The document discusses various parasitic infections that can affect the central nervous system. It covers how parasites can cross the blood-brain barrier and challenges in diagnosing neuroparasitic infections. Common methods include microscopy examination of blood or tissue samples, as well as newer techniques like PCR and antigen detection tests. Specific infections discussed in detail include malaria, toxoplasmosis, and infections caused by free-living amebae. The document emphasizes the importance of integrating clinical signs and laboratory diagnostic methods for accurate diagnosis of neuroparasitic diseases.
Malaria diagnosis, rd ts vs microscopyLamngwa Nfor
The document discusses malaria diagnosis using rapid diagnostic tests (RDTs) and microscopy. It explains that RDTs detect malaria parasite antigens in blood and have advantages over microscopy in settings without reliable electricity or trained lab staff, while microscopy allows species identification and parasite density measurement but requires more resources. The document recommends using both tests based on their situation-specific advantages to ensure universal access to malaria diagnosis.
- Laboratory testing is recommended for any individual meeting the suspected case definition for monkeypox. The preferred specimen is skin lesion material collected via swab.
- Nucleic acid amplification testing (NAAT) can detect monkeypox virus DNA and should be used for diagnostic confirmation. Sequencing is also recommended to determine the virus clade.
- Proper safety procedures and packaging/transport of specimens is essential due to the infectious nature of the virus. Member states should notify WHO of any positive tests.
- The document provides interim guidance on laboratory testing for monkeypox virus. It recommends nucleic acid amplification testing (NAAT) using PCR on skin lesion samples as the primary method for diagnostic confirmation. Positive detection of orthopoxvirus by PCR followed by confirmation of monkeypox virus via PCR or sequencing indicates laboratory confirmation. It outlines specimen collection, transport, and storage procedures as well as biosafety measures for handling potentially infectious samples. Countries are requested to immediately notify WHO of positive results and share genetic sequence data.
Nipah virus is a zoonotic virus transmitted to humans from bats or infected pigs. It was first identified during an outbreak in Malaysia and Singapore in 1999 that affected pig farmers. The virus causes respiratory illness and encephalitis in humans, with symptoms including fever, headache and coma. While there is no vaccine or treatment, supportive care and isolation procedures are important. Further research is needed to understand Nipah virus in bats and prevent future outbreaks.
The document evaluates the usefulness of rapid diagnostic tests (RDTs) for diagnosing malaria compared to microscopic examination. It finds that RDTs diagnosed 41 out of 43 total malaria cases in the study, while microscopy only diagnosed 34 cases. RDTs were found to be highly sensitive (96.55%) and specific (71.79%) for detecting Plasmodium falciparum malaria compared to microscopy. The study concludes that RDTs are an effective, rapid and accurate method for diagnosing malaria, especially in cases where immediate diagnosis is needed. RDTs performed better than microscopy and using both tests together provides the best approach for malaria diagnosis.
This document discusses malaria diagnosis approaches. It notes that while efforts have reduced malaria mortality and morbidity, it remains a major disease burden in sub-Saharan Africa. Current diagnostic methods like microscopy and rapid diagnostic tests (RDTs) are useful but have limitations. More advanced tools are not suitable for field use. There is a need for new diagnostic approaches tailored to conditions in endemic regions, leveraging untapped materials like urine. Novel tools in development promise improved diagnosis if successful.
The document discusses conventional microbiological techniques used in diagnostic microbiology laboratories. It describes how Robert Koch and Ronald Ross helped develop culturing pathogens and the discovery that specific microbes cause diseases. It also discusses how conventional techniques like growing bacteria in broth or on solid media, staining, and microscopy are still important today, but that molecular biology techniques may revolutionize disease diagnosis in the future. Gram staining remains one of the most rapid diagnostic methods for identifying bacteria in clinical specimens.
1) Nanomaterials like gold nanoparticles, carbon nanotubes, and quantum dots show potential for virus detection through their unique optical and electrical properties.
2) Gold nanoparticle probes modified with influenza virus antibodies allow one-step, colorimetric detection of influenza without expensive equipment.
3) Carbon nanotube sensors could allow low-cost, routine monitoring for dengue virus detection by non-experts in places like clinics.
4) Quantum dot probes have been used to simultaneously track multiple viral proteins over time to study respiratory syncytial virus infection.
PCR Swab Test Kits | A Vital Tool in the Fight Against Infectious DiseasesNX Healthcare
PCR swab test kits are indispensable in the fight against infectious diseases. Their accuracy, sensitivity, and versatility make them crucial tools for early detection, monitoring, and managing disease outbreaks. As we continue to face the threat of emerging infectious agents, the development and widespread availability of PCR swab test kits will remain a cornerstone in our defense against such challenges. These kits, along with public health measures, play a vital role in safeguarding global health. Visit us at https://www.nxhealthcare.co.uk/
1) The document discusses the need for better diagnostic approaches for parasitic infections. Traditional diagnostic methods have changed little in over a century and cannot distinguish between different stages of infection or response to treatment.
2) While new technologies like PCR and ELISA have improved diagnosis, many facilities still lack resources and trained technicians to utilize advanced methods. Reliance on microscopy remains common but is time-consuming and requires skill.
3) The author argues that improving diagnostic capabilities for parasitic diseases through incorporating new technologies and training more experts could help reduce antibiotic overprescription and emergence of drug resistance.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like depression and anxiety.
DIAGNOSTICS - Application of nanodiagnostics in point-of-care tests for infec...sudeepbhattacharyya
This document discusses the application of nanodiagnostics in point-of-care tests for infectious diseases. It provides an overview of nanoparticle-based, nanodevice-based, and point-of-care test platforms for infectious disease diagnostics. Specifically, it examines current state-of-the-art point-of-care nanodiagnostic technologies like miniaturized diagnostic magnetic resonance platforms, magnetic barcode assays, cell phone-based polarized light microscopy, cell phone-based dongles, and paper-based tests. The review discusses the potential for nanotechnology to enable affordable, portable and robust point-of-care testing to improve infectious disease diagnosis, treatment and prevention, especially in developing countries.
