Human Ascariasis: An Updated Review

Author(s):  
Alexander K.C. Leung ◽  
Amy A.M. Leung ◽  
Alex H.C. Wong ◽  
Kam L. Hon

Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide. Objective: This article aimed to provide an update on the evaluation, diagnosis, and treatment of ascariasis. Methods: A PubMed search was conducted in February 2020 in Clinical Queries using the key terms “ascariasis” OR "Ascaris lumbricoides". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. The search was restricted to the English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term “ascariasis” OR "Ascaris lumbricoides" in www.freepatentsonline.com. Results: Ascaris lumbricoides is transmitted through ingestion of embryonated eggs from fecal-contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include poverty, poor sanitation, inadequate sewage disposal, and poor personal hygiene. The prevalence is greatest in children younger than 5 years of age. The majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension, and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely, depending on the underlying complications. Complications include Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis, and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova. Patients with A. lumbricoides infection warrant anthelminthic treatment, even if they are asymptomatic, to prevent complications from migration of the parasite. Albendazole and mebendazole are the drugs of choice for children and nonpregnant individuals with ascariasis. Pregnant women with ascariasis should be treated with pyrantel pamoate. Recent patents related to the management of ascariasis are also discussed. Conclusion: The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta, and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.

2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.


2020 ◽  
Vol 16 ◽  
Author(s):  
Alexander K. C. Leung ◽  
Joseph M. Lam ◽  
Kin Fon Leong ◽  
Kam Lun Hon

Background: Vitiligo is a relatively common acquired pigmentation disorder that can cause significant psychological stress and stigmatism. Objective: This article aims to familiarize physicians with the clinical manifestations, evaluation, diagnosis, and management of vitiligo. Methods: A Pubmed search was conducted in Clinical Queries using the key term "vitiligo". The search included metaanalyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to the English literature. The information retrieved from the above search was used in the compilation of the present article. The information retrieved from the above search was used in the compilation of the present article. Results: Approximately one quarter of patients with vitiligo have the onset before 10 years of age. Genetic, immunological, neurogenic and environmental factors may have a role to play in the pathogenesis. Vitiligo typically presents as acquired depigmented, well-demarcated macules/patches that appear milk- or chalk-white in color. Lesions tend to increase in number and enlarge centrifugally in size with time. Sites of predilection include the face, followed by the neck, lower limbs, trunk, and upper limbs. The clinical course is generally unpredictable. In children with fair skin, no active treatment is usually necessary other than the use of sunscreens and camouflage cosmetics. If treatment is preferred for cosmesis, topical corticosteroids, topical calcineurin inhibitors, and narrowband ultraviolet B phototherapy are the mainstays of treatment. Conclusion: The therapeutic effect of all the treatment modalities varies considerably from individual to individual. As such, treatment must be individualized. In general, the best treatment response is seen in younger patients, recent disease onset, darker skin types, and head and neck lesions. Topical corticosteroids and calcineurin inhibitors are the treatment of choice for those with localized disease. Topical calcineurin inhibitors are generally preferred for lesions on genitalia, intertriginous areas, face, and neck. Narrowband ultraviolet B phototherapy should be considered in patients who have widespread vitiligo or those with localized vitiligo associated with a significant impact on the quality of life who do not respond to treatment with topical corticosteroids and calcineurin inhibitors.


2020 ◽  
Vol 11 (2) ◽  
pp. 126-132
Author(s):  
I Gede Gita Sastrawan ◽  
Jordaniel Setiabudi ◽  
Ni Putu Sanjiwani ◽  
Ni Komang Indriyani ◽  
Dewa Ayu Laksemi

