Defined as inflammation of the mucous membrane of stomach and intestine usually causing nausea ,vomiting and diarrhea.
Gastro-intestinal infections represent a major public health and clinical problem worldwide. Many species of bacteria, viruses and protozoa cause gastro-intestinal infection.
Acute infectious diarrhea
Seminar Prepared by :-
Mohammed Musa
Mohammed Saadi
Hussein Jassam
Mahmoud Ahmed
Meran Salih
Internal Medicine
College of Medicine - University of Kirkuk
Acute infectious diarrhoea is the leading cause of morbidity leading to dehydration, hospital admission and death in children.
Viral causes (rotavirus) predominate as the pathogen.
Initial management rely on assessment of severity of dehydration and fluid replacement.
Early refeeding
Antibiotic are needed only in some bacterial and parasitic infections.
Probiotics, prebiotics and zinc reduce the duration and severity of symptoms.
Honey, amazingly contain all these substances and extremely useful in diarrhoea
Acute infectious diarrhea
Seminar Prepared by :-
Mohammed Musa
Mohammed Saadi
Hussein Jassam
Mahmoud Ahmed
Meran Salih
Internal Medicine
College of Medicine - University of Kirkuk
Acute infectious diarrhoea is the leading cause of morbidity leading to dehydration, hospital admission and death in children.
Viral causes (rotavirus) predominate as the pathogen.
Initial management rely on assessment of severity of dehydration and fluid replacement.
Early refeeding
Antibiotic are needed only in some bacterial and parasitic infections.
Probiotics, prebiotics and zinc reduce the duration and severity of symptoms.
Honey, amazingly contain all these substances and extremely useful in diarrhoea
1- Understand the pathophysiologic mechanisms involved in chronic diarrhea.
2. Classification the causes of chronic diarrhea in resource-rich and resource-limited countries
3- Know how to evaluate a child who has chronic diarrhea
4. Know the therapies for the many causes of chronic diarrhea
A bunch of topic were selected for our subject Communicable Diseases, surprisingly I picked up "Cholera El tor"...
I have done enough research regarding this topic from Brunner and Suddarths MedSurg books and other resources. I collated the ideas and came up to this presentation...
Hope it will be able to help my colleagues, students and those people who needs to know the what, why's, and how of Cholera!
xoxo ^___^
1- Understand the pathophysiologic mechanisms involved in chronic diarrhea.
2. Classification the causes of chronic diarrhea in resource-rich and resource-limited countries
3- Know how to evaluate a child who has chronic diarrhea
4. Know the therapies for the many causes of chronic diarrhea
A bunch of topic were selected for our subject Communicable Diseases, surprisingly I picked up "Cholera El tor"...
I have done enough research regarding this topic from Brunner and Suddarths MedSurg books and other resources. I collated the ideas and came up to this presentation...
Hope it will be able to help my colleagues, students and those people who needs to know the what, why's, and how of Cholera!
xoxo ^___^
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. GASTROENTERITIS
Defined as inflammation of the mucous membrane of stomach and
intestine usually causing nausea ,vomiting and diarrhea.
Gastro-intestinal infections represent a major public health and clinical
problem worldwide. Many species of bacteria, viruses and protozoa
cause gastro-intestinal infection.
3. two main clinical syndromes.
1-Non-invasive infection (Enterotoxic syndromes) The organism enters the mucosal cells,
destroys them, causing diarrhea usually with blood in the stool. Or The organisms do not
invade the mucosa, but produce enterotoxins of which act as chemical mediators causing
hypersecretion of the fluid. Little damage to the tissue is done that manifests clinically as
diarrhea and vomiting.
2- Invasive, causing systemic illness, often with few gastro-intestinal symptoms. like
Helicobacter pylori and its associated with gastritis , peptic ulceration and gastric carcinoma.
Gastro-intestinal infections can be transmitted by consumption of contaminated food
.
4. Gastroenteritis Causes:
Viral 50-70% Norwalk virus Caliciviruses ,Rotavirus Adenovirus Parvovirus
,Astrovirus.
Bacterial 15-20% Salmonella, Shigella, and Campylobacter species are the top 3
leading causes of bacterial diarrhea worldwide.
Parasitic 10-15% like Giardia Lambelia ,Entamoeba histolytica and Others.
Development of symptoms after ingestion of gastro-intestinal pathogens depends on
two factors.
Which are :sufficient organisms must be ingested and then survive host defense
mechanisms.
6. Laboratory Diagnosis:
Stool Culture , Hemoccult of stool , Fecal leukocytes,
CBC; If WBC count is elevated increased likelihood of bacterial infection. If eosinophils
present mean parasitic infection).
TREATMENT OPTIONS
Many gastro-intestinal infections are mild and self-limiting and never reach medical
attention.
Where treatment is required, there are three main therapeutic considerations:
7. 1- Fluid and electrolyte replacement is treatment of diarrheal disease.
Most patients can be managed with oral rehydration systems, but
severely dehydrated patients require rapid volume expansion with
intravenous fluids.