Plasmodium falciparum: Molecular diagnosis, drug resistance, and vaccineAbayAyele
The document summarizes information about Plasmodium falciparum molecular diagnosis, drug resistance, and vaccine development. It discusses conventional laboratory diagnosis methods like microscopy and rapid diagnostic tests (RDTs), and highlights the increased sensitivity of molecular diagnostic methods like PCR. Molecular tests can also detect markers of drug resistance for antimalarials. While vaccines aimed at different stages of the parasite's life cycle are being developed, none are currently licensed. Overall molecular methods improve on the limitations of conventional diagnosis, and progress is being made in vaccine development, but more work is still needed.
Field Based Application of Automated Image Processing Using Windows Phone Gui...Melvin Marzan
This document discusses a study on using a Windows phone application called Lifelens along with a specialized lens to diagnose malaria. The study aims to test the efficacy, sensitivity, and reliability of this new diagnostic method in field settings, and compare it to existing diagnostic methods like microscopy and rapid diagnostic tests. The objectives are to measure the sensitivity and specificity of Lifelens, and to evaluate its practicality, cost-effectiveness, and accuracy for diagnosing malaria in community and field settings.
This document discusses sexually transmitted diseases (STDs), specifically focusing on syphilis. It provides information on:
1) What STDs are and how they are transmitted through intimate sexual contact. Common STDs include chlamydia, gonorrhea, herpes, HPV, HIV, and syphilis.
2) The stages of syphilis infection, which are primary, secondary, and tertiary/latent stages. Primary syphilis involves a chancre sore at the infection site. Secondary syphilis causes a body rash and sores.
3) Diagnosis of syphilis is based on clinical examination, dark-field microscopy of sores to view the syphilis
Newer diagnostic methods in tuberculosis detectionApollo Hospitals
One-third of the world's population has been infected with Mycobacterium tuberculosis, with new infections occurring in about 1% of the population each year. However 90–95% of infections remain asymptomatic. Thus early diagnosis of tuberculosis and drug resistance improves survival and helps to promote contact tracing, implementation of institutional cross-infection procedures, and other public-health actions. There have been many advances and modifications to the methodology for tuberculosis diagnosis some of which are very promising. But these advances have not kept pace with the explosion of tuberculosis or the outbreak of drug resistant tuberculosis. This review describes some of the newer advances in tuberculosis diagnostics and the challenges they face.
Dr. T.V. Rao discusses what makes a good lecture. Some key points include:
- A good lecture is well-structured, engaging, and covers the essential material in a clear manner.
- Effective lecturers demonstrate expertise on the topic, use examples to illustrate concepts, and generate interest among students.
- While lecturing remains an important teaching method, especially for large classes, lecturers should aim to actively involve students through questions and other techniques.
- Preparation, clear communication, enthusiasm, and knowledge of the subject matter are hallmarks of successful lecturing. A good lecture facilitates learning while sparking students' curiosity.
The document discusses antibiotic resistance and the need for antibiotic policies in hospitals. It provides background on the development of antibiotic resistance over time. The key points are:
- Inappropriate antibiotic use promotes the spread of resistant bacteria. Hospital settings can foster drug resistance.
- An antibiotic policy aims to reduce resistance by optimizing antibiotic use and educating staff. The policy is developed with input from microbiologists, pharmacists, and clinicians.
- The hospital infection control committee implements and monitors adherence to the antibiotic policy. Continuous education is needed to ensure appropriate antibiotic prescribing.
Toxoplasmosis is caused by the parasite Toxoplasma gondii and can cause encephalitis and neurological disease in patients with low CD4 counts. It is diagnosed through imaging, blood tests, and sometimes brain biopsies. Treatment involves antiparasitic drugs and maintaining CD4 counts through antiretroviral therapy. Cryptosporidiosis is caused by Cryptosporidium parasites and causes diarrhea. It is transmitted through contaminated water or food. Microsporidiosis is caused by various protist parasites and can infect the gut or other organs. It is diagnosed through stool or tissue samples and treated with antiparasitic drugs and antiretroviral therapy. Isosporiasis is
The document discusses the importance of proper specimen management in diagnostic microbiology. It states that specimen management has the most influence on accurate laboratory results and patient outcomes. Proper specimen management is key to accurate diagnosis, reduces errors, and directly impacts patient care and therapeutic decision-making. The document provides guidance on appropriate specimen collection and processing techniques to ensure representative samples and meaningful diagnostic results.
Artificial intelligence shows promise in helping to control infectious diseases and reduce antimicrobial resistance in three key ways:
1) AI can enhance disease surveillance and early detection of outbreaks by integrating diverse data sources to identify patterns.
2) It can help optimize antimicrobial treatment by recommending personalized therapy regimens based on a patient's clinical information.
3) Over time, AI may become an indispensable public health tool by facilitating more accurate intervention strategies and optimizing resource allocation to curb disease spread.
1) Hungarian physician Ignaz Semmelweis observed higher mortality rates of women giving birth in the medical student ward compared to the midwife ward in the 1840s.
2) He discovered that the doctors in the medical student ward were coming directly from dissecting corpses to examining women without washing their hands, possibly transmitting infections.
3) Semmelweis mandated that doctors wash their hands with chlorine before examinations, which dramatically reduced the mortality rates in the medical student ward. This provided early evidence that hand hygiene reduces healthcare-associated infections.
Dr. T.V. Rao discusses causality department practices and environmental safety measures. Proper cleaning and disinfection are top priorities to prevent transmission of infectious agents and protect human safety. Dedicated cleaning practices are especially important when dealing with patients admitted with infectious diseases like diarrhea. Adherence to cleaning protocols and use of appropriate disinfectants can reduce healthcare-associated infections.
Biosecurity and infection control in hospitals aims to prevent the spread of infectious diseases. It includes proper hand hygiene, cleaning and disinfection of surfaces, use of personal protective equipment, and isolation techniques. Ensuring strict adherence to protocols through staff training and environmental monitoring is key to reducing healthcare-associated infections and protecting patients, staff, and the community.
This document discusses how microbiologists can improve clinical care through better laboratory reporting. It emphasizes providing accurate, clinically relevant results and clear interpretive comments to aid clinician decision making. Effective communication between the laboratory and clinicians is key. The document also highlights challenges such as information overload, confusion over terminology, and ensuring rapid reporting, especially for ICU patients.
This document discusses ventilator associated pneumonia (VAP), including its definition, risk factors, pathogenesis, prevention strategies, and more. Some key points:
- VAP is pneumonia that develops in intubated patients and is the leading cause of hospital-acquired infections in the ICU. The risk is 6-21 times higher for mechanically ventilated patients.
