stool examination dr.vinutha
TRANSCRIPT
![Page 1: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/1.jpg)
WELCOME
![Page 2: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/2.jpg)
STOOL EXAMINATIONPresented by
Dr.Vinutha.M.GIII PG Scholar,
Dept of Roga NidanaGAMC, Bangalore
![Page 3: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/3.jpg)
CONTENTSINTRODUCTIONCOMPOSITIONCOLLECTIONPRECAUTIONPRESERVATIONMACROSCOPIC EXAMINATIONCHEMICAL COMPOSITIONMICROSCOPIC EXAMINATIONSTOOL CULTUREMALA/PURISHA
![Page 4: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/4.jpg)
INTRODUCTION Human feces - STOOL.Faeces / Feces- Plural-latin term- faex-
RESIDUE.Waste residue of indigestible materials of an
animal digestive tract expelled through the anus during defecation.
Meconium
SCATOLOGY or CAPROLOGY -study of feces.
![Page 5: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/5.jpg)
COMPOSITION• ¾ Water, ¼ Solid• Undigested and Unabsorbed food• Intestinal secretions, Mucous• Bile pigments and Salts• Bacteria and Inorganic material• Epithelial cells, Leukocytes
![Page 6: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/6.jpg)
COLLECTION• Universal Precautions• Dry, sterilized, wide mouthed container
(50 ml).• Plastic/waxed cardboard box/match box• Uncontaminated with Urine or any other
body secretions.• Properly named• Always a fresh sample -tested • Morning specimen-5 to 6 ml
![Page 7: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/7.jpg)
PRECAUCTION• Labeled specimen • Contamination • Specimen should not be left uncovered
(Prevent drying) • Examined within 1 hr of collection • Disposed properly after examination
![Page 8: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/8.jpg)
PRESERVATIONVarious preservativesAq. 10% formalinMIF-merthiolate iodine formaldehydeLV-PVA-low viscocity polyvinyl alcoholSAF-sodium acetate acetic acid formalinSchaudinn’s fixativeModified PVA Cu and ZnOne vial fixative-ECOFIX,PARASAFE,UNIFIX
![Page 9: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/9.jpg)
![Page 10: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/10.jpg)
![Page 11: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/11.jpg)
Contd..CONSISTENCY AND FORMNormal- Well formed-Semisolid
Abnormal: conditionPale, Bulky, Frothy
Hard
Flattened and Ribbon
Watery
Rice water-
Steatorrhea
Constipation
Obstruction in lumen- Bowel
Bacterial infection
Cholera
![Page 12: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/12.jpg)
COLOUR Normal- Light to dark brown
Color Condition
• Yellow- • Black-
• Bright red/ Hematochezia-• Fresh Blood-• Pale/ Gray-
• White-
• Blue-
• Silver-Aluminium paint
• Violet/ Purple-
Giardiasis, GERD, Gilbert’s syndromeBleeding in the upper GIT, Iron administration, bismuth subsalicylate, BeetrootBleeding in the lower GITAmebic dysentry Cholecystitis, Gallstones, Hepatitis, Chronic pancreatitis, Cirrhosis. After barium meal, Biliary obstruction.RADIOTHERAPY, cesium & Thallium poisoning.Carcinoma of ampulla of vater
Symptom in porphyria.
![Page 13: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/13.jpg)
Infant stages color
• Exclusively breast fed infants-
• Infants fed on cow’s milk preparations-
• Babies fed on newer modified cow’s milk-
• Some healthy children
loose and green or pasty and yellow stools.paler yellow colour and of a much firmer consistency. Clay coloured or greenish stools.
pass frequent, loose stools containing undigested vegetable matter called as Toddler’s diarrhoea.
![Page 14: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/14.jpg)
Contd..ODOURDepends on- PH of stool Methyl sulfidesBenzopyrrole volatiles(indole and sketole)
& Hydrogen sulphidesubstances that produce normal odour-
Intestinal bacterial fermentation and putrefaction.
![Page 15: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/15.jpg)
Odour Condition
• Foul odour-
• Sickly sweet odour-
• Increased odor-
Degradation of undigested protein and excessive carbohydrate intake.
Undigested Lactose.
Celiac disease, Crohn’s disease, Ulcerative colitis, Chronic Pancreatitis, Cystic fibrosis,.
