Entamoeba Health Dictionary

Bloody diarrhoea. The classical manifestations are fever, crampy abdominal pain, tenesmus with mucous bloody stool. All of the enteropathogens that have the facility to invade or destroy the intestinal mucosa, especiallythe colonic mucosa, will have clinical presentation of dysentery. The common organisms are Shigella spp, Salmonella spp, Campylobacter jejuni, Yersinia enterocolitica, Enteroinvasive Escherichia coli (E.I.E.C.), Enterohaemorrhagic Esch. Coli (E.H.E.C.) Entamoeba histolytica.... dysentery

A minute protozoan organism consisting of a single cell, in which a nucleus is surrounded by protoplasm that changes its shape as the protozoon progresses or absorbs nourishment. Several varieties are found under di?erent conditions within the human body. One variety, Entamoeba coli, is found in the large intestine of humans without any associated disease; another, Entamoeba gingivalis, is found in the sockets of the teeth and associated with PYORRHOEA. Entamoeba histolytica is the causative organism of amoebic dysentery (see DYSENTERY); Acanthamoeba and Naegleria fowleri cause the infection of the brain known as MENINGOENCEPHALITIS. Entamoeba histolytica may also cause meningoencephalitis. Other forms are found in the genital organs.... amoeba

Protozoal disease caused by Entamoeba histolytica, which may present as an amoebic liver abscess, intestinal amoebiasis or disseminated amoebiasis.... amoebiasis

Abscess of the liver caused by Entamoeba histolytica and often containing socalled “anchovy sauce” fluid.... amoebic liver abscess (ala)

(Roxb.) G. Don.

Synonym: C. fragrans (Moon) Alston.

Family: Apocynaceae.

Habitat: Dense moist forests throughout India up to 1,500 m altitude.

English: Wood Vine.

Ayurvedic: Used in the Southern states as Muurvaa.

Action: Powdered root and stems— laxative, antibilious.

A lignan derivative has been isolated from the stem. It accelerated uptake of low density lipoprotein by Hep G2 cell by 67.0%.

The root bark contains 3.03% of total alkaloids consisting mainly of chonemorphine. Chonemorphine di- hydrochloride is an anti-amoebic principle. It showed in vitro activity against Entamoeba histolytica and trichomo- nas vaginalis. It proved efficacious against hepatic amoebiasis in golden hamsters and intestinal amoebiasis in Wister rats.... chonemorpha macrophylla

auct. non Linn. C.B.Clarke.

Family: Verbenaceae.

Habitat: Throughout India. Ayurvedic: Bhaandira, Bhaandi, Kaari. Also known as Bhaarangi (C. serratum). Siddha/Tamil: Karukanni, Perugilai.

Action: Leaves—used as a substitute for Chiretta. Leaves and roots— employed externally for skin diseases and alopecia. Leaves are prescribed in headache. Roots are given in cramps and rheumatism.

In homoeopathy, the fresh leaves are employed for colic due to worms, diarrhoea associated with nausea, chronic fever with loss of appetite and in enlargement of liver and spleen with indigestion and constipation.

The alcoholic extract of the whole plant showed antiprotozoal activity against Entamoeba histolytica. It also exhibited hypoglycaemic activity in albino rats. The leaves exhibit antifun- gal activity.

Dosage: Leaf—10-20 ml juice. (CCRAS.)... clerodendrum infortunatum

Benth.

Synonym: C. forskohlii Briq. Plectranthus barbatus Andr.

Family: Lamiaceae.

Habitat: The sub-tropical Himalayas of Kumaon and Nepal; cultivated in Andhra Pradesh.

Ayurvedic: Gandira (Achyranthes aquatica Br. is also equated with Gandira). (Doubtful synonym.)

Folk: Garmar (Gujarat), Gurmal.

Action: Root and leaf—spasmolytic, antithrombotic, anti-inflammatory, lipolytic.

In experimental amoebiasis of rats, the root powder and ethanolic extract showed amoebicidal activity against Entamoeba histolytica.

An alcoholic extract of the roots and essential oil from it, were found to inhibit passive cutaneous anaphylaxis in the mouse and rat.

