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To report novel spectral domain optical coherence tomography and electrophysiologic findings in diffuse unilateral subacute neuroretinitis.
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Annual mass treatment with single-dose diethylcarbamazine (DEC) or ivermectin (IVM) in combination with albendazole (ALB) for 4-6 years is the principal tool of lymphatic filariasis (LF) elimination strategy. This placebo-controlled study examined the potential of six rounds of mass treatment with DEC or IVM to eliminate Wuchereria bancrofti infection in humans in rural areas in south India. A percentage of 54-75 of the eligible population (> or =15 kg body weight) received treatment during different rounds of treatment - 27.4% in the DEC arm and 30.7% in the IVM arm received all six treatments, 4.8% and 5.6% received none, and the remainder received one to five treatments. After six cycles of treatment, the microfilaria (Mf) prevalence in treated communities dropped by 86% in the DEC arm (P < 0.01) (n = 5 villages) and by 72% in the IVM arm (P < 0.01) (n = 5 villages), compared with 37% in the placebo arm (P < 0.05) (n = 5 villages). The geometric mean intensity of Mf fell by 91% (t = 8.11, P < 0.05), 84% (t = 6.91, P < 0.05) and 46% (t = 2.98, P < 0.05) in the DEC, IVM and placebo arms, respectively. The proportion of high-count Mf (>50 Mf per 60 mm(3) of blood) carriers was reduced by 94% (P < 0.01) in the DEC arm and by 90% (P < 0.01) in the IVM arm. Among those who received all six treatments, 1.4% in the DEC arm and 2.4% in the IVM arm remained positive for Mf. Two of five villages in the DEC arm and one of five in the IVM arm showed zero Mf prevalence, but continued to have low levels of transmission of infection. The results also indicate that DEC is as effective as or slightly better than IVM against microfilaraemia. Results from this and other recent operational studies proved that single-dose treatment with antifilarials is very effective at community level, feasible, logistically easier and cheap and hence a highly appropriate strategy to control or eliminate LF. Higher treatment coverage than that observed in this study and a few more than six cycles of treatment and more effective treatment tools/strategies may be necessary to reduce microfilaraemia to zero level in all communities, which may lead to elimination of LF.
Hookworm infection was found in the slum area of Eluru, West Godavari District, A.P. which has scheduled caste population. Infection is related to different climatic conditions and socio-economic status of the population. The inhabitants are coolies in agricultural fields and household workers with a poor level of hygiene and sanitation. All the infected positive cases showed Ancylostoma duodenale infection. The prevalence of hookworm infection was 15.6, 17.9 and 14 % in children, 23.5, 27.9 and 20.5 % in adults during summer, rainy and winter seasons respectively. Single species infection was studied in three periods. Out of 264 faecal samples, 128 children (40 males, 32.5 %) and 136 adults (64 men, 25 % and 72 women, 30.5 %) showed helminthic infection in rainy season. Much variation is seen in the prevalence of disease in rainy and winter seasons in all the age groups. The infected individuals were treated with albendazole just after rainy season. Three weeks after antihelminthic treatment, the infection rate among them was lowered; health education also plays a role in reducing the % of infection.
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Strongyloidiasis which is an infection caused by Strongyloides stercoralis, has a cosmopolitan distribution in tropical and subtropical regions; whereas, it is sporadic in Turkey. It is estimated that 30-100 million people are infected with this agent worldwide. The infection is usually asymptomatic, however, eosinophilia may be the only sign. S. stercoralis have the ability to persist and replicate within the host for decades and it may lead to infections with high mortality especially in immunocompromised host. Humans are generally infected transcutaneously with filariform larvae. Infections with S. stercoralis usually lead to cutaneous, gastrointestinal, or pulmonary symptoms. Definitive diagnosis of strongyloidiasis is made on the basis of detection of larvae in the stool, sputum or duodenal fluid. Hovewer, strongyloidiasis is difficult to diagnose since the parasite load is low and the larval output is irregular in majority of the patients. This situation necessitates the collection of consecutive samples and the use of concentration techniques. The burden of Strongyloides may be overlooked in especially non-endemic regions. Strongyloidiasis should be considered before the application of immunosuppressive therapy in patients with unexplained eosinophilia, serpiginous skin lesions, or pulmonary or gastrointestinal symptoms. The goal of treatment is to eliminate the parasites and ivermectin is the drug of choice. Besides, albendazole or thiabendazole may used as alternative agents in the treatment. Improved human waste disposal services are considered to be the main requirement to reduce the high prevalence of this disease. In this review, it was aimed to withdraw attention to strongyloidiasis and to overview its prevalence, clinical manifestations, diagnosis, management and prevention strategies.
