Fasciola Hepatica: Treatment and Prevention

Fasciola Hepatica: Treatment and Prevention INTRODUCTION   Fascioliasis is a helminthic disease caused by Fasciola Hepatica (liver fluke), which spans worldwide, affecting livestock such as cattle and sheep, which become infected by ingesting water or plants such as watercress, lettuce and spinach (Alatoom et al, 2008). The life cycle of Facisola Hepatica begins when eggs are excreted in the feces of an animal which has been infected. Facisola Hepatica Miricidia move on to its intermediate host (freshwater Lymnaea snail), where it develops into the cercarial form. The Cercariae then leave the snail and encyst on the vegetation of fresh water, until developing into its metacercarial stage. Grazing sheep or cattle ingest the metacercariae, the infective form excyst in the intestine, passing through the peritoneum, later gaining access to the live and bilary tree (Alatoom et al, 2008). Due to migration of the liver flukes, the liver is left necrotized which compromises the function of the liver in animals. These complications may include change in the component of blood, hepatic pathogenesis, liver trauma, decreased lactation, and death (Brennan et al, 2008). Fascioliasis has resulted in a significant loss to farmers and inturn affects the economy as a whole. To control the parasites which cause this disease, treatments such as anthelmintic drugs have been employed in some areas. But as with most drugs problems have arisen, most importantly the development of resistant in parasites to the chemical drugs (Anandaraj et al). This review paper will cover different treatments available for fasciola hepatica, how the parasites have developed a resistance to the available treatment, and new methods in which researchers are trying to combat the drug resistant parasites. Citronella oil and Neem oil For Treatment Anthelmintic drugs have been used to control fasicoliasis disease, but there has been concern over parasites and developing resistance to the drugs. Citronella oil which is collected from dried grass of the species Cymbopogan nardus, and Neem oil which is also collect from dried seeds of the species Azadirachta indic (Anandaraj et al). Experiment were conducted in vitro, exposing the liver flukes to Citronella oil, neem oil, oxyclozanide drug powder treated control and normal RPMI-1640 control at room temperature, in separate petri-dishes. After staining of the dead flukes, flukes were observed under a microscope. Results demonstrated that citronella oil demonstrate flukicidal effect which is very similar to that of oxyclozanide, which affects the tegument, intestinal caeca and uterus of the flukes. But due to no previous study of the effects of these oils on endoparasites , the mechanism by which these oils react to the parasites in not understood (Anandaraj et al). Triclabendazole Drug Treatment Triclabendazole is a drug derived of benzimidazole and is the current drug of choice in the treatment of fascioliasis. Triclabendazole has shown to target Fasciola Hepatica (liver flukes) from as early as 3 days old to fully mature stage, and more importantly, this drug has been shown to successfully eradicate liver fluke infections in humans. (Brennan et al, 2008). For this experiment Eight indoor-reared Dorset X Suffolk sheep approximately 8 to 10 months of age, with no prior liver fluke infection were collected. Sheep stool was examined for fluke eggs to ensure no prior infection to the Fasciola hepatica. The sheep were then artificially infected by oral gavage with metacercarial cysts, which have previously shown to be susceptible to the Triclabendazole drug. Dividing the sheep into two groups, two sheep were used as a control received no treatment, while six were treated with Triclabendazole four weeks after artificial infection. (Brennan et al, 2008). At each time interval 48, 72, and 96 hours, two sheep were euthanized and livers removed for examination and collection of liver flukes, this was also done for control sheep, which were euthanized after 48 hour post treatment. Visual observation demonstrated that liver flukes in the untreated sheep very active with their guts full of contents. Flukes recovered from the treated sheep after 48 hours of treatment were active and clear sign of visible contents in the gut of the liver flukes. When compared to the liver flukes of the control, these showed no differences in appearance and activity. Liver flukes recovered from sheep after 72 hours of treatment were all dead with no gut contents, except for one which displayed minimal activity and little contents in the gut. Liver flukes recovered 96 hours from sheep post-treatment were all dead, displaying a very pale grey color, with no contents within the gut (Brennan et al, 2008) It was observed that