Diarrhoea is a leading cause of childhood morbidity and mortality in developing countries. It is defined as the passage of loose or watery stools at least three times in 24 hours. The main types are acute watery diarrhoea, acute bloody diarrhoea (dysentery), persistent diarrhoea lasting 14 days or longer, and diarrhoea with severe malnutrition. Causes include viral, bacterial, parasitic and fungal infections as well as drugs and diet. Treatment involves oral rehydration, continued feeding, and seeking medical help for signs of dehydration. Antibiotics may be given for specific bacterial infections. Preventing diarrhoea relies on access to safe water, adequate sanitation, handw
To know basic etiology of this disease and difference between duodenal ulcer and peptic ulcer as well as how we can approach if children having peptic ulcer disease. By conservative and surgical means
To know basic etiology of this disease and difference between duodenal ulcer and peptic ulcer as well as how we can approach if children having peptic ulcer disease. By conservative and surgical means
In this video, you can learn about the basics of Typhoid fever and also the symptoms and treatment of this disease in a very simple way. We describe to you here all about,
1. Typhoid fever
2. Symptoms of Typhoid
3. Causes of Typhoid
4. Diagnosis of Typhoid
5. Prevention of Typhoid
6. Treatment of Typhoid
7. Diet for Typhoid fever
You can download the PowerPoint file from below link:
https://docs.google.com/presentation/d/1s8Ix3t8t3O-KYWVze2C8nm4QYIWJdFSXg_sTR78htiQ/edit?usp=sharing
You can learn from video by the below link:
https://youtu.be/PDhr_UmTWuc
Diarrhea is loose, watery stools. Having
diarrhea means passing loose stools three or more times a day. Acute diarrhea
is a common problem that usually lasts 1 or 2 days and goes away on its own.
Diarrhea lasting more than 2 days may be a
sign of a more serious problem. Chronic diarrhea—diarrhea that lasts at least 4
weeks—may be a symptom of a chronic disease. Chronic diarrhea symptoms may be
continual or they may come and go.
Diarrhea of any duration may cause
dehydration, which means the body lacks enough fluid and electrolytes—chemicals
in salts, including sodium, potassium, and chloride—to function properly. Loose
stools contain more fluid and electrolytes and weigh more than solid stools.
People of all ages can get diarrhea. In the
United States, adults average one bout of acute diarrhea each year, and young
children have an average of two episodes of acute diarrhea each year.
Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by Salmonella enterica, subspecies enterica serovar typhi and, to a lesser extent, related serovars paratyphi A, B, and C.
The protean manifestations of typhoid fever make this disease a true diagnostic challenge. The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within 1 month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications.
In this video, you can learn about the basics of Typhoid fever and also the symptoms and treatment of this disease in a very simple way. We describe to you here all about,
1. Typhoid fever
2. Symptoms of Typhoid
3. Causes of Typhoid
4. Diagnosis of Typhoid
5. Prevention of Typhoid
6. Treatment of Typhoid
7. Diet for Typhoid fever
You can download the PowerPoint file from below link:
https://docs.google.com/presentation/d/1s8Ix3t8t3O-KYWVze2C8nm4QYIWJdFSXg_sTR78htiQ/edit?usp=sharing
You can learn from video by the below link:
https://youtu.be/PDhr_UmTWuc
Diarrhea is loose, watery stools. Having
diarrhea means passing loose stools three or more times a day. Acute diarrhea
is a common problem that usually lasts 1 or 2 days and goes away on its own.
Diarrhea lasting more than 2 days may be a
sign of a more serious problem. Chronic diarrhea—diarrhea that lasts at least 4
weeks—may be a symptom of a chronic disease. Chronic diarrhea symptoms may be
continual or they may come and go.
Diarrhea of any duration may cause
dehydration, which means the body lacks enough fluid and electrolytes—chemicals
in salts, including sodium, potassium, and chloride—to function properly. Loose
stools contain more fluid and electrolytes and weigh more than solid stools.
