This document provides a morning report on a case of malaria. It summarizes the patient's history, including previous malaria infections, physical examination findings, laboratory test results showing Plasmodium vivax, and diagnosis of malaria tertiana. The patient's treatment plan includes IV fluids, antipyretics, anti-malarial medications, and patient education.
viral hepatitis is one of the chronic disease and can cured with proper treatment and care .Here is the case study on viral hepatitis for pharmacy students .
Hypoglycemia and ulcus and ck dduty report 13 jan 2016Soroy Lardo
Hypoglycemia on antidiabetic treatment with ulcus diabetic and CKD showed importance of comprehensive approach diabetes with infection and severity condition
13. a case study on convulsions in a kco epilepsy with lactational amenorrhoeaDr. Ajita Sadhukhan
A 25 year old female patient was admitted to the female medicine ward with complaints of 2 and a half month amenorrhoea, epileptic fit convulsions at home, vertigo, generalised weakness and 1 episode of epileptic fit today evening.
viral hepatitis is one of the chronic disease and can cured with proper treatment and care .Here is the case study on viral hepatitis for pharmacy students .
Hypoglycemia and ulcus and ck dduty report 13 jan 2016Soroy Lardo
Hypoglycemia on antidiabetic treatment with ulcus diabetic and CKD showed importance of comprehensive approach diabetes with infection and severity condition
13. a case study on convulsions in a kco epilepsy with lactational amenorrhoeaDr. Ajita Sadhukhan
A 25 year old female patient was admitted to the female medicine ward with complaints of 2 and a half month amenorrhoea, epileptic fit convulsions at home, vertigo, generalised weakness and 1 episode of epileptic fit today evening.
Stroke is the 2nd leading death associated disorder. It is also known as cerebrovascular disorder mainly caused by high blood cholesterol levels or rupture of cerebral arteries.
PHARM-D INTERNSHIP ANNUAL REPORT PRESENTATION UNDER THE GUIDENCE OF DR.R.GO...DR. METI.BHARATH KUMAR
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The differential diagnosis and management for each disease that come with fever and thrombocytopenia. From infectious disease, connective tissue disease to malignanciec
MALARIAL FEVER A CASE PRESENTATION .pptxdrsriram2001
Definition of Malaria:
Malaria is a life-threatening infectious disease caused by parasites of the Plasmodium genus. It is transmitted to humans through the bites of infected female Anopheles mosquitoes.
2. Causative Agent and Life Cycle:
Plasmodium Species:
The primary malaria parasites affecting humans are Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale, and Plasmodium knowlesi.
Life Cycle:
Mosquito Stage: The cycle begins when an infected female mosquito bites a human, injecting sporozoites into the bloodstream.
Liver Stage: Sporozoites travel to the liver, where they mature into schizonts, releasing merozoites.
Blood Stage: Merozoites invade red blood cells, leading to cycles of replication and causing symptoms. Some parasites develop into sexual forms (gametocytes), which can be taken up by mosquitoes during a blood meal, completing the cycle.
3. Symptoms:
Febrile Paroxysms:
Malaria typically presents with recurrent episodes of fever, chills, and sweating, known as paroxysms.
Anemia:
The destruction of red blood cells by the parasites can lead to anemia.
Organ Dysfunction:
Severe malaria, often caused by P. falciparum, can lead to organ dysfunction, including cerebral malaria affecting the brain, severe anemia, respiratory distress, and kidney failure.
4. Treatment:
Antimalarial Drugs:
Artemisinin-based Combination Therapies (ACTs) are the first-line treatment for uncomplicated malaria. Examples include artemether-lumefantrine and artesunate-amodiaquine.
For severe malaria, intravenous artesunate is often recommended.
Preventive Measures:
Bed nets treated with insecticides are effective in preventing mosquito bites.
Chemoprophylaxis with antimalarial drugs is recommended for individuals traveling to malaria-endemic regions.
Vector Control:
Mosquito control measures, such as insecticide spraying and environmental management, are crucial for malaria prevention.
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
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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. IDENTITY
Name : Tn. HFA
DOB/Age : February 20th 1989/ 28 years old
Religion : Moslem
Marital Status : Married
Address : Asr. Yon-23 Grup 2 Kopassus Semplak Bogor
Medical Record : 858699
Admission : July 10th 2017 01.30 AM
Ward : PU Lantai 3
4. HISTORY OF PRESENT ILLNESS
Five days before admission to RSPAD, patient felt dizzy and muscular
aching, but fever was denied
Four days before admission, patient felt fever, repeated at interval 2 days
(once fever once not), fever last throughout the day, followed by chills,
sweating, headache, and muscular aching and weakness. History of fever at
particular time of a day is denied, highest temperature recorded might reach
up to 39◦C
Patient also complained feeling nauseous during meal without history of
vomiting. Decreased of appetite was denied.
