This document provides an overview of stool analysis procedures, including:
- Specimen collection guidelines such as using leak-proof containers and avoiding refrigeration.
- Macroscopic examination of stool color, consistency, and presence of blood or mucus.
- Wet preparation techniques like saline and lugol's iodine slides.
- Concentration methods like formol-ether and flotation that recover parasites.
- Microscopic examination of samples for parasites, eggs, cysts, and trophozoites using 10x and 40x objectives.
Stool/feces is the end product of digestive system of the body. Following digestion and absorption of the essential food ingredients in the stomach and intestine, the undigested food and unabsorbed secretions of stomach, liver, pancreas and intestine appear in stool.
Stool/feces is the end product of digestive system of the body. Following digestion and absorption of the essential food ingredients in the stomach and intestine, the undigested food and unabsorbed secretions of stomach, liver, pancreas and intestine appear in stool.
CONCENTRATIONS TECHNIQUES IN PARASITOLOGY PRESENTATION.pptxShreyayadav91
INTRODUCTION
Concentration procedure separate parasites from fecal debris and increase the chances of detecting parasitic organisms when these are in small numbers.
If number of organisms in stool specimen is low, examination of a direct wet mount may not detect parasites.
Thus, whenever possible, the stool should be concentrated.
Advantages
Maximizes the numbers of organisms detected which may be too scanty to be seen by direct microscopy alone. Worm eggs, larvae, and protozoan cysts may be recovered.
Disadvantages
Destroys trophozoite stages. Most concentration methods destroy trophozoites stages.
Concentration techniques can be classified as the floatation or sedimentation methods.
Floatation technique
Here solutions with higher specific gravity than the organisms to be floated so that the organisms rise to the top and debris sink to the bottom.
Principle
This technique involves suspending the specimen in a medium of greater density than that of the helminthic eggs and protozoan cysts.
Eggs and cysts float to the top and are collected by placing a glass slides on the surface of the meniscus at the top of the tube.
Floatation Methods includes:
Saturated salt solution technique
Zinc sulfate centrifugal floatation
Sugar floatation technique
Saturated salt solution technique
Procedure:
About half tea spoon (about 4 gm) of fresh stool or preserved stool in a flat bottomed container with 20 ml capacity.
Now, few drops of saturated salt solution (specific gravity 1.20) is added and stirred to make a fine emulsion.
More salt solution is added with stirring throughout to fill the container up to the brim, until a convex meniscus is formed.
A glass slide (3”*2”) is carefully laid on the top of the container so that the center is in contact with the fluid.
This preparation is allowed to stand for 20 minutes after which the glass slide is quickly lifted and examined under microscope after putting coverslip.
Zinc sulfate centrifugal floatation
Procedure
Make a fine suspension of about 1 g of feces in 10 m L of water and strain through gauze to remove coarse particles.
Collect the liquid in a small test tube and centrifuge for 1 minute at 2,500 revolutions per minute. Pour off the supernatant, add water, resuspend, and centrifuge in the same manner, repeating the process, till the supernatant is clear.
Pour off the clear supernatant, add a small quantity of zinc sulfate solution (specific gravity 1.18- 1.2) and resuspend the sediment well.
Add zinc sulfate solution to a little below the brim and centrifuge at 2,500 revolution per minute for 1 minute.
Take samples care fully from the surface, using a wire loop, transfer to slide and examine under the microscope. A drop of dilute iodine helps to bring out the protozoan cysts in a better way.
This technique is useful for protozoan cysts and eggs of nematodes and small tapeworms, but it does not detect unfertilized roundworm eggs, nematode larvae, and eggs of most trematodes and large tapeworms.
CONCENTRATIONS TECHNIQUES IN PARASITOLOGY PRESENTATION.pptxShreyayadav91
INTRODUCTION
Concentration procedure separate parasites from fecal debris and increase the chances of detecting parasitic organisms when these are in small numbers.
If number of organisms in stool specimen is low, examination of a direct wet mount may not detect parasites.
Thus, whenever possible, the stool should be concentrated.
Advantages
Maximizes the numbers of organisms detected which may be too scanty to be seen by direct microscopy alone. Worm eggs, larvae, and protozoan cysts may be recovered.
Disadvantages
Destroys trophozoite stages. Most concentration methods destroy trophozoites stages.
Concentration techniques can be classified as the floatation or sedimentation methods.
Floatation technique
Here solutions with higher specific gravity than the organisms to be floated so that the organisms rise to the top and debris sink to the bottom.
Principle
This technique involves suspending the specimen in a medium of greater density than that of the helminthic eggs and protozoan cysts.
