Lamblia Cysts Research Articles

THERAPUTIC EFFICACY OF PROBIOTICS AGAINST EXPERIMENTAL GIARDIASIS: HISTOPATHOLOGICAL, HISTOCHEMICAL AND ULTRASTRUCTURAL CHANGES

Giardia lamblia, protozoan intestinal flagellate, is the causative agent of human giardiasis. Currently used therapeutic agents have significant side effects or contraindicated in some clinical conditions and show failure due to drug resistance. This study evaluated the probiotic in vivo-therapeutic efficacy; potent Acidophillus probiotics versus metronidazole againstgiardiasis in experimentally infected mice, by histopathological changes of intestinal mucosa, and their impact on the ultrastructure of the pathogenic trophozoites. Forty seven Swiss albino mice were divided into groups: GI: 2 mice non-infected, nontreated mice. GII: 15 mice only infected with G. lamblia cysts, (non-treated). GIII: 15 mice infected and treated orally with potent Acidophillus probiotics. G IV: 15 mice infected with G. lamblia cysts and treated orally with metronidazole. All mice were subjected to parasitological, histo-pathological, goblet cells mucous secreting activity and trophozoite ultrastructural studies. There was high significant difference between the infected non-treated controls and potent Acidophillus-treated group concerning; patent period, infection intensity, reduction percentage of cyst shedding and cure rate, but without significant difference between potent Acidophillus-of treated group and metronidazole-treated group.

THERAPUTIC EFFICACY OF PROBIOTICS AGAINST EXPERIMENTAL GIARDIASIS: HISTOPATHOLOGICAL, HISTOCHEMICAL AND ULTRASTRUCTURAL CHANGES

Giardia lamblia, protozoan intestinal flagellate, is the causative agent of human giardiasis. Currently used therapeutic agents have significant side effects or contraindicated in some clinical conditions and show failure due to drug resistance. This study evaluated the probiotic in vivo-therapeutic efficacy; potent Acidophillus probiotics versus metronidazole againstgiardiasis in experimentally infected mice, by histopathological changes of intestinal mucosa, and their impact on the ultrastructure of the pathogenic trophozoites. Forty seven Swiss albino mice were divided into groups: GI: 2 mice non-infected, nontreated mice. GII: 15 mice only infected with G. lamblia cysts, (non-treated). GIII: 15 mice infected and treated orally with potent Acidophillus probiotics. G IV: 15 mice infected with G. lamblia cysts and treated orally with metronidazole. All mice were subjected to parasitological, histo-pathological, goblet cells mucous secreting activity and trophozoite ultrastructural studies. There was high significant difference between the infected non-treated controls and potent Acidophillus-treated group concerning; patent period, infection intensity, reduction percentage of cyst shedding and cure rate, but without significant difference between potent Acidophillus-of treated group and metronidazole-treated group.

Anti-parasitic Activity of Some Medicinal Plants Essential Oils on Giardia lamblia and Entamoeba histolytica, In Vitro

Background and objectives: Giardiasis and amoebiasis are two common diseases in human societies which make increasing problems for the health managing systems. In the present study, the antiparasitic activity of Allium sativum, Artemisia sieberi, Zatraria multiflora, Chenopodium botrys and Eucalyptus globulus essential oils on Giardia lamblia cysts and Entamoeba histolytica trophozoites were investigated in vitro. Methods: Giardia lamblia cysts and E. histolytica trophozoites were isolated from infected sample stools. The parasites were treated by four concentrations (0.2, 0.1, 0.01 and 0.001 µg/mL) of essential oils, separately for 30 min at 37 °C. Results: Theessential oils at the concentration of 0.1 and 0.2 µg/mL indicated appreciate parasiticidal effect (p <0.05). Eucalyptus globulus had maximum efficacy on both G. lamblia and E. histolytica with mortality rates of 79.7% and 87.6% within 30 min. Conclusion: All essential oils showed potent anti-giardiasis and anti-amoebiasis activity. Also, E. globulus with the highest efficiency could be considered as anti-protozoa medication to use an adjunct or primary therapy.