the effects of the drug progressive overtime time, affecting the flukes more severely as time passed. On observation of the liver flukes recovered 48 hours post treatment, normal morphology was noted, there was some minor swelling of the parasites tegument. On examination of the surface morphology of the dead liver flukes from sheep treated at 96 hours post-treatment, the surface of the parasites were very serve and extensive. This Included massive loss of tegument in all flukes, the basal lamina of the fluke was exposed as the entire syncytical layer had been decorticated. Lesions exposing the inner tissues of the fluke were also observed in the basal lamina. (Brennan et al, 2008) Researchers therefore concluded that treatment with Triclabendazole is effective in eradicating a vast majority of liver flukes in sheepwithin a three to four day period after treatment. The severity of the disruption of the parasites tegument increased over time, resulting in the total loss of tegumental syncytium and lesions as deep as the basal lamina (Brennan et al, 2008). One draw back of this drug is that is is prohibited in the use of animals that produce cheese intended for feeding humans (Cringoli et al, 2006). Parasite Drug Resistance and Development of New Treatment With Triciabendazole being the drug of choice for the treatment of fasciola hepatia in vetenary medicine, due to the drugs ability to fight against both juvenile and adult stages of fasciola hepatica. Over time concerns have stirred up over Triciabendazole resistant fasciola hepatia, which were first observed in Australian livestock though the mid-1990à ¢Ã¢â€š ¬Ã¢â€ž ¢s, and has now spread across Europe and most recently, Spain. The need to develop new drugs to treat fascioliasis has become a pressing issue. Some researchers have experimented with OZ78 and Artemether for the reactivity against adult fasciola hepatia resistant to Triciabendazole (Keiser et al, 2007). 30 rats were infected with 20-25 metacercarial cyst of Oberon. Oberon was reported to have low cure rates in sheep treated with Triciabendazole. 10 rats were then infected with 20-25 metacercarial cyst of cullompton isolates. Cullompton isolates were previously identified as Triciabendazole-sensitive. 12-15 weeks after infection, rats infected with Oberon isolate were treated with Artemether and OZ78. Two groups of rats were treated with triciabenazole in different dosages, and six treated with artemether and OZ78, with untreated rats as a control. Four of the rats infected with cullompton isolate were treated with triclabenazole, and six of the rats treated with cullompton isolate remained untreated with no drugs, serving as a control. 17 days after treatment, rats were euthanized and bile ducts were harvested for observation (Keiser et al, 2007). Collected results demonstrates that Triclabendazole was not suffiecient against Triclabendazole-resistant Oberon isolate of Fasiola hepatica. Though at higher dosage there was a significant worm burden reduction observed. Both Artemether and OZ78 were very effective in treating Triclabendazole-resistant isolate of Fasiola hepatica, both resulting in worm burden reduction by 100%. (Keiser et al, 2007). Efficacy and safety of New Treatment Due to promising action of artemether against liver flukes in rat models, researchers have found it necessary to study the efficacy and safety of this drug in which have been naturally unfected with fasciola hepatica (Keiser et al, 2008). Using Dairy sheep from farms in southern italy, stool samples were collect from 100 sheep, which were randomly selected. All sheep tested positive for fasciola hepatica were used in the study, with an overall collection and examination of 5 stool samples. Sheep were separated in groups depending on their weight and mean eggs count. Group one containing seven sheep remain untreated, groups two and three, containing six sheep each where orally treated with one dose of arthemether at 40 and 80 mg/kg, the last three groups four, five and six, each containing 5 sheep received 40, 80 and 160 mg/kg respectively intramuscular injections of artemether. The sheep were observed for any signs of adverse effects for a period of 8 hours, and once daily after treatment. On days 10 and 27 three to four stool samples were collected for examination for egg burden. All sheep were then slaughtered, removing livers and harvesting and counting fasciola hepatica present. Sheep exhibited no physical or clinical signs of toxicity after being treated orally or intramuscularly 8 hours post treatment. Researchers found that statistically there was no significant reduction in egg count in either oral or intermuscular drug administration, except for administration of 160 mg/kg, where a significant egg count reduction was noted and 64.9%.