Eggs and cysts float to the top and are collected by placing a glass slides on the surface of the meniscus at the top of the tube.
Floatation Methods includes:
Saturated salt solution technique
Zinc sulfate centrifugal floatation
Sugar floatation technique
Saturated salt solution technique
Procedure:
About half tea spoon (about 4 gm) of fresh stool or preserved stool in a flat bottomed container with 20 ml capacity.
Now, few drops of saturated salt solution (specific gravity 1.20) is added and stirred to make a fine emulsion.
More salt solution is added with stirring throughout to fill the container up to the brim, until a convex meniscus is formed.
A glass slide (3”*2”) is carefully laid on the top of the container so that the center is in contact with the fluid.
This preparation is allowed to stand for 20 minutes after which the glass slide is quickly lifted and examined under microscope after putting coverslip.
Zinc sulfate centrifugal floatation
Procedure
Make a fine suspension of about 1 g of feces in 10 m L of water and strain through gauze to remove coarse particles.
Collect the liquid in a small test tube and centrifuge for 1 minute at 2,500 revolutions per minute. Pour off the supernatant, add water, resuspend, and centrifuge in the same manner, repeating the process, till the supernatant is clear.
Pour off the clear supernatant, add a small quantity of zinc sulfate solution (specific gravity 1.18- 1.2) and resuspend the sediment well.
Add zinc sulfate solution to a little below the brim and centrifuge at 2,500 revolution per minute for 1 minute.
Take samples care fully from the surface, using a wire loop, transfer to slide and examine under the microscope. A drop of dilute iodine helps to bring out the protozoan cysts in a better way.
This technique is useful for protozoan cysts and eggs of nematodes and small tapeworms, but it does not detect unfertilized roundworm eggs, nematode larvae, and eggs of most trematodes and large tapeworms.
Breif discussion about the organism and food through which the outbreaks have occured. It is also added with Bacteriological Analytical Methods (BAM) for the isolation and enumeration of the organism from the food sample.
It is generally recognized that stained fecal films are the single most productive means of stool examination for intestinal protozoa. The permanent stained smear facilitates detection and identification of cysts and trophozoites and affords a permanent record of the protozoa encountered. Small protozoa, missed by wet mount examinations (of either unconcentrated or concentrated samples) are often seen on the stained smear. The Wheatley Trichrome technique for fecal specimens is a modification of Gomori's original staining procedure for tissue. It is a rapid, simple procedure, which produces uniformly well-stained smears of the intestinal protozoa, human cells, yeast, and artifact material.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
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!
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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.
2. For whom stool analysis is required?
• Patient with abdominal pain.
• Patients with diarrhea.
• Patients with anemia.
• Patients with abnormal stool color.
• Too thin or do not grow well.
Specimen Collection for Stool Samples
• Stool samples are collected in clean, dry, leak-proof containers (not required to be sterile!!), since
fecal specimens contain many strains of normally occurring organisms.
• Three consecutive samples are tested!
• Don’t refrigerate the sample. test within 1 hour.
• Never leave stool specimens exposed to the air in containers without lids.
• Patient should avoid medication that affect the result (anti-parasite).
• Patients should be made aware that samples should not be contaminated with water, cleaners or
with urine!!
• Interference substances: Antibiotics, antiseptics, laxatives, mineral oil, soap.
Alyazeed hussein, BSc-SUST
3. Macroscopic & physical examination of stool
Color: A normal stool is brown (stercobilin pigment). Normal stool color of infants is yellow-green.
• Abnormal:
• Clay colored (gray white) or pale stool (obstructing jaundice).
• Bright red > lower gastrointestinal bleeding (inflammation, anal fissure, hemorrhoids, tumors).
• Green color > medication and vitamins.
• Black > upper gastrointestinal bleeding (peptic ulcer, stomach carcinoma), or iron medication (anemia).
Consistency:
• Normal: formed.
• Abnormal: Hard (constipation), semi formed & soft (parasitic infections), loose (diarrhea),
watery (bacterial infections), rice watery (cholera), steatorrhea (Giardiasis).
pH: Normal: alkaline, varying according to type of diet. Acidic (amoebic dysentery), alkaline (shigellosis).
Mucus: normally: few undetectable amount mixed with stool, high amount with pus indicate bacterial
infection, mucus with blood indicate amoebiasis.
Blood: Nil. Blood seen in case of lower GIT bleeding (Bilharziasis, anal fissure, hemorrhoids).
parasites: Nil. Parasites (worms) seen by naked eye: Ascaris lumbricoides, Enterobius vermicularis, Taenia spp.
