Asthma

What is asthma?

People with asthma have sensitive airways in their lungs. When exposed to certain triggers their airways narrow, making it hard for them to breathe.

Three main factors cause the airways to become narrow:

• The inside lining of the airways becomes red and swollen (inflammation)
• Extra mucous (sticky fluid) may be produced
• The muscle around the airways tightens (bronchoconstriction)

Why do people get asthma in the first place?

The causes of asthma are not really understood but there is often a family history of asthma, eczema or hayfever. Asthma can begin at any age and change over time. Unborn babies whose mothers smoke during pregnancy, and children exposed to smoke in early childhood, have a higher risk of developing childhood asthma.

How do you recognise asthma?

• A dry, irritating, persistent cough, particularly at night, early morning, with exercise or activity
• Chest tightness
• Shortness of breath
• Wheeze

Asthma triggers

• Colds and flu
• Exposure to cigarette smoke
• Exercise/activity
• Inhaled allergens (e.g. pollens, moulds, animal dander and dust mites)
• Environmental (e.g. dust, pollution, wood smoke, bush fires)
• Changes in temperature and weather
• Certain medications (e.g. aspirin)
• Chemicals and strong smells (e.g. perfumes, cleaners)
• Emotional factors (e.g. laughter, stress)
• Some foods and food preservatives, flavourings and colourings (uncommon)

Figures

Today we live in a community where:

• Over 2 million Australians have asthma.
• Approximately 15% of children have currently diagnosed asthma (or one in six children have currently diagnosed asthma).
• Approximately 11% of adults have currently diagnosed asthma (or one in ten adults have currently diagnosed asthma).
• Indigenous Australians have more problems with asthma than other Australians.
• The majority of people with asthma do not have a written asthma action plan.
• Many people with asthma who could benefit by using regular preventer medication are not using it.
• Asthma is one of the most common reasons for hospital admissions in children.
• 397 people died due to asthma in 2002.

Every person’s asthma is different. Not all people will have the same triggers, nor will they react to every trigger listed above. You may not always know what triggers your asthma. It is helpful to identify triggers in order to avoid them however this is not always possible (e.g. colds and flu).

Acupuncture Treatment

Acupuncture and Traditional Chinese Medicine can be very effective for respiratory disorders including Asthma. There are many studies relating to the success of acupuncture treatment for asthma which have been reported in the medical journals. (1)

In 1979 the World health Organisation listed 40 diseases for which acupuncture was considered to be beneficial and diseases of the respiratory tract including asthma and bronchitis were included in that list (2).

In a study conducted at the Department of Anaesthesia and Intensive Care in the University Hospital of Vienna revealed that over 70% of patients with long-standing asthma reported a significant improvement of their ailments after ten weeks of acupuncture treatment. (3)

Traditional Chinese Herbal Treatment

18/10/2005 - An oral combination of three Chinese herbal extracts: Ling-Zhi (Ganoderma lucidum), Ku-Shen (Radix Sophora flavescentis) and Gan-Cao (Radix Glycyrrhiza uralensis) could be as effective as conventional medicines at alleviating asthma symptoms but without such severe side effects, report Chinese and American researchers.

1990 - There has been one positive study involving a Chinese herb called Xifukang (a compound preparation of Chinese herbs) which was published in 1990. The results of treatment of 53 patients indicated that the clinical symptoms including cough, sputum production, chest pain, weakness, etc. were markedly improved and measurements of pulmonary function significantly enhanced . The researchers concluded that the therapeutic mechanism of Xifukang included promoting blood circulation to eliminate blood stasis, increasing ventilation, protecting dust-cells, resisting fibrosis, regulating immune function, enhancing lung clearance, and postponing and preventing development of silicosis. (4)

Green Tea May Help Protect Against Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects more than 2.1 million Americans. It is characterized by joint pain, stiffness, inflammation, swelling, and sometimes joint destruction. Nonsteroidal anti-inflammatory drugs are the standard treatment for RA, but their prolonged use is associated with adverse effects and discomfort. Natural plant alternatives like green tea are being investigated for the management of RA. Green tea is the most widely consumed beverage in the world, and its polyphenols (substances rich in antioxidants) possess anti-inflammatory properties.