- Common risk factors for VAP include underlying illnesses, prolonged mechanical ventilation, supine position, and comorbidities like diabetes or heart failure.
- Bacteria are usually the cause, often multidrug-resistant pathogens like Pseudomonas, Klebsiella, Acinetobacter, and MRSA.
- Prevention strategies include
This document discusses hospital-acquired infections and strategies for prevention. It begins by honoring Ignaz Semmelweis, who in the 1800s established that handwashing reduced maternal mortality during childbirth by 90%. The document then discusses the nature and consequences of hospital-acquired infections. Key strategies for prevention discussed include the importance of handwashing, environmental cleaning, immunization, and establishing infection control committees and antibiotic policies. The challenges of drug resistance and maintaining standards with staff turnover are also addressed.
The document provides information on organizing and operating a bacteriology laboratory. It discusses the importance of the laboratory for hospitals and the roles and basic skills of microbiologists and lab professionals. It covers classifying and identifying common microorganisms like bacteria, examining specimens directly and through staining, culturing specimens using different media, and following sterile technique to prevent contamination. The document emphasizes the need for collecting, transporting, and processing specimens correctly to obtain accurate results and properly diagnose and treat patients.
This document discusses biosecurity and biosafety in healthcare settings. It defines biosecurity as a strategic approach to analyzing and managing risks to human, animal, and plant life from infectious diseases. Biosafety refers to measures that reduce exposure to potentially infectious materials. The document outlines various infection control methods used in hospitals including standard precautions, hygiene practices like hand washing, and managing nosocomial infections and needlestick injuries. It emphasizes the importance of education and surveillance to improve patient safety.
Artificial intelligence has the potential to significantly impact the practice of medicine. It is being used in areas like disease diagnosis using machine learning models, personalized treatment through precision medicine, and providing virtual assistants that can answer patient questions. AI also has benefits such as improving patient safety by reducing errors, lowering healthcare costs, and increasing access to care through tools like chatbots. However, medical professionals need more education on AI applications and their ethical use to ensure they improve patient outcomes.
The document discusses MRSA (methicillin-resistant Staphylococcus aureus), including what it is, how it develops resistance, types of infections it causes, risk factors, screening and testing methods, and prevention strategies. MRSA is a strain of staph bacteria that is resistant to certain antibiotics like methicillin and oxacillin. Screening high-risk patients and implementing good hand hygiene are effective ways to control the spread of MRSA infections in healthcare settings.
This document discusses the history and methods of sterilization and disinfection. It begins with a brief history of sterilization dating back to the invention of the autoclave in 1862. It then covers terminology related to sterilization and discusses various sterilization methods including physical methods like heat, filtration, and irradiation as well as chemical methods. Factors that influence the efficacy of sterilization methods are also examined. The document provides an overview of the development and principles of sterilization.
This document discusses antimicrobial stewardship and the importance of appropriate antibiotic usage. It notes that nearly half of hospitalized patients receive antimicrobial agents. However, there has been misuse of antibiotics through treating trivial infections, commercial pressures, and a lack of understanding of antibiotic principles. This has led to a rise in antibiotic-resistant bacteria. The document advocates for antimicrobial stewardship programs in hospitals to optimize clinical outcomes while reducing unintended consequences of antibiotic usage like toxicity, resistance, and costs. Such programs involve formulary restrictions, guidelines, education, and prospective audits to ensure appropriate antibiotic selection and usage.
Cephalosporins are a class of antibiotics derived from the fungus Cephalosporium. The first generation was introduced in 1964 and provided activity against gram-positive cocci. Subsequent generations have increasingly broader coverage of gram-negative organisms. Mechanisms of resistance include beta-lactamase production and changes to penicillin-binding proteins. Later generations are used for serious hospital-acquired infections and as drugs of last resort for pathogens like Salmonella.
Coxsackieviruses were discovered in 1948-49 in Albany, New York and were named after the town of Coxsackie where samples were originally obtained. They belong to the Picornaviridae family and Enterovirus genus which also includes poliovirus and echovirus. Coxsackieviruses are divided into two groups - A and B - based on their pathogenicity in mice. Group A causes myositis while Group B causes muscle and neuronal tissue damage. Common diseases include hand-foot-and-mouth disease, herpangina, and myocarditis. Transmission is usually via the fecal-oral route. While there is no vaccine, treatment involves rest, fluids, and
This document discusses hospital-associated infections (HAIs), also known as nosocomial infections. It covers topics such as the history of infection control efforts dating back to Ignaz Semmelweiss, the impact of HAIs on patients and hospitals, common causes of HAIs, and strategies for prevention and control of infections. This includes the importance of hand hygiene, infection control committees and policies, and guidelines for reducing various device- and procedure-related infections.
More from Society for Microbiology and Infection care (20)
JMML is a rare cancer of blood that affects young children. There is a sustained abnormal and excessive production of myeloid progenitors and monocytes.
Ventilation Perfusion Ratio, Physiological dead space and physiological shuntMedicoseAcademics
In this insightful lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, delves into the essential concept of the ventilation-perfusion ratio (V˙/Q˙), which is fundamental to understanding pulmonary physiology. Dr. Faiza brings a wealth of knowledge and experience to the table, with qualifications including MBBS, FCPS in Physiology, and multiple postgraduate degrees in public health and healthcare education.
The lecture begins by laying the groundwork with basic concepts, explaining the definitions of ventilation (V˙) and perfusion (Q˙), and highlighting the significance of the ventilation-perfusion ratio (V˙/Q˙). Dr. Faiza explains the normal value of this ratio and its critical role in ensuring efficient gas exchange in the lungs.
Next, the discussion moves to the impact of different V˙/Q˙ ratios on alveolar gas concentrations. Participants will learn how a normal, zero, or infinite V˙/Q˙ ratio affects the partial pressures of oxygen and carbon dioxide in the alveoli. Dr. Faiza provides a detailed comparison of alveolar gas concentrations in these varying scenarios, offering a clear understanding of the physiological changes that occur.
The lecture also covers the concepts of physiological shunt and dead space. Dr. Faiza defines physiological shunt and explains its causes and effects on gas exchange, distinguishing it from anatomical dead space. She also discusses physiological dead space in detail, including how it is calculated using the Bohr equation. The components and significance of the Bohr equation are thoroughly explained, and practical examples of its application are provided.