Diagnosis of parasitic infections in vermiform appendix in patients with appendicitis in Kirkuk city, Iraq

The present study is conducted in Kirkuk city, Iraq; between July to December 2018. Within this period 197 resected appendix are examined to investigate the parasitic infections that may associated with appendicitis. Direct with concentrated methods are used in luminal content examinations. Also, histological examination of haematoxylin and eosin stained tissue sections is performed to diagnose the parasitic infections in the lumen and within the appendix tissue. The parasitic infection reported in 12.69% cases included four species, as well as a mixed infection. Entamoeba histolytica (trophozoite and cyst), Giardia lamblia (trophozoite and cyst), Cryptospordium sp.(oocyst) and Enterobious vermicularis (adult worm and ova) are recorded. The most common determined parasite is E. histolytica (8.63%). The parasitic infection within the resected appendix reported in females (8.12%) more than males (4.57%). The parasitic infections in the study are prevalent in patients within the age groups 13 to 18 years and 19 to 24 years (3.55% for each one).

Giardiasis Alters Intestinal Fatty Acid Binding Protein (I-FABP) and Plasma Cytokines Levels in Children in Brazil.

Giardiasis is an intestinal infection caused by ingestion of water or food contaminated with cysts of Giardia lamblia. Susceptibility is higher in children and overall prevalence can reach up to 90% in low-income areas, although outbreaks are also reported in developed countries. Both parasite and immune-mediated epithelial damage has been observed in vitro and in animal models. However, whether enterocytes are directly damaged during infection is not entirely known. Our goal was to identify whether plasma levels of intestinal fatty acid binding protein (I-FABP), a marker of enterocyte damage, are related to the immune response in giardiasis. Blood plasma was collected from 31 children (19 Giardia-positive) from a public day care in Rio de Janeiro, Brazil. The levels of I-FABP were increased in Giardia-infected children compared to children without detectable infection. There was no difference in I-FABP levels in giardiasis caused by different genetic assemblages of Giardia. Levels of IL-8 were decreased, while there was a trend to elevated IL-17 in the Giardia-positive children. A positive correlation was observed between I-FABP and IL-17 levels as well as TNF, suggesting that epithelial damage can be related to cytokine production during giardiasis. These results help elucidate the relationship between the disruption of the intestinal mucosal barrier and immune responses to G. lamblia in children.

Therapeutic Efficacy of Tomex (Allicin) versus Metronidazole in Experimental Giardia lamblia infection: Ultrastructural and Histopathological studies

Background: Giardia lamblia, a protozoan intestinal flagellate, is the causative agent of human giardiasis allover the world. The current therapeutic agents have considerable adverse effects or be contraindicated in certain clinical situations and may show failure due to drug resistance. Aim of the study: This study was to evaluate the in vivo therapeutic efficacy of Tomex versus Meteronidazole against giardiasis; to declare the histopathological changes of the intestinal mucosa, and their impact on the ultrastructure of the pathogenic trophozoites. Material and Methods: Fourty seven Swiss albino mice divided as following: Group I: 2 non-infected, non-treated mice. Group II: 15 mice, only infected (non-treated). Group III: 15 mice, infected with G. lamblia cysts and treated orally with Tomex. Group IV: 15 mice, infected with G. lamblia cysts and treated orally with Metronidazole. These mice were subjected to parasitological, histopathological and ultrastructural studies. Results: The patent period, intensity of infection, cyst shedding and cure rate in groups treated by Tomex revealed a highly significant difference in comparison with the non-treated control and insignificant difference in comparison with Metronidazole, a finding that might be beneficial in clinical situations, at least, where current chemotherapy is contraindicated. Conclusion: Tomex proved to be injurious to the parasite with evident morphological changes; causing improvement of histopathological changes of the intestinal mucosa, rapid clearance of the parasite and control of giardiasis.

Microfluidic diffraction phase microscopy and its application in parasites measurement

This paper proposes a method of using diffraction phase microscopy combined with microfluidic chip to quantitatively measure waterborne parasites. A diffraction phase microscopy system is built up by combining interferometry with optical microscope to achieve high sensitivity real-time measurement of parasites. Based on soft lithographic techniques, a double-layered microfluidic chip with U-shaped trapping structures is designed and fabricated for high throughput single parasites trapping. Ficoll solution with the same refractive index as polydimethylsiloxane (PDMS) is introduced into the microfluidic chamber to eliminate significant artifacts in phase imaging originating from diffraction at the edges of trapping structures. The accuracy of the system is verified using standard polystyrene microspheres of different diameters, and the error of maximum phase shift does not exceed 3%. 100 Giardia Lamblia (G. Lamblia) cysts and 100 Cryptosporidium Parvum (C. Parvum) oocysts are measured using this system. The phase maps of the parasites are obtained from the interferograms. The morphological parameters and quantitative optical volume difference distribution of the two kind of waterborne parasites are obtained by analyzing the quantitative phase maps. Quantitative data provides the basis for understanding their physiological characteristics. The microfluidic diffraction phase microscopy system has simple structure, good stability and high measurement accuracy, and has great potential for real-time monitoring and label-free quantitative studies of single microorganism.

