now we are going to read about the intestinal protogen infections so in this chapter we will read about different protozoans which cause the intestinal infections and in the book there are many protozoans given out of all of them we will read only three most important protozoans which cause the intestinal infections that is the intermiba histolytica Giardia lablia and the opportunistic cocadian parasites which cause the intestinal infections there are some other protozone also which cause the infection like balanced idiom microsporidia etc etc we are least bothered about those but we are more concerned or more focused on the three protozoans that is antibiotica giardia lamblia and the opportunistic cocadian parasites or the protogens so we will be focusing over these three now First Let Me Clear let me clearly tell you that this chapter intestinal protozoan infection will be covered in three parts the first part will be the introduction of all of these three protozoans or the parasites and then in the second part of this chapter or second part of the video will be about the life cycle of these parasites all the three parasites and then then the third part will be about the lab diagnosis of all these three parasites or the protozoans okay so first coming to the end table history comes from a group of protozoan called the intestinal amiib amiibas so intestinal amiibus if you remember the classification of protozoa that I have taught to you all in the uh in the general parasitology then you must remember that the internet belongs to the intestinal Ami uh I mean intestinal amoeba group okay so in the intestinal amoeba group this anti-histolytica is the only entamoa which causes the infection there are some other ant amoeba also like the entamoeba coli entamoeba disparentamiba Bangladeshi interviewer Moscow whiskey so these are also entamoeba but they do not cause the infection they are present as commensals in the intestine they do not cause any harm but this entombiva histolytica is not found in the intestine it is not a commensal it is present outside okay so when it is ingested when this entire historiatica is ingested uh through the contaminated food or water then it causes the dysentery dysentery means what what is the meaning of dysentery descending means diarrhea plus blood okay that means if diarrhea occurs along with mucus and the blood that is called as the dysentery now that dysentery can be caused by the amoeba as well as with the bacteria also but here we are concerned about the amoebic descent that that means we will rate about the entiretica which causes the amoebic dysentery okay but mind uh remember this that the other end timer that means the equal uh I mean in temecoli dispar and Bangladeshi Moscow whiskey they do not cause any infection they are commensals okay but this histolytica is not a commensal it causes dysentery this should be clear in your mind so now coming to the entiretica proper so talking about specifically about the entiretica first you should remember that it causes the amoebic dysentery then you should remember it has got three stages that is the trophyroid stage precised stage and this cyst stage so trophozoic stage is the invasive form and if it is present in this tool that means you can conclude that there is a active disease going on in the intestine lumen and then we have the previous test is precist means just before the cyst stage so this is also called as the intermediate stage because it is just before this cyst stage and the cysts is the next stage in the life cycle of the uh anti-by-stolytica and it is the diagnostic from this should be remembered that the cyst stage is the diagnostic form and it is present in this tool in both the carriers and the active disease uh person so in both the persons who are carriers as well as in those who are having this active disease or the active amoebic dysentery they pass these cysts in their stool and if we are able to detect these cyst in their stool then we can confirm that the patient is a carrier or it is a A or is suffering from the uh amoebic dysentery caused by antibihistolytica that we can be sure of that we can be sure of and then we have got the this is the introduction part of the entire then we will see a very important difference that is the enzyme between the End by acetylactica and the E coli this is a very important difference you should must know this is not a bacterial E coli okay E coli here means it is please don't make this mistake that this is not a an isia coli this is n tamibakola it is a Ami but not a bacteria okay and then here we are the entire histology this is a commensal yeah this is a commensal but this is infective this causes the dysentery so this small thing or the basic things would be very clear in your mind now coming to the difference uh because this difference is very important and very commonly asked in the university and as well as in the Viva exams so you should must remember this uh difference between the histological and the E coli and for remembering this difference uh you have to remember the diagrams of the tropho joints of the entiretica and the E coli this is the trophozoite of the entire pastelitica and this is the trophozoid of the uh E coli or the entamoeba Colin if you see this size first consider the size of the trophozoite of the interim by histolytic as well as the equalize then we will see that the size of uh trophobic is 15 to 20 micrometer while that of E coli is 20 to 25 micrometer then if you see the cytoplasm then it has got a clear differentiation between the ectoplasm and endoplasm see here this is the ectoplasm outside is part is the ectoplasm and inside part is endoplasm and there is a clear differentiation see clearly there is clear space between all of them there is no uh you know overlapping between the ectoplasm and the endoplasm that's why it is called as the that's what is called as the clear differentiation between the ectoplasm and endoplasm but in case of E coli or the