Back Pain

Back pain (also known "dorsalgia") is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.

The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain. It may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may be felt in the neck (and might radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling.

Back pain is one of humanity's most frequent complaints. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year.

The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities.

Treatment
The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible; to restore the individual's ability to function in everyday activities; to help the patient cope with residual pain; to assess for side-effects of therapy; and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain to a manageable level to progress with rehabilitation, which then can lead to long term pain relief. Also, for some people the goal is to use non-surgical therapies to manage the pain and avoid major surgery, while for others surgery may be the quickest way to feel better.

Not all treatments work for all conditions or for all individuals with the same condition, and many find that they need to try several treatment options to determine what works best for them. The present stage of the condition (acute or chronic) is also a determining factor in the choice of treatment. Only a minority of back pain patients (most estimates are 1% - 10%) require surgery.

Symptom

Symptoms may be chronic, relapsing or remitting. They also may progressively worsen or progressively become better (convalescence). Conditions may also be classified as symptomatic (present and demonstrating symptoms) or asymptomatic (present but without symptoms). Asymptomatic conditions exist for years undiagnosed and may only be found upon medical testing (such as high blood pressure).Constitutional or general symptoms are those that are related to the systemic effects of a disease (e.g., fever, malaise, anorexia, weight loss). They affect the entire body rather than a specific organ or location.

The terms "chief complaint", "presenting symptom", or "presenting complaint" are used to describe the initial concern which brings a patient to a doctor. The symptom that ultimately leads to a diagnosis is called a "cardinal symptom".

Symptom versus signA symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.

A feature might be sign or a symptom, or both, depending on the observer(s). For example, a skin rash may be noticed by either a healthcare professional as a sign, or by the patient as a symptom. When it is noticed by both, then the feature is both a sign and a symptom.

Some features, such as pain, can only be symptoms, because they cannot be directly observed by other people. Other features can only be signs, such as a blood cell count measured in a medical laboratory.

Symptomatic treatment

is any medical therapy of a disease that only affects its symptoms, not its cause, i.e., its etiology. It is usually aimed at reducing the signs and symptoms for the comfort and well-being of the patient, but it also may be useful in reducing organic consequences and sequelae of these signs and symptoms of the disease. In many diseases, even in those whose etiologies are known (e.g., most viral diseases, such as influenza), symptomatic treatment is the only one available so far.

Examples of symptomatic treatments:

• Analgesics, for pain
• Anti-inflammatory agents, for inflammation caused by arthritis
• Antitussives, for cough
• Antihistaminics, for allergy
• Brain shunts, to alleviate hydrocephalus

When the etiology for the disease is known, then specific treatment may be instituted, but it is generally associated to symptomatic treatment, as well.

Symptomatic treatment is not always recommended, and in fact it may be outright dangerous, because it may mask the presence of an underlying etiology which will then be forgotten or treated with great delay. Examples:

• Low-grade fever for 15 days or more sometimes is the only symptom of bacteremia by staphylococcus bacteria. Suppressing it by symptomatic treatment will hide the disease from effective diagnosis and treatment with antibiotics. The consequence may be severe (rheumatic fever, nephritis, endocarditis, etc.)
• Chronic headache may be caused simply by a constitutional disposition or be the result of a brain tumor or a brain aneurysm.

Finally, symptomatic treatment is not exempt of adverse effects, and may be a cause of iatrogenic consequences (i.e., ill effects caused by the treatment itself), such as allergic reactions, stomach bleeding, central nervous system effects (nausea, dizziness, etc.).

Brain tumor

A brain tumor (brain tumour in the UK and Canada; see spelling differences) is any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors). Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain. In the United States in the year 2005, it was estimated that there were 43,800 new cases of brain tumors (Central Brain Tumor Registry of the United States, Primary Brain Tumors in the United States, Statistical Report, 2005–2006), which accounted for 1.4 percent of all cancers, 2.4 percent of all cancer deaths, and 20–25 percent of pediatric cancers. Ultimately, it is estimated that there are 13,000 deaths per year in the United States alone as a result of brain tumors.

Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as gamma knife radiosurgery, remains a viable option.
Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.
Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with a chemical (5-aminolevulinic acid) that causes them to fluoresce . Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors.
UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. They also show a listing of chemotherapy agents used to treat high grade glioma tumors.
Patients with benign gliomas may survive for many years, while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored.
The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.
A shunt operation is used not as a cure but to relieve the symptoms. The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation.

Cancer

Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.
Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Cancer causes about 13% of all deaths. According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007. Cancers can affect all animals.
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells[citation needed]. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.
Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.

Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy or other methods. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient (performance status). A number of experimental cancer treatments are also under development.
Complete removal of the cancer without damage to the rest of the body is the goal of treatment. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness. The effectiveness of chemotherapy is often limited by toxicity to other tissues in the body. Radiation can also cause damage to normal tissue.
Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases.

Surgery
In theory, non-hematological cancers can be cured if entirely removed by surgery, but this is not always possible. When the cancer has metastasized to other sites in the body prior to surgery, complete surgical excision is usually impossible. In the Halstedian model of cancer progression, tumors grow locally, then spread to the lymph nodes, then to the rest of the body. This has given rise to the popularity of local-only treatments such as surgery for small cancers. Even small localized tumors are increasingly recognized as possessing metastatic potential.
Examples of surgical procedures for cancer include mastectomy for breast cancer and prostatectomy for prostate cancer. The goal of the surgery can be either the removal of only the tumor, or the entire organ. A single cancer cell is invisible to the naked eye but can regrow into a new tumor, a process called recurrence. For this reason, the pathologist will examine the surgical specimen to determine if a margin of healthy tissue is present, thus decreasing the chance that microscopic cancer cells are left in the patient.
In addition to removal of the primary tumor, surgery is often necessary for staging, e.g. determining the extent of the disease and whether it has metastasized to regional lymph nodes. Staging is a major determinant of prognosis and of the need for adjuvant therapy.
Occasionally, surgery is necessary to control symptoms, such as spinal cord compression or bowel obstruction. This is referred to as palliative treatment.

Heart disease

There are many types of heart disease. About 25% of all Americans have one or more types of cardiovascular disease. The major types of heart disease are atherosclerosis, coronary, rheumatic, congenital, myocarditis, angina and arrhythmia. Heart disease can arise from congenital defects, infection, narrowing of the coronary arteries, high blood pressure, or disturbances.
The first stages of heart disease are lesions and cracks forming in the blood vessel walls normally at the points of highest pressure or stress (near the heart). The second stage is the body trying to repair itself by depositing fatty substances (cholesterol, lipoproteins) inside the blood vessels to fill the cracks. Over time, without the proper body nutrient, vitamin C, to help keep the blood vessel walls from cracking and requiring constant repair, these fatty substances can begin to build up and clog the blood vessels causing stroke and heart attack

Symptoms of heart disease varies according to the type of heart disease. Unfortunately, some heart diseases cause no symptoms early in its course. When symptoms occur, they vary from person to person. Symptoms may may include chest pain, shortness of breath, weakness and fatigue, palpitations (the sensation of the heart beating in the chest), lightheadedness, and fainting, or feeling about to faint.

Lungs

The Lungs are paired organs in the chest that perform respiration. Each human has two lungs. Each lung is between 10 and 12 inches long. The two lungs are separated by a structure called the mediastinum. The mediastinum contains the heart, trachea, esophagus, and blood vessels. The lungs are covered by a protective membrane called the pulmonary pleura

Mesothelioma and asbestosis are diseases that affect the lungs. They are caused inhalation of asbestos.
Common infectious diseases of the lung include pneumonia, tuberculosis, lung cancer, cystic fibrosis, and emphysema.
A pulmonary embolism is a sudden blockage in a lung artery.
Chronic Beryllium Disease is a serious and sometimes fatal lung disease.
Silicosis is very serious and sometime fatal lung disease.
Black Lung Disease is a disease that often affects coal miners.

