How do you know if you have worms?

They manipulate and control, forcing us to eat what they like. They know how to hide inside us, having mastered the art of camouflage to perfection - it is very difficult to recognize them and understand who the true source of the malaise is. They are gluttonous and insatiable, and do not suffer from attacks of pity or compassion. And there are a huge number of species – 342!

These parasites are called “worms,” or scientifically, “helminths.” The infection is called “helminthic infestation” and today we will talk about how to detect them in the human body at home.

General signs

most common and typical symptoms are:

  • itching in the anus area,
  • weight loss (anorexia),
  • anemia and tired appearance.

Important : these signs are characteristic of mass infestation with worms.

There are atypical signs of helminthic infestation . Their appearance is not associated with helminths, but is blamed on the improper functioning of various organs of the human body, which, in fact, themselves suffer from the dominance of parasites.

The severity of these symptoms depends on the number of parasites and their stage of growth.

  • Migraines, dizziness, chronic fatigue, lethargy.

These signs are caused by the fact that the waste products of worms poison the human body, having a detrimental effect on his nervous system.

Important : Children may experience sleep disturbances. They become capricious, absent-minded, concentration and performance at school decrease, and developmental delays occur.

The same waste products from worms are to blame for this. They weaken the body and destabilize its metabolic processes.

Worms take away some of the nutrients from a person and, moreover, poison him with their toxins. This double load on the body leads to its weakening. A weakened body is easy prey for infections. The circle closes.

The type of parasite dictates the symptom

There are many types of helminths and each has its own specialization, its own taste preferences, its own habitat and symptoms of appearance. And therefore the reaction of the human body to different types of helminths is different.

Roundworms. The human body begins to signal their appearance almost immediately – on the 2-3rd day. The larvae of this type of worms travel through the blood directly to the human lungs. A dry cough with purulent sputum appears. If the infection is severe, you may have to treat bronchitis and pneumonia.

If the larvae reach the intestines with the blood flow, then there will be intestinal manifestations - diarrhea, constipation, even intestinal obstruction.

A person loses weight because roundworms secrete substances that block the absorption of proteins in organisms.

Obstructive jaundice and appendicitis are possible complications of ascariasis.

Pinworms. They give symptoms 2-3 weeks after penetration into the human body. Their most striking manifestation is itching near the anus, which intensifies at night, during the period of egg laying.

Important: if the itching was one-time and repeated only after 2 weeks, it means that there are few pinworms and the degree of invasion is not significant. If the itching does not stop, this is a sign of advanced infection.

Trichinosis. Muscle lovers.

Their presence is accompanied by muscle pain in the absence of physical activity, swelling of the face, and feverish manifestations.

Toxocariasis. This type of helminth is transmitted by dogs and cats. It is more common in young children under 4 years of age who are in constant contact with an infected animal.

It manifests itself as an allergic cough, itchy skin rashes, enlarged lymph nodes, liver and eye problems, including irreversible damage.

Ankylostomiasis, schistosomiasis. Their poison is so destructive to the human body, it has such a detrimental effect on the intestinal microflora that it causes diarrhea, anemia and vitamin deficiency.

Urogenital schistosomiasis. The preferences of this helminth are clear from the name.

It causes diuretic disorders with bloody discharge.

Attention! Intestinal worms are very dangerous if they are asymptomatic in the human body. If there is one parasite in the intestines, the symptom will only occur if the roundworm or tapeworm reaches a huge size.

All types of helminths cause disturbances in the functioning of the central nervous system - dizziness, pain, irritability, manifestations of chronic fatigue syndrome. In children it is also restless dreams with nightmares and seizures.

Symptoms of helminths

Based on the type of parasitic organisms that get inside, the symptoms may differ and manifest themselves in different ways.

Many people may not know that there are worms inside for months or years because there are no signs, while other people experience symptoms almost immediately after infection.

Most often, it takes up to a week after infection when a person begins to learn about worms. In order to detect something wrong in a timely manner, it is important to listen to your body and health conditions.

Most often, symptoms of infection with the most common helminths appear immediately, and most of them settle in the intestines, as well as the gastrointestinal tract, where they begin to actively develop.