2 -Antiemetics and antimotility (antidiarrheal) agents is sometimes
used, especially as self-medication.
3 -Antimicrobial agents useful both in effecting symptomatic
improvement and eliminating of pathogens thus, reducing the risk of
transmitting infection to others.
8. Oral rehydration solutions
In 2004, WHO and UNICEF recommended the use of low-osmolarity
oral rehydration salts (ORS) in association with zinc tablets to treat
all types of diarrhea among all age groups ,The rationale for this was
that zinc supplementation may increase the uptake of ORS and reduce
the severity and duration of the diarrhea episode.
Oral rehydration solutions (glucose/electrolyte mixtures) increase
water absorption by stimulation of sodium-glucose transport in the
small intestine. They are highly effective for combating dehydration
and its serious consequences, and are the treatment of choice in infants
and young children and very elderly.
9. Antimotility agent
Loperamide may cause dangerous prolongation of illness in patients with some forms of
bloody or inflammatory diarrhea and, therefore, should be restricted to patients with non
bloody stool.
bismuth subsalicylate (Pepto-Bismol) is a safe alternative in patients with fever and
inflammatory diarrhea.
10. Probiotics
Defined as are live bacteria and yeasts that are good for your health, especially your
digestive system. useful in the treatment of diarrhea. Probiotics include various
Lactobacillus, Streptococcus.
Several pharmacological effects have been attributed to probiotics include:
1. increased disaccharidase activity
2. production of antibacterial substances
3. competition for bacterial adhesion
4. stimulation of various immune defense mechanisms
11. Antimicrobial agents
The requirement for antibiotic treatment in gastro-intestinal infection depends on;
• causative agent
• type and severity of symptoms
• presence of underlying disease .
12. Management
1-Mild to moderate diarrhea:
Metronidazole (oral or intravenous) or vancomycin (oral) for 10 days
2-Severe or complicated disease:
combined therapy with intravenous metronidazole and oral (or per rectum)
vancomycin may be considered .
3-Traveler’s Diarrhea: a digestive tract disorder that commonly causes loose
stools and abdominal cramps. It's caused by eating contaminated food or drinking
contaminated water.
13. ACUTE DIARRHEA
Diarrhea of < 2 weeks duration is most commonly caused by invasive or noninvasive
pathogens and their enterotoxins.
Acute noninflamatory diarrhea
• Watery, non-bloody (stool)
• Usually mild, self-limited
• Caused by virus or noninvasive bacteria
• Diagnostic evaluation is limited
Acute inflamatory diarrhea
• Blood or pus, (stool)
• Usually caused by an invasive or toxin producing bacterium
• Diagnostic evaluation requires routine stool bacterial culture.
14. CHOLERA
• People get cholera from eating fish that is not cooked
enough (contaminated water ).
• The toxin causes diarrheal disease.
• intestine with a risk of subsequent hypovolaemic shock and
renal failure and death.
15. CHOLERA
Cholera is an infection of the intestine by the bacterium Vibrio cholera.
Symptoms: may range from none, to mild, to severe. The classic symptom is
large amounts of watery diarrhea that continuous for few days. Vomiting and muscle
cramps may also occur. Diarrhea can be so severe that it leads within hours to severe
dehydration and electrolyte imbalance. This may result in sunken eyes, cold skin,
decreased skin elasticity, and wrinkling of the hands and feet. The dehydration may
result in the skin turning bluish. Symptoms start two hours to five days after exposure.
Cholera affects an estimated 3–5 million people worldwide and causes 58,000–130,000
deaths a year as of 2010
17. Cholera can be transmitted by water or by food contaminated with contaminated water.
cholera grows well in warm temperatures, causing marked seasonality in the incidence of
cholera .
Pathogenesis
cholera is a gram-negative becteria , pass through the stomach to small intestine and
produce toxin .The cholera toxin stimulates the intestinal epithelial cells producing
hypersecretion of water and chloride ion and a massive diarrhea.
Death results from hypovolemia.
18. Clinical pointers
1-Abruptly onset of watery diarrhea and vomiting .
2-Large volumes of rice-water stools The liquid stool is without fecal odor, blood, or
pus ("rice water stool") .
3-Dehydration may be severe. Patients suffering from severe dehydration owing to
rapid fluid loss are at risk for death within several hours of disease onset.
4-Metabolic acidosis .
Diagnosis
by Stool cultures .
19. Treatment
1-By replacement of fluids. oral rehydration Solution (ORS) usually is adequate .
2-Intravenous fluids are indicated for persons with signs of severe hypovolemia and those
who cannot take adequate fluids orally .
3- Severe hypokalemia can develop but will respond to potassium given either IV or orally.
4- Antimicrobials administered to patients with cholera decrease the volume of diarrheal
losses, shorten the duration of illness.
20. B- Salmonellae
Salmonellae are enteric gram-negative bacilli that are important because is transmit from
food to humans.
