It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
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.
prof . dr. ihsan edan alsaimary
department of microbiology - college of medicine - university of basrah - basrah -IRAQ
ihsanalsaimary@gmail.com
00964 7801410838
Vibrio cholera and Halophilic vibrio.pptDrmayuribhise
A 4-year-old boy developed severe watery diarrhea and vomiting. The stool collected has a rice water type of appearance. It was sent for bacteriological analysis.
a. What is the probable etiological diagnosis of this condition?
b. Describe in detail the pathogenesis of this condition.
c. Add a note on its laboratory diagnosis.
Which of the following media can be used as transport medium for vibrio?
a. Selenite F broth
b. Nutrient broth
c. Tetrathionate broth
d. Venkatraman–Ramakrishnan medium
All of the following tests can differentiate between classical and El Tor biotypes of V. cholerae, except:
a. β-hemolysis on sheep blood agar
b. Chick erythrocyte agglutination
c. Growth on TCBS agar
d. Polymyxin B (50 IU)
Pathogenesis of V. cholerae involves one of the following second messenger systems:
a. cGMP
b. cAMP
c. Ca2+
d. IP3
Selective media for Vibrio cholerae:
a. TCBS
b. Mannitol salt agar
c. Robertson cooked meat medium
d. Modified Thayer Martin medium
All of the following Vibrio species are halophilic, except:
a. V. cholerae
b. V. parahaemolyticus
c. V. alginolyticus
d. V. vulnificus
O139 (Bengal strain)—all are true, except:
a. Capsulated
b. Toxigenic
c. Clinically similar to El Tor
d. More common than El Tor
All are selective media for V. cholerae, except:
Alkaline peptone water
Alkaline bile salt agar
TCBS agar
Monsur’s agar (GTTTA) medium
Which of the following confirms the isolate of V. cholerae as Hikojima serotype?
a. If agglutinated with Ogawa antisera
b. If agglutinated with Inaba antisera
c. If agglutinated with Hikojima antisera
d. If agglutinated with both Ogawa and Inaba antisera
Gram negative
Rigid, curved rods
“Vibrio” – vibratory motility
Non - sporing
Non - capsulated
Present in marine environments & surface waters worldwide
1854 – observed by Pacini
1883 – first isolated by Koch
Vibrio cholerae Top
V. cholerae was first described as the cause of cholera by Pacini in 1854. Pathogenic V. cholerae
produces a heat-sensitive enterotoxin that causes the characteristic cholera symptoms, including
"rice water stool." The species comprises several somatic (O) antigen groups, including O-group1, which is associated with classical and El Tor biotypes. V. cholerae Ol may have several
serotypes, including Inaba, Ogawa, and Hikojima. V. cholerae non-O1 (referred to in older
literature as nonagglutinable or NAG vibrios) also can cause gastrointestinal disease, though
typically less severe than that caused by V. cholerae O1 (Yamamoto et al., 1983). Serotype O139
is an exception, and produces classic cholera symptoms. This serotype was first identified in
1992 (CWG, 1933) as the cause of a new epidemic of cholera in India and Bangladesh. Non-O1
V. cholerae is found more readily in estuarin! e waters and seafood in the United States than is
the Ol serogroup; however, the 0139 serogroup has not yet been found here. Because this species
can grow in media lacking sodium chloride, it is not considered a halophilic Vibr
In Charaka explains Dashavidha Pariksha Bhavas and
while explaining the aspect of of Desha, Desha is divided into
Bhumi and Deha Desha,Under Deha Desha, Dasha Vidha Atura Pariksha are explained,Dashavidha pariksha is one of important daignostic tool explained in Ayurveda ,in the context of दशविध परीक्षा भािा’ s.
in Ayurveda,Ashtashana pareeksha is one among the different
methods of rogi pareeksha.
• It is mentioned in yogaratnakara.
• Here the physician examines 8 specific sites of patients.
astasthana pareeksha-
1.Nadi -The pulse
2.Mootram – The urine
3.Malam --The faeces
4.Jihwa – The tongue
5.Sabda – The voice
6.Sparsa – Examination by palpation
7.Drik -- The eyes
8.Akriti – Dimentions of the body
Disease is very old nothing has changed it is we who
changed,The one which gives pain to body called roga,Nidana means the factors responsible for producing disease ie. etiological factors
The science with describes roga by means of nidana
purvaroopa,roopa,samprapthi,upashaya,anupashaya,and sadhyaasadhyata called Roganidana and Vikriti Vijnana
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.
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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.
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
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.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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
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
1. Guided by
Presented by
Dr. R K Hibare
Dr. Madhusudan B G
Prof & HOD, Dept of Roga Nidana I MD, Dept of Roga Nidana
GAMC, Bengaluru
GAMC, Bengaluru
2. DEFINITION
Human feces is called as STOOL.
Faeces / Feces is plural
of latin term faex meaning RESIDUE.
It is the waste residue of indigestible materials of
an animal’s digestive tract expelled through the
anus during defecation.