Evaluation of the effectiveness of sterilization materials added to drinking water in the elimination of the Larval stages of parasites in Al-Najaf Al-Ashraf Governorate

The study was conducted to investigate the cysts and eggs of intestinal parasites in drinking water in four models of drinking water for water purification projects in Al-Najaf Al-Ashraf Governorate for the period from 1/10/2017 to 1/10/2018. The results of the examination of river water in four districts in Al-Najaf Al-Ashraf governorate showed the presence of five species of parasites are cysts of Entamoeba histolytica by 39%, and the eggs of the Ascaris worm by 12%, worm Ancylostoma duodenale by 4%, Giardia lamblia cysts 40%, and the eggs of Enterobius vermicularis by 18%. The results of the tap water examination showed that there were five types of intestinal parasites, but at a lower rate than in river water, Entamoeba histolytica cysts by 16%, eggs of Ascaris by 7%, Ancylostoma duodenale eggs by 2%, Giardia lamblia cysts by 29%, and Enterobius vermicularis by 5% overall.

Establishment and evaluation of the detection method of Cryptosporidium specific DNA fragment by recombinase aided isothermal amplification

To establish a recombinase-aided isothermal amplification (RAA) assay for detection of Cryptosporidium. Based on Cryptosporidium-specific 18S rRNA selected as the target gene to be detected, and the primer sequences and fluorescent probes designed using the software Amplfix, and a fluorescent RAA assay was established and optimized. The fluorescent RAA assay was performed to detect 18S RNA target sequence-contained recombinant plasmids at various copies, genomic DNA of Cryptosporidium oocysts at various concentrations, and genomic DNA extracted from various numbers of Cryptosporidium oocysts to assess the sensitivity of the assay, and to detect genomic DNA extracted from Cryptosporidium oocysts, Giardia lamblia cysts, Schistosoma japonicum eggs, Ascaris lumbricoides eggs, Clonorchis sinensis eggs, Salmonella and Shigella to determine the specificity of the assay. A fluorescent RAA assay was successfully established, which was effective to amplify the specific 18S RNA gene fragments of Cryptosporidium within 20 min at 39 ℃. The lowest limits of the fluorescent RAA assay were 102 copies/μL for detection of 18S RNA target sequence-contained recombinant plasmids at various copies, 1 pg/μL for detection of genomic DNA of Cryptosporidium oocysts at various concentrations, and one Cryptosporidium oocyst/μL for detection of genomic DNA extracted from various numbers of Cryptosporidium oocysts, and the fluorescent RAA assay was all negative for detection of genomic DNA from G. lamblia cysts, S. japonicum eggs, A. lumbricoides eggs, C. sinensis eggs, Salmonella and Shigella. A novel fluorescent RAA assay is successfully established, which is simple, rapid, sensitive and specific to detect genomic DNA of Cryptosporidium oocysts.

Microfluidic diffraction phase microscopy for high-throughput, artifact-free quantitative phase imaging and identification of waterborne parasites

An artifact-free microfluidic diffraction phase microscopy (MFDPM) system to measure quantitative phase maps of individual Giardia lamblia (G. lamblia) cysts and Cryptosporidium parvum (C. parvum) oocysts is developed. The system includes a diffraction phase imaging unit aligned with a polydimethylsiloxane (PDMS) microfluidic chip. The microfluidic chip consists of arrays of U-shaped hydrodynamic trapping structures used to trap single cysts/oocysts, and a micromixer to precisely adjust the refractive index of immersion medium in the microfluidic chamber. When the refractive index of immersion medium is tuned to be equal to that of PDMS, the pronounced artifacts in quantitative phase imaging (QPI) originating from diffraction and scattering at the edges of trapping structures can be eliminated. The artifact-free quantitative phase maps of single microparticles are retrieved using Goldstein’s algorithm. Principal component analysis (PCA) is implemented to extract the distinctive features of the quantitative phase maps of G. lamblia cysts and C. parvum oocysts, and they can be identified with 100% accuracy using linear discriminant analysis (LDA) algorithm. The MFDPM is demonstrated to be a simple, accurate and high-throughput technique for artifact-free quantitative phase imaging of waterborne protozoa, and has great potential for label-free and rapid detection and identification of waterborne microorganisms.