The plant produces the labdane diterpenoid, forskolin in its tuberous roots.

Forskolin was discovered during a screening of medicinal plants by Central Drug Research Institute, Luc- know, India, in 1974. (Planta Medica, 1985, 51, 473-477.) The screening revealed the presence of a hypoten- sive and spasmolytic principle, named coleonol (later the name was changed to forskolin). The basic mechanism of forskolin is the activation of an enzyme, adenylate cyclase, which increases the amount of cyclic adeno- sine monophosphate (cAMP) in cells. Raised intracellular cAMP level exhibits following physiological effects : inhibition of platelet activation and degranulation; inhibition of mast cell degranualation and histamine release; relaxation of the arteries and other smooth muscles; increased insulin secretion; increased thyroid function; increased lipolysis.

Forskolin, in clinical studies, reduced intraocular pressure when it was applied to the eyes for treating glaucoma. It has been shown to be a direct cerebral vasodilator. It has also been studied as a possible bron- chodilator (in the treatment of asthma) and has been shown to effectively reverse methacholine-induced broncho constriction in extrinsic asthmatics.

Standardized Coleus extracts containing forskolin (18% in 50 mg) find application in weight-loss programmes. (Michael T. Murray.)

Studies on forskolin and some 50 derivatives of the compound indicate that the natural product is more active than the analogs prepared from it.

The wild var. is known as Kaffir Potato.... coleus barbatus

A drug used in the treatment of invasive intestinal or extraintestinal amoebiasis caused by Entamoeba histolytica. No longer widely used due to it’s toxicity. Dehydroemetine is also effectiv e and is somewhat less toxic.... emetine

ACUTE LIVER DISEASE The hepatitis viruses (A– F) are of paramount importance. Hepatitis E (HEV) often produces acute hepatic failure in pregnant women; extensive epidemics – transmitted by contaminated drinking-water supplies – have been documented. HBV, especially in association with HDV, also causes acute liver failure in infected patients in several tropical countries: however, the major importance of HBV is that the infection leads to chronic liver disease (see below). Other hepatotoxic viruses include the EPSTEIN BARR VIRUS, CYTOMEGALOVIRUS (CMV), the ?avivirus causing YELLOW FEVER, Marburg/Ebola viruses, etc. Acute liver disease also occurs in the presence of several acute bacterial infections, including Salmonella typhi, brucellosis, leptospirosis, syphilis, etc. The complex type of jaundice associated with acute systemic bacterial infection – especially pneumococcal PNEUMONIA and pyomiositis – assumes a major importance in many tropical countries, especially those in Africa and in Papua New Guinea. Of protozoan infections, plasmodium falciparum malaria, LEISHMANIASIS, and TOXOPLASMOSIS should be considered. Ascaris lumbricoides (the roundworm) can produce obstruction to the biliary system. CHRONIC LIVER DISEASE Long-term disease is dominated by sequelae of HBV and HCV infections (often acquired during the neonatal period), both of which can cause chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (‘hepatoma’) – one of the world’s most common malignancies. Chronic liver disease is also caused by SCHISTOSOMIASIS (usually Schistosoma mansoni and S. japonicum), and acute and chronic alcohol ingestion. Furthermore, many local herbal remedies and also orthodox chemotherapeutic compounds (e.g. those used in tuberculosis and leprosy) can result in chronic liver disease. HAEMOSIDEROSIS is a major problem in southern Africa. Hepatocytes contain excessive iron – derived primarily from an excessive intake, often present in locally brewed beer; however, a genetic predisposition seems likely. Indian childhood cirrhosis – associated with an excess of copper – is a major problem in India and surrounding countries. Epidemiological evidence shows that much of the copper is derived from copper vessels used to store milk after weaning. Veno-occlusive disease was ?rst described in Jamaica and is caused by pyrrolyzidine alkaloids (present in bush-tea). Several HIV-associated ‘opportunistic’ infections can give rise to hepatic disease (see AIDS/HIV).