No history of cough, nor shortness of breath, normal micturition and
defecation. No abdominal pain. No nosebleed, no bleeding of gums
5. HISTORY OF PRESENT ILLNESS
Patient has experienced military exercise in Merauke about 2 months.
After 1 month running, patient experienced fever and felt not so good
in his body. Then, he had sought medical assistance to RST Merauke
(July 06th, 2017), ran blood tests and was diagnosed with Malaria
Tropicana (based on his story, but the data was not brought to
Jakarta).
He said that he was injected with Artesunat injection there with 2x60
mg doses for 2 days, and Primakuin 3 tablets single dose but he didn't
get the next dose of Artesunat injection because he already must be
evacuated to Jakarta for further treatment.
Patient was evacuated to Jakarta in July 8th, 2017
6. HISTORY OF PAST ILLNESS
• Patient was already diagnosed with malaria four times before:
• 1st attack was diagnosed with Malaria Tertiana
• 2nd attack was diagnosed with Malaria Tropicana
• 3rd attack was diagnosed with Mix Tropicana-Tertiana
• 4th attack was diagnosed with Malaria Tertiana
and this time is his fifth attack of Malaria
• Three previous Malaria before were got when he was in duty about one year
in Wembi, Papua, and the last one was got in Jakarta a week after he came
back from his duty from Papua
• He has history of Tuberculosis in 2014, taking routine medication for 6
months, and had been declared cured by the physician
• He also has history of fistula anal operation in 2014
• Hypertension and type II diabetes were denied
7. HISTORY OF FAMILY ILLNESS AND
SOCIAL ECONOMIC STATUS
• HISTORY OF FAMILY ILLNESS
• Patient's father has a hypertension
• No diabetes, nor heart disease in his family
• No one has ever had malaria in patient's family
• SOCIAL AND ECONOMIC STATUS
• Patient is second child from 3 siblings in his family
• Patient sometimes smoke 1-2 cigarettes per day, sometimes not at all
• During exercise in Merauke, patient stated that the workload was so high so he
hadn't enough time to got a rest
• Patient works as Kopassus soldier
• Patient has been married for 1 year, now his wife is in fifth month pregnancy
and live in Malang
• Health financing with BPJS Dinas
• Intake of vitamin and another supplement are denied
• No history of chemoprophylaxis of malaria
8. PHYSICAL EXAMINATION
(ON PRESENTATION)
Vital Signs
BP : 132/79 mmHg
HR : 81x/min, regular, adequate
RR : 22x/min, torakal
T : 36.3◦C
BW : 66 kg
Height : 171cm
IMT : 22.7 kg/m2 (normoweight)
General Status
• Conciousness: Compos
mentis
• General condition: mildly
ill
9. PHYSICAL EXAMINATION
• Skin : within normal limit
• Head : normocephal, no coated tongue
• Hair : greyish black hair, hair can’t be plucked easily
• Eyes : no pale conjunctiva, no icteric sclera
• Neck : no lymph node enlargement, JVP 5-2 cmH2O
Lung
Inspection : symmetrical on insipiration and expiration
Palpation : symmetrical fremitus
Percution : sonor on both lungs
Auscultation : vesicular, no wheezing, no rales
Heart
Inspection : ictus cordis can't be located
Palpation : ictus cordis palpable on 1 finger medial to linea
midclavicularis sinistra, thrill (-), heaving (-), lifting (-)
Percussion : heart borders within normal limit
Auscultation : regular S1 S2, no murmur, no gallop
10. PHYSICAL EXAMINATION
Abdomen
Inspection : flat stomach
Palpation : supple, no pain on palpation, no liver or spleen
enlargement
Percussion : no shifting dullness
Auscultation : bowel sound normal
Extremities
CRT<2”, warm lower extremities, no edema, rumple leed test (-)
12. LABORATORY FINDING
Jenis Pemeriksaan Nilai Rujukan 09/07/2017
Glukosa Darah (Sewaktu) 70-140 mg/dL 110
Natrium 135-147 mmol/L 136
Kalium 3.5-5.0 mmol/L 3.3
Klorida 95-105 mmol/L 103
IMMUNOSEROLOGY
Anti Dengue IgM Negatif Negatif
Anti Dengue IgG Negatif Negatif
13. Jenis Pemeriksaan Nilai Rujukan 09/07/2017
Malaria
I. Plasmodium Falciparum Negatif Tidak Ditemukan
• Tropozoit
• Schizont
• Gametosit
Negatif
Negatif
Negatif
Tidak Ditemukan
Tidak Ditemukan
Tidak Ditemukan
II. Plasmodium Vivax Negatif Tidak Ditemukan
• Tropozoit
• Schizont
• Gametosit
Negatif
Negatif
Negatif
Ditemukan 12/200 Leukosit
Ditemukan 180/200 Leukosit
Ditemukan 36/200 Leukosit
III. Plasmodium Malariae Negatif Tidak Ditemukan
• Tropozoit
• Schizont
• Gametosit
Negatif
Negatif
Negatif
Tidak Ditemukan
Tidak Ditemukan
Tidak Ditemukan
IV. Plasmodium Ovale Negatif Tidak Ditemukan
• Tropozoit
• Schizont
• Gametosit
Negatif
Negatif
Negatif
Tidak Ditemukan
Tidak Ditemukan
Tidak Ditemukan
LABORATORY FINDING
14. RESUME
28 year-old-male patient with chief complaint of high fever with
chills since 4 days before hospital admission. Febris with intermittent
pattern, repeated at interval 2 days, followed by headache, and
muscular aching and weakness.