If such an infection occurs, then the characteristic signs will be:

  1. A sharp decrease in body weight with normal nutrition. In some cases, there may be a lack of weight gain with excellent appetite or a deliberate increase in caloric intake.
  2. Loss of appetite that cannot be restored for a long time. Depending on the body, a person may constantly want to eat or lose his appetite altogether.
  3. Abnormal bowel movements, constipation or diarrhea, and possible bleeding during bowel movements.
  4. The anus begins to itch, and worms can be seen in the feces, even without experience in identifying parasites.
  5. Weakness appears, patients get tired quickly, and constantly want to sleep. Against the background of such symptoms, pain in the head develops.
  6. Some people develop allergies due to the release of toxins by parasites that poison the body from the inside.

If infection occurs with extraintestinal parasites, they can affect any part. Worms can enter the brain, lungs, eyes and other internal organs.

In this case, a violation of integrity begins, disturbances in work appear, and in severe cases there may be dysfunction and even death.

In this state, people quickly feel a deterioration in their overall health, and pain appears in the affected area.

Home tests for helminths

It is difficult to find out whether there are parasites at home without laboratory tests. It is impossible to determine with 100% certainty the presence or absence of worms in a person. But there are diagnostic questions, by the number of positive answers to which, you can get a fairly clear picture of helminthic infestation.

Mountains of parasites will come out of you if you drink the usual one in one gulp on an empty stomach.

Helminthic diseases in humans are vile phenomena and negatively affect the body as a whole, as a result of which cancerous tumors, arrhythmic functioning of the heart, destabilization of the nervous and immune system, irreversible liver damage can develop, which ultimately leads to fatal consequences for the carrier himself. Therefore, the diagnosis of helminthic infestations can be assessed as a necessary stage in the life of any member of society. How to check for worms?

Note. Some antihelminthic medications are included in the list of vital and important drugs. After weighing all the pros and cons, you come to the conclusion that it’s not in vain...

How to identify helminthic diseases at home

Worms are worms that live in humans or animals, living off their host. Their nutrition and reproduction is virtually impossible without another living organism. The parasitism of worms affects the body, so our immune system reacts sharply to the invasion by a harmful form of life - that is, the body independently tries in every possible way to get rid of these “creatures”.

The activity of worms can be expressed in acute external or internal manifestations (symptoms), which are difficult to miss, but in most cases it goes unnoticed due to a blurred symptomatic picture or the absence of symptoms at all. Most likely, there are symptoms, but the person is able to ignore them, attributing them to various irritating external factors (the weather has some strange influence, he’s tired at work, etc.). When a person nevertheless goes to a medical institution, the symptoms are associated with other causes or even isolated as a separate disease, prescribing a meaningless therapeutic course. The percentage of such cases is small, but it does happen; unfortunately, the human factor will accompany our society for many years to come.

Testing for worms at home has its significant disadvantages and is possible within certain limits. In other words, it is not possible to identify any type of worm at home, and there is no point in even talking about determining the type of parasitic worm.

How to test for worms at home? There are 3 options:

  • A test that you are unlikely to find on pharmacy displays;
  • Scotch test. This procedure is simple, and anyone can carry it out on their own. We will need a magnifying glass with a good magnification range, a small piece of transparent glass and regular tape or adhesive tape. A small piece of tape must be attached to the skin tissue in the anus area and removed, then placed with the adhesive side on a previously prepared piece of transparent glass. Preparing the glass requires no special instructions other than cleaning with soap and water and then drying. Viewing the back of the glass will reveal the presence of helminthic infestation. It is recommended to carry out this procedure in the morning, immediately after sleep, without first performing hygiene procedures. To achieve the highest possible accuracy of this method, it is recommended to repeat the test 3-4 times over 10-12 days;

Note. The tape test cannot be called a highly effective method, since the eggs of parasites and even some worms, especially the larval form, cannot be seen with a magnifying glass due to their small size (several micrometers). In addition, not all worms lay eggs in the anus, so this method allows you to detect mainly pinworms due to the specific process of egg laying. Other worms can be detected less frequently using this method.