Further, the lecture examines the variations in V˙/Q˙ ratios in different regions of the lung and under different conditions, such as lying versus supine and resting versus exercise. Dr. Faiza analyzes how these variations affect pulmonary function and discusses the abnormal V˙/Q˙ ratios seen in chronic obstructive lung disease (COPD) and their clinical implications.
Finally, Dr. Faiza explores the clinical implications of abnormal V˙/Q˙ ratios. She identifies clinical conditions associated with these abnormalities, such as COPD and emphysema, and discusses the physiological and clinical consequences on respiratory function. The lecture emphasizes the importance of understanding these concepts for medical professionals and students, highlighting their relevance in diagnosing and managing respiratory conditions.
This comprehensive lecture provides valuable insights for medical students, healthcare professionals, and anyone interested in respiratory physiology. Participants will gain a deep understanding of how ventilation and perfusion work together to optimize gas exchange in the lungs and how deviations from the norm can lead to significant clinical issues.
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
Pharmacotherapy of Asthma and Chronic Obstructive Pulmonary Disease (COPD)HRITHIK DEY
This PowerPoint presentation provides an in-depth overview of the pharmacotherapy approaches for managing asthma and Chronic Obstructive Pulmonary Disease (COPD). It covers the pathophysiology of these respiratory conditions, the various classes of medications used, their mechanisms of action, indications, side effects, and the latest treatment guidelines. Designed for students, healthcare professionals, and anyone interested in respiratory pharmacology, this presentation offers a comprehensive understanding of current therapeutic strategies and advancements in the field.
Mainstreaming #CleanLanguage in healthcare.pptxJudy Rees
In healthcare, every day, millions of conversations fail. They fail to cover what’s really important, fail to resolve key issues, miss the point and lead to misunderstandings and disagreements.
Clean Language is one approach that can improve things. It’s a set of precise questions – and a way of asking them – which help us all get clear on what matters, what we’d like to have happen, and what’s needed.
Around 1000 people working in healthcare have trained in Clean Language skills over the past 20+ years. People are using what they’ve learnt, in their own spheres, and share anecdotes of significant successes. But the various local initiatives have not scaled, nor connected with each other, and learning has not been widely shared.
This project, which emerged from work done by the NHS England South-West End-Of-Life Network, with help from the Q Community and especially Hesham Abdalla, aims to fix that.
A comparative study on uroculturome antimicrobial susceptibility in apparentl...Bhoj Raj Singh
The uroculturome indicates the profile of culturable microbes inhabiting the urinary tract, and it is often required to do a urine culture to find an effective antimicrobial to treat UTIs. This study targeted to understand the profile of culturable pathogens in the urine of apparently healthy (128) and humans with clinical UTIs (161). In urine samples from UTI cases, microbial counts were 1.2×104 ± 6.02×103 colony-forming units (cfu)/ mL, while in urine samples from apparently healthy humans, the average count was 3.33± 1.34×103 cfu/ mL. In eight samples (six from UTI cases and two from apparently healthy people) of urine, Candida (C. albicans 3, C. catenulata 1, C. krusei 1, C. tropicalis 1, C. parapsiplosis 1, C. gulliermondii 1) and Rhizopus species (1) were detected. Candida krusei was detected only in a single urine sample from a healthy person and C. albicans was detected both in urine of healthy and clinical UTI cases. Fungal strains were always detected with one or more types of bacteria. Gram-positive bacteria were more commonly (OR, 1.98; CI99, 1.01-3.87) detected in urine samples of apparently healthy humans, and Gram -ve bacteria (OR, 2.74; CI99, 1.44-5.23) in urines of UTI cases. From urine samples of 161 UTI cases, a total of 90 different types of microbes were detected and, 73 samples had only a single type of bacteria. In contrast, 49, 29, 3, 4, 1, and 2 samples had 2, 3, 4, 5, 6 and 7 types of bacteria, respectively. The most common bacteria detected in urine of UTI cases was Escherichia coli detected in 52 samples, in 20 cases as the single type of bacteria, other 34 types of bacteria were detected in pure form in 53 cases. From 128 urine samples of apparently healthy people, 88 types of microbes were detected either singly or in association with others, from 64 urine samples only a single type of bacteria was detected while 34, 13, 3, 11, 2 and 1 samples yielded 2, 3, 4, 5, 6 and seven types of microbes, respectively. In the urine of apparently healthy humans too, E. coli was the most common bacteria, detected in pure culture from 10 samples followed by Staphylococcus haemolyticus (9), S. intermedius (5), and S. aureus (5), and similar types of bacteria also dominated in cases of mixed occurrence, E. coli was detected in 26, S. aureus in 22 and S. haemolyticus in 19 urine samples, respectively. Gram +ve bacteria isolated from urine samples' irrespective of health status were more often (p, <0.01) resistant than Gram -ve bacteria to ajowan oil, holy basil oil, cinnamaldehyde, and cinnamon oil, but more susceptible to sandalwood oil (p, <0.01). However, for antibiotics, Gram +ve were more often susceptible than Gram -ve bacteria to cephalosporins, doxycycline, and nitrofurantoin. The study concludes that to understand the role of good and bad bacteria in the urinary tract microbiome more targeted studies are needed to discern the isolates at the pathotype level.
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Coronary Circulation and Ischemic Heart Disease_AntiCopy.pdfMedicoseAcademics
In this lecture, we delve into the intricate anatomy and physiology of the coronary blood supply, a crucial aspect of cardiac function. We begin by examining the physiological anatomy of the coronary arteries, which lie on the heart's surface and penetrate the cardiac muscle mass to supply essential nutrients. Notably, only the innermost layer of the endocardial surface receives direct nourishment from the blood within the cardiac chambers.
We then explore the specifics of coronary circulation, including the dynamics of blood flow at rest and during strenuous activity. The impact of cardiac muscle compression on coronary blood flow, particularly during systole and diastole, is discussed, highlighting why this phenomenon is more pronounced in the left ventricle than the right.
Regulation of coronary circulation is a complex process influenced by autonomic and local metabolic factors. We discuss the roles of sympathetic and parasympathetic nerves, emphasizing the dominance of local metabolic factors such as hypoxia and adenosine in coronary vasodilation. Concepts like autoregulation, active hyperemia, and reactive hyperemia are explained to illustrate how the heart adjusts blood flow to meet varying oxygen demands.