Intestinal Parasites Associated with Opportunistic Coccidial Infections Among Immunocompromised Individuals in Central Iran: A Cross Sectional Study

Background: Protozoa and helminthic parasites are the most common opportunistic parasites infections associated with the gastrointestinal tract in immunocompromised patients. Objectives: There have been very few studies addressing this issue in central Iran and our purpose was to determine the frequency of the intestinal parasitic infections (IPIs) in different groups of immunocompromised patients admitted to the referral hospitals in Isfahan, Iran. Methods: A cross-sectional study was performed on 204 immunocompromised patients (HIV/AIDS, lymphoma, leukemia, renal transplant and other transplants) between 2015 - 2016. Stool samples were analyzed for intestinal parasites using direct-smear, formol-ether concentration method and modified Ziehl-Neelsen staining techniques. Results: The total rate of any parasites was 43.1% (88/204) in the patients. The prevalence of parasites was 32.7% (17/52), 39.6% (19/48), 46.2% (18/39), 56.0% (28/50), and 40.0% (6/15) in HIV/AIDS, lymphoma, leukemia, renal transplant recipients, and the other transplant recipients, respectively. Blastocystis hominis (30.4%), Cryptosporidium spp. (3.9%), Entamoeba coli (6.3%), Giardia lamblia cyst (5.4%), Endolimax nana (2%), ova of Fasciola spp. (0.5%) and Dicrocoelium dendriticum (0.9%) were the overall parasites that were found in this study. The most common parasites which were related to diarrhea were Blastocystis hominis and Cryptosporidium spp. The parasitic infection was significantly higher in urban patients and females (P < 0.05). Nevertheless, no significant relationship was observed between the prevalence of parasitic infections and age, occupation and level of education. Conclusions: Our findings highlighted that IPIs are a common health problem among immunocompromised patients, in central Iran. Therefore these patients should be screened routinely for intestinal parasites and treated promptly.

Effects of some natural products from fungal and herbal sources on Giardia lamblia in vivo.

Giardia lamblia (G. lamblia) is the most widely known protozoan parasite that causes human gastrointestinal infection worldwide. Some natural compounds exhibited pivotal effects against different infectious diseases. In this research, the antigiardial activity and cytotoxicity of fungal chitosan, nano-chitosan, Rhamnus cathartica (R. cathartica) and emodin were evaluated in Balb/c mice. Genotyping of G. lamblia was assessed by PCR-RFLP technique. Different concentrations of mentioned compounds were used to check their antigiardial and cytotoxicity effects on human intestinal epithelial cells (HT-29) after 24, 48 and 72 h. The G. lamblia strain used in the current work was genotyped and revealed as an AII assemblage. All the concentration showed acceptable activity against G. lamblia cysts and trophozoites in comparison to the negative and positive controls (furazolidone and metronidazole) in vitro (P 0.05). The maximum mortality rate (100%) was achieved at 100 and 50 µg kg-1 concentrations after 48 and 72 h of exposure time, respectively. Our results provide significant information about the new antigiardial agent and proposed the nano-chitosan and emodin for the development of new drugs against G. lamblia in the future.

Giardia lamblia affecting humans in Sohag governorate and its relation with some physical measurements

Background and study aim: Giardiasis is a gastrointestinal disease, caused by the protozoan parasites Giardia lamblia. Thisinfection occurs through the ingestion of contaminated water or food by Giardia lamblia cysts. The aim of this study was to correlate between the presence of Giardia lamblia and some physical measurements. Subjects and methods: the experimental study was performed at the laboratories of Parasitology Department, Faculty of Medicine, Sohag University from October 2016 to October 2017. It was done on 93 patients, who had Giardia from different localities in Sohag governorate after examination of stool samples by saline and iodine wet mount. History taking and some physical measurements, like weight and height, using a meter, a scale and growth charts were taken for cases included in this study. Results: There was a decrease in height, 50 (53.8%), weight for height, 49 (52.7%), body mass index, 45 (48.4%), and weight, 33 (35.5%), of cases with Giardia lamblia infection by different proportions.