Differences in Competencies: Associate Versus Baccalaureate Nurse Essay

The field of nursing has come a long way. It was once considered to be a profession for that of the less fortunate. But as the years went by the field of nursing has made drastic changes in that of schooling and duties of the nurse. No longer has the field of nursing considered for those who has nothing else to do or those of less fortunate, but over the years education has played an important role in the success of this profession. In the eighteen century, nursing were considered to be more hands on, but theories saw the need for a more formal education. Over the years, there have been debates about the entry level for nursing. Some say there’s no difference between the associate (ADN) and the baccalaureate (BSN) degree. In the following paragraphs I will expound on the differences between the ADN and the BSN degree. The ADN program came about because of the shortage in nursing in the post-war years. It is a two year program developed by Mildred Montag designed as an entry level for nursing. Friberg, 2011, p. 14). The outcome of this program was very successful. It yielded the same results and those who had completed the five year program by successfully passing the licensure examination for nurses. Because of this great success the ADN program went full force into action. The ADN program became more popular. It now opens the door for those who were not able to attend the five year program. It worked well for older ladies, especially those who were married, and certainly more cost effective. (Friberg, 2011, p. 15). Nurses at the associate and the baccalaureate level are taught in nursing schools to use the nursing process. This is a tool that is set up for nurses to help the patient recover from their current illnesses, and also to aid the physicians in treating their patients. The nursing process includes assessing the patient or situation, diagnose the patient using nursing diagnosis and gathering pertinent information, developed a care plan on how the needs of the patient will be met, put those plan into action and monitor the patient to see if any changes need to be made to the current interventions. The American Association of Colleges of nursing (AACN) states the difference between the associate and baccalaureate level as that of theory, research, public and community health and that management. (AACN, 2012). Both programs take the same exit exam, the NCLEX to become a registered nurse in order to practice in their own state.. At the BSN level the nurse can take on leadership responsibilities. You may find them as charge nurses, managers, and even as bedside leaders as on the unit that I currently work. Because their training consists more of research; you may also find them to be more efficient with the nursing process. They are able to think fast in an emergency situation and developing a plan of action. Because of their leadership skills they are able to delegate the right task especially to new nurses or those flexing from another floor. My charge nurse currently has her BSN and when in doubt or have questions about a doctor’s order she is always quick in examining the order and ready to make suggestions based on her leadership skills. Three weeks ago I had a fresh post-operative patient from PACU. Upon arrival his blood pressure was 109/62 and heart rate 88. At four A. M. the tech called me and said that the patient’s Bp was 88/55. I immediately lowered the patient’s head and raised his feet, waited for fifteen minutes, then retake his BP. The new reading shows 99/56. Based on the patient’s baseline I was ok with that. I delegate to the tech to retake BP in an hour. An hour later it went even lower. I then went to the charge nurse who has her BSN to let him know of the situation and my plan of action. He immediately got a different BP machine and went to the patient’s room explained what we’re doing and that if his BP is still low we will need to call the emergency response team. To our surprised the patient’s BP was in the low 100’s. At that moment I was not thinking about changing the machine, but he being trained critically was able to think quick in coming up with another plan. I do understand that practice becomes perfect, but the level of education of my charge nurse sure did make a difference. Some say there’s no difference in the competencies of the ADN level versus the BSN level. Based on my own personal experiences and that of the theories, it does demonstrate that those trained with a higher level of education are more versed to critically think their way through problems and act quickly. According to Grand Canyon University philosophers, students are educated to provide, direct, and evaluate client-centered care while focusing on the person as an integrated whole. Baccalaureate degrees also broaden your job search. There are more positions available at this level, than that of the associate level. Most hospitals i. e. Emory no longer employ nurses with an associate degree. A lady once said to me that whatever I am now doing will not take me to where I am going. So it is with the associate degree, based on theological and scientifically advancement, the associate degree will not take us much further throughout this profession.

Democracy Aims of the Ninth Amendment

â€Å"We the People of the United States†¦ do ordain and establish this Constitution for the United States of America. † Within those opening words, the framers of the U. S. Constitution made clear their intentions for democracy in America and their disregard for previous despotic institutions. No longer viewing the individual†s highest duty to be obedience to the state, our founding fathers displayed a firm commitment to bolstering the significance and dignity of the individual. This new found faith in the ability of the populace to govern itself is known as democracy. Democracy itself is an ideal that was developed by the ancient Greeks around 500 B. C. Inherent in all of the freedoms of democracy are certain â€Å"inalienable rights† that are guaranteed to every citizen who resides under that democracy. Following the Constitutional Convention, Federalists, who supported the ratification of the Constitution, obtained the support by promising that an enumeration of the rights of all citizens that would be added as an amendment to the Constitution after it had been ratified, to Anti-Federalists who opposed