Latar belakang: Infeksi kronis dari soil transmitted helminth (STH) dapat menyebabkan gangguan gizi, pertumbuhan dan kognitif pada anak. Untuk mengurangi dampak infeksi STH, diperlukan identifikasi faktor risiko. Penelitian ini bertujuan untuk mengidentifikasi faktor risiko yang berhubungan dengan infeksi STH pada siswa sekolah dasar di Desa Seraya Timur, Karangasem, Bali. Metode: Penelitian ini menggunakan desain potong lintang dengan mengambil total sampel. Penelitian dilaksanakan pada bulan Januari 2020. Data primer mengenai faktor-faktor risiko infeksi STH dikumpulkan dengan menggunakan kuesioner. Diagnosis infeksi STH dilakukan dengan pemeriksaan tinja dengan metode Kato-Katz. Analisis data menggunakan uji chi-square untuk menentukan faktor risiko yang berhubungan dengan infeksi STH. Hasil: Sebanyak 83 siswa yang berusia 6-12 tahun berpartisipasi dalam penelitian ini. Terdapat 9 siswa (10.84%) yang terinfeksi STH dengan intensitas infeksi ringan. Sebanyak 55.56% terinfeksi Trichuris trichiura, 33.33% terinfeksi Ascaris lumbricoides dan 11.11% terinfeksi cacing tambang. Terdapat beberapa faktor risiko yang memiliki hubungan bermakna dengan infeksi STH diantaranya adalah sering bermain tanah (OR=6.86; 95%CI 1.326-35.494), bermain tanpa alas kaki (OR=10.5; 95%CI 1.249-88.278) tidak mencuci tangan setelah bermain tanah (OR=9.450; 95%CI 1.809-49.358) dan tidak memotong kuku secara rutin (OR=6.462; 95%CI 1.250-33.388).  Pemberian obat cacing setiap enam bulan mampu memberikan efek proteksi terhadap infeksi STH (OR=0.085; 95%CI 0.016-0.449). Kesimpulan: Kebersihan diri menjadi faktor risiko yang berhubungan dengan infeksi STH. Direkomendasikan untuk meningkatkan promosi kesehatan terkait kebersihan diri disamping pemberian obat cacing setiap enam bulan. Kata kunci: Faktor risiko, infeksi STH, anak sekolah dasar   Abstract   Background: Chronic soil transmitted helminth (STH) infection might cause nutritional, growth and cognitive impairment in children. Identifying the risk factors of STH infection is crucially needed to minimize the infection effects. This study aimed to identify risk factors associated with STH infections among primary school students in Seraya Timur Village, Karangasem, Bali. Methods: This study used a cross-sectional design with a total sampling method. The study was conducted in January 2020. Risk factors data were collected using a questionnaire. The diagnosis of STH infection was done by stool examination with the Kato-Katz method. The chi-square test was used to determine the risk factors associated with STH infection. Results: 83 students with ages ranging from 6-12 years participated in this study. There were 9 students (10.84%) whose infected with mild infection of STH. 55.56% of students were infected by Trichuris trichiura, 33.33% were Ascaris lumbricoides infections and 11.11% were hookworm infections. There were several risk factors that significantly associated with STH infection including ground’s playing (OR=6.86; 95%CI 1.326-35.494), barefoot (OR=10.5; 95%CI 1.249-88.278), did not wash hands after playing soil (OR=9.450; 95%CI 1.809-49.358) and did not routinely cut their nails (OR=6.462; 95%CI 1.250-33.388). Deworming every six months could provide a protective effect against STH infection (OR=0.085; 95%CI 0.016-0.449). Conclusion: Personal hygiene is a risk factor associated with STH infection. It is recommended to increase personal hygiene promotion besides dewormed every six months. Keywords: Risk factors, STH infection, primary school students