Research and identification of Cryptosporidium and Giardia lamblia in wastewater treatment plants

Introduction: Cryptosporidium spp. and Giardia lamblia are parasitic protozoa that are responsible for diarrhea and gastroenteritis in humans and animals. The most frequently identified source of infestation is water, and exposure involves either drinking water or recreation water. In young and old people as well as in immunocompromised individuals it can cause severe diarrhea, syndrome of malabsorption, growth delay and death. Since the cysts and oocysts are resistant to some treatments used in domestic water systems it is important to understand if the treatment done in wastewater treatment plants (WWTP) is efficient or not. The aim of this work was to evaluate if treatment done in WWTP is enough to eliminate this infections forms. Materials and methods: Samples of 3L were collected before and after the treatment in 7 WWTP of SIMTEJO in the great Lisbon area (Alcantara, Beirolas, Chelas, Ericeira, Frielas, Malveira and São João da Talha). All the samples were concentrated by centrifugation in Centrifuge 5810R (3500 rpm/3 min), followed by 24h of sedimentation. Microscopic analysis for research and identification of Cryptosporidium oocysts and Giardia cysts after different staining methods was done. Results: Before treatment, all water samples presented Cryptosporidium oocysts and Giardia lamblia cysts. All the WWTP that have done the tertiary treatment with chlorine continue to present oocysts and cysts. Only WWTP of Beirolas and of Frielas that have used UV rays, as final treatment, did not presented the resistant parasitic forms (cysts and oocysts). Discussion and conclusions: These results suggest that treatment with chlorine is not efficient to eliminate oocysts or cysts, which is in agreement with other studies as reported by Omarova et al. [1]. The presence of these resistant forms in water represents a risk factor of contamination of population in general, specially children, elderly people and immunocompromised individuals. The treatment of water should not be neglected.

INFECTION OF COMMON PROTOZOAN AND HELMINTHES PARASITES IN THE INTESTINE, UNDER FINGER NAIL’S CONTENT AND ASSOCIATED PREDISPOSING FACTORS AMONG THE ASYMPTOMATIC FOOD HANDLERS WORKING IN THE STUDENT CAFETERIA OF DILLA UNIVERSITY

Background: Infection of food borne diseases is a public health problem in developed and developing countries. Ingestion of infective eggs and cysts of faeco- orally transmissible parasites has been linked with the level of knowledge of infection cycle, environmental and personal hygiene. Asymptomatic food- handlers with poor personal hygiene working in the food cafeteria could be potential sources of infection and these individuals need continuous investigation of parasitic infection. &#x0D; Objectives: This study was aimed at investigating the prevalence of common protozoan and helminthes parasitic infections and associated predisposing factors among the asymptomatic food handlers working in the student cafeteria of Dilla University. &#x0D; Methods: A total of 153 asymptomatic food handlers were involved in the study and specimens of the stool and under fingernail’s content were examined using the standard parasite and ova method. The specimen collected from under fingernail’s content and stool specimens were detected by direct microscopy using saline and iodine wet mount preparation to demonstrate the presence of eggs, and protozoan cysts. Species of parasites were morphologically identified based on their microscopic characteristics and the analysis of the data was made manually using the thematic framework method. &#x0D; Results: From the total of 153 study participants, 60 (39.2%) of the asymptomatic food handlers were found to have either single or double infections due to Ascaris lumbricoides egg, Tsrichuris trichiura egg, Entoamoeba histolytica/dispar cyst, Giardia lamblia cyst, Taenia species egg and Schistosoma mansoni egg. Of the total 60 (39.2%) positive cases, 58 (96.7%) positive cases were identified from the stool specimen and 2(3.3%) positive cases were from the specimen collected from the under fingernail’s content. Moreover, of the total 60 infected asymptomatic food handlers, 46(76.7%) had single infection and 14(23.3%) with double infections. Double infection was due to parasites including A.lubricoides with T. trichiura 5(8.3%), A. lumbriodes with T.species 3(5%), A.lubricoides with E.histolytica/dispar cyst 5(8.3%), and E.histolytica/dispar cyst with T.species 1(1.7%). This result also showed knowledge deficiency of food handlers on associated predisposing factors related to infectious cycle working in student cafeteria. &#x0D; Concluding Remarks and Recommendation: The present study indicated a high prevalence of intestinal parasites in asymptomatic (apparently health) food handlers and such infected food handlers of any food service establishment could serve as potential source of infection to consumers via infectious cycles. Therefore, we need to develop a culture of awareness creation on personal hygiene, environmental sanitation, and food and water safety, mode of parasitic infection and frequent screening of food-handlers to monitor parasitic infections. Moreover, parasitic detection also could be cheaply done using direct microscopy of stool examination.

