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Cystic Echinococcosis is a disease of the middle aged. Ultrasonogram combined with a serological assay is the best diagnostic tool available for abdominal echinococcosis allowing diagnosis and staging, while chest X ray is the best screen for the pulmonary disease. The recommended treatment is endocystectomy with antihelmenthic therapy. But the problem of early detection of echinococcosis in endemic areas needs attention by workers as this approach can potentially prevent the devastating complications due to this disease.
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The modern chemotherapy of intestinal worm diseases is essentially based on niclosamide, thiabendazole and mebendazole. Thus an effective therapy with few side effects has become possible for these helminthiases. In infections with Taenia, Ascaris, Trichuris, Ankylostoma, Strongyloides, Trichostrongylus and Oxyuris, as the most frequently imported helminths, an elimination rate of over 90% of the parasites can be attained. Infections with nematode larvae as with Larva migrans and trichinoses are more problematic therapeutically because the anthelmintics are directed principally against the adult worms.
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Capillaria philippinensis eggs, larvae, and adults were identified in the stool of a 41-year-old female physician from Cairo, Egypt, who had never traveled abroad. She had eaten local and imported fish. She suffered from borborygmi, abdominal pain, severe diarrhea, vomiting, and loss of weight for greater than 3 months. Treatment with Flubendazole (R17889-Janssen) 200 mg twice daily for 30 days resulted in clinical and parasitological cure.
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Mice infected with protoscoleces of Echinococcus granulosus for 12-14 months were treated ig with mebendazole (Meb) 25-50 mg.kg-1 x d-1 for 7-14 d, albendazole (Alb) 200 mg.kg-1 x d-1, cr praziquantel (Pra) 500 mg.kg-1 x d-1 for 14 d. The mice were killed 24 h after the last medication, and acid phosphatase (ACP), alkaline phosphatase (AKP), and adenosine triphosphatase (ATPase) including (Na, K, Mg)-ATPase, (Na, K)-ATPase, and (Mg)-ATPase were determined and compared with those of untreated control group. The results showed that ACP activities of cyst wall in treated groups were lower than the control group. Whereas AKP activity of cyst wall in Pra group increased markedly, this is not the case in Meb and Alb groups. Three ATPase activities of cyst wall were inhibited in both Meb and Alb groups, Meb being more potent. No apparent changes in the ATPase activities were seen in Pra group.
Using social and economic criteria, the efficacy of health improving measures against enterobiasis in the organized groups of pre-school children has been assessed. The introduction of mass treatment of children with vermox into a complex of antienterobiasis measures has a considerable health improving effect, without rendering the procedure more expensive. A considerable difference between the economic damage inflicted by enterobiasis and the economic efficacy of antienterobiasis complex, including mass children treatment, forms the basis for the wide use of anthelmintics in the control of this type of helminthiasis.
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Septal fibrosis is a common form of hepatic fibrosis, but its etiology and pathogenesis are poorly understood. Rats infected with the helminth Capillaria hepatica constitute a good experimental model of such fibrosis. To investigate the pathogenetic contribution of the several parasitic factors involved, the following procedures were performed in rats: a) regarding the role of eggs, these were isolated and injected either into the peritoneal cavity or directly into the liver parenchyma; b) for worms alone, 15-day-old infection was treated with mebendazole, killing the parasites before oviposition started; c) for both eggs and worms, rats at the 30th day of infection were treated with either mebendazole or ivermectin. Eggs only originated focal fibrosis from cicatricial granulomas, but no septal fibrosis. Worms alone induced a mild degree of perifocal septal fibrosis. Systematized septal fibrosis of the liver, similar to that observed in the infected controls, occurred only in the rats treated with mebendazole or ivermectin, with dead worms and immature eggs in their livers. Thus, future search for fibrogenic factors associated with C. hepatica infection in rats should consider lesions with both eggs and worms.
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Conservative management and long term follow up are proposed for the non-active or mebendazole-responsive patients. For the non-respondents or the cases with kidney destruction, surgery is the only hope for cure.
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Chronic inflammatory disease was diagnosed in 10,352 children during 6.4 million person-years of follow-up. The incidence rate ratios was 1.07 for asthma (95% confidence interval [CI]: 1.00-1.13), 1.05 for type 1 diabetes (95% CI: 0.79-1.12), 1.13 for juvenile arthritis (95% CI: 0.94-1.37), 0.77 for ulcerative colitis (95% CI: 0.41-1.46), and 1.44 for Crohn's disease (95% CI: 0.82-2.53). Results were not modified by number of treatments or age at treatment.
Infestation of the eye by larval fly forms (ophthalmomyiasis) is rarely seen in the Western world. We present the case of a 21 year old British soldier who developed external ophthalmomyiasis during an operational tour of southern Afghanistan. This case report and discussion illustrates the potential for ophthalmomyiasis in personnel deployed to this theatre; the possibility of infestation without an identifiable episode of exposure; the importance of proper assessment and follow-up in order to identify sight-threatening complications; and the balance between optimal patient care and the risks inherent to casualty evacuation demanded by modern day stability operations.
According to WHO, half of the world's children suffers from anaemia, which is a silent and neglected endemic resulting from three major causes: iron deficiency intestinal worms and malaria. A two month transversal study was conducted in a rural primary school in Battambang Province, Cambodia, in a malaria-free area. The main objective of the study was to assess the prevalence of anaemia and two of its possible driving factors, intestinal parasites and general malnutrition; a secondary objective was to assess the accuracy of haemoglobin colour scale, an easy and cheap visual technique compared to spectrophotometry used as the reference. Among 168 school children (average age: 11), the prevalence rates of moderate and severe anaemia were 24% and nil respectively; average haemoglobin was 12.6 g/dl. These results compared favourably with previous data from Cambodia. In our study's conditions, the haemoglobin colour scale grossly overestimated the anaemia prevalence: 83 vs. 24%, specificity 22%. Despite its simplicity and very low cost, this technique appeared inaccurate. Anaemia was independently associated with Ancylostoma carriage (p = 0.05), and stunting (p = 0.01), which prevalences were 54% et 40% respectively; and this, despite a mebendazole 500 mg dose given 9 months prior to the study as part of a regular deworming school program. Although periodical mass deworming in schools does not prevent early Ancylostoma reinfection, it may reduce the severity of anaemia. It therefore appears fully justified, and may be strengthened, notably by switching from mebendazole to albendazole.