- Eggs in Medical parasitology.

- when we asked about diagnosis of parasites

we may say that the diagnostic material is eggs

then we must say the characters of eggs

for example :-

Q laboratory diagnosis of fasciola gigantica ?

Answer:- examination of the stool for the characteristic

egg which has the following characters....?....

- when we talk about any egg of helminthes you must

comment on 6 items

4 s ...- size -shell - shape

- special characters

2c ....-content (contain embryo or not)

- colour
===========================
** Size & shape of helminthic eggs :-

-140 x 70 micro meter (oval in shape)

egg of

- Fasciola hepatica .

- Fasciolopsis buski .

- Shistosoma mansoni.
------------------
-180 x 90 micro meter (oval in shape)

egg of - Fasciola gigantica .
------------------

-30 x 15 micro meter (oval in shape)

egg of :

- Heterophyes heterophyes.

- Metagonimus yokogawai.
------------------
-100 x 50 micro meter (oval in shape)

egg of :

- Shistosoma Japonicum.

- Paragonimus westermani.
------------------
-120 x 60 micro meter (oval in shape)

egg of - Shistosoma haematobium.
------------------
- 70 x 45 micro meter (oval in shape)

egg of:

- Diphyllobothrium latum .

- Diphyllobothrium mansoni .

- Fertilized egg of Ascaris lumbricoides .
------------------
- 40 micro meter (rounded in shape)

egg of:

- Taenia solium .

- Taenia saginata .

- Taenia multiceps .

- Echinococcus granulosus .
------------------
- 30 x50 micro meter ( oval in shape)

egg of - Hymenolepis nana.
------------------
- 60 x40 micro meter ( oval with rounded poles)

egg of - Ancylostoma duodenale.
------------------
- 60 x80 micro meter ( oval in shape

egg of - Hymenolepis diminuta.
------------------
- 25 x40 micro meter ( spherical in shape)

egg of -Dipylidium caninum .
------------------
- 90 x45 micro meter ( oval in shape)

egg

- unFertilized egg of Ascaris lumbricoides .

- Trichostrongylus colubriformis.
------------------
- 85 x75 micro meter ( oval in shape)

egg of - Toxocara species.
------------------
- 50 x25 micro meter

egg of

- Enterobius vermicularis
( planoconvex (D shaped).)

- Trichuris trichiura (barrel shaped)
------------------
- 45 x20 micro meter ( oval in shape)

egg of - Capillaria philippinensis.
------------------
- 55 x30 micro meter ( oval in shape)

egg of - Strongyloides stercoralis.
===========================
** Shell of the eggs :-

- Eggs with thin shell:-

egg of

- Fasciola hepatica .

- Fasciolopsis buski .

- Fasciola gigantica .

- Shistosoma mansoni.

- Shistosoma Japonicum.

- Shistosoma haematobium.

- Hookworms.

- Strongyloides stercoralis.

- Trichostrongylus colubriformis.
------------------
- Eggs with thick shell:-

egg of

- Heterophyes heterophyes.

- Diphyllobothrium latum

- Diphyllobothrium mansoni

- Trichuris trichiura .

- Capillaria philippinensis.

- Paragonimus westermani.
-------------------

shell of

-Taenia solium .

- Taenia saginata .

- Taenia multiceps .

- Echinococcus granulosus

is composed of inner shell (thick radially striated

embryophore ) & outer shell (thin membranous)

------------------
- shell of Hymenolepis nana.

is composed of inner layer (embryophore )

& outer layer (thin membranous)

the shell is provided with bipolar knobs & filaments

(4-8) at each pole.

------------------
- shell of Hymenolepis diminuta.

similar to Hymenolepis nana without filaments
------------------

- shell of Dipylidium caninum.

thin shell & is composed of 2 layers &separated

by transparent albuminous material .
------------------

- shell of Enterobius vermicularis.

double walled & a 3rd outer thin albuminous sticky

layer.

- sexually transmitted parasites.

1- Trichomonas vaginalis.

- Cause Trichomoniasis.

- T. vaginalis infection is limited in men due to trichomonocidal activity of prostatic secretion and flushing out of the parasites from the urethra during micturition, although it may cause mild urethritis or occasionally prostatitis.

- In women, it is oftenasymptomatic,but if infections persist with vaginitis with frothy vaginal discharge of offensive odour and associated with itching.

2-Human Lice

a-Pediculus humanus.

- Pediculus humanus capitis (head louse),

- Pediculus humanus corporis (body louse) human lice cause : Epidemic typhus , Trench fever, Epidemic relapsing fever and Pediculosis.

b-Phthirus pubis : which causes Pediculosis and Blepharitis .

3-Sarcoptes scabiei : which is the causative parasite of scabies.

- Blood parasites.

- Parasites transmitted through blood transfusion.

= parasites which have apart of its life cycle in the blood

1- Leishmania donovani .

which causes visceral Leishmaniasis either old world or new world

2- Plasmodia species .

3- Babesia species .

4-Toxoplasma gondii .

5-Trypanosoma species :-

a-Trypanosoma brucei complex

-Trypanosoma brucei gambiense .