ratification due to the lack of enumerated rights. In order to outline and expound upon those rights, the Constitution was amended almost immediately following its ratification in 1788. The Bill of Rights, as the first ten amendments have come to be known, was put into effect on the fifteenth day of December, 1791, and is a formal declaration given by the government to define the fundamental liberties of its citizens and thus limit its own power. The first eight amendments contain the essential rights of every citizen, as well as certain procedural precautions instituted to insure the protection of those rights. The enth amendment guarantees the limitation of federal control to those and only those powers granted it in the Constitution. Inherent in the ninth amendment is the vitality of democracy in the United States. The ninth amendment reads: â€Å"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people. † Amendment nine, while protecting citizens from the infringement of the government on the unenumerated rights of the individual using rights enumerated in the Bill of Rights, also levels any implied hierarchy of rights making no single right of any greater importance than another. The preservation of democracy in America is vitally dependent upon the ninth amendment as illustrated by its inherent ideologies that made it an amendment, its modern judicial implications in relation to the topics of the day, as well as its ability to reinforce those attributes that keep a democracy operating. Once the Constitution had been put into effect and representatives had been sent to Congress, it was time for the amendments that had been promised, to be sent before Congress. The leader in the proposition of amendments to the new Congress was James Madison, the â€Å"Father of the Constitution. † Madison†s chief intention in proposing his amendments to the Constitution was to prevent â€Å"†¦ the abridgment of the freedom of the people by [the] gradual and silent encroachments of those in power. † Madison originally proposed fifteen amendments that were to enumerate all of the inalienable rights of United States citizens. Of those fifteen, twelve were accepted by Congress to be sent to the states for approval under the process outlined in the Fifth Article of the Constitution. What would become the ninth amendment was seen even then as innocuous, but Madison was able to support its importance asking, â€Å"If an enumeration be made of all our rights, will it not be implied that everything omitted is given to the general government? † Democracy, as a free-state, relies inevitably on the protection of the freedoms of the individual; because all of the freedoms that an individual has a right to cannot simply be listed, it is vitally important that those rights which are not spelled out in the body of law that protects the individual continue to be protected from usurpation by the government. Through inference this amendment implies in its own wording that the rights that are listed in the Bill of Rights are so important that they needed to be spelled out, but there are other natural rights belonging to United States citizens that were equally important, but too numerous to mention. These â€Å"natural rights† include the right to choose your own mate, the right to reproductive choice, the right to determine the manner of your child†s education, and even covers rights to personal privacy. Certainly no man would argue the personal, as well as democratic significance of these rights. Thus, Madison, foreseeing the possibilities of the rise of the federal government to the already massive position of power that it now occupies kept it from denying Americans all of those rights that even they take for granted, because they cannot be found specifically enumerated in The judicial implications behind the ninth amendment are innumerable, mainly due to the fact that on a regular basis the government does its best to work its way into the private lives of individuals and instruct them on how to better their conduct in the ace of social morality. One pressing issue facing the people of the United States today is that of doctor-assisted suicide. To date, it has been ruled that suicide is in essence self-murder and accordingly, if murder is illegal so must all forms of it be illegal as well, self and otherwise. However, in light of the unenumerated rights guaranteed to citizens by the ninth amendment, this â€Å"right to die† inherently belongs to the individual as it does ot infringe upon the rights of others. Another modern political debate is that of the legality of homosexuality. Seeing as how, regardless of their sexual orientation, homosexuals are citizens of the United States of America, they also have the right to decide for themselves the person with whom they engage in sexual relations. Sexuality is, therefore, one more of the unenumerated rights bestowed upon the people under the â€Å"innocuous† amendment. Wisely effected for this use, the ninth amendment was cited in the case of Roe v. Wade in the determination of a woman†s right to have an abortion. This right, while not enumerated in the Constitution is still a right of the people under the ninth amendment. The ninth amendment, while famously misunderstood and misinterpreted by Judge Robert Bork in his 1987 confirmation hearing, has only recently been utilized as a tool in the fight for the preservation of the individual citizen†s democratic rights. Bork demonstrated his ineptitude and his inability to be a Supreme Court Justice by stating that he could not logically view the ninth amendment from the mindset of the Constitution†s framers. The ability of a Supreme Court Justice to trust his own insinuations into the minds of our founding fathers is what allows them to make a clear, responsible and accurate assertion about the ramifications of the wording of the Constitution. Unenumerated rights are, by definition, rights that are not specifically listed and are, therefore, more or less unknown. If it was possible to enumerate all of the rights that are delegated to the people under the ninth amendment then it would have been done and the innocuity innate in its creation would be forever erased. As those rights remain constantly emerging and on the verge of emerging the Supreme Court will have to continue to expand its interpretation and better use the ninth amendment for the protection of the intrinsic rights of the American citizen. Democracy