Urinary circulating DNA and circulating antigen for diagnosis of schistosomiasis mansoni: a field study.

To evaluate three non-invasive assays for the diagnosis of schistosomiasis mansoni in an Egyptian village. Urine was collected for the detection of circulating cathodic antigen (CCA) and cell-free parasite DNA (cfpd) by Point-of-contact (POC)-cassette assay and PCR, respectively. These tests were compared to Kato-Katz (KK) faecal thick smear for detection of Schistosoma mansoni eggs. Disease prevalence by POC-CCA assay was 86%; by PCR it was 39% vs. 27% by KK. Compared to KK, the sensitivity of POC-CCA reached 100%, but its specificity was only 19.2% with 41% accuracy. Sensitivity of the PCR assay for cfpd was 55.56%, and specificity was 67.12% with 64% accuracy. A new end point was calculated for combined analysis of KK, POC-CCA assay and PCR. Sensitivity for the three tests was 52.94%, 90.2% and 76.47%; specificity was 100% for KK and PCR and 18.37% for POC-CCA. The accuracy calculated for the three tests at the end point was 76% for KK, 55% for POC-CCA assay and 88% for PCR. Conventional PCR assay for detection of cfpd provides a potential screening tool for intestinal schistosomiasis with reliable specificity, reasonable accuracy and affordable financial and technical cost.

In-vitro antigiardial activity and GC-MS analysis of Eucalyptus globulus and Zingiber officinalis essential oils against Giardia lamblia cysts in simulated condition to human’s body

In order to finding of potent natural medication/agent which can kill giardial cysts in the interval between lysing of outer membrane of cysts due to exposure by acidic condition of stomach and their encystation in proximal small intestine, In-vitro antigiardial activity and GC-MS analysis of Eucalyptus globulus and Zingiber officinalis against Giardia lamblia were studied in simulated condition to human’s body singly and in combination. Essential oils were extracted and their chemical components were identified via GC-MS method. After purification, cysts were exposure to acidic condition and were challenged by different concentrations of essential oils in simulated condition to human’s body. Percentages of inactivated (killed) cysts as efficacy of antigiardial activity were calculated and analyzed statistically. Presence of 1,8-eucalyptol, α-pinene, α-terpineol acetate, etc. in essential oil of E. globulus and presence of geraniol, α-zingiberene, (E,E)-α-farnesene, etc. in Z. officinalis essential oil were identified. Highest antigiardial activity (73.55%) was observed for eucalyptus essential oil in time 480 minutes after exposure. Efficacies of ginger and combined essential oils were different in different times. This study shows considerable antigiardial activity for both of essential oils singly and in combination together against giardial cysts. In-vivo study of protective effect of these essential oils against giardiasis can be considered as a subject for next studies.

Effect of &amp;lt;i&amp;gt;Commiphora molmol&amp;lt;/i&amp;gt; (Myrrh) Extract on Mice Infected by &amp;lt;i&amp;gt;Giardia lamblia&amp;lt;/i&amp;gt;

Objective: To investigate the efficacy of (Commiphora molmol(Myrrh)) extract as alternative treatment in hamsters against giardiasis. This study was conducted to evaluate the effect of the new compound (Commiphora molmol(Myrrh)), as agent a natural product extracted from the roots of Zingiber officinal, on Giardia lamblia infection as anti-protozoal and to study the parasitological and Histopathological impact of this treatment on the duodenal mucosa of infected hamsters. Fifty hamsters were divided into five groups: Group (A): normal control. Group (B): Giardia lamblia infected and untreated hamsters served as control. Group (C): infected with Giardia lamblia and treated with metronidazole in dose (120 μg/kg body weight twice daily for 7 successive days). Group (D) Giardia lamblia infected and orally treated with Myrrh (500 mg/Kg for 1 week). Group (E): Giardia lamblia infected and orally treated with combination 1/3 dose of (120 μg/kg body weight) metronidazole and Myrrh (250 mg/Kg) for 1 week). After 2 weeks of the treatment, hamsters were sacrificed. The highest percentages of reduction in the number of Giardia lamblia cysts and trophozoites were in the group receiving combined metronidazole and myrrh. Histopathological examination revealed complete healing of intestinal mucosa after the combined treatment, while partial healing of the lining epithelium of the intestine was noticed after metronidazole and either myrrh plant treatment.