Diabetes

Diabetes Mellitus, commonly referred to as "diabetes," means "sweet urine." Diabetes mellitus means "to flow, honey" in Greek
Diabetes that affects the body's ability to produce or respond to insulin. Insulin is a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.
Diabetes results from defects in insulin secretion, insulin action, or both. In diabetes, too much glucose stays in the blood. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine.
As a result of elevated levels of blood glucose, two problems occur: body cells become starved for energy, and, over time, the high glucose levels can damage the nerves, eyes, kidneys, heart and blood vessels.
Diabetes is not an infectious disease, like a cold or flu. You can’t "catch" it from someone else, and no one can catch it from you. Diabetes is a lifelong disease.
Men with diabetes often have erectile dysfunction which can begin before the diagnosis of diabetes is made. It is recommended that men with unexplained erectile dysfunction be screened for diabetes with a fasting blood glucose test.

There are 4 main types of diabetes
Insulin-Dependent Diabetes Mellitus (IDDM)
Non Insulin-Dependent Diabetes Mellitus (NIDDM)
Gestational Diabetes
Secondary Diabetes
Secondary diabetes mellitus refers to elevated blood sugar levels that develop as the result of another medical condition. Secondary diabetes mellitus also develops when the pancreatic tissue responsible for the production of insulin is absent because it is destroyed by disease, such as chronic pancreatitis, trauma, or surgical removal of the pancreas. Diabetes can also result from other hormonal disturbances, such as excessive growth hormone production (acromegaly) and Cushing's syndrome.

Some of the most common treatment options are: oral medicines (Diabetes pills), dietary changes, exercise, insulin and islet Cell Transplantation. The oral medicines may have negative side effects. The side effects of the oral medicines include: nausea, diarrhea, metallic taste in mouth, low blood glucose, skin rash or itching, and weight gain.
Rare side effects or oral medicines are Liver failure, Respiratory infection, Headache, and Pain.

Lyme disease

Lyme disease, or borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi is the predominant cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii are implicated in most European cases.
Lyme disease is the most common tick-borne disease in the Northern Hemisphere. Borrelia is transmitted to humans by the bite of infected ticks belonging to certain species of the genus Ixodes (the hard-bodied 'hard ticks').[2] Early manifestations of infection may include fever, headache, fatigue, depression, and a characteristic skin rash called erythema migrans. Left untreated, late manifestations involving the joints, heart, and nervous system can occur. In most cases, the infection and its symptoms are eliminated with antibiotics, especially if diagnosis and treatment occur early in the course of illness. Late, delayed, or inadequate treatment can lead to late manifestations of Lyme disease which can be disabling and difficult to treat.

Antibiotics are the primary treatment for Lyme disease; the most appropriate antibiotic treatment depends upon the patient and the stage of the disease. The antibiotics of choice are doxycycline (in adults), amoxicillin (in children), and ceftriaxone. Alternative choices are cefuroxime and cefotaxime. Macrolide antibiotics have limited efficacy when used alone.
Results of a recent double blind, randomized, placebo-controlled multicenter clinical study, done in Finland, indicated that oral adjunct antibiotics were not justified in the treatment of patients with disseminated Lyme borreliosis who initially received intravenous antibiotics for three weeks. The researchers noted the clinical outcome of said patients should not be evaluated at the completion of intravenous antibiotic treatment but rather 6–12 months afterwards. In patients with chronic post-treatment symptoms, persistent positive levels of antibodies did not seem to provide any useful information for further care of the patient.