A localised (focal) form of liver disease in all tropical/subtropical countries results from invasive Entamoeba histolytica infection (amoebic liver ‘abscess’); serology and imaging techniques assist in diagnosis. Hydatidosis also causes localised liver disease; one or more cysts usually involve the right lobe of the liver. Serological tests and imaging techniques are of value in diagnosis. Whilst surgery formerly constituted the sole method of management, prolonged courses of albendazole and/or praziquantel have now been shown to be e?ective; however, surgical intervention is still required in some cases.

Hepato-biliary disease is also a problem in many tropical/subtropical countries. In southeast Asia, Clonorchis sinensis and Opisthorchis viverini infections cause chronic biliary-tract infection, complicated by adenocarcinoma of the biliary system. Praziquantel is e?ective chemotherapy before advanced disease ensues. Fasciola hepatica (the liver ?uke) is a further hepato-biliary helminthic infection; treatment is with bithionol or triclabendazole, praziquantel being relatively ine?ective.... liver disease in the tropics

Linn.

Family: Oleaceae; Nyctanthaceae.

Habitat: Outer Himalaya, Assam, West Bengal; cultivated in many parts of India.

English: Tree of Sorrow, Night Jasmine, Coral Jasmine.

Ayurvedic: Paarijaata, Shephaali, Shephaalikaa, Mandaara.

Unani: Harasingaar.

Siddha: Pavazha mattigai.

Action: Leaves—bitter tonic, chola- gogue, febrifuge, anti-inflammatory, antispasmodic, hypotensive, respiratory stimulant. Used for fevers, rheumatism, obstinate sciatica.

The leaves and seeds contain iri- doid glycosides; other constituents reported from the leaves are mannitol, beta-amyrin, beta-sitosterol, hentria- contane, benzoic acid, astragalin, nico- tiflorin, oleanolic acid, nyctanthic acid, friedelin and lupeol. The seeds contain a polysaccharide glucomannan.

All parts of the plant are used for allergic disorders. Alcoholic extract of the plant was found to inhibit passive cutaneous anaphylaxis (PCA) in experimental animals. The inhibition was comparable to standard drugs used for allergy and bronchial asthma.

Ethanolic extract of the leaves, flowers and seeds demonstrated strong stimulation of antigen specific and non-specific immunity in mice.

The 50% ethanolic extracts of the leaves, flowers, seeds and roots were found effective in treating caecal amoe- biasis caused by Entamoeba histolytica in rats. But the extracts did not exhibit direct amoebicidal activity in vitro against trophozoites of the parasite.

The iridoid glucosides showed an- tileishmanial activity both in vivo and in vitro.

Dosage: Leaf—10-20 ml juice. (CCRAS.)

Seeds—used in diabetes, also in cutaneous diseases. Filaments— astringent and cooling; prescribed for bleeding piles and menorrhagia. Plant—toxic on the nervous system.

The flowers contain flavonoids including quercetin, kaempferol, api- genin. Cardiac glucoside, nymphalin, showed sedative action in small doses.

The petroleum ether extract of the plant of Nymphaea species, given at a dose of 300 mg/kg i.p. prevented necrosis of the liver tissue and promoted, to some extent, liver regeneration in CCl4-induced toxicity.

Dosage: Dried flowers—3-6 g (API, Vol. III); seed—3-6 g. powder (CCRAS.).... nyctanthes arbor-tristis

Subtypes of a microbial species that are separated on the basis of their isoenzyme patterns (eg. zymodemes of Entamoeba histolytica). ... zymodeme

(amoebic abscess) an abscess of the liver caused by infection with *Entamoeba histolytica. See dysentery.... tropical abscess

Linn.

Family: Compositae; Asteraceae.

Habitat: Tropical and subtropical countries of the world.

English: Congress Grass.

Folk: Pichhi, Machhipatri.

Action: Anti-amoebic, antidysen- teric, febrifuge, analgesic, emmena- gogue.

The grass was introduced into India during 1950 s (it first appeared in Pune).

The grass exhibits in vitro anti- amoebic activity against axenic and polygenic cultures of Entamoeba his- tolytica, comparable to the standard drug for amoebiasis, Metronidazole.

