Uninucleated merozoites can also mature into uninucleate gametocytes which can invade and infect other female Anopheles mosquitoes during feeding, thus spreading the disease onto a wider population of humans. Diagnosis
Fevers in intervals of 72 hours distinguish quartan fever from other forms of malaria where fevers range in 48 hour intervals or fever spikes that occur sporadically.Early indications of quartan fever include having irritated spots, welts, hives and burning skin, however this is dependent on individuals tolerance to mosquito bites and may not be evident on some people. With the Anopheles malaria mosquitoes, the welts are most likely to not appear unless there are severe allergic reactions.The prepatent period is the time interval for when parasites infect a host and when they can be detected on a thick blood film. For quartan fever, P. malariae has a prepatent period ranging from 16 to 59 days. Specifically in the case of quartan fever, the rupturing of liver stage schizonts releases merozoites. This stage of the P. malariae life cycle is known as the "ring stages" and are the first stages which can be detected in human blood for diagnosis. Medical procedures that diagnose a patient with quartan fever
Blood smears can be used to detect the parasites within red blood cells, thick blood smears are typically used initially to detect the parasites, then it is followed by thin blood smears which can detect the parasites as the morphology of erythrocytes is maintained through the process.
In one survey, 8% of men reported being unable to achieve orgasm over a two-month period or longer in the previous year. DEs are either primary and lifelong or acquired. Acquired DEs may be situational. While most men do experience occasional or short term delayed ejaculation issues, the prevalence of lifelong DE and acquired long term DE is estimated around 1% and 4%, respectively. Signs and symptoms
Delayed ejaculation can be mild (men who still experience orgasm during intercourse, but only under certain conditions), moderate (cannot ejaculate during intercourse, but can during fellatio or manual stimulation), severe (can ejaculate only when alone), or most severe (cannot ejaculate at all). All forms may result in a sense of sexual frustration. In most cases, delayed ejaculation presents the condition in which the man can climax and ejaculate only during masturbation, but not during sexual intercourse. Causes
The etiologies of delayed ejaculation can be age-related, organic, psychological, or pharmacological.Primary lifelong DEs are poorly understood and rarely explained by few congenital anatomic causes (viz., Müllerian duct cyst, Wolfian duct abnormalities, prune belly syndrome, imperforate anus, congenital ejaculatory duct obstruction, genetic abnormalities including cystic fibrosis, etc.) Anatomic causes (acquired ejaculatory duct obstruction)
Infective/Inflammation (residual damage from acute infections, chronic infections, urethritis, prostatitis, orchitis, genitourinary tuberculosis, schistosomiasis, lichen sclerosis, etc.) Neurogenic causes (diabetic autonomic neuropathy, spinal cord or nerve root injury from trauma or disc prolapse, multiple sclerosis, etc.).