alcon (eyecare). Novartis is also involved in collaborative research projects that are publicly funded.
Below are some of Novartis best selling drugs and their revenue
1.Cosenty – This is the top selling drug with a revenue of 4.788 billion dollars
2.Enfresto – This has a revenue of 4.644 billions dollars
3.Promacta – This has a revenue 0f 2.088 billion dollars
Medicine manufactured by Novartis and their uses
Medicine Medicine use
Cosentyx Used to treat psoriatic arthritis
Entresto Used to treat heart failure
Lucentis Used to block abnormal vessel growth in the back of the eye
Tasigna Used to treat chronic myelogenous leukemia which has the Philadelphia chromosome
Jakavi Used to treat myelofibrosis, polycythemia vera and graft-versus-host disease
Promacta Used to treat patients with abnormal low platelet count
Sandostatin Used to treat patients with tumor experiencing symptoms like flushing and diarrhea
Xolair Used to treat moderate and severe asthma
Gilenya Used to treat multiple sclerosis
How Novartis became one of the biggest pharmaceutical companies in the world
1.Market control through partnership
Geigy, Sandoz and Ciba combined their power so that they can compete with strong foreign firms and formed a cartel called the Basal Syndicate or Basal IG. Basal IG secured most of the manufacturing facilities all over the US and across Europe. It later joined with IG Farben and other chemical companies to form a big cartel called the Quadrapartite Cartel which dominated all of the European market and enjoyed the profits made from the joint manufacturing.
2.Growth acceleration through mergers
Since competition was very rampant in the pharmaceutical industry, Ciba and Geigy decided to merge with Sandoz AG to form Novartis. With this merge, Novartis became one of the growing giants in the pharmaceutical industry. This made Novartis gain a lot of fame and build a strong reputation over other companies. Novartis majored on agrochemical and pharmaceutical industries which made it easy to focus on a specific mar
easy description of common lut disorders. improvements on the slides accepted. text includes congenital and acquired disorders. more so the causes of bladder outlet obstructions. also management of the disorders are breifly described.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
2. HISTORYHISTORY
• Hydatid disease -Hydatid disease - one of the oldest diseasesone of the oldest diseases known to mankind, is aknown to mankind, is a
parasitic infestation caused by tapeworm of genus Echinococcusparasitic infestation caused by tapeworm of genus Echinococcus
• It was first described in the Talmud as a "It was first described in the Talmud as a "Bladder full of waterBladder full of water" ." .
• HippocratesHippocrates described the human hydatid disease more than twodescribed the human hydatid disease more than two
thousand years ago with a very interesting expression (thousand years ago with a very interesting expression (liver filledliver filled
with waterwith water) .) .
3. HydatidHydatid :: Greek for ‘drop of water’Greek for ‘drop of water’
EchinococcusEchinococcus ::
• ‘‘hedgehog berry’hedgehog berry’
• coined by Rudolphi in the first decade of the 19coined by Rudolphi in the first decade of the 19thth
centurycentury
4. Genus EchinococcusGenus Echinococcus - 4 species:- 4 species:
•E. granulosusE. granulosus - commonest -cystic echinococcosis (hydatid- commonest -cystic echinococcosis (hydatid
disease)disease)
•E. multilocularisE. multilocularis - alveolar echinococcosis - the most virulent.- alveolar echinococcosis - the most virulent.
•E. vogeli & E. oligarthusE. vogeli & E. oligarthus – polycystic echinococcosis– polycystic echinococcosis
5. EPIDEMIOLOGYEPIDEMIOLOGY
• E.granulosusE.granulosus is present virtually worldwide, more common in sheepis present virtually worldwide, more common in sheep
and cattle raising countriesand cattle raising countries
IndiaIndia- AP, Gujarat,Tamil Nadu,West Bengal,- AP, Gujarat,Tamil Nadu,West Bengal, Orissa, Bihar,Orissa, Bihar,
Punjab, Haryana, HP, UP,Punjab, Haryana, HP, UP, Kashmir, Delhi and Pondicherry.Kashmir, Delhi and Pondicherry.