In later stages, the bacteria disseminate throughout the body and may cross the blood-brain barrier, making the infection more difficult to treat. Late diagnosed Lyme is treated with oral or IV antibiotics, frequently ceftriaxone for a minimum of four weeks. Minocycline is also indicated for neuroborreliosis for its ability to cross the blood-brain barrier

West Nile virus

West Nile virus (or WNV) is a virus of the family Flaviviridae. Part of the Japanese encephalitis (JE) antigenic complex of viruses, it is found in both tropical and temperate regions. It mainly infects birds, but is known to infect humans, horses, dogs, cats, bats, chipmunks, skunks, squirrels, and domestic rabbits. The main route of human infection is through the bite of an infected mosquito.
Image reconstructions and cryoelectron microscopy reveal a 45–50 nm virion covered with a relatively smooth protein surface. This structure is similar to the dengue fever virus; both belong to the genus Flavivirus within the family Flaviviridae. The genetic material of WNV is a positive-sense, single strand of RNA, which is between 11,000 and 12,000 nucleotides long; these genes encode seven non-structural proteins and three structural proteins. The RNA strand is held within a nucleocapsid formed from 12 kDa protein blocks; the capsid is contained within a host-derived membrane altered by two viral

AMD 3100, which had been proposed as an antiretroviral drug for HIV, has shown promise against West Nile encephalitis. Morpholino antisense oligos conjugated to cell penetrating peptides have been shown to partially protect mice from WNV disease. There have also been attempts to treat infections using ribavirin, intravenous immunoglobulin, or alpha interferon. GenoMed, a US biotech company, has found that blocking angiotensin II can treat the "cytokine storm" of West Nile virus encephalitis as well as other viruses.
In 2007 the World Community Grid launched a project where by computer modeling of the West Nile Virus (and related viruses) thousands of small molecules are screened for their potential anti-viral properties in fighting the West Nile Virus. This is a project which by the use of computer simulations potential drugs will be identified which will directly attack the virus once a person is infected. This is a distributed process project similar to http://en.wikipedia.org/wiki/SETI@Home where the general public downloads the World Community Grid agent and the program (along with thousands of other users) screens thousands of molecules while their computer would be otherwise idle. If the user needs to use the computer the program sleeps. There are several different projects running, including a similar one screening for anti-AIDS drugs. The project covering West Nile Virus is called "Discovering Dengue Drugs – Together." The software and information about the project can be found at: World Community Grid

Mumps

Mumps or epidemic parotitis is a viral disease of the human species, caused by the mumps virus. Prior to the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide, and is still a significant threat to health in the third world.
Painful swelling of the salivary glands (classically the parotid gland) is the most typical presentation. Painful testicular swelling and rash may also occur. The symptoms are generally not severe in children. In teenage males and men, complications such as infertility or subfertility are more common, although still rare in absolute terms. The disease is generally self-limited, running its course before receding, with no specific treatment apart from controlling the symptoms with painkillers

Mumps is a contagious disease that is spread from person-to-person through contact with respiratory secretions such as saliva from an infected person. When an infected person coughs or sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person. Mumps can also be spread by sharing food, sharing drinks, and kissing. The virus can also survive on surfaces and then be spread after contact in a similar manner.
A person infected with mumps is contagious from approximately 6 days before the onset of symptoms until about 9 days after symptoms start. The incubation period (time until symptoms begin) can be from 14-25 days but is more typically 16-18 days

There is no specific treatment for mumps. Symptoms may be relieved by the application of intermittent ice or heat to the affected neck area and by acetaminophen/paracetamol (Tylenol) for pain relief. Aspirin use is discouraged in young children because of studies showing an increased risk of Reye's syndrome. Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.
Patients are advised to avoid fruit juice or any acidic foods, since these stimulate the salivary glands, which can be painful.

