This document discusses two species of hookworm, Necator americanus and Ancylostoma duodenale. It describes their morphology, including size, shape, mouth structures, and sexual characteristics. It also covers their life cycles, which involve eggs passing in feces and developing through larval stages in soil before penetrating the skin of a new host. In the host, the larvae mature into adults that reside in the small intestine and suck blood, potentially causing anemia. Diagnosis is made by finding hookworm eggs on microscopic exam of stool samples. Treatment involves antihelminthic medications like albendazole and mebendazole to kill the parasites.
Hookworm is one of the most important small intestinal nematodes causing iron deficiency anemia. This PPT illustrates hookworms associated with human diseases, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention of hookworm infection.
Hookworm is one of the most important small intestinal nematodes causing iron deficiency anemia. This PPT illustrates hookworms associated with human diseases, life cycle, pathogenesis, laboratory diagnosis, treatment and prevention of hookworm infection.
discussion about nematode,
their form, general characteristics, life cycle, discussion about their host.
diseases caused by nematodes
and discussion about different class of nematodes.
Dear all MBBS student ,
Myself Dr. Manish Tiwari department of microbiology (SMC Medical college unnao) this presentation only for you not for PG students, if any doubt contact me on mail address..
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
3. Necator americanus
(New World Hookworm)
1. The adult parasites are small cylindrical worms, 0.5 - 1.5mm
long.
2. Males are usually 7mm-9mm long, while females are about
9mm-11mm long
3. The posterior end male worm is equipped with a
characteristic copulatory bursa.
4. The females have a vulva situated near the center of the
body- slightly anterior.
5. Have capsules equipped with cutting plates on the ventral
margins, and within the capsule small dorsal teeth.
6. The eggs are bluntly rounded, thin shelled (60 by 40 µm)
4. • Life span- ( 3-5 years)
• Can produce anywhere between 5000 to 10,000
eggs per day.
• Sexual maturity is reached at the final molt. –
Mating occurs in the intestine of the host.
• look for and inject sperm.
• The male coils around a female with his curved
area over the female genital pore.(Gubernaculum)
• Males use spicules to hold open the genital
opening on the female to allow transfer of sperm
5.
6. Scanning electron micrograph of the mouth capsule
of Necator americanus, another species of human
hookworm. Presence of two cutting "teeth“.
8. Ancylostoma duodenale
• grayish white or pinkish with the head slightly bent.
• a definitive hook shape at the anterior end.
• well developed mouths with two pairs of teeth.
• has two ventral plates at the anterior margin of the buccal capsule.
• males measure 1cm by 0.5 mm, the females are often longer and stouter.
• Special features- males have presence of a prominent posterior
copulatory bursa.
9. • Males (8 mm to 11 mm ) long with a copulatory bursa at the
posterior end and needlelike spicules which are not fused and
have simple tips
• Females are 10 mm to 13 mm long with the vulva located at the
posterior end.
• Lay 10,000 to 30,000 eggs per day.
• Life span is one year.
10. Scanning electron micrograph of the mouth
capsule of Ancylostoma duodenale. Presence of
four "teeth," two on each side.
12. The Morphological Differences between Two species
of Hookworms
Characteristics A. duodenale N. americanus
Size larger smaller
Shape single curve, looks like C double curves, looks like S
Mouth 2 pairs of ventral teeth 1pair of ventral cutting
plates
Copulatory Bursa circle in shape oval in shape
caudal spine present no
Copulatory spicule 1pair with separate endings 1pair of which unite to form
a terminal hooklet
vulva position post-equatorial pre-equatorial
17. 1) Eggs of Necator americanus or Ancylostoma duodenale passed from
infected host via feces.
2) The eggs must reach warm and moist soil. Then, the eggs hatched into
rhabditiform larvae in 48 hours. The larvae developes into second stage
of rhabditiform larvae.
3) The rhabditiform larvae molts into filariform larvae which is infective
form by the 5th – 8th day.
4) The filariform larvae penetrate the skin tissue to gain entry to the host.
In host, the larvae migrates via lymphatic or circulatory vessel. Then the
larvae carried through heart to the lungs. Then they penetrate into the
pulmonary alveoli, cough from the bronchial tree to the pharynx and
swallowed to the esophagus.
5) The larvae reach the small intestine, they reside and matures into adult
form. The adults copulate while they attach at the mucosa.
1) Then the eggs passed from the host via feces.
19. PATHOGENESIS
Hookworm infection caused by nematode parasite:
• Necator americanus
• Ancylostoma duodenale
Pathogenesis:
a) larvae form
- Rhabditiform ( non infective stage)
- Filariform ( infective stage)
b) presence of buccal capsules (mouth)
- N.americanus ( consists of cutting plates)
- A. duodenale ( consists of teeth)
21. PATHOGENESIS
The filariform (parasite) attach to the mucosa
layer using the sharp teeth / cutting plates
the nematodes suck the mucosal tissue
digestion of the mucosa
underlying blood vessels are exposed
the blood vessels burst and blood released
from the lesions
23. Clinical manifestation
• The list of signs and symptoms mentioned in various sources
for Hookworm includes the 24 symptoms listed below:
• Symptoms from entry of the worms into the body:
– Itchy foot
– Ground itch
– Pimply rash at worm entry site
– Foot pimply rash
• Lung symptoms - when the larvae of the worms are temporarily in the lungs from
where they later move to the intestines
– Wheezing
– Coughing
• Gastrointestinal symptoms - when the worms infest the bowel or intestines:
– Diarrhea
– Vague abdominal pain
– Intestinal cramps
– Abdominal colic
– Nausea
24. Clinical manifestation
• Gastrointestinal bleeding
– Blood in stool
– Black stools
– For details see also symptoms of gastrointestinal bleeding
• Anemia - from gastrointestinal bleeding and from worms sucking
blood; see symptoms of anemia including:
– Pallor
– Fatigue
– Malaise
26. DIAGNOSIS
Tests that can help diagnose the infection include:
• Complete blood count (CBC)
• Stool ova and parasites exam
27. DIAGNOSIS
• Diagnosis depends on finding characteristic worm eggs on
microscopic examination of the stools.
