A comprehensive description of leischmaniasis with its types, transmission, epidemiology, pathogenesis, prevention and control. It also includes details regarding lab diagnosis, disease agent, vector and host.
A comprehensive description of leischmaniasis with its types, transmission, epidemiology, pathogenesis, prevention and control. It also includes details regarding lab diagnosis, disease agent, vector and host.
Visceral leishmaniasis (VL), also known as kala-azar, is the most severe form of leishmaniasis caused by the protozoan parasite Leishmania donovani and transmitted by the infected sandflies. It characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia.
LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
Largest viruses that infect vertebrates
Can be seen under light microscope
Poxvirus diseases are characterized by skin lesions – localized or generalized
Important diseases caused by poxviruses are-
Smallpox
Monkeypox
Cowpox
Tanapox
Molluscum contagiosum
Leishmaniasis is caused by a protozoa parasite from over 20 Leishmania species. Over 90 sandfly species are known to transmit Leishmania parasites. There are 3 main forms of the disease:
Visceral leishmaniasis (VL), also known as kala-azar is fatal if left untreated in over 95% of cases. It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. Most cases occur in Brazil, East Africa and in South-East Asia. An estimated 50 000 to 90 000 new cases of VL occur worldwide each year out of which only an estimated 25–45% are reported to WHO. In 2017, more than 95% of new cases reported to WHO occurred in 10 countries: Bangladesh, Brazil, China, Ethiopia, India, Kenya, Nepal, Somalia, South Sudan and Sudan.
Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis and causes skin lesions, mainly ulcers, on exposed parts of the body, leaving life-long scars and serious disability or stigma. About 95% of CL cases occur in the Americas, the Mediterranean basin, the Middle East and Central Asia. In 2017 over 95% of new CL cases occurred in 6 countries: Afghanistan, Algeria, Brazil, Colombia, Iran (Islamic Republic of), Iraq and the Syrian Arab Republic. It is estimated that between 600 000 to 1 million new cases occur worldwide annually.
Mucocutaneous leishmaniasis leads to partial or total destruction of mucous membranes of the nose, mouth and throat. Over 90% of mucocutaneous leishmaniasis cases occur in Bolivia (the Plurinational State of), Brazil, Ethiopia and Peru.
Transmission
Leishmania parasites are transmitted through the bites of infected female phlebotomine sandflies, which feed on blood to produce eggs. The epidemiology of leishmaniasis depends on the characteristics of the parasite and sandfly species, the local ecological characteristics of the transmission sites, current and past exposure of the human population to the parasite, and human behaviour. Some 70 animal species, including humans, have been found as natural reservoir hosts of Leishmania parasites.
(WHO, 2019)
https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
A basic description of Leishmania spp. along with Old and New world Leishmaniasis regarding Parasite morphology, Life Cycle, Pathogenesis, Clinical manifestations, Laboratory Diagnosis and Treatment.
By the end of this presentation we’ll be able to learn about- -Geographical distribution of leishmania parasites- Know the different stages of leishmania parasites and their morphology.-Describe the lifecycle of leishmania.-Causes and pathogenesis of leishmania -Preventive measures of leishmaniasis
LA LEISHMANIASIS EN UNA ENFERMEDAD CAUSADA POR UNA FAMILIA DE PARASITOS QUE ESTAN DISPERSOS POR LAS ZONAS PROXIMAS AL ECUADOR, CUYAS CONSECUENCIAS VARIAN MUCHO DE ACUERDO A LA UBICACION GEOGRAFICA
Visceral leishmaniasis (VL), also known as kala-azar, is the most severe form of leishmaniasis caused by the protozoan parasite Leishmania donovani and transmitted by the infected sandflies. It characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia.
LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
Largest viruses that infect vertebrates
Can be seen under light microscope
Poxvirus diseases are characterized by skin lesions – localized or generalized
Important diseases caused by poxviruses are-
Smallpox
Monkeypox
Cowpox
Tanapox
Molluscum contagiosum
Leishmaniasis is caused by a protozoa parasite from over 20 Leishmania species. Over 90 sandfly species are known to transmit Leishmania parasites. There are 3 main forms of the disease:
Visceral leishmaniasis (VL), also known as kala-azar is fatal if left untreated in over 95% of cases. It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. Most cases occur in Brazil, East Africa and in South-East Asia. An estimated 50 000 to 90 000 new cases of VL occur worldwide each year out of which only an estimated 25–45% are reported to WHO. In 2017, more than 95% of new cases reported to WHO occurred in 10 countries: Bangladesh, Brazil, China, Ethiopia, India, Kenya, Nepal, Somalia, South Sudan and Sudan.
Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis and causes skin lesions, mainly ulcers, on exposed parts of the body, leaving life-long scars and serious disability or stigma. About 95% of CL cases occur in the Americas, the Mediterranean basin, the Middle East and Central Asia. In 2017 over 95% of new CL cases occurred in 6 countries: Afghanistan, Algeria, Brazil, Colombia, Iran (Islamic Republic of), Iraq and the Syrian Arab Republic. It is estimated that between 600 000 to 1 million new cases occur worldwide annually.
Mucocutaneous leishmaniasis leads to partial or total destruction of mucous membranes of the nose, mouth and throat. Over 90% of mucocutaneous leishmaniasis cases occur in Bolivia (the Plurinational State of), Brazil, Ethiopia and Peru.
Transmission
Leishmania parasites are transmitted through the bites of infected female phlebotomine sandflies, which feed on blood to produce eggs. The epidemiology of leishmaniasis depends on the characteristics of the parasite and sandfly species, the local ecological characteristics of the transmission sites, current and past exposure of the human population to the parasite, and human behaviour. Some 70 animal species, including humans, have been found as natural reservoir hosts of Leishmania parasites.
(WHO, 2019)
https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
A basic description of Leishmania spp. along with Old and New world Leishmaniasis regarding Parasite morphology, Life Cycle, Pathogenesis, Clinical manifestations, Laboratory Diagnosis and Treatment.
By the end of this presentation we’ll be able to learn about- -Geographical distribution of leishmania parasites- Know the different stages of leishmania parasites and their morphology.-Describe the lifecycle of leishmania.-Causes and pathogenesis of leishmania -Preventive measures of leishmaniasis
LA LEISHMANIASIS EN UNA ENFERMEDAD CAUSADA POR UNA FAMILIA DE PARASITOS QUE ESTAN DISPERSOS POR LAS ZONAS PROXIMAS AL ECUADOR, CUYAS CONSECUENCIAS VARIAN MUCHO DE ACUERDO A LA UBICACION GEOGRAFICA
Anthelmintics or antihelminthics are drugs that expel parasitic worms and other internal parasites from the body by either stunning or killing them and without causing significant damage to the host. They may also be called vermifuges or vermicides.
Leishmaniasis is a vectorborne disease that is transmitted by sand flies and caused by obligate intracellular protozoa of the genus Leishmania. Human infection is caused by more than 20 species. These include the L. donovani complex with 2 species (L. donovani, L. infantum [also known as L. chagasi in the New World]); the L. mexicana complex with 3 main species (L. mexicana, L. amazonensis, and L. venezuelensis); L. tropica; L. major; L. aethiopica; and the subgenus Viannia with 4 main species (L. [V.] braziliensis, L. [V.] guyanensis, L. [V.] panamensis, and L. [V.] peruviana). The different species are morphologically indistinguishable, but they can be differentiated by isoenzyme analysis, molecular methods, or monoclonal antibodies.