Dengue fever

Dengue fever (pronounced) and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics and Africa, and caused by four closely related virus serotypes of the genus Flavivirus, family Flaviviridae. It is also known as breakbone fever. The geographical spread is similar to malaria, including northern Australia, Singapore, Malaysia, Taiwan, Thailand, Vietnam, Indonesia, Philippines, Pakistan, India, Bangladesh, Puerto Rico, Brazil, Guyana, Venezuela, Trinidad and now Samoa. Unlike malaria, dengue is just as prevalent in the urban districts of its range as in rural areas. Each serotype is sufficiently different that there is no cross-protection and epidemics caused by multiple serotypes (hyperendemicity) can occur. Dengue is transmitted to humans by the Aedes aegypti or more rarely the Aedes albopictus mosquito, which feed during the day.

The mainstay of treatment is timely supportive therapy to tackle shock due to haemoconcentration and bleeding. Close monitoring of vital signs in critical period (between day 2 to day 7 of fever) is vital. Increased oral fluid intake is recommended to prevent dehydration. Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake. A platelet transfusion is indicated in rare cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding. The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion.
Aspirin and non-steroidal anti-inflammatory drugs should be avoided as these drugs may worsen the bleeding tendency associated with some of these infections. Patients may receive paracetamol preparations to deal with these symptoms if dengue is suspected.

Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a human syndrome caused by intestinal viruses of the Picornaviridae family. The most common strains causing HFMD are Coxsackie A virus and Enterovirus 71 (EV71).
HFMD usually affects infants and children, and is quite common. It is moderately contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months. The usual incubation period is 3-7 days.
It is extremely uncommon in adults; however, still a possibility. Most adults have strong enough immune systems to defeat the virus, but those with immune deficiencies are very susceptible. HFMD is not to be confused with foot-and-mouth disease (also called hoof-and-mouth disease), which is a disease affecting sheep, cattle, and swine, and which is unrelated to HFMD (but also caused by a member of the Picornaviridae family).

There is no specific treatment for hand, foot and mouth disease. Individual symptoms, such as fever and pain from the sores, may be eased with the use of medication. HFMD is a viral disease that has to run its course; many doctors do not issue medicine for this illness, unless the infection is severe. Infection in older children, adolescents, and adults is normally very mild and lasts around 1 week or sometimes more. Fever reducers will help to control high temperatures. Luke-warm baths will also help bring temperature down.
Only a very small minority of sufferers require hospital admission, mainly as a result of neurological complications (encephalitis, meningitis, or acute flaccid paralysis) or pulmonary edema/pulmonary hemorrhage

Filariasis

Filariasis (Philariasis) is a parasitic and infectious tropical disease, that is caused by thread-like filarial nematode worms. There are 9 known filarial nematodes which use humans as the definitive host. These are divided into 3 groups according to the niche within the body that they occupy: Lymphatic Filariasis, Subcutaneous Filariasis, and Serous Cavity Filariasis. Lymphatic Filariasis is caused by the worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms occupy the lymphatic system, including the lymph nodes, and in chronic cases these worms lead to the disease Elephantiasis. Subcutaneous Filariasis is caused by Loa loa (the African eye worm), Mansonella streptocerca, Onchocerca volvulus, and Dracunculus medinensis (the guinea worm). These worms occupy the subcutaneous layer of our skin, our fat layer. Serous Cavity Filariasis is caused by the worms Mansonella perstans and Mansonella ozzardi, which occupy the serous cavity of the abdomen. In all cases, the transmitting vectors are either blood sucking insects (fly or mosquito) or Copepod crustaceans in the case of Dracunculus medinensis.
Human filarial nematode worms have a complicated life cycle, which primarily consists of five stages. After the male and female worm mate, the female gives birth to live microfilariae by the thousands. The microfilariae are taken up by the vector insect (intermediate host) during a blood meal. In the intermediate host, the microfilariae molt and develop into 3rd stage (infective) larvae. Upon taking another blood meal the vector insect injects the infectious larvae into the dermis layer of our skin. After approximately one year the larvae molt through 2 more stages, maturing into to the adult worm.
Individuals infected by filarial worms may be described as either "microfilaraemic" or "amicrofilaraemic," depending on whether or not microfilaria are found in their peripheral blood. Filariasis is diagnosed in microfilaraemic cases primarily through direct observation of microfilaria in the peripheral blood. Occult filariasis is diagnosed in amicrofilaraemic cases based on clinical observations and, in some cases, by finding a circulating antigen in the blood.