We present the case of an asymptomatic Loa loa disease in a 28-year-old Nigerian man living in Italy for 5 years. The man was admitted to our clinic for an occasional identification of hypereosinophilia (white blood cell count 5440/mmc, eosinophil 42%) and the presence of microfilaria at an hemoscopic evaluation. The diagnosis was made by testing the diurnal peripheral blood that showed a parasitaemia of 7000 microfilia/mL. The patient was treated with ivermectin 12 mg on the first day followed by albendazole 400 mg every 12 hours for 21 days with a reduction but no negativization of the parasitaemia and no collateral effect. Filariasis should be considered in all patients who come from or have stayed in endemic areas or who present alterations in the leukocyte formula, including hypereosinophilia, or some unexplainable allergic disorders. The lab diagnosis can be conducted through a hemoscopic test or directly with the identification of the adult worm, whereas the parasitaemia can be evaluated only through a hemoscopic test. The therapy can be non-conclusive or carried out with difficulty as finding diethylcarbamazine may be a hard task or potentially fatal anaphylactic reactions may occur.
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Hepatic lesions resembling subacute and chronic fasciolosis of ruminants were identified. An adult fluke was recovered from the liver of one of the birds and was identified as F hepatica. The eggs of the fluke were irregular in shape and size. No fluke eggs were identifiable in faeces of live emus 10 days after treatment of the flock with albendazole at a dose of 10 mg/kg.
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Four studies involving 305 people met the inclusion criteria. None reported on withdrawal of anticonvulsant therapy, headache relief, disability or death as outcomes. A difference just approaching significance was detected between cysticidal therapy and placebo in relation to cyst persistence up to six months (relative risk 0.83, 95% confidence interval 0.70 to 0.99). Two trials reported on seizures after one to two years follow-up and found no difference (relative risk 0.95, 95% 0.59 to 1.51). There was no difference detected for hydrocephalus (relative risk 2.19, 95% confidence interval 0.29 to 16.55).
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Outbreaks of eosinophilic meningitis are reported rarely, even in regions of endemic infestation with the roundworm Angiostrongylus cantonensis, such as the Pacific Basin. We report a cluster of eosinophilic meningitis presumably attributable to A. cantonensis among French policemen returning from French Polynesia.
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In calves given various doses of albendazole as a 4.55% (w/v) drench suspension, removal efficacies against mature Fasciola hepatica were 77.5% with the dose of 7.5 mg/kg; 92.3%, with 10 mg/kg; and 85.9%, with 15 mg/kg. Against immature F hepatica, drug efficacies with these doses were 32.7%, 20.0%, and 36.7%, respectively. Reductions in length and width measurements of mature and immature flukes recovered from the bile ducts correlated with the larger doses reflected a greater efficacy against mature flukes or a possible inhibiting effect of the drug on fluke size or growth. Numbers of eggs recovered in bile at necropsy were reduced by 87.8% with the dose of 7.5 mg/kg; 91.8%, with 10 mg/kg; and 95.6%, with 15 mg/kg.
Hydatid disease is endemic in many parts of the world. Mediastinal hydatidosis is seen less than 0.1% of all hydatid diseases. We want to report our primary mediastinal hydatid cysts.
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Primary pelvic hydatid cyst is a rare entity. Pelvic hydatid cysts usually present with pressure symptoms involving adjacent organs (bladder and rectum usually). A case of primary pelvic hydatid cyst presenting with obstructive uropathy leading to chronic renal failure is presented. A combination of preoperative albendazole therapy of 1.2 g/day for 8-12 weeks and surgical excision were effective in alleviating the symptoms and improving the renal function.
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With hydatid cyst, the skeletal muscles and diaphragm are rarely affected, and hepatic and pulmonary hydatid cysts are far more common. We report a case with an unusual localization of diaphragmatic and serratus muscle anterior hydatidosis that occurred simultaneously.
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Cardiac ecchinococcosis is a rare disease. Its incidence varies from 0.02-2%. Commonly seen in the left ventricle arising from the myocardium in the subepicardial region.We report a 15-year-old boy presented with a rare combination of a left ventricular subendocardial hydatid cyst associated with multiple cysts in the left cerebral hemisphere and right posterior occipital lobe. The patient underwent successful surgical excision of the left ventricular hydatid cyst using cardiopulmonary bypass.
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S1 guideline, non-systematic literature search, consensus process using a circular letter.
Clonorchis sinensis, or Chinese liver fluke, is a parasite of the fish-eating mammals endemic in the East Asia, Far East, particularly in China, Japan, Taiwan, Vietnam, and Korea and among immigrant refugees to European Union and Eastern Mediterranean Countries. This paper reported infection among Egyptian family who practice consumption of imported fishes from the Far East. Diagnosed was based on detection of its characteristic eggs, positive specific ELISA, radiological and family behavior and feeding habit history. Patients were successfully treated.