2021 ◽  
Vol 3 (3) ◽  
pp. 131-139
Author(s):  
Donaliazarti Donaliazarti

Leptospirosis is a disease caused by spirochaeta microorganism of the genus Leptospira, while the amoebic liver abscess is an extraintestinal complication by Entamoeba Histolytica. Both diseases occurred in a 45-year-old man with poor personal hygiene and environment sanitation. Amoebic liver abscess was found to be a coincidence that was thought to have existed before the patient developed leptospirosis so that the two diseases caused overlapping clinical manifestations in the patient, but the acute symptoms experienced by the patient at the time of admission were more likely to be caused by his leptospirosis. Patient complained of high fever, yellowing of the skin and eyes, urinating like concentrated tea, stiffness in both legs, nausea, vomiting and heartburn. On physical examination found febrile, tachycardia, icteric on skin and sclera, ciliary injection, and hepatomegaly. Laboratory tests showed mild anemia with normocytic normochromic features, leukocytosis with neutrophilia shift to the right, thrombocytosis, increased ESR, prolonged APTT, hyperbilirubinemia, elevated SGOT SGPT, ALP and GGT enzymes, hypoalbuminemia, hyperglobulinemia, and bilirubinuria. Microscopic examination with negative staining of urine samples found Leptospira. Abdominal ultrasound examination showed a solitary space occupying lesion (SOL) in the right lobe of the liver and on serological examination showed positive antiamoeba. Based on the above, this patient was diagnosed as having coincident leptospirosis with amoebic liver abscess.


2006 ◽  
Vol 130 (12) ◽  
pp. 1865-1870 ◽  
Author(s):  
Brian P. Adley ◽  
Norm D. Smith ◽  
Ritu Nayar ◽  
Ximing J. Yang

Abstract Context.—Birt-Hogg-Dubé (BHD) syndrome is a rare clinicopathologic condition transmitted in an autosomal dominant fashion. This complex entity is characterized by cutaneous fibrofolliculomas, kidney tumors, pulmonary cysts, and spontaneous pneumothorax. Recently, the gene possibly responsible for the clinical manifestations of BHD syndrome has been cloned and characterized. The few reviews of BHD syndrome found in the English literature mostly focus on the skin lesions or genetics, with limited information on other pathologic changes, particularly the kidney lesions. Objective.—To review the literature on this subject with a special emphasis on BHD syndrome-associated renal pathology as well as recent advances in molecular genetic discovery of the BHD syndrome. Data Sources.—We used all data available after performing a literature search using MEDLINE and searching under the headings “Birt-Hogg-Dubé,” “hybrid oncocytic tumors,” and “folliculin.” Conclusions.—The presence of BHD syndrome should be investigated in any patient with multiple bilateral kidney tumors, especially if the predominant histologic type is chromophobe renal cell carcinoma or the so-called hybrid oncocytic tumor. The genetic alteration for BHD syndrome has been mapped to chromosome 17p12q11, and the gene in this region has been cloned and believed to be responsible for the BHD syndrome. The function of the BHD product, called folliculin, is still unknown, although it is speculated to be a tumor suppressor gene. Numerous mutations have been described in the BHD gene. Studies are ongoing to determine the relationship between the BHD gene and development of sporadic renal cell carcinoma and other lesions.


2020 ◽  
Vol 16 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Amy A.M. Leung ◽  
Alex H.C. Wong ◽  
Kam Lun Hon

Background: Sleep terrors are common, frightening, but fortunately benign events. Familiarity with this condition is important so that an accurate diagnosis can be made. Objective: : To familiarize physicians with the clinical manifestations, diagnosis, and management of children with sleep terrors. Methods: A PubMed search was completed in Clinical Queries using the key terms " sleep terrors" OR " night terrors". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: It is estimated that sleep terrors occur in 1 to 6.5% of children 1 to 12 years of age. Sleep terrors typically occur in children between 4 and 12 years of age, with a peak between 5 and 7 years of age. The exact etiology is not known. Developmental, environmental, organic, psychological, and genetic factors have been identified as a potential cause of sleep terrors. Sleep terrors tend to occur within the first three hours of the major sleep episode, during arousal from stage three or four non-rapid eye movement (NREM) sleep. In a typical attack, the child awakens abruptly from sleep, sits upright in bed or jumps out of bed, screams in terror and intense fear, is panicky, and has a frightened expression. The child is confused and incoherent: verbalization is generally present but disorganized. Autonomic hyperactivity is manifested by tachycardia, tachypnea, diaphoresis, flushed face, dilated pupils, agitation, tremulousness, and increased muscle tone. The child is difficult to arouse and console and may express feelings of anxiety or doom. In the majority of cases, the patient does not awaken fully and settles back to quiet and deep sleep. There is retrograde amnesia for the attack the following morning. Attempts to interrupt a sleep terror episode should be avoided. As sleep deprivation can predispose to sleep terrors, it is important that the child has good sleep hygiene and an appropriate sleeping environment. Medical intervention is usually not necessary, but clonazepam may be considered on a short-term basis at bedtime if sleep terrors are frequent and severe or are associated with functional impairment, such as fatigue, daytime sleepiness, and distress. Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors. Conclusion: Most children outgrow the disorder by late adolescence. In the majority of cases, there is no specific treatment other than reassurance and parental education. Underlying conditions, however, should be treated if possible and precipitating factors should be avoided.