NCCAM-funded investigators at the University of Maryland and Rutgers University examined the effects of green tea polyphenols on RA by using an animal model in rats. The animals consumed green tea in their drinking water (controls drank water only) for 1 to 3 weeks before being injected with heat-killed Mycobacterium tuberculosis H37Ra to induce arthritis. The researchers found that green tea significantly reduced the severity of arthritis.

The researchers suggest that green tea affects arthritis by causing changes in various arthritis-related immune responses—it suppresses both cytokine IL-17 (an inflammatory substance) and antibodies to Bhsp65 (a disease-related antigen), and increases cytokine IL-10 (an anti-inflammatory substance). Therefore, they recommend that green tea be further explored as a dietary therapy for use together with conventional treatment for managing RA.

Acupuncture Shows Promise in Improving Rates of Pregnancy Following IVF

A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF. IVF, which involves retrieving a woman's egg, fertilizing it in the laboratory, and then transferring the embryo back into the woman's womb is an expensive, lengthy, and stressful process. Identifying a complementary approach that can improve success would be welcome to patients and providers.

According to Eric Manheimer of the University of Maryland School of Medicine's Center for Integrative Medicine and colleagues who conducted the systematic review, acupuncture has been used in China for centuries to regulate the female reproductive system. With this in mind, the reviewers analyzed results from seven clinical trials of acupuncture in women who underwent IVF to see if rates of pregnancy were improved with acupuncture. The studies encompassed data on over 1366 women and compared acupuncture, given within one day of embryo transfer, with sham acupuncture, or no additional treatment.

The reviewers found that acupuncture given as a complement to IVF increased the odds of achieving pregnancy. According to the researchers, the results indicate that 10 women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. The results, considered preliminary, point to a potential complementary treatment that may improve the success of IVF and the need to conduct additional clinical trials to confirm these findings.

Acupuncture May Help Symptoms of Posttraumatic Stress Disorder

A pilot study shows that acupuncture may help people with posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Michael Hollifield, M.D., and colleagues conducted a clinical trial examining the effect of acupuncture on the symptoms of PTSD. The researchers analyzed depression, anxiety, and impairment in 73 people with a diagnosis of PTSD. The participants were assigned to receive either acupuncture or group cognitive-behavioral therapy over 12 weeks, or were assigned to a wait-list as part of the control group. The people in the control group were offered treatment or referral for treatment at the end of their participation.

The researchers found that acupuncture provided treatment effects similar to group cognitive-behavioral therapy; both interventions were superior to the control group. Additionally, treatment effects of both the acupuncture and the group therapy were maintained for 3 months after the end of treatment.

The limitations of the study are consistent with preliminary research. For example, this study had a small group of participants that lacked diversity, and the results do not account for outside factors that may have affected the treatments' results.

Cut The Sugar

Each time you eat a snack containing sugar or starch (carbohydrates), the resulting acid attack on your teeth can last up to 20 minutes, and a lot of snacks and drinks contain sugar. How much sugar? A single can of pop contains up to 10 teaspoons of sugar, and if you think that natural sugar (like the sugar in raisins or other fruit) is better for your teeth it’s not. Sugar is sugar, and the average Canadian consumes over 40 kilograms of sugar each year! Click here for a list of how much sugar your favorite snack might contain.

Beat the Clock - foods that are eaten during a meal usually pose less of a threat to teeth because of the additional saliva produced during mealtime eating. Saliva helps to wash food particles from your mouth and lessen the damage from acid.

Brush & floss those teeth - toothbrushing is important, and you should brush twice a day. Did you know that if you don’t floss, you miss cleaning up to 35% of each tooth? If you’re not sure how to floss, just ask your dentist.