• E.multilocularisE.multilocularis -Northern hemisphere, including central Europe and-Northern hemisphere, including central Europe and
the northern parts of Europe, Asia, and North America.the northern parts of Europe, Asia, and North America.
• E.vogeliE.vogeli andand E. oligarthusE. oligarthus -Central and South America.-Central and South America.
7. • Definitive host:Definitive host: dog & other caninedog & other canine
• Intermediate host:Intermediate host: sheep, cattle, camel & humansheep, cattle, camel & human
• Infective stage:Infective stage: egg (gravid proglottid)egg (gravid proglottid)
• Sites of hydatid:Sites of hydatid: liver, lungs, abdominal cavity, spleen, kidneys, heart,liver, lungs, abdominal cavity, spleen, kidneys, heart,
bones, central nervous system etcbones, central nervous system etc
• Man is a dead end hostMan is a dead end host
8.
9. TRANSMISSIONTRANSMISSION
• Ingestion from contaminated grass, usually for herbivoresIngestion from contaminated grass, usually for herbivores
• Contamination caused by poor hygiene, followed by transferContamination caused by poor hygiene, followed by transfer
to the mouthto the mouth
• Accidental ingestion of contaminated soil, berries orAccidental ingestion of contaminated soil, berries or
vegetablesvegetables
10. MORPHOLOGYMORPHOLOGY
Adult wormAdult worm:: 3-6 mm3-6 mm
• ScolexScolex- pyriform 300 µm, 4 suckers and a- pyriform 300 µm, 4 suckers and a
protrusible rostellum with two circular rows ofprotrusible rostellum with two circular rows of
hookletshooklets
• NeckNeck- short, thick- short, thick
• StrobilaStrobila- 3-4 proglottids usually (immature,- 3-4 proglottids usually (immature,
mature and gravid)mature and gravid)
13. PATHOGENICITYPATHOGENICITY
• Hydatid cystHydatid cyst represents larval formrepresents larval form
• Generally acquired duringGenerally acquired during childhoodchildhood..
• GradualGradual displacement of vital host tissuedisplacement of vital host tissue, vessels or parts of organs →, vessels or parts of organs →
damage and dysfunctiondamage and dysfunction
• The cyst wall is formed by:The cyst wall is formed by:
Pericyst-Pericyst-
• fibrous tissue laid down byfibrous tissue laid down by host fibroblastshost fibroblasts and new blood vessels.and new blood vessels.
• merges with surrounding normal tissue.merges with surrounding normal tissue.
• Nutrition derived through this layer.Nutrition derived through this layer.
• In old cysts, it may become sclerosed or calcified and parasite may dieIn old cysts, it may become sclerosed or calcified and parasite may die
within it.within it.
• Absent in lung, bone, muscle, sometimes brainAbsent in lung, bone, muscle, sometimes brain
14. Ectocyst:Ectocyst:
• SecretedSecreted by embryoby embryo
• Tough, acellular, laminated ,elastic hyaline membrane, 1 mmTough, acellular, laminated ,elastic hyaline membrane, 1 mm
• Resembles white of a hard boiled eggResembles white of a hard boiled egg
• Protects the cyst from host enzymes, bile & bacteriaProtects the cyst from host enzymes, bile & bacteria
• Non- infectiveNon- infective
Endocyst:Endocyst:
• Germinal layer, living component of the parasiteGerminal layer, living component of the parasite
• Consists of number of nuclei embedded in a protoplasmicConsists of number of nuclei embedded in a protoplasmic
mass.mass.
• Gives rise to ectocyst, brood capsules and scolicesGives rise to ectocyst, brood capsules and scolices
• SecretesSecretes hydatid fluid.hydatid fluid.
