Diphyllobothriasis is defined as infection with the cestode Diphyllobothrium latum or other Diphyllobothrium species (eg, Diphyllobothrium nihonkaiense). It is endemic in areas where humans frequently consume raw or pickled fish.
Most persons with diphyllobothriasis are asymptomatic. In symptomatic persons it causes Abdominal pain,Indigestion or dyspepsia, Passage of proglottids, Other, less common, symptoms include the following: Fatigue, Diarrhea, Dizziness,Weakness (rare),Numbness of extremities, Sensation of hunger. Most patients with diphyllobothriasis have no signs of illness . Rare physical findings that may be noted include the following: Pallor, Glossitis, Dyspnea, Tachycardia, Weakness, Hypoesthesia, Paresthesias, Disturbances of movement and coordination, loss of vibratory sense and proprioception.
Most patients with diphyllobothriasis, unless they have severe symptoms, can be safely treated as outpatients. Inpatient care is not generally required but may have to be considered in advanced, resistant, or complicated cases.Diphyllobothriasis is treated by pharmacologic means; surgical treatment is not required unless otherwise indicated (eg, in a patient presenting with intestinal obstruction). Even in the face of decreased vitamin B-12 levels, less than 2% of patients with diphyllobothriasis develop anemia. Vitamin supplementation may be required in severe cases. As a rule, no activity limitations or restrictions are necessary.
The state of child health in Singapore from 1914 to the present is chronicled. In 1914, there were 225 reported cases of tetanus neonatorum out of 7,420 births and 340 deaths from gastroenteritis with an infant mortality rate (IMR) of 292.9 per 1000 live births. In 1936 the infant mortality rate was 167.74, and in 1962, it was still high at 31.2, a figure which exceeded the IMR of USA, UK, Australia and New Zealand. However, by 1976, the IMR had fallen to 11.8 which were lower than that of the above countries and the neonatal mortality rate (NMR) was 8.4 which were also lower than the other four developed countries. In 1981, the IMR fell further still to 10.8 and the NMR was 7.7.
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