Ischemic heart disease is a major focus, with an exploration of acute coronary artery occlusion, myocardial infarction, and subsequent physiological changes. The lecture covers the progression from acute occlusion to infarction, the body's compensatory mechanisms, and the potential complications leading to death, such as cardiac failure, pulmonary edema, fibrillation, and cardiac rupture.
We also examine coronary steal syndrome, a condition where increased cardiac activity diverts blood flow away from ischemic areas, exacerbating the condition. The long-term impact of myocardial infarction on cardiac reserve is discussed, showing how the heart's capacity to handle increased workloads is significantly reduced.
Angina pectoris, a common manifestation of ischemic heart disease, is analyzed in terms of its causes, presentation, and referred pain patterns. We identify factors that exacerbate anginal pain and discuss both medical and surgical treatment options.
Finally, the lecture includes a case study to apply theoretical knowledge to a practical scenario, helping students understand the real-world implications of coronary circulation and ischemic heart disease. The role of biochemical factors in cardiac pain and the interpretation of ECG changes in myocardial infarction are also covered.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group.
All clinical trials must be approved by Institutional Ethics Committee before initiation
It is mandatory to register clinical trials with Clinical Trials Registry of India
Informed consent from all study participants is mandatory.
A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected.
Following points high.
2. How Parasites Enter Blood Brain Barrier
• Some intracellular and
extracellular parasites can
traverse the BBB during the
course of infection and cause
neurological disturbances and/or
damage which are at times fatal.
The means by which parasites
cross the BBB and how the
immune system controls the
parasites within the brain are
still unclear.
29-11-2023 Dr.T.V.Rao MD 2
3. Methods to Diagnose Infections
• Methods for the diagnosis of
infectious diseases have
stagnated in the last 20–30
years. Few major advances
in clinical diagnostic testing
have been made since the
introduction of PCR,
although new technologies
are being investigated.
29-11-2023 Dr.T.V.Rao MD 3
4. Are we Practising Older Methods ?
• Many tests that form the
backbone of the
“modern” microbiology
laboratory are based on
very old and labour-
intensive technologies
such as microscopy
for malaria or many
parsites
29-11-2023 Dr.T.V.Rao MD 4
5. Parasitic Infections Migrating from Developing
Nations to Developed Nations
• Parasitic infections of the
CNS, previously restricted
mainly to people living in
developing countries, are
becoming increasingly
more prevalent
throughout the world.
With the advent of
increasing global travel,
29-11-2023 Dr.T.V.Rao MD 5
6. Immune suppression changes the
Adoptability of Infections
•Potent
immunosuppression,
and HIV infection,
parasitic infections
will likely become
even more
commonplace.
29-11-2023 Dr.T.V.Rao MD 6
7. Overall familiarity is Important to Evaluate the
Matters
• Basic familiarity with
common pathogens can
make diagnosis more
expeditious and efficient.
For the clinician
confronted with a patient
with suspected parasitic
infection, additional
assistance with
diagnostic evaluation
29-11-2023 Dr.T.V.Rao MD 7
8. Beginning of Career to Learn and Practice of
parasitology at Mansa General Hospital Zambia
29-11-2023 Dr.T.V.Rao MD 8
9. Is it easy to Diagnose Parasitic Infections of
Nervous system ?
• Parasitic infection of the
nervous system can
produce a variety of
symptoms and signs.
Because symptoms of
infection are often mild
or nonspecific, diagnosis
can be difficult.
29-11-2023 Dr.T.V.Rao MD 9
10. Be familiar with Epidemiology and
Radiology
• Familiarity with basic
epidemiological
characteristics and
distinguishing
radiographic findings can
increase the likelihood
of detection and proper
treatment of parasitic
infection of the nervous
system.
29-11-2023 Dr.T.V.Rao MD 10
11. We are still using the Microscope as a
Traditional tool in Diagnosis
•The primary tests currently used to
diagnose many parasitic diseases have
changed little since the development of the
microscope in the 15th century by
Antonie van Leeuwenhoek.
Furthermore, most of the current tests
cannot distinguish between past, latent,
acute, and reactivated infections.
29-11-2023 Dr.T.V.Rao MD 11
12. Diagnostic Methods in Parasitology are
Complex
If we wish sensitivity and specificity
• The methods currently in use
range from rather simple, easily
managed and routine
techniques to the extremely
complex cutting edge
technologies of modern
molecular biology and high-
throughput miniaturised
methods usually done as part of
thesis and research work and
rarely for diagnostic work
29-11-2023 Dr.T.V.Rao MD 12
13. Newer Serological Assays
• Firstly, a number of newer
serology-based assays that are
highly specific and sensitive
have emerged, such as the
Falcon assay screening test
ELISA (FAST-ELISA) , Dot-ELISA
rapid antigen detection
system (RDTS) , and luciferase
immunoprecipitation system
(LIPS).
29-11-2023 Dr.T.V.Rao MD 13
14. Emerging Molecular methods
• Secondly, molecular-based
approaches such as loop-
mediated isothermal
amplification (LAMP) , real-
time polymerase chain
reaction and Luminex have
shown a high potential for
use in parasite diagnosis
with increased specificity
and sensitivity.
29-11-2023 Dr.T.V.Rao MD 14
15. Parasites Infections of the Central Nervous System
•Toxoplasma gondii associated with congenital
defects and AIDS
•Plasmodium falciparum cerebral malaria
•Endamoeba histolytic rare invasion of the brain
•Free-living amebae rare cases
•African trypanosomes African sleeping sickness
29-11-2023 Dr.T.V.Rao MD 15
17. Malaria Continues to be a Emergency in
many countries
• Malaria should be
considered a potential
medical emergency and
should be treated
accordingly. Delay in
diagnosis and treatment is a
leading cause of death in
malaria patients in Many
Countries
29-11-2023 Dr.T.V.Rao MD 17
18. Peripheral Blood Smear a Great tool
• Clinicians seeing a malaria
patient may forget to consider
malaria among the potential
diagnoses and not order the
needed diagnostic tests.