21. ORGANS AFFECTEDORGANS AFFECTED
The parasite can colonise virtuallyThe parasite can colonise virtually every organevery organ in the bodyin the body
• Liver- 52-77% (¾ right liver)Liver- 52-77% (¾ right liver)
• Lung- 8.5-44%Lung- 8.5-44%
• Abdominal cavity- 8%Abdominal cavity- 8%
• Kidney- 7%Kidney- 7%
• Central nervous system- 0.2-2.4%Central nervous system- 0.2-2.4%
• Bone- 1-2.5%Bone- 1-2.5%
• Less common- spleen,Less common- spleen,
bladder, thyroid, prostate , heart, eye, adrenal gland, cervix,bladder, thyroid, prostate , heart, eye, adrenal gland, cervix,
fallopian tube, ovaries, breast, pancreas, subcutaneous tissuesfallopian tube, ovaries, breast, pancreas, subcutaneous tissues..
22.
23. WORK UPWORK UP
• Generally, routine laboratory tests do not show specific results.Generally, routine laboratory tests do not show specific results.
• In patients with rupture of the cyst in the biliary tree,In patients with rupture of the cyst in the biliary tree,
marked andmarked and transient elevation of cholestatic enzymetransient elevation of cholestatic enzyme
levelslevels occurs, often in association withoccurs, often in association with
hyperamylasemiahyperamylasemia andand eosinophiliaeosinophilia (as many as 60%).(as many as 60%).
• Indirect hemagglutination test and enzyme-linkedIndirect hemagglutination test and enzyme-linked
immunosorbent assay are the most widely usedimmunosorbent assay are the most widely used
methods for detection of anti-Echinococcus antibodiesmethods for detection of anti-Echinococcus antibodies
(immunoglobulin G [IgG]).These tests give false(immunoglobulin G [IgG]).These tests give false
positive results in cases of schistosomiasis andpositive results in cases of schistosomiasis and
nematode infestations that is why they are not specificnematode infestations that is why they are not specific
for diagnosing hydatidosis.for diagnosing hydatidosis.
24. MAN'S ARM SHOWING POSITIVE SKIN TEST FORMAN'S ARM SHOWING POSITIVE SKIN TEST FOR
HYDATID DISEASEHYDATID DISEASE
30. • Contraindications:Contraindications: Early pregnancyEarly pregnancy,, bone marrow suppressionbone marrow suppression,,
chronic hepatic diseasechronic hepatic disease,, large cysts with the risk of rupturelarge cysts with the risk of rupture,,
andand inactive or calcified cysts are contraindicationsinactive or calcified cysts are contraindications. A relative. A relative
contraindication is bone cysts because of the significantlycontraindication is bone cysts because of the significantly
decreased response.decreased response.
• Outcome : Response rates in 1000 treated patients were thatOutcome : Response rates in 1000 treated patients were that
30%30% had cyst disappearance (had cyst disappearance (curecure),), 30-50%30-50% had a decrease inhad a decrease in
the size of the cyst (the size of the cyst (improvementimprovement), and), and 20-40% had no20-40% had no
changeschanges. Also, younger adults responded better than older. Also, younger adults responded better than older
adults.adults.
31.
32.
33. SURGICAL MANAGEMENTSURGICAL MANAGEMENT
• Indications:Indications:
1-Large liver cysts with multiple daughter cysts; superficially1-Large liver cysts with multiple daughter cysts; superficially
located single liver cysts that may rupture (traumatically orlocated single liver cysts that may rupture (traumatically or
spontaneously).spontaneously).
2-liver cysts with biliary tree communication or pressure effects2-liver cysts with biliary tree communication or pressure effects
on vital organs or structures.on vital organs or structures.
3-infected cysts .3-infected cysts .
4-cysts in lungs, brain, kidneys, eyes, bones .4-cysts in lungs, brain, kidneys, eyes, bones .