  • Stool testing is a “very interesting procedure” that can reveal the presence of live or dead worms after forced or natural bowel movements. After a regular “go to the toilet,” the chance of finding worms in the stool is not as great as with forced cleansing of the intestines using an aqueous solution of salt and soda. If you find small white or gray-white elements in the stool after a natural bowel movement, this indicates the presence of a long-term helminthic infestation. How to check for worms in an adult using a cleansing enema:
  • It is better to choose the evening for this procedure;
  • We will need 500-700 ml of boiled water, 2 tablespoons of soda and a spoon of salt;
  • Mix, cool to a temperature of 28-30 degrees;
  • We take the resulting solution into the enema (it is better to use an Eismarch mug);
  • We lubricate the tip of the enema with Vaseline and insert it into the anus, the position is as follows: we kneel on the floor, we also place our arms bent at the elbows on the floor. An alternative position is to lie on your side with your knees bent as much as possible;
  • We administer the enema, hold the enema spout with the buttock muscles for 20 seconds, then carefully remove it from the anus and try to hold the solution for 3-5 minutes. If you have taken a lying position, it is recommended to “turn over” a little, alternately taking a position on your left/right side, stomach and back, staying in one area for about a minute. If you are kneeling, straighten your arms and stand there for 1-2 minutes, then return to the starting position;
  • We go to the toilet, relax and “look at the result”;

Disadvantages of this method: it allows you to detect only types of worms that are visible to the eye, it does not allow you to determine the presence of eggs in feces, with forced defecation there is a high probability of a worm/worms getting into the general sewer system, which will not allow it/them to be detected. It is wise to use a separate container for defecation to prevent worms from floating down the drain.

Note. These methods can serve as a stimulating “kick” towards a medical institution to undergo a normal, full diagnosis. If you find a worm in your feces, it is recommended to preserve it with vodka and go to honey with such a load. institution to determine it.

How to check whether a person has worms using modern diagnostics? Next we will move on to address this issue.

How to get rid of worms in humans?

When infection occurs, the pressing question is how to get rid of parasites in children and adults.

Currently, treatment of worms in humans is carried out using modern drugs. Treatment of helminths in an adult is carried out using more than ten drugs that are active against different types of worms. There are broad-spectrum and narrow-spectrum medications. Since a person can be infected with different types of helminths (in total, more than 70 species parasitize them in our regions), it is important to choose the right specific drug. Therefore, the decision on how to treat and how to treat helminthiasis should be made only by a specialist after testing. To get a detailed consultation, you should contact a parasitologist. However, if a patient goes to a small clinic or outpatient clinic, you can find out which doctor treats this disease directly at the medical institution.

It is important to note that medications for worms are very toxic. Therefore, only a doctor can identify symptoms and prescribe treatment for helminths in a person, having established a diagnosis. In the process of prescribing medications, a person’s weight and age are taken into account. Also, when infected with different helminths, different treatment regimens are required.

Therefore, those who are interested in how to recover from infection should definitely consult a doctor and not practice exclusively treatment with folk remedies.

There is a lot of advice on how to remove worms from a person at home, but a guaranteed method of getting rid of parasites is drug treatment.

The answer to the question whether helminths can exit through the mouth is positive. But they vomit only after taking certain medications.

Drugs used to treat helminthiasis

Active substanceDrugsAction
PiperazinePiperazineWorms in the stomach are subject to paralysis, since under the influence of the drug the flow of nerve impulses to the muscles is disrupted. Excreted in feces.
PirantelPyrantel , Helmintox , Combantrin, NemotsidThey cause neuromuscular blockade in worms, they quickly die. They come out with feces.
MebendazoleVermakar , Vermox , Vero-Mebendazole, Mebex, Vormin, ThermoxUnder the influence of the tablets, the processes of cellular globulin synthesis are suspended. As a result, paralysis occurs and the worms die.
AlbendazoleGelmodol-VM, Nemozol, VormilThey paralyze worms and also disrupt their metabolism at the cellular level. Excreted in feces or vomit and may be digested or unchanged.
KarbendatsimMedaminParalyzes the muscles of helminths. It comes out in the feces.
LevamisoleDekarisAffects metabolism worm cells. They experience paralysis, after which 24 hours after taking the drug, the helminths are excreted in the feces. They don't come out vomiting.
Pyrvinium embonatePirkon, Vanquin, PyriviniumEffective against enterobiasis, they block the enzyme systems of helminths, thereby disrupting the transport and metabolism of glucose.

How do worms come out from a person after treatment? They are excreted in feces and vomit, remaining unchanged and in a state of paralysis.