People of all ages can get diarrhea. In the
United States, adults average one bout of acute diarrhea each year, and young
children have an average of two episodes of acute diarrhea each year.
Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by Salmonella enterica, subspecies enterica serovar typhi and, to a lesser extent, related serovars paratyphi A, B, and C.
The protean manifestations of typhoid fever make this disease a true diagnostic challenge. The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within 1 month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications.
THESE SLIDES ARE PREPAREED TO UNDERSTAND CHILD HEALTH DISORDERS IN EASY WAY Important links- NOTES- https://mynursingstudents.blogspot.com/ youtube channel https://www.youtube.com/c/MYSTUDENTSU... CHANEL PLAYLIST- ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list=PL93S13oM2gAPM3VTGVUXIeswKJ3XGaD2p COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPyslPNdIJoVjiXEDTVEDzs CHILD HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gANcslmv0DXg6BWmWN359Gvg FIRST AID- https://www.youtube.com/playlist?list=PL93S13oM2gAMvGqeqH2ZTklzFAZhOrvgP HCM- https://www.youtube.com/playlist?list=PL93S13oM2gAM7mZ1vZhQBHWbdLnLb-cH9 FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPFxu78NDLpGPaxEmK1fTao COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list=PL93S13oM2gAOWo4IwNjLU_LCuhRN0ZLeb ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list=PL93S13oM2gAPkI6LvfS8Zu1nm6mZi9FK6 MSN- https://www.youtube.com/playlist?list=PL93S13oM2gAOdyoHnDLAoR_o8M6ccqYBm HINDI ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAN4L-FJ3s_IEXgZCijGUA1A ENGLISH ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAMYv2a1hFcq4W1nBjTnRkHP facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-S... facebook group NURSING NOTES- https://www.facebook.com/groups/24139... FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsu... Twitter- https://twitter.com/student_system?s=08 #PEM, #HEALTH,#NEW,#BORN,#ASSESSMENT, #APPEARENCE,#PULSE,#GRIMACE,#REFLEX,#RESPIRATION,#RESUSCITATION,#NEWBORN,#BABY,#VIRGINIA, #CHILD, #OXYGEN,#CYANOSIS,#OPTICNERVE, #SARACHNA,#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
Diarrhea is a very common daily based issue with lots of contributing factors. The need is to determine the underlying causes, otherwise the consequences may get worsen.
Diarrhoea is passage of three or more loose stools or watery stools in a 24-hour period.
The main cause of death from acute diarrhoea is dehydration, which results from the loss of fluid and electrolytes in diarrhoeal stools.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. INTRODUCTION
• Leading cause of childhood morbidity & mortality in
developing countries
• Important cause of malnutrition
• 80% of deaths due to diarrhoea occur in the first two years
of life.
• Children <3 years of age in developing countries experience
around three episodes of diarrhoea each year.
4. Clinical Types
Acute watery diarrhoea :
Lasts several hours or days
Main danger is dehydration
Weight loss occurs if feeding is not continued;
Acute bloody diarrhoea:
Also called dysentery
Main dangers - damage of the intestinal mucosa,
sepsis and malnutrition
Other complications : dehydration , HUS
5. Persistent diarrhoea :
Lasts 14 days or longer a/w malnutrition
Main danger - malnutrition & serious non-intestinal
infection
Other complications : dehydration
Diarrhoea with severe malnutrition :
Main dangers - severe systemic infection ,
dehydration,
heart failure and vitamin and mineral deficiency.
6. Key facts
• Diarrhoeal disease is the second leading cause of
death in children under five years old. It is both
preventable and treatable.
• Each year diarrhoea kills around 760 000 children
under five.
• A significant proportion of diarrhoeal disease can
be prevented through safe drinking-water and
adequate sanitation and hygiene.
• Globally, there are nearly 1.7 billion cases of
diarrhoeal disease every year.
• Diarrhoea is a leading cause of malnutrition in
children under five years old.
