DEATH DANCE OF BILIARY DEMON

.. death dance of biliary demon..




Ascariasis is endemic in India and many developing countries; however, impact of this ubiquitous parasite on human health had never been quantified. In fact, this human infection had been identified as benign without any major potential for disease.




Over the years (1982-1995), I and my colleagues got interested in public health importance of this human infection. In an endemic area in Kashmir, we identified that the commonest manifestation of this infection was due to peculiar but natural behavior of this large motile organism to explore human orifices, this time, papillary orifice of the bile and pancreatic ducts. In doing so, the hapato-biliary and pancreatic ducts are freely traversed. Ascarides make repeated visits into and out of the ducts till at some stage of the travel they die in the duct (death dance of biliary demon). During its repeated but limited exploration of papillary orifice and advance into ducts, the person comes down with severe hepato-biliary or pancreatic disease, the nature of which is predictably defined by the numbers and placement of the Ascarides in the ducts. We have named this disease as Hepatobiliary and Pancreatic Ascariasis (HPA). The dead Ascarides in the ducts forms a nidus to the formation of brown pigment stones, leading to the syndrome of Recurrent Pyogenic Cholangitis, a disease more often known in the Orient as Oriental Cholangiohepatitis.

HPA is a disease of great public health importance in endemic areas. In Kashmir, one such area, HPA is as common as gall stones in causing biliary disease and every third patient with acute pancreatitis is caused by HPA. HPA is only second to bleeding peptic ulcer as a cause of emergency room visits. Moreover, around 12.5% of all biliary lithiasis are caused by primary brown pigment stones, placed in hepatic ducts and are secondary to aftermath of repeated Ascaris invasion into ducts.

The data on epidemiology, clinical picture, diagnostic tools, management strategies including therapeutic endoscopic interventions and of course control measures have been collected in a series of carefully planned studies and formed a series of important publications (see references overleaf).

In view of the frequent international travel and emigration of eastern population to the West, HPA can be frequently encountered by the western physicians dealing with high-risk population or in those who have had recent travel to endemic zones. In Middle East, HPA has is of special importance in view of substantial proportion of expatriate population from endemic areas.

Prof MS Khuroo
Director
Dr Khuroo's Medical Clinic
Srinagar Kashmir India

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• WORMS

[szqsk8]

This is why I never eat sushi/sashimi!

[wybie016]

i'd been looking for an awesome video that i can present to my professor about ascaris lumbricoides or also known as roundworm. thanks for this clip, i can finally take a rest... what the, worms are killing me! hahahha :))) i can't wait to see my classmates reaction after watching this! GREAT!

[wybie016]

@Freddykid123 : pampurga

[padude64]

stomach and duodenal ulcers

[padude64]

They diagnose me with biliary colic

[thatsMrSmileytoyou]

Man I thought live worms inside me were bad but I think I'd be pretty worried about the dead ones too..

Thanks so much for the video and the description

[babyhef]

dung means feces

[AndyMcArren1356]

Deworm? And what are dungs? cuz I never heard of anyone use the word dung..

[babyhef]

people went to toilet and never wash hands properly including the eggs. the next person touches contaminated taps/doors/knobs will get it on their hands but at lower chances. you won't see it because it's small. once digested, i grows from there on. this include vegetables that are not washed properly (because they fertilize with animals dungs) anyway i eat as usual and deworm every 3 months or 6.

[Lillian0001]

o.o" i think i lost my appetite.. O.O"

wow.. i wish i hadnt watched this. :'(