![Page 16: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/16.jpg)
PARTS OF PARASITE AND ADULT PARASITEWorms and their parts• Round worm• Hook worm• Tape worm• Pin worm• Whipworm
![Page 17: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/17.jpg)
C H E M I C A L E X A M I N A T I O N
NORMAL
• Water –
• pH –
• Occult blood- • RS –
• Bile –
• Sodium –
• Chlorides –
• Potassium –
• Lipids / Fatty acids –
• Nitrogen -
Upto 75%
5.8 to 7.5
NegativeNegative
Negative in Adults
5.8 to 9.8 mEq/24hrs
2.5 to 3.9 mEq/24hrs
15.7 to 20.7 mEq/24hrs
0 to 6 gms/24hrs
<2.5g/24hrs
![Page 18: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/18.jpg)
PHProcedure Increased pH-
ALKALINEDecreased pH-ACIDIC
• Atleast ½ ml of faeces -collected.
• Patient shouldn’t receive any antibiotics.
• Strip of nitrazine paper – dipped in sample.
• Colitis
• Antibiotic use
• Villous adenoma
• Excess Protein in diet.
• Carbohydrate Malabsorption- Lactose intolerance
• Fat Malabsorption
• Disaccharidase defficiency
• Contagoin- E.Coli, rotavirus.
![Page 19: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/19.jpg)
OCCULT BLOOD:Principle Method Intpretation
Benzidine test-Perioxidase
+hemoglobin in blood converts
hydrogen peroxide
water and nascent oxygen
oxygen oxidises
benzidine in acidmedium
green to blue coloured complex.
Benzidine – Glacial acetic acid – Hydrogen peroxide – Over stool in slide – Colour change.
Ulcers,Diverticullitis,Ulcerative Collitis,Diaphragmatic Hernia,Adenoma,CA Colon, Gastrium
![Page 20: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/20.jpg)
FATMicroscopic examination:
Quantitative fecal fat test:
Interpretation
•Random faeces stained with Sudan staining ( Sudan III or IV)•Visible amounts of fat
•Done over a period of 3 days•In a container all faeces collected•Thoroughly mixed to homogenize•Small sample is obtained•Fat content extracted with solvents•Measured by saponification
• Malabsorption Syndrome
• Obstructive Jaundice
• Non tropical sprue/Coeliac Sprue
• Crohn’s disease• Cystic Fibrosis• Whipple’s disease• Enteritis and
Pancreatic diseases
![Page 21: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/21.jpg)
Contd..REDUCING SUBSTANCESScreening test -carbohydrate
malabsorbtion disorders -lactose intolerance or disaccharidase deficiency,
Stool - positive for RS -Rota viral Infection in Infants.
![Page 22: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/22.jpg)
Materials: Reagents: Procedure:
•Wooden applicator sticks•Plastic transfer pipette, 6 inches16 x 125 mm test tubes•Clinitest color reaction chart•Vortex mixer
•Clinitest tablets •Type I water•MAS Urinalysis Abnormal Level 1 control•Normal Urinalysis Control
•1 volume of stool (approximately “pea” size) to a 16 x 125 mm test tube. •Add 2 volumes of type I water. •Mix thoroughly using a vortex mixer • centrifuge for 5 minutes at 2000 rpm (full speed).•Using a plastic (uniform drop) pipette, transfer 15 drops of this suspension to a clear test tube (16 x 125). •Add one Clinitest tablet.•end of this 15 second waiting period•Compare the color of the liquid
![Page 23: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/23.jpg)
Contd.. Warning: This is an exothermic reaction
and the test tube will become very hot. Keep hands and face away from the test tube opening.
Note: Ignore sediment that may form in the bottom of the test tube and changes after the 15 second waiting period.
![Page 24: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/24.jpg)
ResultsCLINITEST % REPORTING
SYSTEMCOLOUR
0.0 N -Normal BLUE
0.25 T-Nomal Blue to green
0.5 1+ Suspicious Shades of green
0.75 2+ To Brown
1.0 3+ to
2.0 4+ Orange
>2 >4+ greenish-brown
![Page 25: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/25.jpg)
![Page 26: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/26.jpg)
M I C R O S C O P I C E X A M I N AT I O N O F T E M P O R A R Y M E T H O D
RequirementsMicroscope slidesCover slipsSodium chloride solutionLugol’s Iodine SolutionWooden applicatorFresh stoolGloves
![Page 27: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/27.jpg)
Method:A drop of warm Saline or Lugol’s Iodine is placed
over a clean microscopic slide.• About 2mg of stool sample should be taken and
mixed with soln placed over the slide.• Coverslip is placed avoiding air bubbles.• Examined under Microscope.
![Page 28: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/28.jpg)
STOOL EXAMINATIONTemporary
![Page 29: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/29.jpg)
Scanty infectionConcentration techniques
![Page 30: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/30.jpg)
Saline sedimentation
![Page 31: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/31.jpg)
Formol Ether Sed. Conc.