Alyazeed hussein, BSc-SUST
4. Adult worm of Taenia spp.
Gravid (proglottid) segment
Adult worm of E. vermicularis
Adult worms of A. lumbricoidesAlyazeed hussein, BSc-SUST
5. Stool preservatives:
1. 5%–10% formalin (helminths eggs, larvae and protozoan cysts), concentration
techniques.
2. Polyvinyl alcohol (PVA) for protozoan trophozoites (E. histolytica), cysts and
helminths eggs and larvae.
3. Merthiolate –Iodine Formalin MIF, good for wet preparations and
concentration techniques (preservation and staining).
4. Sodium acetate–acetic acid–formalin (SAF) for protozoan cysts, trophozoites (E.
histolytica) and helminths eggs, larvae. For concentration techniques.
5. Bayer’s solution (modified formalin solution containing copper chloride, glacial
acetic acid, and formalin) for long period.
• Formed stools may be refrigerated for 1–2 days
Alyazeed hussein, BSc-SUST
6. Parasite stagesMaximum time for
examination
Stool
consistency
Trophozoites, helminth eggs, larvae30 minutesLiquid
Trophozoites, cysts, helminth eggs, larvae1 hourSemisolid
Cysts, helminth eggs, larvae24 hoursFormed
• Blood and mucus may be found in faeces from patients with amoebic dysentery, intestinal
schistosomiasis, invasive balantidiasis (rare infection), and in severe T. trichiura infections. Other
non-parasitic conditions in which blood and mucus may be found include bacillary dysentery,
Salmonellosis, Intestinal TB, Campylobacter enteritis, ulcerative colitis, intestinal tumor, and
hemorrhoids.
• Pasty stool with high fat content is suggestive of CBD Obstruction, Cystic fibrosis.
• Translucent gelatinous mucous on the surface of the formed stool is found in Spastic Constipation,
colitis.
Alyazeed hussein, BSc-SUST
7. Stool examination
Wet preparation:
I. 0.85% Normal saline (NaCl) preparation.
II. 1% Lugol's iodine preparation.
III. Permanent stain for best morphology.
Concentration techniques, more sensitive than direct wet mount
(detect small numbers of parasites):
I. Formol-ether concentration technique (FECT)
II. Flotation technique (zinc sulphate).
Alyazeed hussein, BSc-SUST
9. Wet preparation normal saline &
Lugol's iodine (Direct smear)
• Place a drop of normal saline (NaCl) or Lugol's
iodine is on a clean microscopic slide. Take a
small amount 2 mg, (matchstick head amount) of
stool with wooden stick. Mix well. Place coverslip,
avoid air bubbles formation!
• Examine under microscope.
• Note that! any part contain mucus, blood and pus
should be included & examined firstly (touch
different parts of stool).
• It is a rapid method for detect ova, cysts and
motile form of parasites, but not sensitive (light
infection).
• Iodine stain cysts, nucleus, glycogen (good
contrast). Note that! iodine kill the parasite
(motile form!).
Alyazeed hussein, BSc-SUST
10. Examination of dysenteric and unformed specimens:
• Using a wire loop or piece of stick, place a small amount of specimen, to
include blood and mucus on one end of a slide. Without adding saline,
cover with a cover glass and using a tissue, press gently on the cover glass
to make a thin preparation.
• Place a drop of eosin reagent on the other end of the slide. Mix a small
amount of the specimen with the eosin and cover with a cover glass. Eosin
does not stain living trophozoites but provides a pink background which
can make them easier to see.
Alyazeed hussein, BSc-SUST
11. Concentration techniques
(concentrate & separate the
parasites from fecal debris)
Formol-ether concentration technique (FECT): concentrate the parasites in
sediment, formalin for fixation, ether cleans the specimen by dissolving
and float the fat & fecal debris. Recovers eggs, larvae & cysts.
• Procedure:
1. Using a rod or stick, transfer a 1 g (pea-size) of faeces into 7 ml of 10%
formalin and mix well.
2. Sieve (tea strainer or gauze) and collect the suspension in a conical
(centrifuge) tube 15 ml.
3. Add 3 ml of ether, cap the tube then mix well by shaking for 1 minute.
4. Centrifuge at 1500 – 2500 rpm for 5 – 10 minutes.
5. Four layers will be formed, using a stick loosen the layer of fecal debris
from the side of the tube and invert the tube to discard the top three
layers leaving the sediment.