2012 ◽  
Vol 78 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Lya Crichlow ◽  
Sarah Walcott-Sapp ◽  
Joshua Major ◽  
Bernard Jaffe ◽  
Charles F. Bellows

Acute acalculous cholecystitis has been identified as a rare but potentially devastating entity after trauma, and burns, as well as in critically ill patients, and in the postoperative period. Gastrointestinal surgery is most frequently implicated in postoperative acute acalculous cholecystitis, especially after gastric and colorectal procedures. Review of the English literature identified 28 articles reporting 76 cases of acute acalculous cholecystitis after gastrointestinal operations, which included a case from Tulane University Medical Center of a 64-year-old man who developed postoperative acute acalculous cholecystitis after elective left hemicolectomy. A total of 52.4 per cent of the patients developed gangrenous acute acalculous cholecystitis, with a mortality rate of 21.1 per cent, much higher than that reported in postoperative calculous cholecystitis. This emphasizes the need for a high level of suspicion and early detection in the postoperative period to avoid devastating consequences.


2019 ◽  
Vol 56 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Eduardo Pachu Raia dos SANTOS ◽  
Fernando SANTA CRUZ ◽  
Eduarda Araújo HINRICHSEN ◽  
Álvaro Antônio Bandeira FERRAZ ◽  
Josemberg Marins CAMPOS

ABSTRACT BACKGROUND: Internal hernia (IH) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a major complication that challenges the surgeon due to its non-specific presentation and necessity of early repair. Delayed diagnosis and surgical intervention of IH might lead to increased morbidity of patients and impairments in their quality of life. OBJECTIVE: To evaluate the predictive factors for early diagnosis and surgical repair of IH after LRYGB. METHODS: This study analyzed 38 patients during the postoperative period of LRYGB who presented clinical manifestations suggestive of IH after an average of 24 months following the bariatric procedure. RESULTS: The sample consisted of 10 men and 28 women, with a mean age of 37.5 years and a mean body mass index (BMI) of 39.6 kg/m2 before LRYGB. All patients presented pain, 23 presented abdominal distension, 10 had nausea and 12 were vomiting; three of them had dysphagia, three had diarrhea and one had gastro-esophageal reflux. The patients presented symptoms for an average of 15 days, varying from 3 to 50 days. Seventeen (45.9%) patients were seen once, while the other 20 (54.1%) went to the emergency room twice or more times. Exploratory laparoscopy was performed on all patients, being converted to laparotomy in three cases. Petersen hernia was confirmed in 22 (57.9%). Petersen space was closed in all patients and the IH correction was performed in 20 (52.6%) cases. The herniated loop showed signs of vascular suffering in seven patients, and two (5.3%) had irreversible ischemia, requiring bowel resection. CONCLUSION: The presence of recurrent abdominal pain is one of the main indicators for the diagnosis of IH after LRYGB. Patients operated at an early stage, even with negative imaging tests for this disease, benefited from rapid and simple procedures without major complications.