Stock up on Dairy Products - yogurt and cheese, milk and milk products contain things that are good for your teeth. Everything that’s made from milk is a good source of calcium - an essential nutrient for the development of bones and teeth. Some scientific studies have shown that eating cheese might actually help to protect your teeth from cavities by preventing something called demineralization (the loss of important calcium in your teeth).

BRACES

Having straight teeth is important. Teeth that are crooked or out of place (misaligned) affect the way a person chews and talks and how their smile looks. Because they have unnatural spaces, crooked teeth are harder to clean and are more likely to have cavities.

In some cases, crooked teeth can affect the way the jaws line up and can cause pain and discomfort.

Severe Malocclusion

One method to correct this is to have Orthodontic treatment (or braces and retainers as they are sometimes called). Orthodontic treatment works by exerting a gentle pressure over time to straighten teeth that are growing, or have already grown, out of place.

Braces have three basic parts:
1) Brackets - brackets that are attached to each tooth
2) Bonding or band - the material that attaches the bracket to the tooth
3) Arch Wire - a thin metal wire that runs from bracket to bracket

Braces have come a long way from the "train track" look of years ago. Today, many orthodontic patients can get braces that attach to the backs of the teeth, or use transparent brackets.

A retainer is a custom-made, removable appliance that helps keep teeth in their new, straightened position after braces have been removed. Retainers can also be used to treat more minor orthodontic problems.

Do Allergies Cause Asthma?

People who have certain kinds of allergies are more likely to have asthma. Do you have allergies that affect your nose and eyes, causing stuff like a runny nose or red, itchy eyes? If so, you're more likely to have asthma, too. Whatever causes the allergic reaction, such as pollen or dust, can also trigger asthma symptoms.

But not everyone who has allergies gets asthma, and not all asthma happens because of allergies. Huh? Allergies and asthma can be a little confusing, so let's find out more.

About 9 million kids in the United States have been diagnosed with asthma. Of these, about three out of four have asthma symptoms that are triggered by an allergy to something (called an allergen). In these people, the symptoms of asthma like wheezing, coughing, or trouble breathing are often brought on by being around allergens.

Allergies have a lot to do with your immune (say: ih-myoon) system. Most of the time your immune system fights germs and bacteria to help you stay healthy. But in a kid with allergies, the immune system treats allergens (such as pollen) as if they're invading the body, like a bad germ.

When the immune system reacts to an invading allergen, the body releases substances that cause allergy symptoms, such as a runny nose or red, itchy eyes. Some kids can also get asthma symptoms, like coughing, wheezing, or a tight feeling in the chest.

If you have asthma, it is a good idea to find out whether allergies may be causing your asthma symptoms. To figure out what they're allergic to, sometimes kids will visit a special doctor called an allergist (say: ah-lur-jist).

If the allergist finds out that you are allergic to certain things, the best way to prevent allergic reactions (and to help stop asthma symptoms from bugging you) is to avoid being around the allergens. The doctor may also prescribe medicine for your allergies, if you can't completely avoid what's causing them.

heart attack

What happens during a heart attack? The heart muscle requires a constant supply of oxygen-rich blood. The coronary arteries provide the heart with blood. If you have coronary artery disease, the inside of your coronary arteries may look like this: Plaques (made of fatty matter, calcium, and stray cells) of different sizes attach to the walls of the arteries. Many of the plaques are hard on the outside and soft and mushy on the inside. The plaque builds up and narrows the artery. When the plaque's hard, outer shell ruptures (cracks or tears), platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes "starved" for oxygen and nutrients (called ischemia) in the region below the blockage. Within a short time, death of heart muscle cells occur, causing permanent damage. This is called a myocardial infarction (MI) or heart attack. A heart attack can also occur less frequently by a spasm of a coronary artery. During coronary spasm, the coronary arteries constrict or spasm on and off, causing lack of blood supply to the heart muscle (ischemia). It may occur at rest and can even occur in people without significant coronary artery disease. If coronary artery spasm occurs for a long period of time, a heart attack can occur.