end time there is no clear differences and see here the ectoplasm is here then some ectoplasm is here and the endoplasm and the endoplasm is overlapping here so there is no clear differentiation between the ectoplasm and the endoplasm now coming to the cytoplasmic inclusions so in the cytoplasm of the trophozoit of the enzyme by histolytica we see rbcs wbcs and the food vacuoles while in the entire back coli we see that the rbcs are absent okay although there may be wbc's or food vehicles present in the entire coli also but the RBS is a certainly absent in the trophozoite of the n-tamiva coli and if you talk about the nucleus see here first let's talk about the inside of ASM inclusions see the rbc's are present here but there is no RBC here these are all the food vacuoles in the cytoplasm of the entire sorry and this is this is the RBC present in the cytoplasm of the entire histolytica so that is the difference between the cytoplasmic inclusions now communal nucleus so in the nucleus we see that the carryosome is small and Central see if we see this diagram then you can clearly appreciate you can clearly appreciate that this is the this is the our Central uh karyosome and this is the nucleus okay this is nucleus and this is Central carrier zone so kerosome is present at the center of the nucleus well if we if you see the if you see the n-tembroke choline nucleus then you see this is the nucleus this is the nucleus while the uh the carrier zone is present at the corner not at the center that means it is a eccentric eccentric means eccentric the meaning of eccentric is that it is the meaning of eccentric is that it is a present at a corner or towards the periphery of the nucleus okay so this is the difference between the this is the difference between the nucleus of the two this is the difference between the nucleus of the two that is the nucleus of the entire stolotica and the antivircoli now coming to the cyst so there is difference between the cyst of the anterior histologetica and the entire coli as well so if again we will go by the Same by the features of those cysts so first we will talk about the size of this list of the antimasterolactic as well as this size of cyst of the entire coli so first coming to the size of histol idea we see the size is 12 to 15 micrometer but the size in case of the coli is more that is 15 to 25 micrometer the size of trophy rate was also more for the coli and this first is also the size is more for the coli okay by that you can remember and if you talk about nucleus then the same as tropholete like there was the central nuclei Central cariosome and the carriesome wall is small similarly here also in this stage also the carosome will be small and will be Central and if we talk about about coli then there also similar to the tropholets like like in the trophozet on the E coli in the coli The karyosomal Eccentric and relatively large here also it will be eccentric and relatively large now if we talk about nuclei so nuclei varies in one to four in numbers so there are about one to four uh nuclei so if we see this is the quadrine nuclear disease there are four nuclei okay there are four nuclei inside this cyst that means it is a quadral nucleated cyst so it is one to four nuclei in case of historiotic about in case of coli there are one to eight nucleic AC count here one two three four five six seven eight so it has got eight nuclei inside it so cyst in case of coli has got eight uh nuclei so that's why it is called as octonucleated cyst this was quadrinucleated this is octonucleated CIS so that is the difference between the nuclei of the coli and the histolytica remember everything is more in case of the uh coli the size was also more than number of nuclei is also more everything is more in case of nucleus so uh there is a H the coli has a upper hand okay by that you can remember then the chromatid body chromatic body uh has not been um shown here in this diagrams but you can remember if you want to remember the chromatic body is thick participate in case of historiatica and it is filamentous in case of the coli so this is the uh very important difference between the entire coli and the end of histolytica you should remember this is asked in the University exams and this is important as well now coming to some McQ points so as I have talked about the enzyme histology is not only the end amoeba there are some other antarvis also which are present as commensals in the intestine like the end time by this part Bangladeshi and the Moscow whiskey and they have got the morphological similarity they have got morphological similarity in the prophylate and the cyst so if you see the trophozoite or deceased of the dispar Bangladesh or most of whiskey they all will look similar to the histolytica so you can cannot differentiate that this is a cyst of Bangladeshi or Moscow whiskey or dispar or this is a cyst of histological you kind of differentiate like that but you can differentiate by doing the PCR so this may be asked as a McQ in your questions so PCR can be used to differentiate between the histolytica dispar Bangladeshi and mosque whiskey but you cannot difference it by microscopy that's what I want to tell you that it cannot be described by microscopy PCR can be used to describe it and this triage pan tries parasite panel that that can also not distinguish between the histological and dispar we will see what is triage parasite panel it is a method of diagnosis of the parasites we will see about that later on perfect for the time being you can remember that triage parasite panel can also not distinguish between the histologetica and the dispar this was the introduction part of the entire histological now coming to the giardia lamblia so talking about the giardia lamblia in this Giardia Lambda it causes grd asses it causes grdss which is diarrhea and remember it is a watery diet yeah it does not cause dysentery if blood is present you can surely say you can surely say that it is be sure that it is not