9. Pathophysiology of acute diarrhea
• Increased secretion of fluid and electrolytes
• Decreased digestion and absortion of nutrients
• Abnormal transit due to aberrations of intestinal
motility
10. Assessment of the child with diarrhoea
History
Ask the mother or other caretaker about:
• Presence of blood in the stool;
• Duration of diarrhoea;
• Number of watery stools per day;
• Number of episodes of vomiting;
• Presence of fever, cough, or other important
problems (e.g. convulsions, recent measles);
• Pre-illness feeding practices;
• Type and amount of fluids (including breastmilk) and
food taken during the illness;
• Drugs or other remedies taken;
• Immunization history.
11. LAB INVESTIGATIONS FOR DIARRHOEA
Investigations are not routinely done in case of no or
some dehydration
I) STOOL: MICROSCOPY : low sensitivity & specificity
a) leucocyte (>10/hpf )- Invasive diarrhoea
b) hanging drop – V. cholera.
c) culture & sensitive - persistant diarrhoea
II) BLOOD TESTS
a) CBC
b) S. electrolyte
c) BUN & creatinine
12. Dysentery:
Mucous & blood in stool
Persistent diarrhoea:
Min 14 days
Malnutrition with diarrhoea:
Weight-for-length or weight-for-age indicate moderate
or severe malnutrition
Oedema with muscle wasting
Obvious marasmus
13. Dehydration
• During diarrhoea there is an increased loss of
water and electrolytes (Na, Cl , K , and HCO3 )
in the liquid stool.
• Dehydration occurs when these losses are not
replaced adequately and a deficit of water
and electrolytes develops.
14. DEGREES OF DEHYDRATION
• Early dehydration – no signs or symptoms.
• Moderate dehydration:
– thirst
– restless or irritable behaviour
– decreased skin elasticity
– sunken eyes
• Severe dehydration:
– symptoms become more severe
– shock, with diminished consciousness, lack of urine
output, cool, moist extremities, a rapid and feeble pulse,
low or undetectable blood pressure, and pale skin.
15. Prevention
• access to safe drinking-water;
• use of improved sanitation;
• hand washing with soap;
• exclusive breastfeeding for the first six months of
life;
• good personal and food hygiene;
• health education about how infections spread;
and
• rotavirus vaccination.
16. Treatment Plan A: home therapy to
prevent dehydration and malnutrition
• Children with no signs of dehydration need
extra fluids and salt to replace their losses of
water and electrolytes due to diarrhoea. If
these are not given, signs of dehydration may
develop.
17. four rules of
Treatment Plan A:
• Rule 1: give the child more fluids than usual
Suitable fluids : two groups:
• Fluids that contain salt :
• ORS (Oral Rehydration Salts) solution
• Salted drinks (e.g Salted rice water or a salted yoghurt drink)
• Vegetable or chicken soup with salt.
• Fluids that do not contain salt, such as:
• Plain water
• Water in which a cereal has been cooked
• Unsalted soup
• Yoghurt drinks without salt
• Green coconut water
• Weak tea (unsweetened)
• Unsweetened fresh fruit juice.
18. • Unsuitable fluids
• Drinks sweetened with sugar, which can cause
osmotic diarrhoea and hypernatraemia.
• Some examples are:
• Commercial carbonated beverages
• Commercial fruit juices
• Sweetened tea.
• With stimulant, diuretic or purgative effects, for
example:
• Coffee
• Some medicinal teas or infusions.
19. • How much fluid to give
• The general rule is: give as much fluid as the child
or adult wants until diarrhoea stops.
• Children under 2 years of age: 50-100 ml (a
quarter to half a large cup) of fluid;
• Children aged 2 up to 10 years: 100-200 ml (a
half to one large cup);
• Older children and adults: as much fluid as they
want.
20. • Rule 2: Give supplemental zinc (10 - 20 mg) to the
child, every day for 10 to 14 days
• Dose : infant – 0.5 mg/kg/day
<6 mth – 10 mg/day
>6 mth – 20 mg/day
• Preparations : zinconia 20mg/5ml
zincovit 10mg/5ml
21. • Rule 3: Continue to feed the child, to prevent
malnutrition
• Food should never be withheld
• Breastfeeding should always be continued.