34. CHOICE OF SURGICALCHOICE OF SURGICAL
TECHNIQUETECHNIQUE::
• 1-Radical surgery (total pericystectomy or1-Radical surgery (total pericystectomy or
partial resection, if possible),partial resection, if possible),
• 2-Conservative surgery (open cystectomy), or2-Conservative surgery (open cystectomy), or
simple tube drainage for infected andsimple tube drainage for infected and
communicating cysts are choices for surgicalcommunicating cysts are choices for surgical
technique.The more radical the procedure, thetechnique.The more radical the procedure, the
lower the risk of relapses but the higher the risklower the risk of relapses but the higher the risk
of complications.of complications.
35.
36. • Concomitant treatment with benzimidazoles (albendazole orConcomitant treatment with benzimidazoles (albendazole or
mebendazole) has been reported to reduce the risk ofmebendazole) has been reported to reduce the risk of
secondary echinococcosissecondary echinococcosis.Treatment is started 4 days.Treatment is started 4 days
preoperatively and lasts for 1 month.preoperatively and lasts for 1 month.
37. COMPLICATIONS:COMPLICATIONS:
1-All the usual complications related to the surgical procedure and anesthesia1-All the usual complications related to the surgical procedure and anesthesia
2-Related to the parasite Recurrence2-Related to the parasite Recurrence
•MetastasisMetastasis
•InfectionInfection
•Spillage and seeding (secondary echinococcosis) - Allergic reaction or anaphylactic shockSpillage and seeding (secondary echinococcosis) - Allergic reaction or anaphylactic shock
3-Related to the medical treatment Hepatotoxicity3-Related to the medical treatment Hepatotoxicity
•AnemiaAnemia
•ThrombocytopeniaThrombocytopenia
•AlopeciaAlopecia
•EmbryotoxicityEmbryotoxicity
•TeratogenicityTeratogenicity..
38. COMPLICATIONS , CONT.COMPLICATIONS , CONT.
4-Related to PAIR4-Related to PAIR
• HemorrhageHemorrhage
•Mechanical damage to other tissueMechanical damage to other tissue
•InfectionsInfections
•Allergic reaction or anaphylactic shockAllergic reaction or anaphylactic shock
•Persistence of daughter cystsPersistence of daughter cysts
•Sudden intracystic decompression leading to biliary fistulasSudden intracystic decompression leading to biliary fistulas
5-Related to scolicidal agents - Chemical sclerosing cholangitis5-Related to scolicidal agents - Chemical sclerosing cholangitis
39. PREVENTIONPREVENTION
• The best way to keep dogsThe best way to keep dogs
from being infected is tofrom being infected is to
prevent them from eatingprevent them from eating
infected feces, orinfected feces, or
contaminated meatcontaminated meat
• The best way to avoidThe best way to avoid
human infection is to avoidhuman infection is to avoid
ingesting food or otheringesting food or other
substances contaminatedsubstances contaminated
with dog feceswith dog feces
40. PREVENTION (CONT’D)PREVENTION (CONT’D)
• The best method is to disrupt the lifecycleThe best method is to disrupt the lifecycle
• Basic hygiene practicesBasic hygiene practices
• Avoid feeding raw offal (internal organs of butchered animals) toAvoid feeding raw offal (internal organs of butchered animals) to
dogsdogs
• By doing this hydatids have been virtually eliminated in New ZealandBy doing this hydatids have been virtually eliminated in New Zealand
(a once common place for this parasite)(a once common place for this parasite)
41. CONCLUSION:CONCLUSION:
• Many hydatid cysts remain asymptomatic, even into advancedMany hydatid cysts remain asymptomatic, even into advanced
age. Parasite load, the site, and the size of the cysts determine theage. Parasite load, the site, and the size of the cysts determine the
degree of symptoms.degree of symptoms.
• The liver is the most common organ involved, followed by theThe liver is the most common organ involved, followed by the
lungs.These 2 organs account for 90% of cases of echinococcosis.lungs.These 2 organs account for 90% of cases of echinococcosis.
• Surgery remains the main Treatment of the hydatied liver diseaseSurgery remains the main Treatment of the hydatied liver disease
, PAIR technique still promising., PAIR technique still promising.
• Patient education about the prevention of this zoonotic infection .Patient education about the prevention of this zoonotic infection .
