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circulation and circulatory changes at birth By 12 weeks of fetal life the primitive vascular tube is fully developed. Fetal circulation di ff ers from that of the adult in that the right and left ventricles pump blood in parallel rather than in series. This ...

ACKNOWLEDGEMENT The authors acknowledge the contribution of Professor Ahmed Hassan Fahal MBBS, FRCS, FRCSI, FRCSG, MD, MS, FRCP (London), Professor of Surgery , University of Khartoum, Khartoum, Sudan, in the section relating to Mycetoma. ACKNOWLEDGEMENT Th...

AMOEBIASIS Introduction Amoebiasis is caused by Entamoeba histolytica. The disease is common in the Indian subcontinent, Africa and parts of Central and South America, where almost half the population is infected. The majority remain asymptomatic carriers. Th...

ASIATIC CHOLANGIOHEPATITIS Introduction This disease, also called oriental cholangiohepatitis, is caused by infestation of the hepatobiliary system by a trematode, Clonorchis sinensis. It has a high incidence in the tropical regions of South East Asia, parti...

Aetiology and pathology Cassava (tapioca) is a root vegetable that is readily available and inexpensive and is therefore consumed as a staple diet by people from a poor background. It contains derivatives of cyanide that are detoxified in the liver by sulphur-c...

Amoeboma This is a chronic granuloma arising in the large bowel, most commonly seen in the caecum. It is prone to occur in long standing amoebic infection that has been treated intermittently with drugs without completion of a full course, a situation that ar...

Classification In 2003, the WHO Informal Working Group on Echinoco - ccosis (WHO-IWGE) proposed a standardised ultrasound ( Table 6.1 ). This is universally accepted, particularly because it helps to decide on the appropriate management. Three groups have been ...

Clinical features and diagnosis The disease is slowly progressive and a ff ects the skin, upper respiratory tract and peripheral nerves. In tuberculoid leprosy , the damage to tissues occurs early and is localised to one part of the body , with limited deformi...

Clinical features The typical patient with an amoebic liver abscess is a young adult male with a history of insidious onset of non-specific symptoms, such as abdominal pain, anorexia, fever, night sweats, malaise, cough and weight loss. These symptoms gradual...

Clinical presentation As mycetoma is painless, presentation is late in the majority . It presents as a slowly progressive, painless, subcutaneous swell ing commonly at the site of presumed trauma. The swelling is variable in its physical characteristics: firm ...

Culture A variety of microorganisms are capable of producing myce - tomata that can be identified by their textural description, morphology and biological activities in pure culture. Deep surgical biopsy is always needed to obtain the grains that are the source...

Diagnosis The disease may remain dormant for many years. Clinical features are non-specific and include fever, malaise, anorexia and upper abdominal discomfort. The complete clinical picture can consist of fever with rigors due to ascending cholangitis, the co...

Differential diagnosis Mycetoma should be distinguished from Kaposi’s sarcoma, malignant melanoma, fibroma and foreign body (thorn) gran uloma. A radiograph that demonstrates the presence of bone destruction in the absence of sinuses is suggestive of tubercu...

Epidemiology and pathogenesis The condition predominantly occurs in the ‘mycetoma belt’ that lies between latitudes 15° south and 30° north, compris - ing the countries of Sudan, Somalia, Senegal, India, Y emen, Mexico, V enezuela, Columbia, Argentina and a f...

FILARIASIS Introduction Filariasis is mainly caused by the parasite Wuchereria bancrofti , which is transmitted by the mosquito. Variants of the parasite called Brugia malayi and Brugia timori are responsible for caus - ing the disease in about 10% of those ...

FURTHER READING AMOEBIASIS Barnes SA, Lillemore KD. Liver abscess and hydatid disease In: Zinner NJ, Schwartz I, Ellis H (eds). Maingot’s abdominal operations, 10th edn, vol. 2. New Y ork: Appleton and Lange, McGraw-Hill, 1997: 1527–45. Blessmann J, Van Linh P...

Fine-needle aspiration cytology Fine-needle aspiration cytology (FNAC) can yield an accurate diagnosis and helps in distinguishing between eumycetoma and actinomycetoma. The technique is simple, rapid and sensitive. Fine-needle aspiration cytology Fine-needle ...

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