itself is reliant upon several things to keep it working: citizen participation, voluntary action and education. The ninth amendment strengthens the wide-spread participation of the citizenry by entrusting them with rights that are God-given, rights that are so innately human that they need not be itemized in the body of law that was created to itemize the inborn rights of all citizens. Any and every individual has the right to run for public office. Each individual is also capable of supporting which ever political party he feels best represents his own personal opinions. He also retains the right to keep those personal opinions to himself if he so chooses. Another characteristic of democracy is its faith and dependence upon education. Although widespread participation is a significantly substantial aspect of democracy, it alone does not ensure the proper maintenance of good government. An active populace is nothing if it is not an educated populace. Education is not an institution that can be left to sort itself out, either. Whether an individual should choose to attend public or private schools, continue to a college or university, or perhaps be taught directly by his parents at home is a right that remains his under the ninth amendment. Without the freedoms and rights that are built-into the educational systems of America by the ninth amendment, the ability of the nation to take action, keep informed, vote intelligently and produce leaders worthy of public trust and responsibility would be drastically diminished. The lack of force inbred in all democracies requires a distinct amount of voluntary action to replace it. The right of the citizen to participate or not to participate in the everyday workings of the democracy in which he lives is always his. The ninth amendment can in that manner work against itself, but thanks to the safeguard of education it can be assumed a majority of the individuals inhabiting a democracy are there of their own free will and there because they wish to cooperate with and for the established system and not against it. The successful operation of American democracy, as well as that of any other democracy, is dependent upon the rights granted to the people of the United States by the ninth amendment. In The Federalist, â€Å"Number 47,† James Madison said that, â€Å"The accumulation of all powers, legislative, executive, and judiciary, in the same hands, whether of one, a few, or many, and whether hereditary, self-appointed, or elective, may justly be pronounced the very definition of tyranny. † Madison proposed the Bill of Rights in order to avoid allowances for the federal government to secure a position of tyranny as well as to promote the permanent establishment of democracy. Amendment nine of the Bill of Rights is the amendment that best exemplifies the preservation of that new state of democracy in America by withholding from the national government all those rights that went unenumerated in the Bill of Rights, but which continue to be retained by the people. The right to personal privacy, the right to a choice of educational institutions, the right to receive an abortion, the right to choose your own sexual orientation, the right to follow the political party of your choosing and even the right to die are all bestowed upon the citizenry by the ninth amendment. Democracy, as an institution of sentiment, law and government, could not survive without the guarantee of the ninth amendment that the people shall retain those rights which were given them with birth and which will neither be denied nor disparaged. The increasing clarity of the ninth amendment will continue to provide boundless possibilities for the people of the United States to not only continue in life, liberty and the pursuit of happiness, but also to inhibit federal interference with that goal.

Book Report On Eric Ross - 2079 Words

Today I was finally granted a day off from work. The first place I knew I would head, after sleeping in, would be to the coffee house down on 1st Avenue. The leaves were just starting to fall outside. Soon winter would be here. The smell of fresh brewed coffee invaded my nose as I stepped inside the door. I walked up to the counter and viewed the numerous amount of tasty treats they had on display today. I ordered a double chocolate muffin with a caramel latte and then sat down on my most loved couch with my sketchbook and pencils. This couch had a lot of memories. Memories of me planning the kill and over analyzing every aspect of it to the memories of me and him cuddling on this couch to a cup of coffee and a good book. Eric Ross was in†¦show more content†¦I decided I would do a little research on him. How could I be so oblivious? The signs were all there, and I was so blind to them. I overwhelmed with the feeling of being used and manipulated. He was the man of my dreams till now. A tear trickled down my cheek as I read the article on some of his history. It wasn’t a tear of complete sadness. This tear was a mixture of anger, sorrow and desperation. Little did I know, he had been married for three years to the woman who gave birth to his child 12 years prior. After more digging, I came across an article about his wife. A year after they got married, they found her dead in the bathroom of his million dollar mansion. She had committed suicide by slitting her veins open on her wrists. She had left a note expressing her feelings about him straying the path from their marriage. So he isn’t cheating now, but he has before. Why is it such a big deal now that he can’t introduce me to his family? Maybe even just his daughter? It was time for Eric and I to have a chat about what was going on between us. So I decided that the next day I would pay him a visit. ************* I made sure I had on my most form fitting outfit that would accentuate my curves. He’ll be putty in my hands. On my way to work I started running through ways I was going to bring it up. Maybe by just asking him about past relationships would be the best way? Or what he thought about kids someday? EventuallyShow MoreRelatedWhat Company Has Become More Successful Than Other Chinese Car Companies1247 Words   |  5 PagesGEELY from China to go outside, and it has high technology for car making because VOLVO has some high technology and GEELY can provide the money to give the VOLVO research and examine the car technology. 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