Giardia lamblia affecting humans in Sohag governorate and its related symptoms

Background and study aim: Giardiasis is a gastrointestinal disease, caused by the protozoan parasites Giardia lamblia. Thisinfection occurs through ingestion of contaminated water or food by Giardia lamblia cysts. The aim of this study was to correlate between the presence of Giardia lambilia and different gastrointestinal symptoms. Subjects and methods: experimental study was performed at the laboratories of Parasitology Department, Faculty of Medicine, Sohag University from October 2016 to October 2017. It was done on 93 patients, who had Giardia from different localities in Sohag governorate after examination by saline and iodine wet mount. History taking and questionnaire survey about gastrointestinal symptoms was followed. Results: Diarrhea was the first complaint that affected all cases, abdominal colic was the second most common complaint affecting 84 (90.3 %) cases, followed by failure to thrive affecting 32 (34.5 %) cases, followed by abdominal distension affecting 26 (28 %) cases, and vomiting affecting 6 (6.6 %) of cases. Conclusion: We concluded that However diarrhea was the first complaint that affected all cases, abdominal colic was the second most common complaint affecting 84 (90.3 %) cases, followed by failure to thrive affecting 32 (34.5 %) cases, followed by abdominal distension affecting 26 (28 %) cases, and vomiting affecting 6 (6.6 %) of cases.

Seeing Spots: Eosinophilic Abscess as an Endoscopic Marker of Giardiasis

Introduction:Giardia lamblia is recognized as the most common protozoan found in the gastrointestinal tract, with the prevalence up to 60% in developing countries. Though typical symptoms may include diarrhea, abdominal discomfort, nausea, and dyspepsia, these are certainly not ubiquitous. A large retrospective review delineated diarrhea in only 29% of patients and abdominal pain in 71%. Gross upper endoscopic features of Giardiasis are nonspecific, including duodenal ulcers and duodenitis, and may be unremarkable in 75% of cases. Colonoscopic features have rarely been reported. To our knowledge, this case represents the first documentation of eosinophilic microabscesses visualized on colonoscopic examination in association with Giardia lamblia. CASE: A 49-year-old Ethiopian man was evaluated for episodic melena over 6 months. He denied abdominal pain, weight loss, fevers, alcohol or NSAID use. Laboratory testing revealed a hemoglobin of 14.3 g/dL, thrombocytopenia to 83 K/uL and peripheral eosinophilia of 11.1%. On upper endoscopy, a normal esophagus and stomach were visualized, though within the duodenal bulb, edema, inflammation, and an apthous ulcer were identified. Biopsies from the stomach and duodenum noted varied degrees of eosinophilic infiltration in the lamina propria, most prominently in the duodenal bulb, without suggestion of Helicobacter pylori. Colonoscopy revealed multiple subcentimeter white mucosal plaques within the cecum with mild surrounding erythema, as well as 3 small “polyps”. Biopsies from these cecal lesions showed polypoid colonic mucosa with marked patchy eosinophilic infiltration in the lamina propria. Both trichrome staining on duodenal aspirate and stool microscopy revealed moderate Giardia lamblia cysts and trophozoites. The patient was treated with oral metronidazole with resolution of symptoms. DISCUSSION: Screening for Giardia with stool microscopy or stool antigen detection by ELISA can be misguided by false negatives due to irregular parasite shedding. Giardia cysts or trophozoites may be identified in duodenal aspirate or on small bowel biopsy. Visualization of similar mucosal and submucosal white plaques or exudates have been reported in association with other hypereosinophilic disorders such as Eosinophilic Esophagitis. Given our case, visualization of these lesions on colonoscopy may prompt consideration of biopsy and analysis of stool to evaluate for parasitic infections such as Giardia lamblia.1915_A Figure 1. Duodenal Bulb endoscopic findings of edema, erythema, erosions, and superficial ulceration.1915_B Figure 2. Multiple sub-centimeter white mucosal plaques seen in the cecum, and identified throughout the colon.1915_C Figure 3. Cecal biopsy showing polypoid colonic mucosa with marked patchy eosinophilic infiltration in the lamina propria.