The document defines diarrhea and describes its causes, risk factors, classifications, and management. Diarrhea is characterized by loose or watery stools, increased stool frequency, or large stool volume. It has infectious and non-infectious causes like viruses, bacteria, antibiotics, and non-GI infections. Proper management involves oral rehydration, continued feeding, and seeking medical help for dehydration signs. Prevention relies on vaccines, handwashing, safe water, and breastfeeding.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
WHO and UNICEF recommended management of Childhood Diarrhoea.
HLFPPT has been implementing Childhood Diarrhea management programmes with UNICEF and Micronutrient Initiative.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
WHO and UNICEF recommended management of Childhood Diarrhoea.
HLFPPT has been implementing Childhood Diarrhea management programmes with UNICEF and Micronutrient Initiative.
Diarrhea is an increased frequency and decreased consistency of fecal discharge as compared with an individual’s normal bowel pattern.
It is often a symptom of a systemic disease.
Acute diarrhea is commonly defined as shorter than 14 days’ duration.
Persistent diarrhea as longer than 14 days’ duration.
Chronic diarrhea as longer than 30 days’ duration.
Most cases of acute diarrhea are caused by infections with viruses, bacteria, or protozoa, and are generally self-limited.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Sectors of the Indian Economy - Class 10 Study Notes pdf
Diarrhea in children
1.
2. DIARRHEA DEFINITION
• The normal frequency and consistency of bowel
movements varies with a child's age and diet and
the definition of diarrhea varies accordingly.
• Diarrhea :
• excessive loss of fluids & electrolytes in stool,
Increase in liquidity.
• loose or watery stools, excessively frequent
stools, or stools that are large in volume.
• A more exact definition is excessive daily stool
liquid volume (>10 mL stool/kg body
weight/day).
3. • Frequency — It is normal for young infants to
have up to 3 to 10 stools per day, although this
varies depending upon the child's diet (breast
milk versus formula; breastfed children usually
have more frequent stools). Older infants,
toddlers, and children normally have one to two
bowel movements per day.
• Diarrhea can usually be defined as an increase in
stool frequency to twice the usual number per
day in infants, or three or more loose or watery
stools per day in older children.
4. • Consistency and color — The consistency and color of
a child's stool normally changes with age, which
highlights the importance of knowing what is normal
for your child. Young infants, especially those who are
breastfeeding, usually have soft stools. Their stools
may be yellow, green, or brown, and/or appear to
contain seeds or small curds.
• All children's stools can vary as a result of their diet.
Development of stools that are runny, watery, or
contain mucus is a significant change that should be
monitored. The presence of visible blood or black
stools is never normal and always requires medical
attention.
5. High risk groups
Young age groups
Immune deficient individuals
Measles
Malnutrition
Travel to endemic areas
Lack of breast feeding
Exposure to unsanitary conditions
Attendance to child care centers
Poor maternal education
6. Causes and risk factors
• Microbial,
• Host and
• Environmental
factors interact to
cause GE
Diarrhoea pathogens
Environmental
factorsHost factors
7. Diarrhea Classification
• According to Pathogens.
• According to Duration.
• According to Mechanism of Diarrhea.
• According to clinical types of Diarrhea.
8. DIARRHEA CAUSES
• Infective, non-infective
• The most common cause of acute diarrhea is a
viral infection.
• Other causes include:
• bacterial infections,
• side effects of antibiotics, and
• infections not related to the gastrointestinal (GI)
system.
• In addition, there are many less common causes
of diarrhea.
9. • Acute diarrhea last<14days.
• When episode last >14days it is called chronic
or persistent diarrhea.
Diarrhea according to Duration
11. Clinical types of diarrhea
There are 2 main clinical types of AD
Each is a reflection of the underlying pathology and altered physiology
Clinical type Description
Nausea,vomiting,fever,abdominal
pain&cramp,diarrhea,tenesmus.
Common pathogens
Acute watery
diarrhoea
This is the most common. It is of recent onset,
commencing usually within 48 hours of presentation. It
is usually self limiting and most episodes subside within
7 days. The main complication is dehydration.
Rotavirus, Vibrio cholera
Acute bloody
diarrhoea
Also referred to as dysentery. This is the passage of
bloody stools. It is as a result of damage to the
intestinal mucosa by an invasive organism. The
complications here are sepsis,
HUS(hemolytic uremic syndrome), malnutrition and
dehydration.
Shigella spp, Entamoeba
histolytica
12. DIARRHEA EVALUATION
• The evaluation of diarrhea in children who do seek
medical evaluation requires a careful review of:
• Medical history, a
• Physical examination, and
• Diagnostic testing.
• The clinician will perform a thorough examination
because there are some infections unrelated to the
bowels (such as an ear infection) that can cause
diarrhea.