Meconium is newborn’s first feces.
SCATOLOGY or CAPROLOGY is the study of feces.
3. COMPOSITION
•
•
•
•
•
•
¾ Water, ¼ Solid
Undigested and Unabsorbed food
Intestinal secretions, Mucous
Bile pigments and Salts
Bacteria and Inorganic material
Epithelial cells, Leukocytes
4. COLLECTION
• Universal Precautions
• Stool should be collected in a dry, sterilized,
wide mouthed container.
• It should be uncontaminated with Urine or any
other body secretions.
• Properly named and always a fresh sample
should be tested.
5. M A C R O S C O P I C E X A M I N AT I O N
•
•
•
•
•
•
Volume <200gms/day
Colour
Consistency
Odour
Blood, Mucous
Parts of parasite and Adult Parasite
6. COLOUR OF STOOL
Human fecal matter is normally yellowish brown in
colour which results from a combination of bile
and bilirubin.
VARIATIONS
Bright Red/Maroon
Tan/Clay
Blood streak
White
Yellow
Pale greasy
Green
Black
Blue
7. COLOUR OF FECES-in Infants
Exclusively breast fed infants pass loose and green
or pasty and yellow stools.
Infants fed on cows’ milk preparations pass stools
of a paler yellow colour and of a much firmer
consistency.
Babies fed on newer modified cows’ milk
preparations have clay coloured or greenish
stools.
Some healthy children may pass frequent, loose
stools containing undigested vegetable matter
called as Toddler’s diarrhoea.
8. CONSISTENCY OF STOOL
Separate hard lumps, like nuts (hard to pass).
Sausage-shaped but lumpy.
Like a sausage but with cracks on the surface.
Like a sausage or snake, smooth and soft.
Soft blobs with clear-cut edges.
Fluffy pieces with ragged edges.
Watery, no solid pieces. Entirely Liquid.
9. ODOUR OF STOOL
Basically depends on the pH of the stool and
INDOLE and SKETOLE are the substances that
produce normal odour formed by Intestinal
bacterial fermentation and putrefaction.
A foul odour is caused by degradation of
undigested protein and excessive carbohydrate
intake.
Sickly sweet odour is produced by undigested
Lactose.
10. • Diarrhoea mixed with mucous and Blood is
suggestive of Typhoid, Amoebiasis, Typhus,
Large bowel Carcinoma.
• Diarrhoea mixed with mucous and Pus is
suggestive of Ulcerative Collitis, Regional
Enteritis, Shigellosis, Salmonellosis, Acute
diverticullitis, Intestinal TB.
• Pasty stool with high fat content is suggestive of
CBD Obstruction, Cystic fibrosis-butter stool.
• Translucent gelatinous mucous clinging to the
surface of the formed stool is found in Spastic
Constipation, Excessive straining, Mucous
collitis.
11. • Rice water stools which is colourless and almost
devoid of odour is suggestive of Cholera.
• Stools may look like Redcurrant jelly in
Intussusception.
12. PA R A S I T E
•Round worm
•Hook worm
•Tape worm
•Pin worm
•Whipworm
14. M AT E R I A L S
• Microscope slides
• Cover slips
• Sodium chloride solution
• Lugol’s Iodine Solution
• Wooden applicator
• Fresh stool
• Gloves
15. S L I D E P R E PA R AT I O N
•
•
•
•
Saline Specimen Prpn.
SLIDES
Iodine Specimen Prpn.
CONCENTRATION METHOD to detect Ova.
A drop of warm Saline or Lugol’s Iodine is placed
over a clean microscopic slide.
About 2mg of stool sample should be taken and
mixed with soln placed over the slide.
Coverslip is placed avoiding air bubbles.
Examined under Microscope.
16. PIN WORM EGG COLLECTION
Eggs of Pin worm – Enterobius vermicularis rarely
appear in stools. These are usually collected in
the folds of skin in perianal region.
COLLECTION
Cotton swab / Plaster patch – Anus especially in
early morning – Dipped in Saline – Observed.
17. E X A M I N AT I O N O F PA R A S I T E S
Warm stools are best for detecting Ova or
parasites. Do not refrigerate the specimen.
Because of cyclic life cycle of parasites, three
separate random stool specimens are
recommended for examination.
18. N O R M A L VA L U E S
• Undigested food materials – None to small
amount
• Starch – None
• Eggs, Cysts, Parasitic fragments – None
• Yeasts – None
• Leukocytes – None
19. L E U KO C Y T E S I N S T O O L
Large amounts of leukocytes is suggestive of
Chronic Ulceratice Collitis, Chronic Bacillary
Dysentry, Localised Abscess, Fistulas.
Mononuclear Leukocytes appear in Typhoid.
Polymorphonuclear Leukocytes appear in
Shigellosis, Salmonellosis, Invasice E. coli
diarrhoea, Ulceratice Collitis.