The recommended treatment for killing adult filarial worms in patients outside the United States is albendazole (a broad spectrum anthelmintic) combined with ivermectin. A combination of diethylcarbamazine (DEC) and albendazole is also effective.
In 2003 the common antibiotic doxycycline was suggested for treating elephantiasis. Filarial parasites have symbiotic bacteria in the genus Wolbachia, which live inside the worm. When the symbiotic bacteria are killed by the antibiotic, the worms themselves also die. Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week course almost completely eliminated microfilaraemia

Fasciolosis

Fasciolosis is an important helminth disease caused by two trematodes Fasciola hepatica (the common liver fluke) and Fasciola gigantica. This disease belongs to the plant-borne trematode zoonoses. In Europe, the Americas and Oceania only F. hepatica is a concern, but the distributions of both species overlap in many areas of Africa and Asia.
The definitive host range is very broad and includes many herbivorous mammals, including humans. The life cycle includes freshwater snails as an intermediate host of the parasite. Recently, worldwide losses in animal productivity due to fasciolosis were conservatively estimated at over US$3.2 billion per annum. In addition, fasciolosis is now recognized as an emerging human disease: the World Health Organization (WHO) has estimated that 2.4 million people are infected with Fasciola, and a further 180 million are at risk of infection.[

For high efficacy and safety, triclabendazole (Egaten) in dose 10–12 mg/kg is drug of choice in human fasciolosis. No drug alternatives are available for humans. On the other hand, nitazoxanide were successfully used in human fasciolosis treatment in Mexico. Bithionol is another drug of choice used for treatment of F. hepatica.

Enterobiasis

Enterobiasis is the medical condition of being infected with pinworms (Enterobius vermicularis). It may be referred to, less precisely, as oxyuriasis, in reference to the family Oxyuridae, which contains the genus Enterobius.

The condition can be treated with mebendazole (Vermox), piperazine (Antepar), or mostly commonly pyrantel pamoate (Combatrin, Povan). Also great care should be taken to shower daily, and wash hands before every meal to avoid re-infection. All infected materials (pajamas, bedclothes, and underwear) should be washed with soap and hot water daily. Taking a second dose of medication two weeks after the first will usually kill any pinworms that might have hatched in the meantime, before they are able to produce new eggs.

Elephantiasis

Elephantiasis is a disease that is characterized by the thickening of the skin and underlying tissues, especially in the legs and genitals. In some cases, the disease can cause certain body parts, such as the scrotum, to swell to the size of a softball or basketball. ("Elephantitis" is a common mis-hearing or mis-remembering of the term, from confusing the ending -iasis -- process or resulting condition -- with the more commonly heard -itis -- irritation or inflammation.) Its proper medical name is lymphatic filariasis

Treatments for lymphatic filariasis differ depending on the geographic location of the endemic area. In sub-Saharan Africa, albendazole (donated by GlaxoSmithKline) is being used with ivermectin (donated by Merck & Co.) to treat the disease, whereas elsewhere in the world, albendazole is used with diethylcarbamazine.[9] Geo-targeting treatments is part of a larger strategy to eventually eliminate lymphatic filariasis by 2020.[9]
Another form of effective treatment involves rigorous cleaning of the affected areas of the body. Several studies have shown that these daily cleaning routines can be an effective way to limit the symptoms of lymphatic filariasis. The efficacy of these treatments suggests that many of the symptoms of elephantiasis are not directly a result of the lymphatic filariasis but rather the effect of secondary skin infections.
Also, surgical treatment may be helpful for issues related to scrotal elephantiasis and hydrocele. However, surgery is generally ineffective at correcting elephantiasis of the limbs.
A vaccine is not yet available but is likely to be developed in the near future.

