This document provides information on the diagnosis and treatment of uncomplicated and severe malaria. It defines uncomplicated malaria as a fever with symptoms like headache and joint pains. Uncomplicated malaria is diagnosed through blood smear microscopy and treated with Coartem over 3 days. Severe malaria involves additional symptoms like impaired consciousness and is treated with intravenous or intramuscular artesunate or quinine. Laboratory confirmation is required and differential diagnosis of other illnesses should be considered.
Philippine CPG on Diagnosis & Screening for Gestational DiabetesIris Thiele Isip-Tan
Philippine CPG on diagnosis and screening of gestational diabetes presented for comments at the 3rd Unite for Diabetes Annual Convention this September.
Omnacortil (Prednisolone Tablets) is a corticosteroid hormone which is used to treat conditions such as arthritis, blood problems, immune system disorders, skin and eye conditions, breathing problems, cancer, and severe allergies. It decreases the immune system's response to various diseases to reduce symptoms such as pain, swelling and allergic-type reactions.
Philippine CPG on Diagnosis & Screening for Gestational DiabetesIris Thiele Isip-Tan
Philippine CPG on diagnosis and screening of gestational diabetes presented for comments at the 3rd Unite for Diabetes Annual Convention this September.
Omnacortil (Prednisolone Tablets) is a corticosteroid hormone which is used to treat conditions such as arthritis, blood problems, immune system disorders, skin and eye conditions, breathing problems, cancer, and severe allergies. It decreases the immune system's response to various diseases to reduce symptoms such as pain, swelling and allergic-type reactions.
All about Malaria in a brief.
It is prepared for medical undergraduates for passing their written, clinical and viva exam.
About sign symptoms, investigation, treatment of malaria. It will be helpful in diagnosing and giving treatment of malaria especially for Bangladesh and Indian Sub-continent.
Reference: Davidsons Medicine, WHO guideline of Malaria.
SImplified Malaria overview for practising pediatricians in India - north india more specifically with a low incidence of malaria. By Dr Gaurav Gupta MD Pediatrician, Charak Clinics, Mohali, Chandigarh
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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
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
2. UNCOMPLICATED MALARIA.
Uncomplicated malaria definition:
Fever and any of the following:
Headache,
Body and joint pains
Feeling cold and sometimes shivering
Loss of appetite and sometimes abdominal pains
Diarrhoea, nausea and vomiting.
Splenomegaly
3. Confirmed diagnosis of malaria.
All clinically suspected malaria cases require
laboratory examination and confirmation.
Only in case where laboratory confirmation is
not possible start treatment immediately.
Parasitological confirmation is done by thin-
thick blood smear microscopy examination or
by dipstick (Rapid Diagnostic Test [RDT]).
4. Treatment of uncomplicated malaria
• P. falciparum malaria
The treatment of uncomplicated P. falciparum
malaria is undertaken after diagnosis of
malaria by light microscopy or Dipstick.
Patients with positive think-thick blood
smears or dipstick for P. falciparum malaria is
treated by blisters of Coartem® (artemether
20mg/lumefantrine 120mg). See Table 1 for
details of prescription.
5. Table 1 : Dosage and administration Coartem (Artemether 20
mg/Lumefantrine 120 mg) for uncomplicated
malaria falciparum. Source: Guideline for the treatment of malaria, WHO; 2006
Age group Weight group
Blister
color
(Day 1) (Day 2) (Day 3)
4 months
to 5yrs
5 to 14 kg Yellow
1 tb , 1 tb , 1 tb ,
1 tb 1 tb 1 tb
6 to 11y 15 to 24 kg Blue
2 tb , 2 tb , 2 tb ,
2 tb 2 tb 2 tb
12 to 14y 25 to 34 kg Orange
3 tb , 3 tb , 3 tb ,
3 tb 3 tb 3 tb
> 14y > 34 Green
4 tb , 4 tb , 4 tb ,
4 tb 4 tb 4 tb
7. Follow-up of uncomplicated malaria:
If symptoms persist after treatment with coartem®
or if the patient comes back before the 14th day
after treatment.
Treatment failure within 14 days of receiving
coartem® is extremely rare and is more likely to be
an inadequate absorption of the drug(s) than
resistance of the parasites. It is important to
determine from the patient’s history whether he or
she vomited during the previous treatment or did
not complete the full course.
If patient is in health facility where microscope is
available failure of treatment should be confirmed
parasitologically and could be treated using the
following regimen:
8. Follow-up of uncomplicated malaria:
• For adult:
Quinine (10mg salt /kg bw three times a day)
+ doxycycline (3.0mg/kg bw once a day) for 7
days. Do not give doxycycline with milk or
iron, which will reduce its absorption.
9.
If patient is in health facility where
microscopy facility is not available
patient should be referred to the facility
where microscope is available. If refer
is not possible treatment should be
given Quinine + Doxycycline. Please
refer to Table 5 for details of the
prescription.