• Nontyphoidal salmonellae (e.g., Salmonella typhimurium and many others) cause the
clinical syndromes of Gastroenteritis.
• Typhoidal salmonellae (Salmonella typhi and Salmonella paratyphi A, B, and C) cause
the syndromes of enteric fever
21. 1-Salmonella Gastroenteritis
• Clinical feature and diagnosis.
Patients with Salmonella gastroenteritis present with an acute fever, diarrhea,
dehydration, and abdominal cramping within 6 to 72 hours of ingestion of
contaminated foods.
• Diagnosis stool culture.
• Treatment
Salmonella gastroenteritis is usually self-limited, and antibiotics have no
proven value. Patients respond well to ORT. Symptoms typically diminish in 3
to 7 days. Antimotility agents should not be used.
22. 2-Enteric Fever
Enteric fever caused by S. typhi is referred to as “typhoid fever,” whereas enteric fever caused
by S. paratyphi is referred to as “paratyphoid fever.”
Symptoms and Signs
1-During the first week, there is an increasing headache, cough, often with abdominal pain and
constipation, while the fever increased gradually.
2-In the second week, the rash (rose spots) but may be very difficult to see . And it disappears in
3–4 days .
3- In third week, intestinal perforation and intestinal hemorrhages may occur.
Not/ Paratyphoid a milder illness than typhoid fever
23. Diagnosis
by blood culture.
Complications:
Usually occurring in the third week . It include Intestinal hemorrhage (may lead to shock),
or intestinal perforation. Other complications such as: pneumonia , meningitis , cholecystitis
and osteomyelitis .
Some patients become chronic carrier ( the patient excrete salmonella from stool for more
than 1 year after infection)
24. Treatment :
1-Fluid uptake and good nutrition.
2-Several other antibiotics, including ampicillin, azithromycin effective for treatment of
enteric fever caused by drug-susceptible strains .
3-The 1–5% of patients who develop chronic carriage of Salmonella can be treated for 4–6
weeks with an appropriate oral antibiotic. Treatment with oral amoxicillin, trimethoprim-
sulfamethoxazole, ciprofloxacin ~80% effective in eradicating chronic carriage of
susceptible organisms.
25. D-Shigellosis
Shigella causes bacillary dysentery (dysentery: refers to a diarrheal stool containing pus and
blood).
Symptoms and Signs
The illness usually starts abruptly, with diarrhea and lower abdominal cramps. The diarrheal
stool often is mixed with blood and mucus. Systemic symptoms are fever, chills, anorexia
and malaise, and headache .
Laboratory Findings Stool culture is positive for shigellae in most cases .P
26. GIARDIASIS
microscopic parasite
E-Parasitic infections:
1-Giardiasis
• Transmitted by contaminated water or food (Symptoms normally begin 1 to 3 weeks after
becoming infected- incubation period )
• Diagnosed by microscopic examination of stool.
Symptoms
•Diarrhea •Gas or flatulence
•Greasy stool that can float
•Stomach or abdominal cramps
•nausea• Dehydration
27. Treatment
1-All symptomatic adults and children over the age of 8 years should be treated with
metronidazole 250 mg three times daily for 7 days, or tinidazole 2 g as a single dose.
2-The pediatric dose of metronidazole is 15 mg/kg per day three times daily for 7 days.
2-Amebiasis
Transmitted by contaminated water or food
Pathology
E. histolytica invades mucosal cells of colonic epithelium lead to tissue necrosis and ulceration .
Sometimes the organisms penetrate the bowel wall and enter the portal circulation, and then it
will be carried to the liver, where it produces abscess and fibrosis .
28. Symptom
1. Intestinal Disease
• Vague abdominal discomfort
• Symptoms may range from malaise to severe abdominal cramps, flatulence, and bloody
diarrhea with mucus . The stools often have an offensive odor .
2- Amebic Liver Abscess
• May present with high fever with significant leukocytosis , and elevated alanine
aminotransferase .
• Physical findings: hepatomegaly, and liver tenderness (a feel of pain when touched ) .
Diagnosis
•Intestinal amebiasis is diagnosed by stool culture.
29. Treatment
1-Metronidazole, diloxanide furoate and paromomycin.
A systemic or tissue-acting agent may be so well absorbed that the amounts of the drug
remaining in the bowel may be insufficient to have local effects .
2-Asymptomatic cyst passers (identified by stool examinations, and who may develop
invasive disease) should receive a luminal agent like diloxanide furoate 500 mg three times
daily for 10 days.
Paromomycin is the preferred agent in pregnant patients .
30. 3-Patients with symptomatic intestinal disease or liver abscess should
receive metronidazole 750 mg three times daily for 10 days, followed by the
luminal agents indicated above since metronidazole does not eradicate cysts
.
The pediatric dose of metronidazole is 50 mg/kg per day in divided doses,
which should be followed by a luminal agent.
Tinidazole administered in a dose of 2 g daily for 3 days is an alternative to
metronidazole. Patients who cannot tolerate oral doses of metronidazole
should receive metronidazole intravenously.