-Trypanosoma brucei rhodesiense.

b-Trypanosoma cruzi.

==============================

- Transplacental (congenital ) transmitted Parasites.

=1- All transmitted by blood except Babesia species.

2- Ancylostoma duodenale ( rare).
==============================
- Parasites Detected in peripheral blood.

1. Plasmodia species inside RBCs.
2. Babesia species inside RBCs.
3. Leishmania donovani inside WBCs ( macrophage).
4. Toxoplasma gondii inside WBCs ( macrophage).
5. Trypanosoma species Intercellular (between blood cells) .
6. Microfilariae except onchocerca volvulus Intercellular (between blood cells) .

==============================
- Parasites which cause anaemia :-

1. Leishmania donovani ...Aplastic anaemia.
2. Plasmodia species....Haemolytic anaemia.
3. Shistosoma species..iron deficiency anaemia.
4. Hookworms............iron deficiency anaemia.
5. Diphyllobothrium latum...Perniciuos anaemia.
6. Trichuris trichiura......... Perniciuos anaemia.

- Acid Reflux.

Acid Reflux

Def:- Acid Reflux is a common irritation of the walls of the esophagus after eating.

Commonly called "Heart Burn" as it give epigastric burning sensation.

causes:-
- Incompetent Lower espohageal sphincter ( LES)which fail to close during digestion.
a properly functioning sphincter, holds food and acid away from the esophagus during the digestion process.

-For acid reflux to occur, the LES relaxes, thereby allowing the food and acid to seep into the esophagus. The acid seepage in turn causes irritation or burning. Secondary peristalsis, or the movement of the esophagus caused by swallowing pushes about 90% of the food and acid back into the stomach. The LES closes again for normal digestion. The remaining 10% of food and acid left in the esophagus is neutralized by saliva.
-While many people experiences with acid reflux is asymptomatic, acid reflux can be part of a larger problem. Acid reflux is lumped into a much larger category called Gastroesophageal Reflux Disease or GERD. According to GERD.com, this is "Any symptomatic clinical condition or change in tissue structure that results from the reflux of stomach or duodenal contents into the esophagus."

GERD is said to be caused by many different factors:-
- transient LES relaxation,
- decreased LES resting tone,
- impaired esophageal clearance,
- delayed gastric emptying,
- decreased salivation,
- impaired tissue resistance.

An individual's lifestyle can also be a factor in causing this condition:-
-Smoking,
- large meals,
- fatty foods,
- caffeine,
- pregnancy,
- obesity,
- body position,
- drugs,
- hormones may all exacerbate GERD.
- hiatal hernia frequently accompanies severe GERD.
- wearing tight clothing
- lying down after a meal
- bending over can help trigger acid reflux.

With my best wishes
Dr-hema

- Lactose Intolerance.

Lactose Intolerance

Def:- lactose intolerance is the inability to digest dairy products containing lactose, most notably milk.

Lactose is a sugar that is broken down in the body by an enzyme called lactase.

Lactase is normally secreted by cells lining the small intestine, and breaks down lactose into glucose& galactose.

Cause of Lactose Intolerance:-

When lactase is deficient, undigested lactose begins to ferment in the lower intestines.

symptoms of Lactose Intolerance:-

This can cause physical discomfort :-
- bloating(إنتفاخ).
- nausea.
- gas.
- cramps.
- diarrhea.

The severity of the physical discomforts will depend on how much lactase a person produces in relation to how much lactose is consumed. For example, one glass of milk may not cause a person any problems, while two glasses could.


N.B:-

While it is rare for children to be born without the ability to produce lactase, after about 2 years of age the body's production of this enzyme diminishes. It's not unusual then that so many adults are affected by lactose intolerance to varying degrees.

Diagnosis:-
1- - A lactose-rich liquid is consumed after a short fast.
- The doctor might then draw several blood samples over a 2-hour period to see how the body is digesting the lactose.
- If digested properly, it should be converted to glucose that will be found the blood.
- Or, if you opt for the hydrogen breath test, your breath will be tested for the presence of hydrogen. Hydrogen is normally not present in the breath except in very small quantities, but fermenting lactose will produce greater amounts of hydrogen that will be detected and measured.

2- - If a very young child or an infant needs to be tested for lactose intolerance, an alternate test is available that checks for acidity in the stool.
- Undigested lactose creates lactic acid and other fatty acids that will be found in the stool sample.

Traetment:-
- Lactose intolerance is controlled through diet. Often a small amount of lactose is fine and it is simply a matter of finding your level of tolerance and limiting foods with lactose content.
- Lactase enzymes are also available over the counter. Taken with lactose food, the enzymes break down the lactose for your body.
- Lactose-reduced dairy products are also an option.

- Lactose intolerant people may be concerned about calcium intake. Many non-dairy foods are high in calcium, such as green vegetables like broccoli and kale. Some types of fish are also high in calcium.


Lactose intolerance can be annoying but it is not a serious concern, nor is it a food allergy. If you do have an allergy to dairy products this can produce more severe effects.

With my best wishes
Dr-hema