Parthenin and some of its derivatives exhibited significant antimalarial activity against a multi drug-resistant strain of Plasmodium falciparum.

The main toxic constituent of the grass responsible for causing dermatitis and other forms of allergy are parthenin and coronopilin. Parthenin in present up to 8% in the capitulum and 5% in the leaves.... parthenium hysterophorus

Willd.

Family: Malvaceae.

Habitat: North-West India, Bengal and Konkan.

English: Fragrant Sticky Mallow.

Ayurvedic: Vaalaka, Baalaka, Baala, Barhishtha, Hrivera, Ambu, Jala, Nira, Paya, Toya, Udichya, Vaari, Muurdhaja. Sugandhbaalaa (also equated with Valeriana Jatamansi). In the South, Celus vettiveroides is equated with Baalaka.

Siddha/Tamil: Peraamutti, Kastoori vendai.

Action: Plant—anti-inflammatory and spasmolytic. Used in rheumatic affections. Root—stomachic, astringent, demulcent. Used in dysentery, haemorrhages from intestines; ulcers and bleeding disorders.

The roots gave an essential oil containing isovaleric acid, isovaleralde- hyde, armomadendrene, pavonene, alpha-terpinene, azulene and pavo- nenol.

The plant exhibits antiparasitic activity against Entamoeba histolytica.... pavonia odorata

(Thunb.) Miq.

Synonym: S. crataegoides Buch. Ham. ex Don. S. chinensis (Lour.) Druce. Prunus paniculatus Thunb.

Habitat: The Himalayas from Kashmir to Arunachal Pradesh and Assam; Khasi Hills at 1,0002,500 m.

English: Sapphire Berry.

Ayurvedic: Lodhra-Pattikaa.

Unani: Lodh Pathaani.

Action: Leaf—spasmolytic, antiviral, antiprotozoal, anthelmintic. Bark— used as a tonic for preventing abortion. Other uses same as of S. racemosa.

The water-soluble fraction from the bark has been reported to exhibit anti- oxytocic activity. Ethanolic extract of the leaves showed activity against Entamoeba histolytica strain STA, Ascaridia galli and Ranikhet-disease virus. It also affected blood pressure in dogs and cats, and showed activity on the ileum of guinea-pigs. The extract of stem also affected the blood pressure.

The leaf and stem are CVS active.... symplocos paniculata

(DC.) Craib.

Synonym: Carum roxburghianum (DC.) Benth. & Hk. f.

Family: Umbelliferae; Apiaceae.

Habitat: Cultivated throughout India.

English: Ajmud.

Ayurvedic: Ajamodaa, Ajamoda, Ayamoda, Ajmoja, Dipyaka.

Unani: Karafs-e-Hindi.

Siddha/Tamil: Ashamtagam.

Action: Seeds—carminative, stomachic, stimulant, cardiac tonic.

Used for dyspepsia, vomiting, hiccough, bronchitis, asthma, and pain in bladder; also as an emmenagogue.

The seeds yield the coumarins— bergaptene, 7-methoxy-6-methyl cou- marin and umbelliferone. Beta-sitos- terol is also reported.

Major constituent of the essential oil from the seeds are d-limonene (35.1), alpha-terpinene (19.4), d-linalool (4.7), dl-terpineol (5.7) and dl-piperitone (13.6%). Thymol content is 1.7%.

The fruit (Ajmud) induced hyperac- tivity of the central nervous system in mice. It also exhibited activity against Entamoeba histolytica. The ketonic substances exhibit powerful antispas- modic activity.

The fruit left after the extraction of the essential oil showed pronounced cardiotonic activity.

The oil produced marked diuretic effect in rabbits. It lowered blood pressure in dogs and rats.... trachyspermum roxburghianum

(Burm. f.) Merrill.

Synonym: T. asthamatica Wight & Arn.

Family: Asclepiadaceae.

Habitat: Assam, West Bengal, Orissa and Peninsular India.

English: Emetic Swallow Wort, Indian or Country Ipecacuanha.

Ayurvedic: Antamuula, Muulini, Arkaparni.

Siddha/Tamil: Nay Palai, Nangilaip- piratti.