Laboratories may lack
experience with malaria and fail
to detect parasites when
examining blood smears under
the microscope
29-11-2023 Dr.T.V.Rao MD 18
19. Making a Smear is Most Important Part of
Microscopy
29-11-2023 Dr.T.V.Rao MD 19
20. Microscopic Diagnosis
• Malaria parasites can be
identified by examining under
the microscope a drop of the
patient's blood, spread out as a
"blood smear" on a microscope
slide. Prior to examination, the
specimen is stained
(most often with the Giemsa
stain) to give the parasites a
distinctive appearance. This
technique remains the gold
standard for laboratory
confirmation of malaria.
29-11-2023 Dr.T.V.Rao MD 20
23. Clinical examination a collaborating point
•Cerebral malaria, with
abnormal behaviour,
impairment of
consciousness,
seizures, coma, or
other neurologic
abnormalities
29-11-2023 Dr.T.V.Rao MD 23
24. Antigen Detection
• Various test kits are available to
detect antigens derived from
malaria parasites. Such
immunologic
("immunochromatographic") tests
most often use a dipstick or
cassette format, and provide
results in 2-15 minutes. These
"Rapid Diagnostic Tests" (RDTs)
offer a useful alternative to
microscopy in situations where
reliable microscopic diagnosis is
not available.
29-11-2023 Dr.T.V.Rao MD 24
26. No Single Test is Perfect
• Current evidence indicates that no single method for
the diagnosis of malaria is perfect nor can any one of
them be a stand-alone accurate and effective
diagnostic criterion . Accurate and effective malaria
diagnosis should thus involve a rational approach to
each patient with suspected malaria employing both
symptoms/signs-based and laboratory-based malaria
diagnostic methods.
29-11-2023 Dr.T.V.Rao MD 26
27. Emerging methods at even Smaller Clinks
• The prioritizing of any of the
malaria diagnostic methods, at
all times, should be influenced
by various factors including
malaria endemicity, transmission
pattern, the urgency of the
diagnosis, the experience of the
health worker, effectiveness of
the health care system, and
available budget resources.
29-11-2023 Dr.T.V.Rao MD 27
28. Rapid Diagnostic Tests
• RDTs do not require laboratory equipment and are all
based on the same principle and detect malaria
antigen in blood flowing along a membrane
containing specific anti- malaria antibodies . Most of
the available RDTs are P. falciparum protein specific
(either histidine rich protein II - or lactase
dehydrogenase-LDH) while some RDTs detect P.
falciparum and other Plasmodium proteins such as
aldolase or pan-malaria pLDH.
29-11-2023 Dr.T.V.Rao MD 28
29. Rapid diagnostic tests proving useful
• Several studies have
reported the
performance of RDTs to
be excellent. Inarguably,
RDTs are enhancing the
benefits of parasite-
based diagnosis of
malaria though not
without problems or
limitations
29-11-2023 Dr.T.V.Rao MD 29
30. Molecular Malaria laboratory diagnostic tests
• Molecular malaria techniques
such as PCR on blood or, more
recently, even on saliva samples
devised in Zambia by
(Mharakurwa et al), the loop-
mediated isothermal
amplification (LAMP),
microarray, mass spectrometry
(MS), and flow cytometry (FCM)
assay techniques are all new
developments mainly utilized in
research settings than during
routine patient care.
29-11-2023 Dr.T.V.Rao MD 30
31. Serology
• Serology detects antibodies
against malaria parasites,
using either indirect
immunofluorescence (IFA)
or enzyme-linked
immunosorbent assay
(ELISA). Serology does not
detect current infection but
rather measures past
exposure.
29-11-2023 Dr.T.V.Rao MD 31
32. Rapid Tests
•RDTs currently available
in the market are quite
a few and include
brands such as O p t i M
A L , P a r a c h e c k , I
C T, p a r a - s i g h t - F,
parascreen, and SD
Bioline.
29-11-2023 Dr.T.V.Rao MD 32
35. Free Living Amoeba
• Naegleria fowleri and
Acanthamoeba spp., are
commonly found in lakes,
swimming pools, tap water, and
heating and air conditioning units.
While only one species of
Naegleria, N. fowleri, is known to
infect humans An additional agent
of human disease, Balamuthia
mandrillaris, is a related free-living
amoeba that is morphologically
similar to Acanthamoeba in tissue
sections in light microscopy.
29-11-2023 Dr.T.V.Rao MD 35
36. Diagnostic Findings
• In Naegleria infections, the
diagnosis can be made by
microscopic examination of
cerebrospinal fluid (CSF). A wet
mount may detect motile
trophozoites, and a Giemsa-stained
smear will show trophozoites with
typical morphology. Confocal
microscopy or cultivation of the
causal organism, and its
identification by direct
immunofluorescent antibody, may
also prove useful.
29-11-2023 Dr.T.V.Rao MD 36
37. Naegleria fowleri/Primary Amoebic
Meningo encephalitis
• Early symptoms include severe,
throbbing headache, fever, nausea,
and vomiting.124 Most patients
have a history of swimming or
bathing in stagnant water.
• Meningismus is common, and
some patients present with
seizures or coma. Differentiation
between PAM and bacterial
meningitis can be difficult but is
crucial given the rapid progression
of N. fowlerii infection.
29-11-2023 Dr.T.V.Rao MD 37
38. Wet mounts are beneficial
• Organisms are not visualized
with Gram’s stain because
amoebas are killed during
the fixation process.
• CSF wet mount should be
performed to look for
trophozoites. Giemsa
staining of CSF may also be
useful. In the past,
29-11-2023 Dr.T.V.Rao MD 38
39. Acanthamoeba
• In Acanthamoeba infections,
the diagnosis can be made
from microscopic
examination of stained
smears of biopsy specimens
(brain tissue, skin, cornea)
or of corneal scrapings,
which may detect
trophozoites and cysts
29-11-2023 Dr.T.V.Rao MD 39
40. Acanthamoeba histolytica and Balamuthia
mandrillaris/Granulomatous Amoebic
• CNS infection by A.
histolytica is uncommon
in immunocompetent
hosts. In contrast to A.
histolytica, B.
mandrillaris causes
infection
inimmunocompetent and
immunosuppressed hosts
with equal frequency
29-11-2023 Dr.T.V.Rao MD 40
41. Corneal scrapings
•Definitive diagnosis
can be obtained by
demonstration of
trophozoites or cysts
of A. histolytica on
stained smears of
biopsy specimens or
corneal scrapings
29-11-2023 Dr.T.V.Rao MD 41
42. Immunofluorescence studies
• Direct IFA tests can be
useful. Differentiation
between B. mandrillaris and
A. histolytica infection
requires
immunofluorescence
studies. Examination of
contact lenses from patients
with keratitis can reveal A.
histolytica
29-11-2023 Dr.T.V.Rao MD 42
43. 1Trophozoite of N. fowleri in CSF, stained with haematoxylin and eosin
2Trophozoite of N. fowleri in CSF, stained with haematoxylin and eosin
29-11-2023 Dr.T.V.Rao MD 43
44. 1Cyst of Acanthamoeba sp. from brain tissue, stained with haematoxylin and
eosin
2Trophozoites of Acanthamoeba sp. in a corneal scraping, stained with H&E.