Patient already had malaria four times before, and had history of
visiting malaria endemic areas. Patient was treated as Malaria
Tropicana in Merauke and had injection Artesunat and Primaquine
per oral 1x3 tab single dose.
Physical examination revealed within normal limit. From laboratory
findings, patient is known to have Plasmodium Vivax from
microscopic examination and trombocytopenia.
16. Problem Assessment Plan of Care Plan
Malaria
Tertiana
Based on:
History :
Fever, repeated at interval 2 days,
intermittent pattern (once fever once
not), and followed by chills, sweating,
headache, and muscular aching and
weakness
Patient was diagnosed and treated as
Malaria Tropicana in Merauke and
had injection Artesunat and
Primaquine per oral single dose.
Already had Malaria four times
before
Laboratory findings:
Plasmodium Vivax (+), Ditemukan
12/200 Leukosit (tropozoit)
Ditemukan 180/200 Leukosit
(schizont)
Ditemukan 36/200 Leukosit
(gametosit)
Plasmodium Falciparum (-)
Trombocytopenia
Target:
Clinical
improvement
Malaria cured
Diagnostic:
Thin and thick blood film for
evaluate therapy post treatment
Therapy :
- IVFD NaCl 0.9% 500 cc/8
hour
- Paracetamol 3x500mg
- DHP 1x4 tab (3 days)
- Primakuin 1x1 tab (14 days)
- Ranitidine inj. 2x1 amp
- Antacida syr 3xC1
- Domperidone 3x1 tab
Education :
─ Increase endurance by
eating lots of vegetables,
fruits, drink a lot of water,
and have enough time to get
rest
─ Take routine and regular
medication
─ Use mosquito net when
sleep
17. MALARIA
• Malaria is caused by the protozoan parasite Plasmodium, with an
incubation period of 7 days or longer
• Human malaria is caused by four different species of
Plasmodium: P. falciparum, P. malariae, P. ovale and P. vivax.
• The malaria parasite is transmitted by female Anopheles
mosquitoes
• P. vivax and P. ovale can remain dormant in the liver. Relapses
caused by these persistent liver forms (“hypnozoites”) may
appear months, and rarely several years, after exposure
• People who are immunosuppressed and elderly travellers to
endemic areas are particularly at risk of severe disease
• Falciparum malaria may be fatal, other Plasmodium species are
rarely life-threatening
20. DIAGNOSIS
• Anamnesis
– Main complaints: fever (based on pattern), chills, sweating and may be
accompanied by headache, nausea, vomiting, diarrhea and muscle aches
– Visiting history and overnight 1 - 4 weeks to the region of endemic
malaria
– The history of living in malaria endemic areas
– History of sick malaria and take malaria drug
• Physical Examination
– Fever (measurement with thermometer more than 37.5 ° C)
– Pale conjunctiva (anemia)
– Enlargement of spleen (splenomegali) and liver (hepatomegaly) can be
found
21. DIAGNOSIS
• Laboratory Finding
– Microscopic examination (Blood and thin blood test (SD) examination to
determine:
• 1. The presence or absence of malaria parasites (positive or negative)
• 2. Species and stadium plasmodium
• 3. Parasite density:
– Semi kuantitatif
» Negatif (tidak ditemukan parasit dalam 100 LPB/Iapangan
pandang besar)
» positif 1 (ditemukan 1 -10 parasit dalam 100 LPB)
» positif 2 (ditemukan 11 -100 parasit dalam 100 LPB)
» positif 3 (ditemukan 1 -10 parasit dalam 1 LPB)
» positif 4 (ditemukan >10 parasit dalam 1 LPB)
– Kuantitatif (Jumlah parasit dihitung per mikro liter darah pada
sediaan darah tebal (leukosit) atau sediaan darah tipis (eritrosit)
– Rapid Diagnostic Test (RDT)
22.
23. TREATMENT
• ACT (Artemisinin
Combination Therapy)
– Artesunate - Amodiaquin
– Dihydroartemisinin -
Piperaquin
The drug dose for malaria vivax
is similar to malaria falciparum,
where the difference is the
administration of medication
primakuin in malaria vivax is
given for 14 days with dose
0.25 mg/kgBB
24. PROGNOSIS
• Ad vitam : Bonam
• Ad functionam : Bonam
• Ad sanationam : Dubia ad bonam