Helmids can also be released in vomit or feces in the form of fragments. If the patient has very active intestinal motility, intensive digestion of food and, accordingly, helminths occurs, which are then eliminated in the form of particles.

Regardless of how the worms come out, it is important that particles or whole worms are visible. However, sometimes no worms are found in the stool after taking medications. This may indicate that the body has digested the dead helminths inside.

However, if the parasites cannot be removed, this may be an indication that the dose of the medicine was chosen incorrectly, or the drug was chosen incorrectly.

However, if the tablets were taken for preventive purposes, then, of course, they will not fall out, since there are no helminths in the body.

Since some medications do not act on the larvae and eggs of worms, in order to completely drive away the parasites, you need to repeat the treatment after 2-3 weeks. If the treatment was carried out correctly and infection does not occur, then getting rid of the parasites is sure to occur.

In addition to “scientific” treatment, there are also folk remedies, the use of which is relevant for those who are interested in how to get rid of parasites, in particular, to get rid of tapeworm. We are talking about the use of pumpkin seeds and tansy grass, which have long been used to “poison” parasites. Those who have already been interested in how to get rid of parasites in the human body know that pumpkin seeds are a good remedy for removing parasites from the body. To rid yourself of helminths, it is better to eat raw seeds with a thin film between the peel and the seed. There is the following recipe for those who treat helminth infections: 300 g of pumpkin seeds, crushed and mixed with honey, should be eaten within an hour in the morning. After this, you can’t eat anything for 3-4 hours. Next you need to do an enema. Reviews indicate that such a medicine can be effective. There is also evidence that ginger, garlic, etc. help drive out worms.

The fact that the fight against worms was successful is evidenced by an improvement in the general state of human health. It is very important not to hope that the infection will go away on its own, because the answer to the question “Can the worms themselves go away?” ambiguous. After all, even if a person’s white worms or other types of helminths die, then the likelihood of the one who was infected will “catch” the parasites again is very high. Therefore, it is necessary to fight helminths systematically and correctly. And after taking the pills, be sure to get checked: a check in the form of tests is needed to thoroughly check the condition of the body and make sure that all helminths have been removed.

If the body is parasitized by subcutaneous worms, then tablets are not relevant in this case. If a parasite grows under the skin, surgical treatment is practiced: the skin is cut open and they come out. Why is it important to see a doctor on time? To avoid unwanted complications, especially in the elderly and children.

Laboratory diagnosis of worms

Submitting feces to identify worms is a coprogram. The principle of examining smears and feces is approximately the same, but when analyzing feces and other biological material, laboratory staff use special magnifying devices rather than a magnifying glass, which significantly increases the likelihood of detecting even the smallest details (eggs, larvae, helminths of even the smallest size). In addition, the coprogram has many advantages, since the study of feces is carried out in more depth.

How to identify worms in humans using these methods? A smear is taken, as a rule, in a medical clinic. institution, in the morning. It is strongly recommended to exclude hygiene procedures before taking the test.

Delivery of feces is also provided at earlier times of the day. To collect biological material, a special kit is used, which can be purchased at any pharmacy: a sterile container and a special spatula included in the kit. It is necessary to collect biological material from different places in the morning stool, since this greatly increases the chances of detecting the presence of worms in the body.

For the most accurate results, it is recommended to repeat tests with an interval of 2-3 days, the optimal number of tests is 3-4 times.

How to check if there are worms in the blood? For this purpose, an enzyme-linked immunosorbent method is used to conduct a blood test. This method allows you to determine which immunoglobulins are present in the human body and, accordingly, allows you to identify the parasitic worm based on the information received.

The fact is that our immune system is activated due to the release of specific antibodies by worms, characteristic of a certain species. Our natural defense system begins to produce antibodies that are suitable in a particular case - that is, characteristic of a given type of helminth.

Note. There are many additional laboratory diagnostic methods that can identify antigens or determine damage to internal organs, which may indirectly indicate parasitic activity in the body.

It is believed that ELISA (enzyme-linked immunosorbent assay) is the most accurate and effective way to detect worms, regardless of their location in the body. The accuracy of the result reaches 95%, however, as we indicated at the very beginning, much depends on the qualifications of the employee conducting the blood test. Biological material is collected in the morning. Venous blood is taken for examination.

What tests should I take for parasites?

Helminths can live in the human body for years and practically not manifest themselves in any way.