29-11-2023 Dr.T.V.Rao MD 44
45. Real-Time PCR
• A real-time PCR was
developed at CDC for
identification of
Acanthamoeba spp.,
Naegleria fowleri, and
Balamuthia mandrillaris in
clinical samples.1 This assay
uses distinct primers and
TaqMan probes for the
simultaneous identification
of these three parasites
29-11-2023 Dr.T.V.Rao MD 45
47. Cerebral toxoplasmosis : Centre for Disease
Control (CDC) criteria for diagnosis
•Recent onset of focal neurological
abnormality consistent with intracranial
disease or reduced consciousness
•Evidence from brain imaging of a lesion (CT
or MRI)
•Positive serum antibody to T. gondii or
response to treatment
29-11-2023 Dr.T.V.Rao MD 47
48. Diagnosis of toxoplasmosis
• Diagnosis of toxoplasmosis is rarely made through the
detection or recovery of organisms, but relies heavily
on serological procedures. Parasites can be detected
in biopsied specimens, buffy coat cells, or cerebral
spinal fluid. These materials can also be used to
inoculated mice or tissue culture cells. However,
detecting tachyzoites from these materials is difficult..
Therefore, serologic tests are recommended for
diagnosis
29-11-2023 Dr.T.V.Rao MD 48
49. IgM and Toxoplasmosis
• Acute infections are
characterized by high IgM
titres and/or a significant
increase in total antibody
titre in a sample taken two
weeks later. The serology
may also correlate with the
acute stage symptoms in
some individuals.
29-11-2023 Dr.T.V.Rao MD 49
50. Diagnostic tests for Toxoplasma
•Sabin-Feldman dye test (DT)
•Enzyme immunoassay for T. gondii specific IgM
(EIA)
•Immunsorbent agglutination assay (ISAGA)
•Enzyme immunoassay for IgG avidity
•Isolation and culture of parasite
•Direct detection by microscopy and PCR
29-11-2023 Dr.T.V.Rao MD 50
51. Persons with ocular disease
•Eye disease (most
frequently retinochoroiditis)
from Toxoplasma infection
can result from congenital
infection or infection after
birth by any of the modes of
transmission discussed on
the epidemiology and risk
factors page.
29-11-2023 Dr.T.V.Rao MD 51
52. Persons with compromised immune
systems
•Persons with
compromised immune
systems may
experience severe
symptoms if they are
infected with
Toxoplasma while
immune suppressed.
29-11-2023 Dr.T.V.Rao MD 52
53. Serology
•In the second situation, a second specimen
should be drawn and both specimens
submitted together to a reference lab which
employs a different IgM testing system for
confirmation. Prior to initiation of patient
management for acute toxoplasmosis, all
IgG/IgM positives should be submitted to a
reference lab for IgG avidity testing.
29-11-2023 Dr.T.V.Rao MD 53
54. Diagnosis
• The diagnosis of toxoplasmosis is
typically made by serologic testing.
A test that measures
immunoglobulin G (IgG) is used to
determine if a person has been
infected. If it is necessary to try to
estimate the time of infection,
which is of particular importance
for pregnant women, a test which
measures immunoglobulin M (IgM)
is also used along with other tests
such as an avidity test.
29-11-2023 Dr.T.V.Rao MD 54
55. Diagnosis by staining methods
• Diagnosis can be made by
direct observation of the
parasite in stained tissue
sections, cerebrospinal fluid
(CSF), or other biopsy
material. These techniques
are used less frequently
because of the difficulty of
obtaining these specimens.
29-11-2023 Dr.T.V.Rao MD 55
57. Cysticercosis
• This infection is caused by pork
tapeworm larvae (see Tapeworm
Infection). It is the most
common parasitic infection in
the Western Hemisphere. After
people eat food contaminated
with cysticercus eggs, secretions
in the stomach cause the eggs to
hatch into larvae. The larvae
enter the bloodstream and are
distributed to all parts of the
body, including the brain
29-11-2023 Dr.T.V.Rao MD 57
58. MRI AND CT SCNNING CONTINUES TO BE MAIN IN
STAY IN DIAGNOSIS
•Magnetic resonance
imaging (MRI) or
computed tomography
(CT) can often show the
cysts. But blood tests and
a spinal tap (lumbar
puncture) to obtain a
sample of cerebrospinal
fluid are often needed to
confirm the diagnosis.
29-11-2023 Dr.T.V.Rao MD 58
59. PRIMARY EXAMINATIONS
• Infection with adult T. solium
worms can usually be
diagnosed by microscopic
examination of stool samples
and identification of eggs
and/or proglottids. However, T.
solium eggs are present in ≤
50% of stool samples from
patients with cysticercosis.
29-11-2023 Dr.T.V.Rao MD 59
60. CDC standarsises the Immunoblot Testing
• The CDC's immunoblot
assay (using a serum
specimen) is highly specific
and more sensitive than
other enzyme
immunoassays (particularly
when > 2 CNS lesions are
present; sensitivity is lower
when only a single cyst is
present).
29-11-2023 Dr.T.V.Rao MD 60
61. Immunoblot assay
• CDC's immunoblot assay with
purified Taenia solium antigens
has been acknowledged by the
World Health Organization and
the Pan American Health
Organization as the
immunodiagnostic test of choice
for confirming a clinical and
radiologic presumptive diagnosis
of neurocysticercosis.
29-11-2023 Dr.T.V.Rao MD 61
62. We mainly Dependent on
• There are two available
serologic tests to detect
cysticercosis, the
enzyme-linked
immunoelectrotransfer
blot or EITB, and
commercial enzyme-
linked immunoassays.