What are the symptoms of a heart attack? Ask your doctor about your risk of heart attack and how to reduce this risk. Share this information with your family members and caregivers so they learn to recognize the symptoms of a heart attack and when to help you seek emergency treatment. If you are having any one of the symptoms described below that lasts for more than 5 minutes, SEEK EMERGENCY TREATMENT WITHOUT DELAY. These symptoms could be the signs of a heart attack and immediate treatment is essential. Symptoms of a heart attack include: Chest pain or discomfort in the center of the chest; a “squeezing,” “heaviness” or “crushing” feeling that lasts for more than a few minutes or goes away and comes back Pain or discomfort in other areas of the upper body including the arms, back, neck, jaw, or stomach Difficulty breathing, shortness of breath Sweating or “cold sweat” Fullness, indigestion, or choking feeling (may feel like “heartburn”) Nausea or vomiting Extreme weakness or anxiety Rapid or irregular heart beats Do not wait for your symptoms to “go away.” Early recognition and treatment of heart attack symptoms can reduce the risk of heart damage and allow treatment to be started immediately. Even if you’re not sure your symptoms are those of a heart attack, you should still be evaluated. Some people have a heart attack without having any symptoms (a "silent" myocardial infarction). A silent MI can occur among all patients, though it is more common among diabetics. If you have a silent MI, your heart attack may be diagnosed during a routine doctor’s exam.

The first symptoms start the clock At the first signs of a heart attack, call for emergency treatment. The best time to treat a heart attack is within the first one to two hours from the first onset of symptoms. Studies show that the people who have symptoms of a heart attack often delay, or wait to seek treatment, for longer than seven hours. People who delay tend to be older, female and to have a history of angina, high blood pressure or diabetes. Do not wait : Fast action can save lives - including your own Reasons people delay They are young and cannot believe it is happening to them Symptoms are not what they expected They may deny the symptoms are serious and wait until they go away They may ask the advice of others, especially family members They may first try to treat the symptoms themselves, using aspirin or antacids They may think the symptoms are related to other health problems (upset stomach, arthritis) They may put the care of others first (first take care of children or other family members) and not want to worry them. Waiting just a couple hours for medical help may limit your treatment options, increase the amount of damage to your heart muscle, and reduce your chance of survival. Know in advance: The symptoms of a heart attack. Who to call for emergency help. Do not call a friend or family member. Call for an ambulance to take you to the nearest A&E. Treat all chest discomfort as angina or a heart attack unless your doctor has told you otherwise. Treatments (medications, open heart surgery and interventional procedures) do not cure coronary artery disease. Having had a heart attack or treatment does not mean you will never have another heart attack; It CAN happen again.

Understand Cholesterol

Cholesterol is a waxy substance produced by the body and found in foods that come from animals. Cholesterol is needed by your body to make hormones, skin oils digestive juices and vitamin D. You could not live without some cholesterol in your body.

However, too much cholesterol is a major risk factor for heart disease, particularly LDL (low density lipoprotein) cholesterol. LDL causes the build-up of fatty deposits within your arteries, reducing or blocking the flow of blood and oxygen to your heart.

Why Is Cholesterol Important?

Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack.

How Does Cholesterol Cause Heart Disease?

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

Diet: Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.

Weight: Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.

Exercise: Regular exercise can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to exercise for 30 minutes on most, if not all, days.

However, there are things you cannot do anything about also can affect cholesterol levels. These include:

Age and Gender: As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.