2019 ◽  
Vol 6 (2) ◽  
pp. 78-82
Author(s):  
Eka Tanti Fauzia ◽  
Lilis Majidah ◽  
Dwi Prasetyaningati

Pendahuluan:Infeksi cacing Ascaris lumbricoides di Indonesia cukup tinggi yang umumnya ditularkan melalui tanah ataupun makanan. Anak yang sering kontak dengan tanah dan juga masih sering tidak mencuci tangan sebelum makan bisa terjadi terinfeksi kecacingan karena cacing STH seperti cacing Ascarislumbricoides.Cacing jenis ini hidup di daerah yang beriklim panas dengan kelembapan yang tinggi.Tujuan: Penelitian ini adalah untuk mengidentifikasi adanya telur Ascarislumbricoides pada siswa kelas 3 Sekolah Dasar Negeri Badas Desa Badas Kecamatan Sumobito Kabupaten Jombang. Metode: Desain penelitian ini adalah deskriptif. Identifikasi telur cacing Ascarislumbricoides ini menggunakan metode langsung dengan menggunakan larutan Eosin. Sampel yang digunakan yaitu feses siswa kelas 3 Sekolah Dasar Negeri Badas Desa Badas Kecamatan Sumobito Kabupaten Jombang yang diambil di Sekolah Dasar Negeri Badas Desa Badas Kecamatan Sumobito Kabupaten Jombang dan hasil disajikan dalam bentuk tabel.Hasil:Penelitian dari 14 sampel feses siswa kelas 3 Sekolah Dasar Negeri Badas Desa Badas Kecamatan Sumobito Kabupaten Jombang yang telah di uji di Laboratorium Parasitologi STIKes ICMe Jombang menunjukkan hampir seluruhnya terinfeksi telur cacing Ascarislumbricoides 86%.Kesimpulan:Berdasarkan penelitian yang telah dilakukan  diharapkan para siswa Sekolah Dasar Negeri Badas terutama pada siswa kelas 3 supaya lebih memperhatikan personal hygiene, tidak terlalu lama kontak dengan tanah dan supaya dibiasakan mencuci tangan sebelum makan atau minum.Saran :Saran yang diberikan penulis yaitu diharapkan kepada pihak sekolah supaya memberikan penyuluhan tentang pencegahan infeksi kecacingan pada siswa Sekolah Dasar Negeri Badas Kecamatan Sumobito Kabupaten Jombang terutama pada siswa kelas 3, serta edukasi untuk melakukan pengobatan pada siswa yang terinfeksi.


2019 ◽  
Vol 7 (4) ◽  
pp. 86 ◽  
Author(s):  
Natalia Yuwono ◽  
Dominicus Husada ◽  
Sukmawati Basuki

Soil transmitted helminthiasis are common in the world and cause illness, especially in developing countries. It can cause infection in humans by contact with parasitic eggs or larvae that live in moist and warm soil. Soil-transmitted helminthiasis is often caused by Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. In Indonesia, Soil transmitted helminthiasis prevalence is still high in some places. The tropical climate and high humidity support for the development of worms like in Sorong District, but there was no data. The purpose of this study is to identify the presece of Soil transmitted helminthiasis in primary school children in Sorong District. A cross-sectional study was conducted in two elementary schools located in Sorong District, West Papua, Indonesia. The two elementary schools are SDN 22 in Klain village and SD  Inpres 24 in sub-district Mayamuk. Once collected, the pot that has contained stool is given formalin 10%. Stool examinattion using direct smear method to determine the presence of soil transmitted helminthiasis. Researchers get the subject as many as 147 children. The proportion of elementary school children by sex consists of 72 boys (49%) and 75 girls (51%). The prevalence of Soil transmitted helminthiasis as a whole was 30.6% (45/147) with 40.1% (18/45) single infections and 59.9% (27/45) mixed infections. The single infection that most frequent is Trichuris trichiura, then followed by Ascaris lumbricoides. Soil-transmitted helminthiasis mostly found in girl than boy and mostly found in 6-9 years age group.  The worm species that infect elementary school children in the district is Ascaris lumbricoides, Trichuris trichiura, Hookworm, and Strongyloides stercoralis. This is probably related with the climate and low sanitation level. To eliminate soil transmitted helminthiasis among elementary school children, in addition to routine treatment also needs intensive counseling about the importance of maintaining personal hygiene and the environment.


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