the ideal MDI if there is a history of dysentery only if there is history of diarrhea simple diarrhea then all only you can think of the Giardia Lambda or I mean you can include the ZL Amelia into your differential diagnosis but once blood is blood has been reported in this tool then you cannot include Giardia lamblia into your differential diagnosis so if blood is present then go for any alternate diagnosis so this is the only flagellated uh intestinal parasite protozoa you should remember that JD Lambda has got a flagella in it also and it exists in two forms one is the pure separate trophozoid form and the tetra-nuclear cyst form so this spear sepetrophone trophyroid stage is the invasive form that means it is the infective form in case of the enzyme isolated the infective form was the trophojoiced stage for the infective and here the I mean sorry this pear separate trophylloid is not the infective form whether it is an invasive form that means it invaded into the tissues and the tetranuclear resist is both the infective and the diagnostic form while in case of histor lighting are the uh trophozet was the invasive form and the cyst was the diagnostic form but here uh the Tetra nucleotide cyst is the infective as well as the diagnostic form is more than enough now coming to the next group of coconut parasites and or the intestinal protozoans that is the opportunistic pedian infections or opportunity and parasites and these are the cryptosporidium these are the crypto supportium Cyclospora chiatineensis and this is to isospora Billy okay these are the three opportunistic cocadian parasites so in the cryptosporidium we have got uh two species that is cryptosporidium Power Worm and the cryptosporidium who mean is so if we come to the cryptosporidium infection it differs from the cyclospo Cyclospora and the cysto isospora in three points this may be asked in the explain why question you know uh all of you know that uh recently the pattern of the questions has been changed in the nmc guidelines that there will be at least four or five explain why questions in each paper so this question may be asked as the explain why question in your University exams like the question uh can be asked like uh why cryptosporidium infection is different from the cyclos isospora and the cystosis isospora so you should remember these three points to write in the exams as the answer to that question so why this cryptosporidium infection is different different from this cyclosporaneous because in the cryptosporidium Auto infection is observed which is not seen in the cyclos isospora and the systose isos4 Cyclospora and this is to isospora and the second difference is that the Oasis released in the feces is sporulated which is not the case in case of Cyclospora and the cysto isospora so in case of cryptosporidium the oocyst is formulated but in case of Cyclospora and the cystole isospora the Oasis is not sporulated then is formulation of the ocean occur in the intestine in case of cryptospodium but this sporulation does not occur in the cyclosis Bora and this sorry cyclosporane this is to isospora that means if the sporulation is occurring in the uh cyst I mean in the cryptosporidium that means obviously there will be production of sporulated Oasis if there is no sporulation like in case of Cyclospora and cysto isosceles that means they will not produce these sporulated usage this is simply all of them are related to each other and if it is sporulated that means uh if the same hand is used for eating something then of course there will be Auto infection okay so all of these three points are in I mean related to each other okay so if you remember that this correlation of the Oasis occurs in case of the cryptosporidium only but not in case of Cyclospora and the side cysto isospora then you can remember all these three points how because if this formulation will occur then sporulated ocist will be produced which is not in case which is not the case uh in case of this cyclospore and the system isospora and if it's formulated Oasis is getting passed through the feces that means of course there will be Auto infection present because same hand if used for eating something or eating food then through that contaminated hand there will be a injection of those sporulated ocist will be which will cause the outer infection so of course these three points will infection differs from this Cyclospora and this is to isospora now I have made the some diagrams of the cysts if you practice this diagrams then the features can you can remember uh for longer duration if you want to practice them then you can do otherwise leave this so this is the cyst of the Giardia lamblia see this it has got a cyst wall it has got an exonym and there are four nucleus then this is the uh this is the sporulated Oasis of the cryptosporidium where you have got the cyst wall and four sporo joints are there inside the Spore inside these asporated obsessed when this is of the Cyclospora where in the cyst wall there are two sporosis and in both of these sporosis we have got sporozoids two two sporogoods are present in both of these sporosis while this is of this cystoysosphora Bailey vary again you have got two sporosized two is four assists but the spores words are four in each one of them so this is the difference between these Cyclospora and the cysto isospora is correlated CIS this is all about the first part or the introduction part of the introduction part of the uh you know the intestinal protozoan index and next we will see about the life cycle of all of these three parasites in the uh all of these three protozoans in the second part of the video uh in a single page we will cover that so that is going to be a very great video you must see though that video and in the third part we will discuss the live diagnosis uh of all of these three uh you know all of these three infections or three parasites are protozoas okay so that's all for the introduction part of these three parasites I think