• Aim - give as much nutrient rich food as the child
will accept.
22. • Rule 4: take the child to a health worker if there are
warningsigns of dehydration or other problems
• Starts to pass many watery stools;
• Has repeated vomiting;
• Becomes very thirsty;
• Is eating or drinking poorly;
• Develops a fever;
• Has blood in the stool; or
• The child does not get better in three days.
23. Treatment Plan B: oral rehydration therapy for
children with some dehydration
25. Bacteria Antibiotic
Salmonella typhi,
Salmonella paratyphi
Ampicillin,† chloramphenicol,† TMP-SMZ, cefotaxime,
ciprofloxacin‡
Nontyphoidal
Salmonella
Usually none (if ≥ 3 months old); ampicillin, cefotaxime,
ciprofloxacin‡
Shigella ( Dysentery ) Children: Third-generation cephalosporin, TMP-SMZ
Nalidixic acid
Adults: fluoroquinolones‡
Escherichia coli
Enterotoxigenic Usually none if endemic; TMP-SMZ or ciprofloxacin for
traveler's diarrhea
Enteroinvasive TMP-SMZ, ampicillin if susceptible
Enteropathogenic TMP-SMZ or an aminoglycoside
Enterohemorrhagic Usually none
Enteroaggregative TMP-SMZ or an aminoglycoside
Campylobacter jejuni Mild disease needs no treatment; erythromycin or
azithromycin for diarrhea; aminoglycoside, ciprofloxacin,‡
26. Bacteria Antibiotic
Yersinia enterocolitica None for uncomplicated diarrhea;
TMP-SMZ; gentamicin or cefotaxime
for extraintestinal disease
Vibrio cholerae Tetracycline, doxycycline, TMP-SMZ
Clostridium difficile Oral metronidazole,§ oral
vancomycin
Entamoeba histolytica Metronidazole§ followed by
iodoquinol to treat luminal infection
Giardia lamblia Metronidazole,§ quinacrine,
furazolidone, others
Cryptosporidium parvum None; azithromycin or paromomycin
and octreotide in persons with
HIV/AIDS
27. Anti secretory agents
• Racecadotril
• also known as acetorphan
• acts as a peripherally acting enkephalinase inhibitor.
• antisecretory effect—it reduces the secretion of
excessive water and electrolytes into the intestine.
• Role is controvertial.
• Dose: 1.5mg/kg/dose up to 4 doses a day
• Duration : 5 days but not >7 days
• Adverse effects : vomitting , fever , hypokalemia , ileus ,
bronchospasm , skin rashes.
28. ORAL REHYDRATON SOLUTION
ORS -special combination of dry salts that,
when properly mixed with clean water, can help
rehydrate the body when a lot of fluid has been
lost due to diarrhoea.
Basis of ORS – Glucose linked absorption of
sodium remains intact irrespective of etiology
of diarrhoea.
29. TYPES OF ORS FORMULATIONS
• Glucose based ORS
• Rice based ORS
• Low osmolarity ORS
• Home available ORS
• Mineral based ORS(zinc)
33. • Muscular dystrophy is a heterogeneous group
of inherited disorders recognized by
progressive degenerative muscle weakness
and loss of muscle tissue (started in
childhood).
• Affect muscles strength and action.
• Generalized or localized.
• Skeletal muscle and other organs may involve
34.
35. • Causes
– Inheritance
– Dominant genes
– Recessive gene
• Risk
– Because these are inherited disorders, risk include a
family history of muscular dystrophy
46. DMD: Diagnosis
• Gait
• Absent DTR
• Ober test
• Thomas test
• Meyeron sign - child slips
through truncal grasp
• Macroglossia
• Myocardial deterioration
• IQ ~ 80
• Increase CPK (200x)
• Myopathic change in
EMG
Bx: m. degeneration
• Immunoblotting:
Absence dystrophin
• DNA mutation
analysis
47.