Leishmaniasis is a wide array of clinical manifestations caused by parasites of the Trypanosomatida genus Leishmania. It is generally spread through the bite of phlebotomine sandflies, Phlebotomus and Lutzomyia, and occurs most frequently in the tropics and sub-tropics of Africa, Asia,
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
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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
1. Leishmania
Dr N P Singh
Professor
Deptt. Of Microbiology
2. Leishmania
Phylum Sarcomastigophora
Order Kinetoplastida
Family Trypanosomatidae
Genus Leishmania
• Transmitted to the mammalian hosts by the bite of
infected sandflies, Phlebotomus and Lutzomyia
3. • Currently, leishmaniasis occurs in 4 continents and is
considered to be endemic in 88 countries, 72 of which are
developing countries:
90% of all VL: Bangladesh, Brazil, India, Nepal and
Sudan
90% of all MCL: Bolivia, Brazil and Peru
90% of all CL : Afghanistan, Brazil, Iran, Peru, Saudi
Arabia and Syria
• Annual incidence: 1- 1.5 million cases of CL
: 500,000 cases of VL
• Prevalence: 12 million people
• Population at risk: 350 million
(WHO, 2010)
4. SITUATION IN INDIA
• 40-50% of global burden
(Bora 1999, Natl Med J India)
• Surveillance being done by
NVBDCP
• INDIA: 15538 cases and 47
deaths by VL (2010)
• Endemic states in Eastern
India: Bihar, Jharkhand, West
Bengal, Uttar Pradesh
• Estimated 165.4 million
population at risk in 4 states
(NVBDCP, 2010)
5. • On the basis of development, divided in two genera:
Subgenus Leishmania: in the anterior part of alimentary
tract of sandfly
Subgenus Viannia: midgut and hindgut of sandfly
Leishmania L. major complex (L. major) Old
L. tropica complex (L. tropica, L. killicki) World
L. aethiopica complex (L. aethiopica)
L. donovani complex (L. donovani, L. infantum)
L. donovani complex (L. chagasi) New
L. mexicana complex World
(L. mexicana, L. venezuelensis, L. garnhami,
L. amazonensis, L.pifanoi)
Viannia L. braziliensis complex (L. braziliensis, L. peruviana, L.
columbiensis, L. lainsoni)
L. guyanensis complex (L. guyanensis, L. panamensis)
13. • Most severe form of the disease, may be fatal if
left untreated
• Usually associated with fever, weight loss, and an
enlarged spleen and liver
• Anemia (low RBC), leukopenia (low WBC), and
thrombocytopenia (low platelets) are common
• Lymphadenopathy may be present
• Visceral disease from the Middle East is usually
milder with less specific findings than visceral
leishmaniasis from other areas of the world
14. Post Kala Azar Dermal
Leishmaniasis
• Normally develops <2 years after recovery
• Recrudescence
• Restricted to skin
• Rare but varies geographically
15. Cutaneous Leishmaniasis
• Most common form
• Characterized by one or more sores, papules or
nodules on the skin
• Sores can change in size and appearance over
time
• Often described as looking somewhat like a
volcano with a raised edge and central crater
• Sores are usually painless but can become painful
if secondarily infected
• Swollen lymph nodes may be present near the
sores (under the arm if the sores are on the arm
or hand…)
16.
17. Cutaneous Leishmaniasis
• Most sores develop within a few weeks of the sandfly
bite, however they can appear up to months later
• Skin sores of cutaneous leishmaniasis can heal on their
own, but this can take months or even years
• Sores can leave significant scars and be disfiguring if
they occur on the face
• If infection is from L. tropica it can spread to
contiguous mucous membranes (upper lip to nose)
18. Mucocutaneous Leishmaniasis
• Occurs with Leishmania species from Central and South
America
• Very rarely associated with L. tropica which is found in the
Middle East
- This type occurs if a cutaneous lesion on the face spreads
to involve the nose or mouth
- This rare mucosal involvement may occur if a skin
lesion near the mouth or nose is not treated
• May occur months to years after original skin lesion
• Hard to confirm diagnosis as few parasites are in the lesion
• Lesions can be very disfiguring
20. Direct evidence:
Demonstration of Leishmania
Specimens that may be collected
• Splenic aspirate and biopsy
• Liver biopsy
