CLINICAL FEATURES - Minimal except for anal and parianal itching.

may prove fatal. DIAGNOSIS - Larvae of S. stercorails may be found in sputum of in lung and jejunal biopsy samples, as also duodenal contents and faeces. TREATMENT - Thiabendazoie 25 mg/kg b.d. for 5 days (maximum dose 3g/day) after meals. The tablets must be chewed. Side effects • Nausea, anorexia, vomiting, diarrhoea and giddiness. Rarely drowsiness. pruritus, xanthopsia, bradycardia and hypotension. Urine often smells of asparagus. Albendazole 400 mg/day for 3 days in adults, teptomeninges). Myelogram showing multiple tilling detects. Positive immunological tests (serum immunoblot and CSF enzyme-linked immunosorbent assay) for detection of anticysticercal antibodies. Plain radographs showing 'cigar-shaped' calcifications in (high and calf muscles TREATMENT - Nictosamide - Adults - Single dose of 2.0 gm. Children under 5 years of age - Single dose of 0.5gm. Older children -Single dose of 1.0 gm. The tablets should be given on empty stomach, chewed thoroughly and washed down with a little water. A purgative e recommended if the dead. segments are not passed out within a few hours. Praziquantel - Single dose of 5-10 mg/kg after a light breakfast (all age groups). For cerebral cysticercosis - Praziquantel 50 mg/kg/day for 15 days, or Albendazole 15 mg/kg/day for 30 days. Treatment is considered successful when the sacolex is found, no proglottids appear within 4 months of tharapy in case of T. saginata. faecal examination ramains negative for 3 months after treatment incase of T. solium Enterobiasis -is caused by the pinworm (thread worm) E. vermicularis. The adult threadworms live in the colon and rectum. and the gravid female emerges from the anus to deposit the eggs on the surrounding skin. These eggs if swallowed liberate the contained larvae which mature as they pass down the intestine. CLINICAL FEATURES - Minimal except for anal and parianal itching. Heavy infestation may cause insomnia due to pruritus. anorexia and abdominal discomfort. COMPLICATIONS -Appendicitis is a known intestinal complication. Non-intestinl complicaitions- include vulvo-vaginitis inyoung girls and occasionally endometritis and chronic pelvic poritonitis due to granulomas formed round staying enterobius worms. invasion of the urinary tract, which faciliates bacterial infection may cause enuresis. Some patients with pritected or recurrent infection have psychological problems DIAGNOSIS - Adult female E. vermicularis can be seen in perianal area, in faeces. or during proctoscopy or vaginoscopy. Presence of eggs can be demonstrated by applying adhesive cellophane tape to the perianal skin for microscopic inspection at night. removed and examined the next morning. TREATMENT Mebendazole - Single dose of 100 mg (all ages). Pyrantel - Single dose of 10mg/kg (maximum 500 mg) Pyrivinium - Single dose of 5 mg/kg (maximum 600 mg). Piperazine citrate - 85 mg/kg or 7 days (maximum 2 5 mg) Sporadic infections are usually cured by one treatment. In internsive and symptomatic infections, drug therapy snould be rapeated after 2 weeks, and then if necessary every 2 months. Adjuvant measures - to prevent reinfection. Nails should be cut short and gloves and close-titting sleeping drawers should be worn at night. Childs hands must be scrubbed will brush before meals. All infected members of the family should be treated simultaneously. Strongyloidiasis - is caused by the nematode Strongyloides stercoralis. Infection is acquired in the same way as hookworms and thereafter it is self-perpetuating. CLINICAL FEATURES - (a) Asymptomatic. (b) Skin - Penetration of larvae causestranslent linear, itching erythema, (c) Respiratory - Pneumonitis and Loeffier's syndrome (during lung migration). (d) Intestinal - Ufcerative and/or hemmorrhagic enteritis due to superficial inflammation of jejunal mucosa, resulting in savere hypoproteinamia and anemia. (e) Acute disseminated stronglyloidisis - may develop during pregnancy, puerperium. or in immunosuppressed subjects when it may prove fatal. DIAGNOSIS - Larvae of S. stercoralis may be found in sputum or in lung and jejunal biopsy samples, as also duodenal contents and faeces. TREATMENT - Thiabendazole 25 mg/kg b.d for 5 days (maximum dose 3 g/day) after meals. The tablets must be chawed. Side effects - Nausea, anorexia, vomiting, diarrhoea and giddiness. Rarely drowsiness, pruritus, xanthopsia, bradycardia and hypotension. Urine often smells of asparagus. Albandazole 400 mg/day for 3 days in adults, TREATMENT - Praziquantel in three equal doses of 20 mg/kg at 4h intervals with meals. Apart from mild sids-effects of drowsiness, headache, dizziness, etc. a syndrome of severe abdominal pain followed by bloody diarrhoea may occur. PREVENTION -1. Protection of small habitats from infection by provision of clean water and toilet facilities, and health education 2 Mass therapy with oxamniquine. metriphonate or praziquantel to reduce amount of egg excretion 3 Snail destruction by improved irrigation methods and use of moIluscicides. 4. Prevention of infection by wearing protective clothing 18. HYDATlD DISEASE : Defination - Hydatid disease of man is zoonosis caused by infection with tapeworm larvae of the genue Echinococcus. There are two forms -(a) Cystic: The much more common E. granulasus causes unilocular hydatid cysts and is