Insomnia, loss of appetite, and periodic digestive disorders are associated with absolutely other diseases. The only way to detect them is through laboratory tests and a full medical examination.

How to check for parasites?

During their existence, parasites destroy the intestinal microflora and release waste products and toxins. These factors cause a number of unpleasant symptoms to appear.

These include:

  • diarrhea, constipation, flatulence;
  • weight loss with good appetite;
  • increased fatigue;
  • depression, apathy;
  • poor sleep;
  • pale skin, develops with exhaustion of the body, lack of nutrients, vitamins;
  • allergic manifestations, cough, rash that begin for no apparent reason;
  • itching in the genital area, especially in the morning (with enterobiasis);
  • decreased immunity, frequent respiratory diseases.

If you find at least three of the listed symptoms, you need to see a doctor as soon as possible and undergo an examination.

There may be not one, but several types of worms in the body, so the doctor will prescribe several methods of examination. This will allow us to establish the type and degree of infestation.

Diagnostic methods to detect helminths:

  1. Feces for worm eggs and scraping. These are the simplest and most accessible methods. Using scraping, roundworms and their eggs are identified. Eggs, larvae, whole parasites or their fragments are found in the feces. It is not always possible to find them after the first time, because... worms reproduce at regular intervals. Therefore, they should be taken three times in a row, every two days. After collection, deliver to the laboratory no later than two hours later.
  2. PCR (Polymerase chain reaction) diagnostics. Makes it possible to find out with high accuracy the presence of viruses, bacteria, protozoa, and helminths.
  3. Microscopic and microbiological studies.

They can be taken either at a local clinic or at a private laboratory.

If the results obtained do not make it possible to form a complete clinical picture, the doctor refers the patient for additional examinations:

  • Radiography;
  • Ultrasound diagnostics;
  • CT scan.

Carrying out these examinations will allow you to notice changes in the structure of organs, such as compaction and enlargement. Ultrasound - detect cysts that appear during echinococcosis. X-ray – calcifications in the shoulder girdle, lungs, liver, which are formed in the presence of pork tapeworm. It is recommended to undergo examination twice a year, with the exception of obvious symptoms of infestation, when immediate diagnosis is required.

How to test for parasites at home?

There are circumstances when it is impossible to get tested, then many people wonder if there is a way to identify worms without leaving home. First of all, you need to pay attention to the condition of the stool and know the main symptoms of infection.

It is not always easy to detect them, because they successfully disguise themselves as ordinary diseases. For example, poor sleep, irritability and outbursts of anger are associated with overwork, and in the spring with a lack of vitamins. But the reason may turn out to be much more serious, so there is no need to immediately buy vitamin complexes.

The presence of an infestation can be determined without leaving home by a number of symptoms:

  1. Disturbances in the digestive system. Most of them affect the intestines and cause diarrhea, constipation, and flatulence.
  2. Itching in the anal area. Pinworms lay eggs, crawling out of the anus, and cause itching, which a person mainly experiences at night, unknowingly scratching and spreading the eggs around the room.
  3. Allergic manifestations. The excreted waste products cause intoxication and the appearance of all kinds of rashes and diathesis.
  4. Malfunctions of the nervous system are manifested by irritability, sleep disturbances, and fatigue.
  5. Constant feeling of nausea, weight loss, despite a good appetite, lack of appetite.
  6. Frequent headaches.
  7. Reduced protective functions. Parasites absorb all useful substances and vitamins, causing the development of anemia and vitamin deficiency. As a result, immunity decreases, a person begins to suffer from viral and bacterial infections, sore throats, bronchitis, and pneumonia.

Their presence also affects reproductive functions. For example, women begin to suffer more often from inflammation and menstrual irregularities. Men from prostatitis and potency.

Signs of infection in children:

  • itching in the anus;
  • indigestion, diarrhea, constipation, frequent abdominal pain;
  • nails become brittle, hair becomes dull and split;
  • the skin of the eyelids peels off;
  • drowsiness, lethargy, or, conversely, excessive mobility, uncharacteristic of his behavior;
  • increased salivation, which is not associated with teething;
  • restless, night sleep, teeth grinding.

These signs are a reason to contact a doctor as soon as possible, who can make a diagnosis and prescribe the correct treatment. Even the smallest parasites can significantly disrupt the functioning of internal organs.