6. Place a drop of sediment and examine microscopically (10X and 40X).
Alyazeed hussein, BSc-SUST
12. Concentration techniques (cont.)
Flotation technique (33% zinc sulfate): floats parasites free of fecal debris by using
a solution having a specific gravity (1.180-1.200) greater than the parasites, good
for G. lamblia, E. histolytica and eggs of H. nana. Note that! This method not
suitable for operculated and larger eggs since they are too heavy to float, and the
protozoan cysts become distorted (difficult to identify). Ether is flammable!!
• Procedure:
1. In a glass beaker contain (3 – 4 ml) of zinc sulphate solution mix about 1 g of
faeces (or 2 ml if a fluid sample). Transfer the suspension to test tube.
2. Fill the tube with zinc sulphate. Using a Pasteur pipette, add the solution drop
by drop to fill the tube up to the top.
3. Carefully place a clean cover glass on top of the tube.
4. Leave undisturbed for 30 – 45 minutes!!!(don’t leave longer, the cysts become
distorted and the eggs will be being to sink.
5. Carefully remove the cover glass from the tube, place the cover glass face
downwards on a slide. Alternatively, the tube is centrifuged at 2500 rpm for 2
minutes, take a drop from the surface (supernatant).
6. Examine microscopically (10X and 40X). Alyazeed hussein, BSc-SUST
13. Permanent stains for faecal smears
• Trophozoites and cysts of the intestinal amoebae, flagellates and ciliates can be found and identified best in
permanently stained faecal smears.
1. Trichrome stain (fresh+Schaudinn’s or PVA preserved samples): for trophozoites or cysts of protozoa:
70% alcohol 2 min> 5 min in a mixture of iodine & 70% alcohol> 70% alcohol 2 times> stain in trichrome stain
10 min> acid alcohol 2-3 sec> dip slide in 95% alcohol then 100% alcohol then xylene> mounting medium
(DPX)> coverslip.
2. Iron haematoxylin stain (fresh, PVA or SAF preserved samples):
70% alcohol 5 min> 50% alcohol 2 min> tape water 5 min> haematoxylin stain 10 min> D.W 1 min> picric acid
1 min> tape water 10 min> 70% alcohol+1 drop of ammonia for 5 min> 95% alcohol 5 min> 100% alcohol then
xylene> mounting medium> coverslip.
3. Modified Kinyoun's Ziehl-Neelsen technique (acid-fast stain), for coccidia e.g. C. parvum:
Thin smear, air-dry fixed in methanol for 2-3 min> stain with cold carbol-fuchsin 5-10 min> differentiate in 1%
HCL-ethanol> rinse in tape water> counter stain with 0.25% malachite green or methylene blue 30 sec> rinse
in tape water.
Alyazeed hussein, BSc-SUST
14. Special technique
• Adhesive tape (cellophane)
method for detecting of
Enterobius vermicularis
(pinworm) eggs:
1. Prepare the tape.
2. Take sample on peri-anal
skin in the morning.
3. Stick tape on microscope
slide.
Cotton swab (dipped in
saline also can be used.
Fingernails.
1 2 3
Alyazeed hussein, BSc-SUST
16. Microscopic examination
• The 10x objective: eggs and larvae of helminths and of ciliates.
• The 40x objective: most of the protozoans.
• Oil immersion+Lugol’s solution smear: differentiation of species.
Alyazeed hussein, BSc-SUST
17. Fertile egg
Fertile egg (infective stage)
with larvae
Infertile egg Infertile decorticated
egg
Fertile decorticated
eggInfertile egg
Larvae from a broken egg
Ascaris lumbricoides
Alyazeed hussein, BSc-SUST
52. Infection control
Faecal specimens, like other specimens received in the laboratory, must be
handled with care to avoid aquiring infection from infectious parasites, bacteria
and viruses.
• Infective forms of parasites such as S. stercoralis, E. vermicularis, taenia spp, E.
histolytica, G. lamblia, B. coli and C. parvum.
• Bacteria such as Shigella, Salmonella and V. cholerae.
• Viruses such as hepatitis A, E and rotavirus.
Alyazeed hussein, BSc-SUST
53. In the minds of most laboratory personnel, analysis of fecal specimens
fits into the category of a “necessary evil” and few enjoy such tasks
• This has been a presentation of Alyazeed Hussein.
• Thanks for your attention and kind patience.
• Any questions, additions, or comments?
Alyazeed hussein, BSc-SUST
54. References
• Clinical Parasitology A PRACTICAL APPROACH, 2nd e
• Medical parasitology 5th e
• Bailey & Scott's DIAGNOSTIC MICROBIOLOGY, 14th e
• CDC.
• A handbook of medical laboratory technology 2nd e
• Fundamentals of the study of urine and body fluids, Springer.
• www.researchgate.com
Alyazeed hussein, BSc-SUST