Heredity: Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

Angina Useful Info

Angina (angina pectoris - Latin for squeezing of the chest) is the chest discomfort that occurs when the blood oxygen supply to an area of the heart muscle does not meet the demand. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis (see below). Angina is usually felt as a squeezing, pressure, heaviness, tightening, or aching across the chest, particularly behind the breastbone. This pain often radiates to the neck, jaw, arms, back, or even the teeth. Patients may also complain of indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath. Angina usually occurs during exertion, severe emotional stress, or after a heavy meal. During these periods, the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina typically lasts from 1 to 15 minutes and is relieved by rest or by placing a nitroglycerin tablet under the tongue. Nitroglycerin relaxes the blood vessels and lowers blood pressure. Both resting and nitroglycerin decrease the heart muscles demand for oxygen, thus relieving angina. Causes The most common cause of angina is coronary artery disease. A less common cause of angina is spasm of the coronary arteries. Coronary arteries supply oxygenated blood to the heart muscle. Coronary artery disease develops as cholesterol is deposited in the artery wall, causing the formation of a hard, thick substance called cholesterol plaque. The accumulation of cholesterol plaque over time causes narrowing of the coronary arteries, a process called arteriosclerosis. Arteriosclerosis can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. When coronary arteries become narrowed by more than 50% to 70%, they can no longer meet the increased blood oxygen demand by the heart muscle during exercise or stress. Lack of oxygen to the heart muscle causes chest pain (angina). The walls of the arteries are surrounded by muscle fibers. Rapid contraction of these muscle fibers causes a sudden narrowing (spasm) of the arteries. A spasm of the coronary arteries reduces blood to the heart muscle and causes angina. Angina is usually a warning sign of the presence of significant coronary artery disease. Patients with angina are at risk of developing a heart attack (myocardial infarction). A heart attack is the death of heart muscle precipitated by the complete blockage of a diseased coronary artery by a blood clot. During angina, the lack of oxygen (ischemia) to the heart muscle is temporary and reversible. The lack of oxygen to the heart muscle resolves and the chest pain disappears when the patient rests. The muscle damage in a heart attack is permanent. The dead muscle turns into scar tissue with healing. A scarred heart cannot pump blood as efficiently as a normal heart, and can lead to heart failure. Up to 25% of patients with significant coronary artery disease have no symptoms at all, even though they clearly lack adequate blood and oxygen supply to the heart muscle. These patients have "silent" angina. They have the same risk of heart attack as those with symptoms of angina. Diagnosis The resting electrocardiogram (EKG) is a recording of the electrical activity of the heart muscle, and can detect heart muscle which is in need of oxygen. The resting EKG is useful in showing the changes which are caused by a heart attack. It is less useful in patients with angina, since the chest pain and lack of oxygen supply to the heart only become evident during exertion or excitement.

Tooth Anatomy

People use their teeth to bite and chew food - they are the first step in the digestion of food. The long, sharp canine teeth tear up food (like meat). The wide, flat molars grind and mash up food. While we chew food, the tongue pushes the food to the teeth and saliva helps digestion and wets the food. Teeth also help us say certain sounds.

People have two sets of teeth in their lives, the primary teeth (also called the baby, milk or deciduous teeth) and the permanent teeth (also called the adult or secondary teeth). Children have 20 primary teeth; they are replaced by the permanent teeth by about age 13. Adults have 32 permanent teeth.

Primary Teeth:
Most babies are born with no visible teeth -- the teeth are forming inside the gums. The 20 primary teeth (also called baby teeth or first teeth) erupt (poke through the gums) over the time from when a baby is from about 6 months to a year old.

Permanent Teeth:
Primary teeth fall out and are replaced by 32 permanent teeth (also called the adult teeth). This happens over the time from when a child is from about 6 to 14 years old.

As a permanent tooth forms under the gums and in the jawbone, the roots of the primary tooth it is replacing dissolve. Then the primary tooth becomes loose and falls out. The permanent tooth will fill the space.

Wisdom Teeth:

Wisdom teeth (also called the third molars) are molars that usually erupt from the ages of 17 to 21.


Tooth Glossary:

Cementum - a layer of tough, yellowish, bone-like tissue that covers the root of a tooth. It helps hold the tooth in the socket. The cementum contains the periodontal membrane.

Crown - the visible part of a tooth.