Doxycycline should not be given to
pregnant or lactating woman, or child
aged up to 8 years.
10. For pregnant or lactated woman or child
less than 8 years:
Quinine (10mg salt /kg bw three times a
day) + clindamycin (10mg/kg bw twice a
day) for 7days. For small children,
(quinine and clindamycin) crush tablets
and mix with water and sugar.
11. NOTE
For high transmission areas
where parasitological
confirmation is not available,
children <5 yrs of age is
recommended to be treated
with anti malarial drugs when
symptomatic (especially fever).
12. SEVERE MALARIA.
Severe or complicated malaria definition:
Fever and any of the following:
Impaired consciousness
Anxiety, palpitation and sweating
Convulsions or fits with this fever
Fast or difficult breathing
Vomiting every feed / unable to feed
Pale hands, tongue and inner parts of the eyelid
Generalized body weakness
Dehydration
Jaundice
Severe malnutrition
Dark urine or no urine
13. Pre-referral treatment of severe malaria
• A patient who is non responsive should be quickly
assessed and managed. This includes assessment
of the airway, breathing and circulation. The staff
at the first level health facility should be able to
maintain airway, provide assisted breathing and
manage shock if required.
• Pre-referral treatment for severe malaria the
administration of Artesunate by the rectal route is
recommended for all except pregnant women first
trimester pregnancy. For the complete dosage and
treatment.
• Check blood sugar, if possible!
14. • In case Artesunate suppository is not available
IM quinine injection 20mg/kg bw should be
given. The Quinine injection dosage should be
split and injections given in the anterior part of
the thigh.
• In case Artesunate suppository is not
available, give also Quinine for children with
severe malaria.
15. Confirmed diagnosis of severe malaria:
• All clinically suspected severe malaria cases
require laboratory examination and
confirmation.
• Only in case where laboratory confirmation is
not possible start treatment immediately.
Parasitological confirmation is done by thin-
thick blood smear microscopy examination or
by dipstick (Rapid Diagnostic Test [RDT]).
16. Differential diagnosis for complicated malaria
Consider other illnesses, such as:
Measles, meningitis, tonsillitis, dengue, otitis
media (ear infection), influenza, pneumonia,
typhoid fever, tuberculosis, hypoglycemia.
17. Specific severe malaria treatment
• Artesunate (60 mg): 2.4 mg/kg body weight (bw) IV or IM
on admission (time=0), followed by 2.4 mg/kg at 12 and 24
hours, followed by once daily for seven days. Once the
patient can tolerate oral therapy, treatment should be
switched to a complete dosage of coartem® for three days
as recommended in the national treatment guidelines for
uncomplicated malaria .
• The congenital malaria is also treated with Artesunate,
where 2.4 mg/kg is initially given through IV, followed by
1.2 mg/kg at 12 and 24 hr then every 24 hr for 3 -5 days.
18. Specific severe malaria treatment
Artemether (80mg for adult and 40 mg for children and
the newborn): 3.2 mg/kg bw IM on the first day followed
by 1.6 mg/kg bw daily for seven days. Once the patient
can tolerate oral therapy, treatment should be switched
to a complete dosage of coartem®.
Arteether (150 mg): 3.2 mg/kg bw IM on the first day,
followed by 1.6 mg/kg bw for the next 4 days. Once the
patient can tolerate oral therapy, may switch to a
complete dosage of coartem®.
19. • If Coartem® is not available, quinine should
be administered in combination with
tetracycline or doxycycline or clindamycin, to
complete the seven-day treatment, except
for pregnant women and children under eight
years of age for whom
tetracycline/doxycycline is contraindicated.
20. QUININE.
• Loading dose: Quinine dihydrochloride 20 mg
salt/ kg bw diluted in 10 ml/kg bw of 5%
dextrose or dextrose saline administered by IV
infusion over a period of four hours for both
adult and children. In severe Childhood
falciparum malaria, if patient received quinine
or quinidine or mefloquine in 48 hrs before
arrival, give 10 mg/kg over 2 hours.
21. QUININE.
Maintenance dose: Quinine dihydrochloride 10 mg salt/
kg body weight diluted in 10 ml/kg body weight of 5%
dextrose or dextrose saline administered by IV infusion.
In adults, the maintenance dose is infused over a period
of four hours and repeated every eight hours.
Similarly in children including congenital malaria, it is
infused over a period of two hours and repeated every
eight hours (calculated from the beginning of the
previous infusion) until the patient can swallow. To
complete the seven-day to eight-day treatment in
children, give Quinine sulfate 10 mg/kg per oral three
times in a day. Increase the dosage of Quinine sulfate to
15-20 mg/kg after 4 days or add tetracycline 5 mg/kg
twice a day for children above 7 years.