48.
49. Becker Muscular Dystrophy
• Milder version of DMD
• Etiology
– single gene defect
– short arm X chromosome
– altered size & decreased amount of
dystrophin
50. Clinical features
• Less common
– 1: 30000 live male birth
• Less severe
• Family history: atypical MD
• Similar & less severe than DMD
• Onset: age > 7 years
• Pseudohypertrophy of calf
• Equinous and varus foot
• High rate of scoliosis
• Less frequent cardiac involvement
51. Diagnosis
• The same as DMD
• Increase CPK (<200x)
• Decrease dystrophin and/or altered size
Natural history
– Slower progression
– ambulate until adolescence
– longer life expectancy
Treatment
– the same as in DMD
– forefoot equinous: plantar release, midfoot dorsal-
wedge osteotomy
59. • Classification
–Pelvic girdle type
• common
–Scapulohumeral
type
• rare • Diagnosis
– Same clinical as
DMD/BMD carriers
– Moderately elevated
CPK
– Normal dystrophin
60. • Natural history
– Slow progression
– After onset > 20 y: contracture & disability
– Rarely significant scoliosis
• Treatment
– Similar to DMD
– Scoliosis: mild, no Rx.
61. Fascioscapulohumeral Muscular
Dystrophy
• Etiology
– Autosomal dominant
– Gene defect (FRG1)
– Chromosome 4q35
• Epidemiology
– Female > male
• Clinical
manifestation
– Age of onset: late childhood/
early adult
– No cardiac, CNS
involvement
– Winging scapula
– Markedly decreased
shoulder flexion & abduction
– Horizontal clavicles
– Rare scoliosis
62.
63. • Muscle weakness
–face, shoulder, upper arm
• Sparing
–Deltoid
–Distal pectoralis major
–Erector spinae
64. • “Popeye”
appearance
– Lack of facial mobility
– Incomplete eye
closure
– Pouting lips
– Transverse smile
– Absence of eye and
forehead wrinkles
POPEYE ARMS
65. • Diagnosis
– PE, muscle biopsy
– Normal serum CPK
• Natural history
– Slow progression
– Face, shoulder m.
pelvic girdle,
tibialis ant
– Good life
expectancy
• Treatment
– Posterior
scpulocostal fusion/
stabilization
(scapuloplexy)
66. Distal Muscular Dystrophy
• Autosomal dominant trait
• Rare
• Dysferlin (mb prot) defect
• Age of onset: after 45 yrs
• Initial involvement: intrinsic
hands, claves, tibialis
posterior
• Spread proximally
• Normal sensation
73. `Classical form' of the disease is seen in
adolescent or early adult life with variable
presenting features.
• Muscular weakness,
• myotonia,
• mental retardation,
• cataract,
• neonatal problems
• 18% remain asymptomatic.
74. Summary
Clinical DMD LGMD FSMD DD CMD
Incidence common less Not common Rare Rare
Age of onset 3-6 y 2nd decade 2nd decade 20-77 y At/ after
birth
Sex Male Either sex M = F Either sex Both
Inheritance Sex-linked
recessive
AR, rare AD AD AD Unknown
Muscle
involve.
Proximal to
distal
Proximal to
distal
Face &
shoulder to
pelvic
Distal Generalized
Muscle
spread until
late
Leg, hand,
arm, face,
larynx,eye
Upper ex,
calf
Back ext,
hip abd,
quad
Proximal -
75. Clinical DMD LGMD FSMD DD CMD
Pseudo
hypertrophy
80%
calf
< 33% Rare no No
Contracture Common Late Mild, late Mild, late Severe
Scoliosis
Kyphoscoliosis
Common, late Late - - ?
Heart Hypertrophyt
achycardia
Very rare Very rare Very rare Not
observed
Intellectual decrease Normal Normal Normal ?
Course Stead, rapid Slow Insidious benign Steady