• The eggs are oval or elliptical, colorless, measuring 60 µm by
40 µm
• As the eggs of both Ancylostoma and Necator are
indistinguishable, to identify the genus, they must be cultured in
the lab to allow larvae to hatch out.
28. DIAGNOSIS
• Development of DNA-based tools for
diagnosis of infection
specific identification of hookworm
analysis of genetic variability within hookworm
populations
• PCR assays
hookworm eggs are often indistinguishable from other
parasitic eggs
PCR assays serve as a molecular approach for accurate
diagnosis of hookworm in the feces.
30. Let’s sing along!!
Hookworm
Involve certain treatments
The medications, such as albendazole
Pyrantel pamoate, revapol, vermicol
Vermidil, vermin, vermox
And there is ,
For emergency care,
It involves the phase, of larval migration
Wheezing and cough, Are managed with
inhaled beta agonists
And when there is established infection
We use effective antihelminthic
And as for the early infection
We may use the thiabendazole
But some hookworm infections
Are asymptomatic
That requires little treatment
And also nutrition
These are all for the treatment
That we need to know
As long as you remember
All the medicines
31. Treatment
Parasite-killing medications are usually prescribed such as:
• Albendazole
• Mebendazole
• Pyrantel pamoate
• Vermox
• Revapol
• Vermicol
• Vermidil
• Vermin
Symptoms and complications of anemia are treated as they
arise. The doctor will likely recommend increasing the
amount of protein in diet.
32. Treatment
Other medications involved are:
– Antihelmintics
This difference permits effective treatment using directed
pharmacologic agents in relatively small doses.
– Albendazole
Decreases ATP production in worm, causing energy depletion,
immobilization and finally death.
– Pyrantel pamoate
Causes worm paralysis by a depolarizing neuromuscular blockade.
33. Treatment for emergency care
• Larval migration phase
• Early infection
• Established infection
35. The most important control measures consist of reducing the
contamination of the soil by:
Education and improved sanitation.
Controlled disposal of human feces.
Treatment of infected persons.
Health education with improved sanitary latrines and use of
footwears.
Avoid pollution of soil with human excreta.
Don’t use raw house sewage for fertilizing the edible plants and
vegetables.
Maintain good nutrition and iron intake without being anemic
37. A 62-year-old Vietnamese man presented with a sore throat and bloody
sputum in September 1997. He had arrived in the United States in 1994 with a
history of bright red blood passed rectally. In early 1995, examination by
barium enema and flexible sigmoidoscopy was unremarkable. His medical
history included six years in a re-education camp in northern Vietnam, where
he had lived in near-starvation conditions. In May 1996, his blood count was
significant for an absolute eosinophil level of 559 per mm3 (0.6 3 109 per L). Dry
cough was noted in June 1997.
Physical examination revealed a well-developed, well-nourished patient with
minimal pharyngeal erythema. The chest radiograph showed a parenchymal
opacity at the base of the right lung. The blood count was unremarkable except
for an eosinophil level of 1,870 per mm3 (1.9 3 109 per L). Three stool samples
were negative for occult blood, but all showed hookworm eggs. The patient
was treated with 10 days of oral penicillin, multivitamins and a single 400-mg
dose of albendazole.
CASE STUDY
38. Epidemiology
Hookworm infection is acquired when larvae from the soil penetrate the skin and
enter the circulation. The spread of this nematode infection is aided by poor
sanitary practices in which infected persons defecate in areas where others walk
without shoes.
Clinical Presentation
Patients may develop dermatitis when filariform hookworm larvae penetrate the
skin. Pulmonary symptoms and signs, such as cough, wheezing and pulmonary
infiltrates, may occur when the larvae pass through the lungs after entering the
circulation. In addition, patients may complain of gastrointestinal discomfort when
the larvae are coughed up, swallowed and then reach adult form in the small
intestine, where the worms attach and suck blood.
EPIDEMIOLOGY AND CLINICAL
PRESENTATION
39. Diagnosis
The diagnosis of hookworm infection is based on the presence of ova in stool.
Laboratory findings may also include iron-deficiency anemia and eosinophilia.
Treatment
Albendazole is a synthetic nitroimidazole with broad-spectrum antinematodal
activity plus anticestodal activity and some antiprotozoal activity.
A single dose of albendazole is effective treatment for most forms of intestinal
helminthiasis. However, the drug is officially labeled in the United States only for
the treatment of neurocysticercosis and Echinococcus infection. Mebendazole
(Vermox), another drug used to treat hookworm, must be given for three days.
Patients with iron-deficiency anemia related to hookworm infection also require
iron supplementation. Albendazole and mebendazole should not be used in
pregnant women.
DIAGNOSIS AND TREATMENT