![Page 32: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/32.jpg)
Baermann’s technique
![Page 33: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/33.jpg)
![Page 34: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/34.jpg)
Permanent Stained smearsIron haematoxylin stainTrichrome stain Modified Ziehl Neelsen stain (Crypto.)
![Page 35: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/35.jpg)
Iron haematoxylin stainFecal smear- fixed in Schaudinn’s solution-15minImmersed 2-5 min 70%alcohol70%alcohol having trace of iodine50% alcohol for 2-5minWashed in H2o-5-10minImmersed in 2%aqeous ferric ammonium sulphateWashed in H2o 3-5 min & stained by 0.5% aqueous hematoxylin
5-15minWashed 2-5 min & differentiated in saturated aq. Picric acid 10-
15minWashed 10-15min & dehydrated by passing through increasing of
alcoholCleared in toulene /xylol and mounted
![Page 36: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/36.jpg)
Trichrome stain
Quicker & simplerSmear is fixed in Schaudinn’s solutionTaken up by alcohol Trichrome stain- applied-5-10minDifferentiated in acid-alcohol Dehydrated ClearedMounted
![Page 37: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/37.jpg)
Normal
• Undigested food materials – None to small amount
• Starch – None• Eggs, Cysts, Parasitic fragments – None• Yeasts – None• Leukocytes – None
![Page 38: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/38.jpg)
ABNORMALABNORMAL IMPLICATION
Large amounts of leukocytes Chronic Ulceratice Collitis, Chronic Bacillary Dysentry, Localised Abscess, Fistulas.
Mononuclear Leukocytes Typhoid
Polymorphonuclear Leukocytes
Shigellosis, Salmonellosis, Invasice E. coli diarrhoea, Ulceratice Collitis.
![Page 39: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/39.jpg)
EGG COUNTING METHODSSemi quantitative assessmentStandard Wet mountModified Kato thick smear techniqueMc. Master’s methodStoll’s dilution techScotch tape method- Enterobius vermicularisBell’s dilution-filtration count- schistosome eggs
![Page 40: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/40.jpg)
STANDARD WET MOUNT
![Page 41: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/41.jpg)
Thick smear-Kato technique
![Page 42: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/42.jpg)
MC. MASTER’S METHODChamber
Eggs in 20mg
Salt floatation
Concentration
Square grid on the roof of
chamber
![Page 43: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/43.jpg)
Stoll’s technique
![Page 44: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/44.jpg)
Scotch tape methodApp. 4inch cellophane
tape
Sticky side of tape pressed against
the skin across the anus
Sticky side of tape placed
on glass slide
Drop of toulene/xylol
betW. Tape & slide
3 consecutive days @ early
morning
![Page 45: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/45.jpg)
STOOL CULTURE
Gram –ve - E. coli, Enterobacter, Proteus, Pseudomonas aeruginosa, Bacteroides.
Gram +ve - Clostridia, Lactobacilli, Enterococci, Anaerobic streptococci.
![Page 46: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/46.jpg)
Contd..Culture media -
AGAR and is done aerobically.
XLD Agar media – Salmonella,
Shigella.
TCBS Agar media– Cholera.
MacConkey media – Yersinia
enterocolitica
Campylobacter culture media - Campylobacter
species.
![Page 47: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/47.jpg)
Hanging drop test:
Drop stool -centre of a coverslip.
Drop of water / vaseline- each corner of the coverslip.
Invert a slide -central depression over the coverslip.
The coverslip -stick to the slide
Inverted the drop of bacterial culture-suspended in the central depression
of the slide.
Examine microscopically (X100) -motile organisms.
![Page 48: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/48.jpg)
![Page 49: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/49.jpg)
Cultures
Harada mori filter paper strip culture
S.StercoralisTrichostrongylus
Agar plate cultureS.Stercoralis
sensitive Charcoal culture
![Page 50: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/50.jpg)
Contd..HARADA MORI FILTER PAPER STRIP
CULTURE:
![Page 51: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/51.jpg)
AGAR PLATE CULTURE
App. 2g• Inoculated• Agar plates
SealedRoom
temperature
2 daysLarva crawl over
agar
![Page 52: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/52.jpg)
CHARCOAL CULTURE
Softened faeces
Mixed 5-10 parts of moistened charcoal granules
Covered, stored-7-10 days, larvae
![Page 53: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/53.jpg)
![Page 54: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/54.jpg)
Contd..Wet film- microscopyCulture on selective media- salmonella, shigella &
Camphylo bacter spp.,etcMolecular genetics-PCR probes- detect Shiga toxin-
E.coliEIA- detection of rotavirus & adeno virus-
childrenDiarrhoel outbreaks- Norovirus-PCR/electron
microscopyOutbreaks of viral meningitis/encephalitis-
viral culture
![Page 55: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/55.jpg)
INTESTINAL PARASITESEntamoeba histolytica- Pathogenic
![Page 56: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/56.jpg)
Entameoba coli-Non pathogenic
![Page 57: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/57.jpg)
Endolimax nana- Non pathogenic
![Page 58: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/58.jpg)
Iodamoeba buetschlii –Non pathogenic
![Page 59: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/59.jpg)
Balantidium coli-Pathogenic
![Page 60: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/60.jpg)
Giardia lamblia-Pathogenic
![Page 61: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/61.jpg)
Trichomonas vaginalis- Pathogenic
![Page 62: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/62.jpg)
Cryptosporidium parvum-Pathogenic
![Page 63: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/63.jpg)
Ascaris lumbricoides- Large round worm
![Page 64: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/64.jpg)
Contd..