• Bone marrow (Sternum or iliac crest)
• FNAC and biopsy
• Blood buffy coat
• Tegumantary leishmaniasis- dermal scrapings, sections
from skin biopsy
DEMONSTRATION OF Leishmania
AMASTIGOTES/ L.D. BODIES
22. CULTURE
Culture media for axenic culture
• SOLID MEDIUM
NNN medium
Evan’s modified Tobie’s medium
• LIQUID MEDIA
Schneider’s Drosophila medium
Grace’s insect tissue culture medium
DEMONSTRATION OF Leishmania PROMASTIGOTES
Animal inoculation
• Golden hamsters inoculated intraperitoneally
25. Indirect Fluorescent
Antibody test
• Detection of anti-leishmanial
antibody using fixed promastigotes
• Demonstrated in the very early
stages of infection and
undetectable six to nine months
after cure
• Titers >1:20 are significant and
above 1:128 are diagnostic
• Cross reaction with trypanosomal
sera (overcome by
using Leishmania amastigotes as
the antigen instead of the
promastigotes)
26. Direct Agglutination Test
• Use of whole, stained • Relative long incubation time
promastigotes either as a of 18 hours
suspension or in a freeze-dried • Need for serial dilutions of
form. serum
• The freeze-dried form is heat • No prognostic value
stable • Remain positive for several
• Utilized for field purposes years after cure
27. Modifications of DAT
• Fast Agglutination Screening Test
(Schoone et al, 2001)
Need of only 1 serum dilution
Rapid: results available in less than 3 hours
• EasyDAT method
(Gomez-Ochoa et al, 2003, Clin Diagn Lab Immunol)
29. Many antigens have been explored for the diagnosis of
leishmaniasis:
• Whole soluble antigens (Ld-ESM—Excretory, secretory and
metabolic antigen by L.donovani)
• Purified antigens such as fucose- mannose
• Defined, synthetic peptides
• Recombinant antigens
rGBP (L.major protein encoding a hydrophilic protein)
rORFF (L. infantum)
gp63
rK39
rK26, rK9
rKE16
30. rK39
• Rapid dipstick test
• Based on the recombinant k39 protein, a 39-amino acid
cloned in Escherichia coli, from the C terminus of the
kinesin protein of Leishmania major in India
31. • Case definition for enrolling a subject
“A case presenting to a clinician with a fever of more
than two weeks duration, with splenomegaly and not
responding to the full course of anti-malarials”
• Sensitivity-100%, Specificity-97% (NVBDCP, 2010)
• Not to be used in the following cases:
Kala-azar relapses
In cases of kala-azar re-infection
Kala-azar and HIV co-infection
• This test has been incorporated in NVBDCP for the
diagnosis of VL in India.
32. Prevention
• Suppress the reservoir: dogs, rats, gerbils, other small
mammals and rodents
• Suppress the vector: Sandfly
• Critical to preventing disease in stationary troop populations
• Prevent sandfly bites: Personal Protective Measures
• Most important at night
• Sleeves down
• Insect repellent w/ DEET
• Permethrin treated uniforms
• Permethrin treated bed nets
33. Treatment
Cutaneous and Mucocutaneous
• Antimony (Pentostam®, Sodium stibogluconate) is the drug
of choice
• Given under an experimental protocol at Walter Reed Army Medical
Center (WRAMC)
• 20 days of intravenous therapy
• Available at WRAMC for all branches of the military
• Requires patient to come to WRAMC
• Fluconazole may decrease healing time in L. major infection
• Biopsy and culture to determine species is required
• Six weeks of therapy is needed
34. Visceral Leishmaniasis
• Liposomal amphotericin-B (AmBisome®) is the drug of
choice
• 3 mg/kg per day on days 1-5, day 14 and day 21
• Pentostam® is an alternative therapy
• 28 days of therapy is required
• Although AmBisome® is widely available, the difficulty of
accurate diagnosis and the potential severity of visceral
infection suggest possible patients be referred to the
Leishmania Treatment Center at WRAMC for maximal
diagnostic efficiency
35. Vaccine
• There is as yet no effective vaccine for prevention
of any form of leishmaniasis.
• first generation vaccine was prepared using
whole killed parasites combined or not with BCG.
• Live: including new genetically modified
constructs
• 1st generation vaccines: whole killed parasite
with/without adjuvants or fractions of the
parasite
• 2nd generation vaccines: recombinant proteins,
DNA vaccines & combinations