Action: Leaves—used for bronchial asthma and allergic rhinitis.

The whole plant yielded alkaloids including tylophorine, tylphorinine, desmethyltylophorine and desmethyl- tylophorinine, and a flavonoid kaem- pferol. The root yielded alkaloids, tylophorinidine and gamma-fagarine. The leaves gave tylophorinidine, d- septicine, d-iso-tylocrebrine; triterpe- noids alpha-and beta-amyrin; beta- sitosterol, stigmasterol and campes- terol; phenylalanine; and quercetin. Ceryl alcohol has also been reported from the plant.

The plant exhibited anti-amoebic activity against axenic and polyax- enic strains of Entamoeba histolytica. Tylophorine and 4-methoxy-14- hydroxytylophorine are 2 and 4 times more effective, respectively, than the standard drugs Emetine dihydrochlo- ride and Metroindazole. Tylophorine is found effective in intestinal as well as hepatic amoebiasis in test animals, but its gross toxicity excludes its potential use in humans.

Tylophorine also exhibits anti-inflammatory and anti-tumour properties.

Desmethyltylophorine gave promising results in leukaemia.

The drug irritates the digestive tract.... tylophora indica

Blume.

Family: Caprifoliaceae.

Habitat: The Himalayas from Punjab and Bhutan at altitudes of 1,200-2,500 m, also in the Nilgiris.

Ayurvedic: Tilvaka (related species).

Folk: Kaalaa Titmuliyaa, Tita, Karwaa (Kumaon).

Action: The root and stem bark— antispasmodic, uterine sedative.

Ethanolic extract of the aerial parts shows antiprotozoal activity against Entamoeba hystolytica.

The root and stem bark (also of V. foetidum) possess distinct odour of the root of valerian. The extracts of root and stem bark exhibited antispas- modic activity and were comparable with those of the bark of V. opulus var. americanum and V. prunifolium.

Laal Titmuliyaa (Kumaon) is equated with Viburnum mullaha Buch-Ham. ex D. Don syn. V. stellulatum Wall ex DC.... viburnum coriaceum

Usually contracted in a tropical country during foreign travel. Likely to be associated with amoebic dysentery by the organism Entamoeba histolytica from contaminated drinking water or decaying foods (uncooked vegetables), foods exposed to flies. Onset of the disease may not be apparent until years after original infection. It presents with tenderness over the liver. On palpation, liver area is tender and the diaphragm elevated.

Symptoms. Fever, sweating, constitutional upset.

Differential diagnosis: diverticulitis, Crohn’s disease, salmonella, carcinoma, bacillary dysentery.

Alte rnative s:– Blue Flag, Boneset, Burdock, Chaparral, Echinacea, Elecampane, Elder flowers, Eucalyptus, Fringe Tree, Milk Thistle, Marshmallow, Queen’s Delight, Thyme (garden), Wild Indigo, Wild Yam, Yarrow, Yellow Dock.

Tea. Combine: equal parts, Yarrow, Burdock leaves, Marshmallow leaves. 2 teaspoons to each cup boiling water: infuse 10-15 minutes; 1 cup freely.

Decoction. Echinacea 2; Fringe Tree bark 1; Yellow Dock root 1. 2 teaspoons to 2 cups water gently simmered 20 minutes. Half a cup freely.

Formula: Combine: Echinacea 2; Fringe Tree bark 1; Boneset 1; Goldenseal quarter. Dose: Liquid Extracts: 2-4ml. Tinctures: 4-8ml. Powders: 500mg (two 00 capsules, or one-third teaspoon). In water, honey, or cup of Fenugreek tea.

Cold puree. Pass Garlic corm through food blender. Eat with a spoon as much as tolerated. Blend with adjutants: carrots, raisins, apple. ... amoebic liver abscess

Amoebiasis. Ulcerative colitis of the large bowel chiefly with entamoeba histolytica from infected food, water, or by ‘carriers’. Penetration through colon walls may lead to increased peristalsis. Period of infection – one to six months. Travelling upwards via the portal vein. Symptoms: may invade the liver causing abscess. Colic, changed bowel habits. Where severe – fever, bloody stools and pain in iliac fossa.