29-11-2023 Dr.T.V.Rao MD 62
63. Antigen Detection
• Tests that detect circulating
cysticercal antigens in serum and
CSF have been developed and may
prove to be most useful to follow
response to therapy in in
subarachnoid and ventricular forms
of neurocysticercosis. Antigen
levels drop quickly in cured NCC
patients, so serum antigen
monitoring is useful for assessing
treatment and determining of
clinical cases.
29-11-2023 Dr.T.V.Rao MD 63
64. Antigen Detection Methods lack sensitivity
•Antigen detection
testing is not as
sensitive as antibody
detection and should
not be used to
diagnose
neurocysticercosis
29-11-2023 Dr.T.V.Rao MD 64
65. Molecular Detection
•PCR tests have been
developed to detect T.
solium DNA in CSF but
these are not widely
used for clinical
laboratory diagnosis of
neurocysticercosis.
29-11-2023 Dr.T.V.Rao MD 65
66. Schistosomiasis (Bilharzia)
• EPIDEMIOLOGY—Schistosomiasis
occurs in up to 300 million people
worldwide each year and is caused
by five species of blood flukes
(digenetic trematodes):
Schistosoma mansoni,
S.haematobium, S. japonicum, S.
intercalculatum, and S. mekongi.62
CNS involvement has beenreported
with three of the five species: S.
mansoni, S. haematobium, S.
japonicum
29-11-2023 Dr.T.V.Rao MD 66
67. Neurological involvement
• Neurological involvement usually
appears weeks ormonths after
initial infection when eggs migrate
through the vascular system to the
brain orspinal cord; symptoms may
result from mass effect of the egg
itself or from granulomaformation
around the egg. Because the
parasite likely enters the CNS via
Batson’s plexus,the spinal cord and
posterior fossa are the most
common sites of involvement
29-11-2023 Dr.T.V.Rao MD 67
68. DIAGNOSIS
• Definitive diagnosis of CNS
schistosomiasis is obtained by
identification ofan egg in biopsy
tissue. Detection of schistosomal
eggs in stool or urine confirms
the diagnosisof
schistosomiasis.14 Stool
examination is more sensitive for
S. mansoni and S. japonicum,and
examination of urine is best for
S. hematobium.
29-11-2023 Dr.T.V.Rao MD 68
70. Echinococcus (Hydatid Disease) CESTODES
• Hydatid infection often remains
undetected until cyst
enlargement produces
symptoms. The cyst can cause
more severe symptoms if it
ruptures or becomes super-
infected. Central nervous system
(CNS) involvement complicates 2
and 5% of infections with E.
granulosis and E. multilocularis,
respectively.1,3
29-11-2023 Dr.T.V.Rao MD 70
71. DIAGNOSIS
• Diagnosis of E. granulosus infection
can be confirmed by serum indirect
hemagglutination (IHA), indirect
fluorescent antibody (IFA), or
enzyme-linked immunosorbent
assay (ELISA), with assay sensitivity
rates ranging from 50 to 60% in
patients with pulmonary cysts to
98% in patients with hepatic cysts.
Serum assays to detect E.
multilocularis are more sensitive
than assays for E. granulosis and are
not cross-reactive
29-11-2023 Dr.T.V.Rao MD 71
72. NEUROIMAGING
• Contrast-enhanced
computerized tomography (CT)
of the brain is usually sufficient
for evaluation, but magnetic
resonance imaging (MRI) is
warranted if surgical
intervention is planned. CT
demonstrates cysts of various
sizes, sometimes in grapelike
clusters. Chronic disease may
develop a granulomatous
appearance
29-11-2023 Dr.T.V.Rao MD 72
73. Serum indirect hemagglutination
(IHA),
• Diagnosis of E.granulosus infection
can be confirmed by serum indirect
hemagglutination (IHA),
indirectfluorescent antibody (IFA),
or enzyme-linked immunosorbent
assay (ELISA), with assaysensitivity
rates ranging from 50 to 60% in
patients with pulmonary cysts to
98% in patientswith hepatic cysts.9
Serum assays to detect E.
multilocularis are more sensitive
than assaysfor E. granulosis and are
not cross-reactive.
29-11-2023 Dr.T.V.Rao MD 73
74. CDC Helps in Diagnosis of
Parasitic Infections
29-11-2023 Dr.T.V.Rao MD 74
75. I wish many use this Facility
• The modern generation
of Microbiologists can
use digital imaging
technology of parasitic
infections with Web site
developed and
maintained by CDC's
Division of Parasitic
Diseases and Malaria
(DPDM)
29-11-2023 Dr.T.V.Rao MD 75
76. CDC Helps with Tele diagnosis of Paasitic
Infection
• DPDx is a unique online
educational resource that
includes visual depictions of
parasite lifecycles, a
reference library of free
images of parasites, and
guidance on proper
laboratory techniques for
diagnostic parasitology. But
it is much more than a Web
site.
29-11-2023 Dr.T.V.Rao MD 76
77. 1Encysted larvae of Trichinella sp. in muscle tissue,
2 Babesia and Falciparum
29-11-2023 Dr.T.V.Rao MD 77
78. Diagnostic Assistance function
A Diagnostic Assistance
function, in which
laboratory and other health
professionals can ask
questions and/or send
digital images of specimens
for expedited review and
consultation with DPDx
staff. This assistance is free
of charge.
29-11-2023 Dr.T.V.Rao MD 78
79. Why we Stand Today In Diagnosis
•In spite of many Advances in Medical profession
the Parasitology suffers much lacunae in
diagnosis for optimal treatment, great reason
being lack of human dedication in the matters
concerned, parasitic infection identified with
poverty and lack of evaluation of skills in
matters of diagnostic talents in postgraduate
examinations, and above all non-availability of
advancing technologies
29-11-2023 Dr.T.V.Rao MD 79
80. The Great Question hunts many of us,
If we are true to our Job
Are we really
diagnosing the
Parasitic Infections?
29-11-2023 Dr.T.V.Rao MD 80
82. What Can be Done?
• Speciality of Parasitology
hangs between the
domains of Microbiology
and Pathologists. However
it needs more inputs and
coordination of Vetenary
sciences and Zoology
Professionals.
29-11-2023 Dr.T.V.Rao MD 82
83. •Program file created by Dr.T.V.Rao MD for
the benefit of Medical, Nursing and
Paramedical Professionals in the
Developing world
•doctortvrao@gmail.com
29-11-2023 Dr.T.V.Rao MD 83