Dentin - the hard but porous tissue located under both the enamel and cementum of the tooth. Dentin is harder than bone.

Enamel - the tough, shiny, white outer surface of the tooth.

Gums - the soft tissue that surrounds the base of the teeth.

Nerves - nerves transmit signals (conveying messages like hot, cold, or pain) to and from the brain.

Periodontal membrane/ligament - the fleshy tissue between tooth and the tooth socket; it holds the tooth in place. The fibers of the periodontal membrane are embedded within the cementum.

Pulp - the soft center of the tooth. The pulp contains blood vessels and nerves; it nourishes the dentin.

Root - the anchor of a tooth that extends into the jawbone. The number of roots ranges from one to four.

Malaria

Plasmodium is a group of one-celled animal parasites that lives on the red cells in the blood of many birds, reptiles and mammals. There are four human malaria species - P. falciparum, P. ovale, P. vivax and P. malariae. P. falciparum is by far the most dangerous. Unfortunately, it is also the most common in Africa. Malaria is transmitted by certain Anopheles mosquitoes. The parasite has to undergo a crucial development process in the mosquito, and this can only happen in certain mosquitos.

Malaria kills over one million people each year, most of whom are children under 5, and almost 90% of whom live in Africa, south of the Sahara. Each year there are over 300 million clinical cases of malaria, that is five times as many as combined cases of TB, AIDS, measles and leprosy. Malaria is responsible for one out of every four childhood deaths in Africa.

Women are four times more likely to get sick, and twice as likely to die from malaria if they are pregnant. Malaria-afflicted families are able to harvest only 40% of their crops, compared with healthy families, suggesting a link between malaria and poverty. The direct and indirect costs of malaria in Africa are estimated to exceed $2 billion per year. It is believed that it could be controlled with a budget amounting to one-tenth of this amount. Malaria slows economic growth in African countries by an estimated 1.3% each year.

The cheapest and safest malaria drug - chloroquine - is rapidly losing its effectiveness. In some parts of the world, malaria is resistant to the four leading front-line drugs. Malaria quickly rebounded from the mass insecticide spraying campaigns in the 1950's and 1960's. It then eluded mass treatment strategies based on a single drug, such as chloroquine. Malaria can quickly adapt and rebound when efforts are fragmented and uncoordinated. Yet it has been shown that malaria deaths could be reduced with coordinated intervention.

Malaria life cycle

Life cycle of Plasmodium falciparum
(© DPDx: CDC's web site for laboratory identification of parasites)

The malaria parasite life cycle involves two hosts. During a blood meal, a malaria-infected female Anopheles mosquito inoculates sporozoites into the human host (1). Sporozoites infect liver cells (2) and mature into schizonts (3), which rupture and release merozoites (4). (Of note, in Plasmodium vivax and P. ovale a dormant stage [hypnozoites] can persist in the liver and cause relapses by invading the bloodstream weeks, or even years later.) After this initial replication in the liver (exo-erythrocytic schizogony [A]), the parasites undergo asexual multiplication in the erythrocytes (erythrocytic schizogony [B]). Merozoites infect red blood cells (5). The ring stage trophozoites mature into schizonts, which rupture releasing merozoites (6). Some parasites differentiate into sexual erythrocytic stages (gametocytes) (7). Blood stage parasites are responsible for the clinical manifestations of the disease.
The gametocytes, male (microgametocytes) and female (macrogametocytes), are ingested by an Anopheles mosquito during a blood meal (8). The parasites' multiplication in the mosquito is known as the sporogonic cycle [C]. While in the mosquito's stomach, the microgametes penetrate the macrogametes generating zygotes (9). The zygotes in turn become motile and elongated (ookinetes) (10) which invade the midgut wall of the mosquito where they develop into oocysts (11). The oocysts grow, rupture, and release sporozoites (12), which make their way to the mosquito's salivary glands. Inoculation of the sporozoites into a new human host perpetuates the malaria life cycle (1). (The above graph and description were copied from the Parasite Image Library)