Treatment by or in liaison with general medical practitioner.

Attention to water supply. Water should be boiled for five minutes to destroy cysts. Avoid fruits and salad materials from unhygienic sources and exposure to flies.

Alternatives. Agrimony, Balm, Bayberry, Bistort, Blue Flag, Burdock, Calamus, Catechu (black), Cranesbill, Echinacea, Fenugreek, Garlic, Goldenseal, Holy Thistle, Ipecacuanha, Ladies Mantle, Marshmallow, Mullein, Nettles, Pulsatilla, Raspberry leaves, Red Clover, Shepherd’s Purse, Slippery Elm, Spurge (hirta), Tormentil root, Thyme (garden), Wild Yam, Witch Hazel, Yarrow.

Tea. Equal parts: Holy Thistle, Marshmallow, Thyme. 2 teaspoons to each cup boiling water; infuse 5-15 minutes; 1 cup thrice daily or every 2 hours acute cases.

Decoction. Combine, Wild Yam 1; Marshmallow root 1; Echinacea 2. One heaped teaspoon to two cups water. Simmer gently 20 minutes. Half-1 cup thrice daily: every 2 hours acute cases.

Formula. Equal parts: Bayberry, Burdock, Echinacea, Peppermint. Dose: Liquid extract: one 5ml teaspoon. Tinctures: one to two 5ml teaspoons. Powders: 750mg (three 00 capsules or half teaspoon) in water, honey or fruit juice, thrice daily: every 2 hours for acute cases.

Practitioner. (1) Tincture Ipecacuanha (BP 1973). Dose: 0.25-1ml as prescribed.

(2) Formula. Liquid Extract Echinacea 15ml; Liquid Extract Monsonia ovata 4ml; Liquid Extract Marigold 4ml; Tincture Goldenseal 2ml; Oil Cinnamon 1ml. Distilled water to 240ml (8oz). Dose: 1 dessertspoon (8ml) every 3 hours. (A. Barker)

Preventative: two Garlic capsules at night.

Note: Fenugreek tea: frequent cupfuls. Good results reported. Drink plenty of fluids: milk, oatmeal porridge, vegetable juices. ... dysentery, amoebic

n. inflammation of the colon due to infection, inflammation, or ischaemia. It is diagnosed by clinical assessment combined with radiological imaging, stool cultures, and endoscopic evaluation. Infectious colitis may be due to viruses, bacteria, or protozoans (for example, *Entamoeba histolytica causes amoebic colitis: see dysentery). Inflammatory colitis encompasses *Crohn’s disease (Crohn’s colitis), *ulcerative colitis, and microscopic colitis. Microscopic colitis can only be seen under a microscope (at endoscopy the colon appears normal). Symptoms of inflammatory colitis may include diarrhoea, abdominal pain, and the passage of blood and mucus in the stools. Ischaemic colitis occurs when there is partial or complete cessation of the blood supply to a particular region of the colon.... colitis

n. 1. an abnormal sac or closed cavity lined with *epithelium and filled with liquid or semisolid matter. There are many varieties of cysts occurring in different parts of the body. Retention cysts arise when the outlet of a glandular duct is blocked, as in *sebaceous cysts. Some cysts are congenital, due to abnormal embryonic development; for example, *dermoid cysts. Others are tumours containing cells that secrete mucus or other substances, and another type of cyst is formed by parasites in the body (see hydatid). Cysts may occur in the jaws: a periapical cyst occurs at the apex of a tooth, a dentigerous cyst occurs around the crown of an unerupted tooth, and an eruption cyst forms over an erupting tooth. See also fimbrial cyst; ovarian cyst; pseudocyst. 2. a dormant stage produced during the life cycle of certain protozoan parasites of the alimentary canal, including *Giardia and *Entamoeba. Cysts, passed out in the faeces, have tough outer coats that protect the parasites from unfavourable conditions. The parasites emerge from their cysts when they are eaten by a new host. 3. a structure formed by and surrounding the larvae of certain parasitic worms.... cyst