• Many tests are available to diagnose the cause of
diarrhea and to determine the severity of dehydration,
although most children will not require testing.
13. Assessment of the child with diarrhoea
History
Ask the mother or other caretaker about:
Duration of diarrhoea;
Presence of blood in the stool;
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 breast milk) and
food taken during the illness;
Drugs or other remedies taken;
Immunization history.
16. I) STOOL: MICROSCOPY : low sensitivity & specificity
a) leucocyte (>10/hpf )- Invasive diarrhea
b) RBC ,ova,Trophozoite or cyst.
c) culture & sensitive - persistent diarrhea
II) BLOOD TESTS
a) CBC
b) S. electrolyte
c) BUN & creatinine
III)GUE
IV) Others: Tests for specific diagnoses should be sent when
appropriate, such as serum antibody tests for celiac
disease or colonoscopy for suspected UC. A trial of
lactose restriction for several days is helpful to rule out
lactose intolerance, or a more specific test, such as
lactose breath hydrogen analysis, can be performed.
Laboratory investigations
17. Management
Treating dehydration is the corner stone in managing
diarrhea.(Oral rehydration therapy)
Feeding: Continue Breast feeding and routine normal
diet and energy dense feeds.
Hand washing after defecation & before meal alone
can reduce 40% of water & excreta related disease
Drug therapy has very little place
Antibiotic
Antisecretory
Antimotility.
Follow-up to ensure recovery
18. Treatment : 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
19. Composition of standard and reduced osmolarity
ORS solutions
Standard ORS
solution
Reduced ORS
solution
(mEq or mmol/l) (mEq or mmol/l)
Glucose 111 75
Sodium 90 75
Chloride 80 65
Potassium 20 20
Citrate 10 10
Osmolarity 311 245
20. The advantages of this new reduced osmolarity ORS
solution
• It reduces stool output or stool volume by
about 25% when compared to the original
WHO-UNICEF ORS solution
• It reduces vomiting by almost 30%
• It reduces the need for unscheduled IV
therapy by more than 30%.
22. warning signs
Take the child to a health worker if there are
warning signs of dehydration or other problems
• The child does not get better in three days.
• Starts to pass many watery stools;
• Has repeated vomiting;
• Becomes very thirsty; lethargy, poor urine output
• Is eating or drinking poorly;
• Develops high fever;
• Has blood in the stool;
23. Indications for IV therapy:
1. Depressed level of consciousness.
2. Moderate dehydration when there is no
improvement after the firs 4 hours of
treatment with ORS.
3. Severe dehydration
4. Uncontrolled vomiting, poor urine out put
5. Patients unable to drink from extreme
fatigue, stupor, or coma
6. Patients with Abdominal distention.
25. Zinc in Diarrhea
• Zinc deficiency is common in developing countries and zinc is lost during
diarrhea
• Zinc deficiency is associated with impaired electrolyte and water
absorption, decreased brush border enzyme activity and impaired cellular
and humeral immunity .
• Treatment with zinc reduces the duration and severity of AD and also
reduces the frequency of further episodes during the subsequent 2-3 months
• WHO recommends that children from developing countries with
diarrhea be given zinc for 10-14 days
10mg daily for children <6 months
20 mg daily for children >6 months
26. Probiotics in the Treatment of
Diarrhea
Mechanisms:
1. Protect the intestine by competing with
pathogens for attachment.
2. Strengthening tight junctions between
enterocytes
3. Enhancing the mucosal immune
response to pathogens.
27. Antibiotic in Acute Diarrhoea
Indicated only for :
• Acute bloody diarrhea with gross blood
• Severe invasive bacterial diarrhea e:g Shigella
• Cholera,
• Associated systemic infection
• Severe malnutrition.
• Giardiasis ,Entamoeba hitolytica
• Suspected or proven sepsis
• Immuno compromised children
Antibiotics are contraindicated in:
E. coli 0157: H7 because they increase the risk of Haemolytic Uraemic syndrome (HUS)
Uncomplicated salmonella enteritis because they prolong bacteria shedding
28. Complications & consequences of
watery diarrhea:
o Dehydration.
o electrolyte disturbance.
o Base deficit acidosis.
o Malnutrition
o Persistent diarrhea
o Toxic illus
o Renal Failure.
o Hus(hemolytic uremic syndrome)
o DIC
o Convulsion
o Cerebral damage and cerebral venous thrombosis.
30. How can we prevent diarrhoeal
disease?
This involves intervention at two levels:
Primary prevention (to reduce disease transmission)
Rotavirus and measles vaccines
Hand washing with soap
Providing adequate and safe drinking water
Environmental sanitation
Secondary prevention (to reduce disease severity)
Promote breastfeeding
Vitamin A supplementation
Treatment with zinc