Absent Leukocytes in Cholera, Viral diarrhoea,
Non-specific diarrhoea, Amoebic Collitis,
Giardiasis.
27. S T O O L C U LT U R E
Normal Microbial flora of GI tract contains following
organisms.
Gram –ve - E. coli, Enterobacter, Proteus,
Pseudomonas aeruginosa, Bacteroides.
Gram +ve - Clostridia, Lactobacilli, Enterococci,
Anaerobic streptococci.
Human feces contain approximately 1011 organisms
per gram wet weight as normal flora. Whereas gut
bacterial pathogens rarely exceed 105 organisms per
gram.
28. C U LT U R E M E D I A S
Culture media usually used is of AGAR and is done
aerobically.
•
•
•
•
XLD Agar media – Salmonella, Shigella.
TCBS Agar media– Cholera.
MacConkey media – Yersinia enterocolitica
Campylobacter culture media for Campylobacter
species.
The mainstay of diagnosis of bacterial infections of
the gut is by culture.
29. HANGING DROP TEST
•Place a drop stool in the centre
of a coverslip.
•Place a drop of water / vaseline
at each corner of the coverslip.
•Invert a slide with a central
depression over the coverslip.
•The coverslip will stick to the
slide and when the slide
is
inverted the drop of bacterial
culture will be suspended in the
central depression of the slide.
•Examine microscopically (X100)
for motile organisms.
32. NORMALCY
•
•
•
•
•
•
•
•
•
Water – Upto 75%
pH – 5.8 to 7.5
Occult blood, RS – Negative
Bile – Negative in Adults
Positive in Children
Sodium – 5.8 to 9.8 mEq/24hrs
Chlorides – 2.5 to 3.9 mEq/24hrs
Potassium – 15.7 to 20.7 mEq/24hrs
Lipids / Fatty acids – 0 to 6 gms/24hrs
Nitrogen - <2.5g/24hrs
33. pH
Increased pH-ALKALINE
• Colitis
• Antibiotic use
• Villous adenoma
• Excess Protein in diet.
Decreased pH-ACIDIC
• Carbohydrate
Malabsorption
• Fat Malabsorption
• Disaccharidase
defficiency
34. O C C U LT B L O O D
PRINCIPLE – BENZIDINE TEST
Perioxidase action of hemoglobin in blood
converts hydrogen peroxide to water and nascent
oxygen. This oxygen oxidises benzidine in acid
medium to form green to blue coloured complex.
METHOD
Benzidine – Glacial acetic acid – Hydrogen peroxide –
Over stool in slide – Colour change.
GUAIAC TEST - gFOBT
35. O C C U LT B L O O D c o n t …
Found in Ulcers,
Diverticullitis,
Ulcerative Collitis,
Diaphragmatic Hernia,
Adenoma,
CA Colon, Gastrium
36. FAT I N S T O O L S
Increased Fats is associated with Malabsorption
Syndromes
Obstructive Jaundice
Non tropical sprue/Coeliac Sprue
Crohn’s disease
Cystic Fibrosis
Whipple’s disease
Enteritis and Pancreatic diseases
Surgical removal of section of Intestine.
37. R E D U C I N G S U B S TA N C E S
Tested for RS especially in infants with Chronic
diarrhea to rule out Lactose Intolerance.
Stool will be positive for RS in variety of conditions
especially in Rota viral Infection in Infants.
38. MALA / PURISHA
•
•
•
•
•
•
•
•
•
Mala – 7 Anjali Pramana
One among ASHTA Sthana Pariksha
Aama / Pakwa Purisha
Tila Pishtha Nibha Varchas…………..
Purishaja Krimi
Purisha Virajaneeya Dravyas
Mala in Rajayakshma.
Mala in Lakshanas of diseases.
Mala in asadhyavastha of diseases.
39. BIBILOGRAPHY
•
•
•
•
•
•
•
•
•
•
•
•
•
Charaka Samhita
Susruta Samhita
Ashtanga Hrudaya
Yoga Ratnakara
Bhaishajya Ratnavali
Wallace’s interpretation of Diagnostic Procedures
Hutchison’s Clinical Methods
Guyton and Hall Text book of Medical Physiology
Godkar’s Textbook of Medical Laboratory Technology
Fundamentals of Biochemistry – Dr. A. C. Deb
Pharmacology and Pharmacotherapeutics – Satoskar et al.
http://www.wikipedia.org
http://www.medicineplus.com
Editor's Notes
Preservative fluid is Bayer’s solution or Methiolate-Iodine-Formalin. Only formed stools can be refrigerated at 4’C for an overnight.
Colour – Disease.
Importance of these types.
Indole, Sketole, Mercaptans, H2S.
Explain Concentration method/Cover slip method.
Eggs – Worms, Cysts – Protozoa.
To detect Entamoeba, the fecal specimen must be kept at body temperature until it can be examined.
As there are a large number of bacterial species that can cause diarrhea, many different selective culture media will be used in order to increase the isolation rate.