Antibiotics as a possible treatment in 2003 it was suggested that the common antibiotic doxycycline might be effective in treating elephantiasis. The parasites responsible for elephantiasis have a population of symbiotic bacteria, Wolbachia, that live inside the worm. When the symbiotic bacteria are killed by the antibiotic, the worms themselves also die.
Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week course almost completely eliminated microfilariaemia.

Echinococcosis

Echinococcosis, also known as hydatid disease, hydatid cyst, unilocular hydatid disease or cystic echinococcosis, is a potentially fatal parasitic disease that can affect many animals, including wildlife, commercial livestock and humans. The disease results from infection by tapeworm larvae of the genus Echinococcus - notably E. granulosus, E. multilocularis, E. vogeli and E. oligarthrusAs already noted, Echinococcus infection causes large cysts to develop in intermediate hosts. Disease symptoms arise as the cysts grow bigger and start eroding and/or putting pressure on blood vessels and organs. Large cysts can also cause shock if they happen to rupture.
Infection with E. granulosus, common in Eurasia, China and India, typically results in the formation of hydatid cysts in the liver, lungs, kidney and spleen of the intermediate host. In echography or CT scans, hydatid cysts are often large with a flaky appearance (this is referred to as "hydatid sand"); this indicates the first stage of infection. In the second stage, medical imaging may show multiple daughter cysts. Hydatid cyst of liver can be accurately diagnosed by a serologic assay (Weinberg reaction, a specific example of complement fixation). However, the Weinberg reaction can be falsely negative; in one series, 38% of cases demonstrated a false negative result. Newer studies, such as ELISA, may be more sensitive. Eosinophilia is not a feature of cysts unless rupture occurs. In fact, usually there are no changes in blood biochemistry.

Metronidazole 400-600mg
Albendazole
Surgical
Marsupialization
Omentopexy
Laminated Membrane Removal
Mebendazole to prevent recurrence
Praziquan, tab 20 mg/kg 12 hourly for 2 weeks is given pre operatively
Surgery may be appropriate in certain

Dracunculiasis

Dracunculiasis, more commonly known as Guinea worm disease (GWD) or Medina Worm, is a parasitic infection caused by the nematode, Dracunculus medinensis. The name, dracunculiasis, is derived from the Latin "affliction with little dragons". The common name "Guinea worm" appeared after Europeans first saw the disease on the Guinea coast of West Africa in the 17th century. The painful, burning sensation experienced by the infected patient has led to the disease being called "the fiery serpent". Once prevalent in 20 nations in Asia and Africa, the disease remains endemic in six countries in Sub-Saharan Africa. It is hoped that Guinea worm disease will be the first parasitic disease to be eradicated and the first disease in history eradicated through behavior change, without the use of vaccines or a cure. Guinea worm disease is only contracted when a person drinks stagnant water contaminated with the larvae of the Guinea worm. There is no animal or environmental reservoir of D.medinensis. The infection must pass through humans each year.

There is no vaccine or medicine to treat or prevent Guinea worm disease. Once a Guinea worm emerges a person must wrap the live worm around a piece of gauze or a stick to extract it from the body. This long, painful process can take up to a month. This is the same treatment that is noted in the famous ancient Egyptian medical text, the Ebers papyrus from 1550 B.C.. Some people have said that extracting a Guinea worm feels like they are being stabbed or that the afflicted area is on fire.
Although Guinea worm disease is usually not fatal, the wound where the worm emerges could develop a secondary bacterial infection such as tetanus, which may be life-threatening—a concern in endemic areas where there is typically limited or no access to health care. Analgesics can be used to help reduce swelling and pain and antibiotic ointments can help prevent secondary infections at the wound site.