![Page 65: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/65.jpg)
Enterobius vermicularis-pin worm
![Page 66: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/66.jpg)
Contd..
![Page 67: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/67.jpg)
Trichuris trichura- Whipworm
![Page 68: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/68.jpg)
![Page 69: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/69.jpg)
Necator americanus and Ancylostoma duodenale- Hookworm
![Page 70: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/70.jpg)
Necator americanus and Ancylostoma duodenale
![Page 71: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/71.jpg)
Strongyloides stercoralis-Threadworm
![Page 72: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/72.jpg)
Taenia solium- Tape worm
![Page 73: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/73.jpg)
Taenia solium- Tape worm
![Page 74: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/74.jpg)
M A L A / P U R I S H A
Dosha dhathu mala moolam hi ….Synonyms:- Shakrit, Upveshana, Vit,
Gutha,Varcha
![Page 75: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/75.jpg)
Formation of purisha“Pakwashya Tu Prapatasya
ShoshyemanasyeVahinna Paripinditpakavasye VayuSyat Katubhavata” [Charak Chikitsa
Sthana15/11]“Kittam Annasye Vinmutram”. [CharakChikitsa Sthana 15/18]
![Page 76: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/76.jpg)
Panchbhautika constitution of purishaPurisha predominantly consists of agni andvayu mahabhuta.“Purisham parthivam” (Bhanumati onSushruta sutrasthan15/8)
![Page 77: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/77.jpg)
Site of formation“Purishvahanam srotsam pakvashyo
mulamsthulgudam” (Charak vimansthana5/8)“Tatra vatvaschonirasnam
sthulantrapratibaddamgudam naam marmamch”(Sushruta
sharirsthana 6/25)
![Page 78: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/78.jpg)
Purishadhara kala“Panchmi purishdharanam,ya Ante
kosthemalam Abhivibhajyte pakvashyastha”
[SushrutaShareer Sthana 4/16] “Yakrit samantat koshte ch tathaantrani
Samashrita Undukastham vibhajte Malam Maladharakala” [Sushruta shareer Sthana 4/17]
![Page 79: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/79.jpg)
Quantity- Functions of purisha“Sapta Anjali purishasye” [Charak
shareerSthana 7/15]“Avshtambh purishasye” [Ashtang HridyaSutrasthana Sthana 11/5]
![Page 80: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/80.jpg)
ASHTA STHANA PARIKSHA
![Page 81: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/81.jpg)
![Page 82: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/82.jpg)
•Mala swaroopaArishta
•Ati krishna, atishubra•Atipeeta, Aruna
Mruthyu karaka
•Excess ushnaAvashya mruthyu karaka
![Page 83: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/83.jpg)
Mala pareeksha Contd..Condition Lakshana
Saama mala Guru, Durgandhi, Apsu nimajjathi
Nirama mala Laghu, Na Apsu nimajjathi
Kamala Tila pista Nibha
Atisara Bahu drava
Pravahika Kapha yukta mala
Grahani Muhur baddam, muhur dravam
![Page 84: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/84.jpg)
PURISHAJA KRIMI
Sthana• Pakvashaya
Akruty• Sookshma
(minute),Vritha (round), Deergha (long)
• Sthoola(big), Prithavapucksa (flat tail) and Tanu(thin)
Varna• Shweta(white),
Shyava (pale), Neela (blue),
• Harita (green), Peeta (yellow).
![Page 85: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/85.jpg)
Kakeruka –highly motile Makeruka – shape of MudrikaSausrada- shelters on fermented materialsLeliha- continuously licks/feeds and consume
Dhatus (seven tissue elements of the body)Sashoolika -causing pain in the host.21
![Page 86: Stool examination dr.vinutha](https://reader035.vdocument.in/reader035/viewer/2022062412/58f9b1c6760da3da068bc44b/html5/thumbnails/86.jpg)
THANK YOU