Home methods for detecting worms:

  1. Visual examination of stool. Most often, small worms can be seen when going to the toilet at night or in the evening. It is at this time that their reproduction and activity peak. If a whole parasite or part of it is found there is no doubt, the person is sick. He needs to seek medical help as soon as possible, undergo an examination and begin treatment.
  2. Scotch tape - test. Can be purchased at a regular pharmacy. Consists of glass and transparent adhesive tape. The test is carried out in the morning, immediately after waking up. The adhesive tape is placed on the anus and glued back to the glass. Then you need to examine it under a magnifying glass. Allows you to detect adults or their eggs. This test is carried out at intervals of 3 – 4 days, for two weeks.

Such simple methods will allow you to find out in a timely manner whether there are worms in the body and avoid serious health problems.

What tests should I take to check for parasites?

Statistics provide data that from 80 to 90% of the entire population suffer from invasion. Such terrifying figures suggest that you need to take antiparasitic pills for preventive purposes. Before purchasing them, it is recommended to get tested and find out whether worms are actually present. Taking them unnecessarily is harmful to health. Infection can occur not with one, but with several species at once.

Therefore, there are several diagnostic methods:

  1. For prevention. Conducted twice a year, they allow detection of worms at the initial stage of their reproduction. This is especially necessary for children of preschool and primary school age.
  2. Barrier. The main purpose is to stop further infection of people around with worms. Prescribed to children before entering kindergarten and school, employees of children's and medical institutions, and the food industry. Held once a year.
  3. According to indications. Prescribed by a doctor in the presence of characteristic symptoms, nausea, diarrhea, constipation. They are taken several times to confirm the diagnosis.

They need to be done by children and people whose work involves processing raw meat, fish, agricultural workers, and veterinarians. For lovers of a raw food diet and non-traditional cuisine, who practice eating marinated, raw fish or meat.

Depending on the symptoms experienced by the patient, the following diagnostic methods may be prescribed:

  1. Scraping Helps to establish the presence of pinworms, which infect the intestines, leaving it through the anus for the purpose of laying eggs. Prescribed to children before starting kindergarten. Recommended for cases of itching at night in the genital area, sleep disturbances, and loss of appetite. Disadvantage: only pinworms can be detected.
  2. Coprogram. Feces are examined under a microscope to detect helminth particles or eggs. Allows you to establish ascariasis, trichuriasis, enterobiasis, hookworm infection, etc. Reliability is about 35%, because worms do not lay eggs all the time.
  3. General blood analysis. The toxins released by helminths affect the mucous membrane of the intestines and internal organs. The changes that occur are immediately reflected in the composition of the blood. The immune system begins to produce immunoglobulin, which is found during the examination.

Only the doctor deciphers the results obtained. Taking blood will help determine the presence of absolutely any helminth, regardless of which organ it is located in.

The most reliable is the enzyme immunoassay, the accuracy of which is 90%.

Conclusion

If you care about your health, the health of your loved ones and those around you, in order to prevent the number of cases of helminthic infestation, you need to take simple tests twice a year. They do not require special preparation or time.

The prolonged presence of helminths causes malfunctions of organs, decreased performance, and the presence of unpleasant symptoms that significantly change life plans. The sooner helminths are found, the greater the likelihood that treatment will not take a long time, and the recovery process will be faster.

Other methods

Other research methods are also used to diagnose tissue helminthiases and the acute or medicinal phase of helminthic infestations. The most common serological methods associated with the study of the patient's blood composition include indirect hemagglutination, latex agglutination, complement fixation and immunofluorescence reactions.

If diagnostics confirm that you have worms, you should not self-medicate. It is better to consult an infectious disease doctor who will select the necessary drugs for parasites in accordance with your diagnosis, age and individual characteristics.

Polymer chain reaction diagnostics (PCR diagnostics)

PCR diagnostics is a molecular diagnostic method that involves measuring the concentration of nucleic acid fragments (DNA) in the patient’s blood. This method allows you to diagnose a patient’s infection with protozoa, viruses and intracellular parasites; it has been thoroughly tested in clinical conditions and has stood the test of time. A significant disadvantage of this method is the impossibility of determining the number of parasites in the patient's body.

Rating
( 2 ratings, average 4.5 out of 5 )
Did you like the article? Share with friends: