This document discusses the clinical manifestations and management of malaria. It begins by outlining the incubation periods for different Plasmodium species that cause malaria. It then describes the prodromal, clinical features and presentations of both uncomplicated and complicated/severe malaria. Complications discussed include cerebral malaria, anemia, pancytopenia, hepatic dysfunction, renal failure, hypoglycemia, pulmonary edema, and more. The diagnosis, treatment, and management of both uncomplicated and severe malaria are also summarized.
This document provides information on malaria, including its epidemiology, clinical features, diagnosis, and complications. It discusses that malaria is a major public health problem, with half of the world's population at risk. Clinical features include fever, chills, and headaches. Malaria can be uncomplicated or complicated/severe, with the latter presenting dangers like cerebral malaria, anemia, and respiratory distress. Diagnosis involves microscopy of blood smears or rapid diagnostic tests detecting malaria antigens.
This document discusses malaria, which affects over 2 billion people globally. It causes over 1 million deaths annually, mostly in African children. The malaria parasite is transmitted via the bite of infected female Anopheles mosquitoes. Symptoms include cyclic fevers, chills and sweats. Severe malaria can cause complications like cerebral malaria, respiratory distress, hypoglycemia, and kidney failure. Diagnosis involves microscopic examination of blood smears to identify the malaria parasite. Rapid diagnostic tests and PCR methods provide additional diagnostic options. Treatment depends on the malaria species, patient factors, and local drug resistance patterns, with artemisinin-based combination therapies recommended.
Severe malaria is an important cause of U-5 morbidity and mortality in malaria endemic areas like the subsaharan Africa particularly Nigeria which accounts for more than half of the burden on the continent.
It is a life threatening condition, a medical emergency requiring in-patient care. Early treatment curtails the dismal outcomes of this condition.
The most important preventive measures is use of insecticide treated mosquito nets in addition to environmental control, seasonal chemoprophylaxis and use of Malaria Vaccine.
The recent recommendations by the WHO is use of IV Artesunate or if unavailable, artemether and quinine followed by full course of ACTs. Other complications should be treated as required and those with life threatening complications should preferably be managed in the ICU.
The document discusses malaria, including:
1. Malaria remains a global health problem, with most cases occurring in Africa and Southeast Asia. P. falciparum causes severe malaria with high mortality.
2. Severe malaria is defined as impaired consciousness, respiratory distress, hypoglycemia, acidosis, circulatory collapse, jaundice and renal failure.
3. Treatment of non-severe malaria uses ACT plus primaquine depending on parasite species. Severe malaria requires intensive care treatment including parenteral antimalarials and supportive care.
Dr. Tulasiram Nallam presented on malaria at a conference chaired by Dr. Chandramohan Kumar. Malaria remains a major global health problem caused by the Plasmodium parasite and transmitted by Anopheles mosquitoes. In 2021, there were an estimated 247 million cases and 619,000 deaths globally, with India accounting for around 79% of cases in the WHO Southeast Asia region. Treatment involves prompt diagnosis and effective antimalarial drugs like chloroquine and artemisinin-based combination therapies along with supportive care for severe cases presenting complications such as cerebral malaria, hypoglycemia, or acute kidney injury.
Cerebral malaria is the most severe complication caused by Plasmodium falciparum infection. It is characterized by coma and occurs when infected red blood cells sequester in the brain's microvasculature. Sequestration is mediated by cytoadherence of parasite proteins on infected cells to endothelial receptors and results in reduced blood flow and organ damage. Diagnosis involves identifying the parasite on blood smears with treatment consisting of intravenous artesunate or quinine along with supportive care. Prompt and complete antimalarial therapy is needed to prevent relapses.
Malaria is caused by infection with Plasmodium parasites transmitted through the bites of infected Anopheles mosquitoes. The most common causative species vary geographically but include P. falciparum, P. vivax, P. malariae, and P. ovale. Symptoms include fever, chills, flu-like illness, and in severe cases life-threatening complications. Diagnosis is via microscopic examination of blood smears or rapid diagnostic tests. Treatment depends on the species and severity of infection, utilizing antimalarial medications like chloroquine, primaquine, artemisinin combinations, or quinine for severe cases. Control and elimination efforts focus on vector control measures and developing an effective
This document provides information on malaria, including its epidemiology, clinical features, diagnosis, and complications. It discusses that malaria is a major public health problem, with half of the world's population at risk. Clinical features include fever, chills, and headaches. Malaria can be uncomplicated or complicated/severe, with the latter presenting dangers like cerebral malaria, anemia, and respiratory distress. Diagnosis involves microscopy of blood smears or rapid diagnostic tests detecting malaria antigens.
This document discusses malaria, which affects over 2 billion people globally. It causes over 1 million deaths annually, mostly in African children. The malaria parasite is transmitted via the bite of infected female Anopheles mosquitoes. Symptoms include cyclic fevers, chills and sweats. Severe malaria can cause complications like cerebral malaria, respiratory distress, hypoglycemia, and kidney failure. Diagnosis involves microscopic examination of blood smears to identify the malaria parasite. Rapid diagnostic tests and PCR methods provide additional diagnostic options. Treatment depends on the malaria species, patient factors, and local drug resistance patterns, with artemisinin-based combination therapies recommended.
Severe malaria is an important cause of U-5 morbidity and mortality in malaria endemic areas like the subsaharan Africa particularly Nigeria which accounts for more than half of the burden on the continent.
It is a life threatening condition, a medical emergency requiring in-patient care. Early treatment curtails the dismal outcomes of this condition.
The most important preventive measures is use of insecticide treated mosquito nets in addition to environmental control, seasonal chemoprophylaxis and use of Malaria Vaccine.
The recent recommendations by the WHO is use of IV Artesunate or if unavailable, artemether and quinine followed by full course of ACTs. Other complications should be treated as required and those with life threatening complications should preferably be managed in the ICU.
The document discusses malaria, including:
1. Malaria remains a global health problem, with most cases occurring in Africa and Southeast Asia. P. falciparum causes severe malaria with high mortality.
2. Severe malaria is defined as impaired consciousness, respiratory distress, hypoglycemia, acidosis, circulatory collapse, jaundice and renal failure.
3. Treatment of non-severe malaria uses ACT plus primaquine depending on parasite species. Severe malaria requires intensive care treatment including parenteral antimalarials and supportive care.
Dr. Tulasiram Nallam presented on malaria at a conference chaired by Dr. Chandramohan Kumar. Malaria remains a major global health problem caused by the Plasmodium parasite and transmitted by Anopheles mosquitoes. In 2021, there were an estimated 247 million cases and 619,000 deaths globally, with India accounting for around 79% of cases in the WHO Southeast Asia region. Treatment involves prompt diagnosis and effective antimalarial drugs like chloroquine and artemisinin-based combination therapies along with supportive care for severe cases presenting complications such as cerebral malaria, hypoglycemia, or acute kidney injury.
Cerebral malaria is the most severe complication caused by Plasmodium falciparum infection. It is characterized by coma and occurs when infected red blood cells sequester in the brain's microvasculature. Sequestration is mediated by cytoadherence of parasite proteins on infected cells to endothelial receptors and results in reduced blood flow and organ damage. Diagnosis involves identifying the parasite on blood smears with treatment consisting of intravenous artesunate or quinine along with supportive care. Prompt and complete antimalarial therapy is needed to prevent relapses.
Malaria is caused by infection with Plasmodium parasites transmitted through the bites of infected Anopheles mosquitoes. The most common causative species vary geographically but include P. falciparum, P. vivax, P. malariae, and P. ovale. Symptoms include fever, chills, flu-like illness, and in severe cases life-threatening complications. Diagnosis is via microscopic examination of blood smears or rapid diagnostic tests. Treatment depends on the species and severity of infection, utilizing antimalarial medications like chloroquine, primaquine, artemisinin combinations, or quinine for severe cases. Control and elimination efforts focus on vector control measures and developing an effective
Malaria is a significant parasitic disease that claims many lives, especially children. It is caused by Plasmodium parasites transmitted via mosquito bites. P. falciparum is the most deadly species and can cause severe complications like cerebral malaria, acidosis, pulmonary edema, renal failure, severe anemia, and liver dysfunction if left untreated. These complications have high mortality rates. Malaria disproportionately impacts pregnant women and children, who are more likely to experience severe forms of the disease. Prompt diagnosis and treatment with antimalarial drugs is needed to prevent mortality from this widespread and deadly infectious disease.
The document summarizes information about malaria, including that it is caused by Plasmodium parasites and can range from uncomplicated to severe. Severe malaria affects multiple organ systems and has a 20% mortality rate if not properly treated. Diagnosis involves examining thick and thin blood films under a microscope. Treatment depends on the severity of the case, with uncomplicated malaria typically treated with artemisinin-based combination therapy and severe malaria requiring hospitalization and parenteral antimalarial drugs along with supportive therapies.
Malaria is a life-threatening disease caused by Plasmodium parasites transmitted via mosquito bites. It is most prevalent in developing countries, especially sub-Saharan Africa. The most severe form is caused by P. falciparum. Symptoms include fever, chills, and flu-like illness. Diagnosis involves microscopy of blood smears or rapid diagnostic tests to detect parasites. Treatment depends on the Plasmodium species and disease severity, ranging from chloroquine for non-severe P. vivax to artemisinin-based combination therapy for P. falciparum. Prevention involves mosquito control and antimalarial drugs. Malaria poses a major global health challenge but can be controlled through
This document summarizes malaria, caused by protozoan parasites of the Plasmodium genus. It describes the different Plasmodium species that cause malaria in humans, epidemiology, pathogenesis, clinical manifestations, complications, treatment approaches, and prevention. The most severe form of malaria is caused by P. falciparum, which can result in cerebral malaria, respiratory distress, hypoglycemia, and other life-threatening complications if not promptly treated. Diagnosis involves microscopic examination of blood smears to identify the parasite species and load. Treatment depends on the severity of illness and suspected drug resistance, and may involve artemisinin-based combination therapies.
The document discusses malaria, caused by parasites of the Plasmodium genus transmitted via mosquito bites. It affects over 100 countries and kills approximately 2,000 people per day. The most common species causing malaria in India are P. vivax, P. falciparum, P. ovale, and P. knowlesi, with P. falciparum being the most lethal. Malaria symptoms include fever, fatigue, nausea, and in severe cases can include cerebral malaria, acidosis, anemia, renal failure, pulmonary edema, hypoglycemia, and death. Diagnosis involves examining blood smears under a microscope for parasites. Treatment depends on the Plasmodium species and may include chloroquine,
This document summarizes malaria, including its causative agents, transmission, distribution, pathology, clinical features, complications, diagnosis, management, prevention, and control. Malaria is transmitted by mosquitoes and causes millions of deaths each year, mostly in children in Africa. Plasmodium falciparum is the most dangerous malaria parasite and can cause severe complications including cerebral malaria, if not promptly treated. Diagnosis involves examining blood films for malaria parasites. Treatment depends on the malaria species and severity, ranging from chloroquine for non-falciparum malaria to quinine or artemisinin combinations for falciparum malaria. Prevention focuses on avoiding mosquito bites through protective clothing, repellents, and insecticide
This document provides an overview of malaria, including:
1. The five Plasmodium species that cause human malaria, with P. falciparum and P. vivax present in Sri Lanka.
2. The life cycles of the parasites, including their prepatent and incubation periods in the human host.
3. The pathophysiology of malaria, including the erythrocytic cycle causing haemolysis, host immune response, and mechanisms of severe malaria like cytoadherence.
4. Clinical features ranging from uncomplicated to severe malaria, and differences between recrudescence and relapse.
This document provides an overview of a lecture on parasitic infections, focusing on malaria. It defines malaria as a protozoan infection caused by Plasmodium parasites and transmitted via mosquito bites. The epidemiology, causes, pathogenesis, clinical features, diagnosis and management of malaria are discussed in detail. Malaria remains a major public health problem in Zambia, with P. falciparum causing over 95% of cases. Clinical features range from acute to chronic or severe manifestations. Diagnosis involves blood smear microscopy or rapid diagnostic tests. First line treatment of uncomplicated malaria in Zambia is artemether-lumefantrine given over three days.
The document discusses malaria, a disease transmitted through mosquito bites that infects over 2 billion people globally. It provides details on malaria symptoms, types, transmission, and treatment. Specifically, it summarizes a study of 1364 malaria cases at Kantha Bopha Children's Hospitals in Cambodia between 2008-2009. The study found high rates of severe complications like anemia, hypoglycemia, and cerebral malaria among patients. Prompt treatment with antimalarial drugs achieved good outcomes in most cases.
This document provides an outline and overview of malaria management. It begins with an introduction describing how malaria is caused by Plasmodium parasites transmitted via mosquitos. It then covers the epidemiology, noting high-risk groups and prevalence in Africa. Etiology describes the 5 Plasmodium species infecting humans. Pathophysiology explains genetic resistance factors. Clinical features are described for both uncomplicated and complicated malaria. Diagnosis, treatment, complications, prognosis and prevention/control methods are also summarized.
- Malaria is caused by Plasmodium parasites and spread by Anopheles mosquitoes. It is a major public health issue, with hundreds of millions of cases annually.
- The document discusses the epidemiology and transmission of malaria, symptoms, diagnosis, treatment including for severe and drug-resistant cases, prevention through vector control, and the use of artemisinin derivatives like artesunate which have improved treatment outcomes.
This document discusses peripartum convulsions and eclampsia. It begins by defining convulsive disorders and their origins in the central nervous system. It then discusses the causes of peripartum convulsions, with 98% being obstetric (eclampsia) and 2% being non-obstetric. Eclampsia is defined as a disease of pregnancy involving high blood pressure, convulsions, and proteinuria. The document outlines the presentation, types, investigations, and management of eclampsia. Management involves controlling seizures, lowering blood pressure, delivering the baby, and preventing recurrence through magnesium sulfate administration. Complications and ominous signs are also noted.
This document provides an overview of sepsis and septic shock, including definitions, epidemiology, pathogenesis, clinical features, investigation, treatment, complications, and prognosis. It defines sepsis as infection plus SIRS, and septic shock as sepsis that is not responsive to fluid resuscitation and requires vasopressors. The pathogenesis involves an initial inflammatory response to infection that can become dysregulated and lead to organ dysfunction. Treatment involves prompt resuscitation, antibiotics, source control, and organ support. Outcomes depend on factors like age, immune status, pathogen, and need for prolonged vasopressor support.
Complicated malaria refers to any clinical presentation requiring parenteral treatment, including severe malaria which meets strict WHO criteria. Of falciparum malaria cases, around 10% are severe, with a mortality of 10% without treatment but up to 50% for those meeting the severe criteria. Pathophysiology of severe manifestations includes sequestration of infected red blood cells in organs, hypoglycemia, acidosis, anemia, acute renal failure, and shock. Diagnosis involves blood smears to identify Plasmodium species and quantify parasitemia level.
A 30-year-old man recently traveled to several countries in Africa, Asia, and Europe and has now presented with fever, headache, weakness and malaise for three days. Malaria is considered the most likely diagnosis given his travel history, symptoms, and physical exam findings. Malaria is a mosquito-borne parasitic infection that infects 300-500 million people annually, causing over 1 million deaths mostly in young children in Africa. Diagnosis is made through blood smears and rapid diagnostic tests detecting malaria antigens or DNA.
This document defines severe malaria and describes its symptoms, risk factors, diagnosis, and treatment. Severe malaria is characterized by high parasite levels in the blood and/or organ dysfunction. Diagnosis involves microscopic examination of blood smears, rapid diagnostic tests, or molecular tests. Treatment consists of supportive care and intravenous antimalarial drugs like artesunate or quinine. Complications are treated based on affected organ systems and may involve oxygen supplementation, anticonvulsants, or blood transfusions.
This document provides information on severe and complicated malaria. It begins by defining malaria and describing the different species of Plasmodium that cause it. It then distinguishes between uncomplicated and severe malaria. Severe malaria is defined as malaria illness that threatens a patient's life, with features like cerebral malaria, severe anemia, respiratory distress, hypoglycemia, or circulatory collapse. The document outlines groups at high risk of severe malaria and describes diagnosing and managing severe malaria cases, including giving parenteral antimalarial treatment like artesunate immediately, managing complications, and providing supportive care.
This document discusses the pharmacotherapy of malaria. It begins by describing the life cycle and species of the Plasmodium parasite that causes malaria. It then outlines who is most at risk of malaria and the clinical classification of uncomplicated and severe malaria. The major sections cover antimalarial drug classes, treatment guidelines for uncomplicated and severe malaria caused by different parasite species, and prevention through insecticide-treated bed nets, repellents and chemoprophylaxis in travelers.
The document provides an overview of antiphospholipid antibody syndrome (APS). It defines APS as a systemic autoimmune disease characterized by vascular thrombosis or adverse obstetric outcomes in patients with persistent antiphospholipid antibodies. The classification criteria for APS requires at least one clinical criterion (vascular thrombosis or pregnancy morbidity) and one laboratory criterion (presence of lupus anticoagulant or antiphospholipid antibodies). Common clinical manifestations of APS include venous thromboses, arterial thromboses, obstetric complications, and valvular heart disease. Treatment involves anticoagulation to prevent future thrombotic events.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Malaria is a significant parasitic disease that claims many lives, especially children. It is caused by Plasmodium parasites transmitted via mosquito bites. P. falciparum is the most deadly species and can cause severe complications like cerebral malaria, acidosis, pulmonary edema, renal failure, severe anemia, and liver dysfunction if left untreated. These complications have high mortality rates. Malaria disproportionately impacts pregnant women and children, who are more likely to experience severe forms of the disease. Prompt diagnosis and treatment with antimalarial drugs is needed to prevent mortality from this widespread and deadly infectious disease.
The document summarizes information about malaria, including that it is caused by Plasmodium parasites and can range from uncomplicated to severe. Severe malaria affects multiple organ systems and has a 20% mortality rate if not properly treated. Diagnosis involves examining thick and thin blood films under a microscope. Treatment depends on the severity of the case, with uncomplicated malaria typically treated with artemisinin-based combination therapy and severe malaria requiring hospitalization and parenteral antimalarial drugs along with supportive therapies.
Malaria is a life-threatening disease caused by Plasmodium parasites transmitted via mosquito bites. It is most prevalent in developing countries, especially sub-Saharan Africa. The most severe form is caused by P. falciparum. Symptoms include fever, chills, and flu-like illness. Diagnosis involves microscopy of blood smears or rapid diagnostic tests to detect parasites. Treatment depends on the Plasmodium species and disease severity, ranging from chloroquine for non-severe P. vivax to artemisinin-based combination therapy for P. falciparum. Prevention involves mosquito control and antimalarial drugs. Malaria poses a major global health challenge but can be controlled through
This document summarizes malaria, caused by protozoan parasites of the Plasmodium genus. It describes the different Plasmodium species that cause malaria in humans, epidemiology, pathogenesis, clinical manifestations, complications, treatment approaches, and prevention. The most severe form of malaria is caused by P. falciparum, which can result in cerebral malaria, respiratory distress, hypoglycemia, and other life-threatening complications if not promptly treated. Diagnosis involves microscopic examination of blood smears to identify the parasite species and load. Treatment depends on the severity of illness and suspected drug resistance, and may involve artemisinin-based combination therapies.
The document discusses malaria, caused by parasites of the Plasmodium genus transmitted via mosquito bites. It affects over 100 countries and kills approximately 2,000 people per day. The most common species causing malaria in India are P. vivax, P. falciparum, P. ovale, and P. knowlesi, with P. falciparum being the most lethal. Malaria symptoms include fever, fatigue, nausea, and in severe cases can include cerebral malaria, acidosis, anemia, renal failure, pulmonary edema, hypoglycemia, and death. Diagnosis involves examining blood smears under a microscope for parasites. Treatment depends on the Plasmodium species and may include chloroquine,
This document summarizes malaria, including its causative agents, transmission, distribution, pathology, clinical features, complications, diagnosis, management, prevention, and control. Malaria is transmitted by mosquitoes and causes millions of deaths each year, mostly in children in Africa. Plasmodium falciparum is the most dangerous malaria parasite and can cause severe complications including cerebral malaria, if not promptly treated. Diagnosis involves examining blood films for malaria parasites. Treatment depends on the malaria species and severity, ranging from chloroquine for non-falciparum malaria to quinine or artemisinin combinations for falciparum malaria. Prevention focuses on avoiding mosquito bites through protective clothing, repellents, and insecticide
This document provides an overview of malaria, including:
1. The five Plasmodium species that cause human malaria, with P. falciparum and P. vivax present in Sri Lanka.
2. The life cycles of the parasites, including their prepatent and incubation periods in the human host.
3. The pathophysiology of malaria, including the erythrocytic cycle causing haemolysis, host immune response, and mechanisms of severe malaria like cytoadherence.
4. Clinical features ranging from uncomplicated to severe malaria, and differences between recrudescence and relapse.
This document provides an overview of a lecture on parasitic infections, focusing on malaria. It defines malaria as a protozoan infection caused by Plasmodium parasites and transmitted via mosquito bites. The epidemiology, causes, pathogenesis, clinical features, diagnosis and management of malaria are discussed in detail. Malaria remains a major public health problem in Zambia, with P. falciparum causing over 95% of cases. Clinical features range from acute to chronic or severe manifestations. Diagnosis involves blood smear microscopy or rapid diagnostic tests. First line treatment of uncomplicated malaria in Zambia is artemether-lumefantrine given over three days.
The document discusses malaria, a disease transmitted through mosquito bites that infects over 2 billion people globally. It provides details on malaria symptoms, types, transmission, and treatment. Specifically, it summarizes a study of 1364 malaria cases at Kantha Bopha Children's Hospitals in Cambodia between 2008-2009. The study found high rates of severe complications like anemia, hypoglycemia, and cerebral malaria among patients. Prompt treatment with antimalarial drugs achieved good outcomes in most cases.
This document provides an outline and overview of malaria management. It begins with an introduction describing how malaria is caused by Plasmodium parasites transmitted via mosquitos. It then covers the epidemiology, noting high-risk groups and prevalence in Africa. Etiology describes the 5 Plasmodium species infecting humans. Pathophysiology explains genetic resistance factors. Clinical features are described for both uncomplicated and complicated malaria. Diagnosis, treatment, complications, prognosis and prevention/control methods are also summarized.
- Malaria is caused by Plasmodium parasites and spread by Anopheles mosquitoes. It is a major public health issue, with hundreds of millions of cases annually.
- The document discusses the epidemiology and transmission of malaria, symptoms, diagnosis, treatment including for severe and drug-resistant cases, prevention through vector control, and the use of artemisinin derivatives like artesunate which have improved treatment outcomes.
This document discusses peripartum convulsions and eclampsia. It begins by defining convulsive disorders and their origins in the central nervous system. It then discusses the causes of peripartum convulsions, with 98% being obstetric (eclampsia) and 2% being non-obstetric. Eclampsia is defined as a disease of pregnancy involving high blood pressure, convulsions, and proteinuria. The document outlines the presentation, types, investigations, and management of eclampsia. Management involves controlling seizures, lowering blood pressure, delivering the baby, and preventing recurrence through magnesium sulfate administration. Complications and ominous signs are also noted.
This document provides an overview of sepsis and septic shock, including definitions, epidemiology, pathogenesis, clinical features, investigation, treatment, complications, and prognosis. It defines sepsis as infection plus SIRS, and septic shock as sepsis that is not responsive to fluid resuscitation and requires vasopressors. The pathogenesis involves an initial inflammatory response to infection that can become dysregulated and lead to organ dysfunction. Treatment involves prompt resuscitation, antibiotics, source control, and organ support. Outcomes depend on factors like age, immune status, pathogen, and need for prolonged vasopressor support.
Complicated malaria refers to any clinical presentation requiring parenteral treatment, including severe malaria which meets strict WHO criteria. Of falciparum malaria cases, around 10% are severe, with a mortality of 10% without treatment but up to 50% for those meeting the severe criteria. Pathophysiology of severe manifestations includes sequestration of infected red blood cells in organs, hypoglycemia, acidosis, anemia, acute renal failure, and shock. Diagnosis involves blood smears to identify Plasmodium species and quantify parasitemia level.
A 30-year-old man recently traveled to several countries in Africa, Asia, and Europe and has now presented with fever, headache, weakness and malaise for three days. Malaria is considered the most likely diagnosis given his travel history, symptoms, and physical exam findings. Malaria is a mosquito-borne parasitic infection that infects 300-500 million people annually, causing over 1 million deaths mostly in young children in Africa. Diagnosis is made through blood smears and rapid diagnostic tests detecting malaria antigens or DNA.
This document defines severe malaria and describes its symptoms, risk factors, diagnosis, and treatment. Severe malaria is characterized by high parasite levels in the blood and/or organ dysfunction. Diagnosis involves microscopic examination of blood smears, rapid diagnostic tests, or molecular tests. Treatment consists of supportive care and intravenous antimalarial drugs like artesunate or quinine. Complications are treated based on affected organ systems and may involve oxygen supplementation, anticonvulsants, or blood transfusions.
This document provides information on severe and complicated malaria. It begins by defining malaria and describing the different species of Plasmodium that cause it. It then distinguishes between uncomplicated and severe malaria. Severe malaria is defined as malaria illness that threatens a patient's life, with features like cerebral malaria, severe anemia, respiratory distress, hypoglycemia, or circulatory collapse. The document outlines groups at high risk of severe malaria and describes diagnosing and managing severe malaria cases, including giving parenteral antimalarial treatment like artesunate immediately, managing complications, and providing supportive care.
This document discusses the pharmacotherapy of malaria. It begins by describing the life cycle and species of the Plasmodium parasite that causes malaria. It then outlines who is most at risk of malaria and the clinical classification of uncomplicated and severe malaria. The major sections cover antimalarial drug classes, treatment guidelines for uncomplicated and severe malaria caused by different parasite species, and prevention through insecticide-treated bed nets, repellents and chemoprophylaxis in travelers.
The document provides an overview of antiphospholipid antibody syndrome (APS). It defines APS as a systemic autoimmune disease characterized by vascular thrombosis or adverse obstetric outcomes in patients with persistent antiphospholipid antibodies. The classification criteria for APS requires at least one clinical criterion (vascular thrombosis or pregnancy morbidity) and one laboratory criterion (presence of lupus anticoagulant or antiphospholipid antibodies). Common clinical manifestations of APS include venous thromboses, arterial thromboses, obstetric complications, and valvular heart disease. Treatment involves anticoagulation to prevent future thrombotic events.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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2. CLINICAL FEATURES
🞭 Patients are asymptomatic during the initial
phase– the incubation period
P falciparum ---- 9-14 days
P vivax---- 12-17 days
P ovale---- 16-18 days
P malariae--- 18-40 days
Prolonged in p vivax, partial immunity and
incomplete chemoprophylaxis.
4. CLINICAL FEATURES (CONT…)
🞭 Fever is the cardinal symptom of malaria
🞭 Febrile paroxysms associated with rigors ,
headache, myalgia , back pain, abdominal
pain, nausea and vomiting.
🞭 Paroxysms coincide with rupture of schizonts
🞭 P vivax: every 48 hours( benign tertian
malaria)
🞭 P falciparum and mixed infections: no
periodicity or less appparent.
6. On the basis of severity malaria can be
classified as
uncomplicated complicated
7. UNCOMPLICATED MALARIA
🞭 Uncomplicated malaria is defined as
symptomatic malaria without signs of severity or
evidence (clinical or laboratory) of vital organ
dysfunction.
🞭 The signs and symptoms of uncomplicated
malaria are nonspecific.
🞭 Malaria is usually suspected clinically on the
basis of fever or a history of fever.
Guidelines for the treatment of malaria – 2nd edition World Health
Organization, 2010
8. COMPLICATED OR SEVERE MALARIA
In a patient with P. falciparum parasitaemia
presence of certain clinical features or
laboratory parameters classify the patient as
severe or complicated malaria
9. COMPLICATED MALARIA (CONT..)
Clinical features
🞭 Impaired consciousness or unrousable coma
🞭 prostration
🞭
🞭 Multiple convulsions (more than 2 episodes in 24 h)
🞭 Deep breathing, respiratory distress
10. COMPLICATED MALARIA (CONT..)
Clinical features (cont..)
🞭 Circulatory collapse or shock, systolic blood
pressure < 70 mm Hg in adults and < 50 mm Hg
in children
🞭 Clinical jaundice ( serum bil > 3 mg/dl) plus
evidence of other vital organ dysfunction
🞭 Haemoglobinuria
🞭 Abnormal spontaneous bleeding
🞭 Pulmonary oedema (radiological)
11. COMPLICATED MALARIA (CONT…)
Laboratory parameters
🞭 Hypoglycemia (blood glucose < 2.2 mmol/l or < 40 mg/dl)
🞭 Metabolic acidosis (plasma bicarbonate < 15 mmol/l)
🞭 Severe normocytic anaemia (Hb < 5 g/dl)
🞭 Haemoglobinuria
🞭 Hyperparasitaemia (> 2%in low intensity transmission areas or > 5%
in ar eas of high stable malaria transmission intensity)
🞭 Hyperlactataemia (lactate > 5 mmol/l)
🞭 Renal impairment (serum creatinine 3 mg/dl)
13. CEREBRAL MALARIA
• 🞭 Cerebral malaria is the most severe
neurological complication of Plasmodium
falciparum
• 🞭 It is a major cause of acute non-traumatic
encephalopathy in tropical countries
14. CEREBRAL MALARIA (CONT..)
Clinical syndrome characterised by
🞭 Coma (inability to localise a painful stimulus)
at least 1 h after termination of a seizure or
correction of hypoglycaemia
🞭 Detection of asexual forms of P falciparum
malaria parasites on peripheral blood
smears, and exclusion of other causes
15. CEREBRAL MALARIA (CONT...)
🞭 Seizures
Seizures are commonly reported and occur in
over 60% of children
causes of seizures
In children not associated with fever at the time
of the seizure or electrolyte disturbances.
Sequestration of infected erythrocytes
Parasite-derived toxins
Immune mechanisms
16. CEREBRAL MALARIA (CONT..)
🞭 Coma
Cerebral malaria is a diffuse encephalopathy characterised
by coma and bilateral slowing on Electroencephalography
coma is potentially reversible.
🞭 Brainstem signs
Changes in pupillary size and reaction
Disorders of conjugate gaze and eye movements.
Abnormal respiratory patterns (such as
hyperventilatory, ataxic, and periodic breathing)
posture (decerebrate, decorticate, or opisthotonic
posturing), and motor abnormalities of tone and reflexes
17. CEREBRAL MALARIA (CONT..)
• 🞭 Cerebral malaria should be considered in the
differential diagnosis of any patient who has
a febrile illness with impaired consciousness
who lives in or has recently travelled to
malaria endemic areas
• 🞭 The mortality rate in children is about
20%, and most deaths happen within 24 h
of admission.
20. MALARIAL RETINOPATHY
🞭 Common in children with
cerebral malaria(60%)
and may be related to
pathological changes
🞭 Malarial retinopathy
consists of four main
components: retinal
whitening, vessel
changes(whitening of
retinal vessels), retinal
hemorrhages, and
papilledema
🞭 Bad prognostic indicator
Lancet Neurol 2005; 4: 827–40
21. ANEMIA OFMALARIA
• Hemoglobin less than 8 g/dl, which is equivalent
to a hematocrit of less than 24% in a
parasitemic individuals.
• World Health Organization has defined severe
malarial anemia (SMA) as a hemoglobin less
than 5 g/dL or a hematocrit less than 15% seen
in the context of malaria but without specifying
parasitemia .
WHO (2000). Severe falciparum malaria. Trans. R. Soc. Trop. Med. Hyg. 94: Suppl.
1.
22. PANCYTOPENIA
• 🞭 Pancytopenia can occur in both falciparum
and vivax infections.
• 🞭 Can be due to microangiopathic
hemolytic anemia, hypersplenism
• 🞭 Few cases due to bone marrow suppression
have and hemophagocytosis have been
reported
J Fam Community Med. 2009;16:71-73
23. HEPATIC DYSFUNCTION
🞭 In patients with severe malarial infestation,
the incidence of jaundice is reported to be
around 2.5%
🞭 Transient abnormalities of liver enzymes are
most commonly seen
🞭 If serum bil > 3 mg/dl---- severe malaria
🞭 Hepatic encephalopathy is almost never
seen.
Bhalla A J Postgrad Med 2006 Oct-
Dec;52(4):315-20.
24. RENAL FAILURE
• In P. falciparum malaria, acute renal failure may
develop in 0.1-0.6% of the patients
🞭 Defined as Urine output <400 ml/24 hours in
adults (<12 ml/kg/24 hours in children) and a
serum creatinine >265 µmol/l (> 3.0 mg/dl)
despite adequate volume repletion
🞭 Renal failure is rare in children
• High mortality (upto 45%)
Indian Academy of Clinical Medicine Vol. 3, No. 2 April-June
2002
25. RENAL FAILURE CONTD..
The vulnerable group of patients are:
🞭 with high parasitaemia
🞭 with deep jaundice
🞭 with prolonged dehydration
🞭 patients receiving NSAIDs
🞭 Manifests as ATN ,renal cortical necrosis
never develops
26. MET
ABOLICACIDOSIS
Venous lactate concentration at 4 hours after
admission to hospital is the BEST PROGNOSTIC
INDICATOR in severe malaria. (>5mmol/l has
bad prognosis)
This may result form renal failure, but more
commonly there is a primary lactic acidosis
29. COMPLICATIONS OF P VIVAX CONTD..
🞭 Severe anemia
🞭 Acute respiratory distress syndrome (ARDS)
Incidence is less in children compared adults
🞭 Coma
🞭 Malnutrition
🞭 Splenic rupture
🞭 Thrombocytopenia
🞭 Acute renal failure and shock
🞭 mortality rate - 1.6% among hospitalized patients
Trends in Parasitology Vol.25 No.5
31. DIAGNOSIS
🞭 Symptom-based (clinical) diagnosis
Not possible to accurately diagnose malaria using any one
set of clinical criteria
🞭 Microscopy
Microscopy of stained thick and thin blood smears remains
the gold standard for confirmation of diagnosis of malaria.
32. DIAGNOSIS(CONT..)
🞭 In profound anemia ---parasite --often absent
🞭 malaria pigment in polymorphonuclear
leukocytes and monocytes-- malaria
🞭 If more than 5% of PNM contains visible
pigment it denotes poor prognosis.
Recommendations and IAP plan of action indian pediatrics volume 42
november 2005
33. EXAMINATION OF BLOOD FILM
🞭 A minimum of 100 fields should be examined
before concluding the slide to be negative.
🞭 Samples may be examined for at least three
consecutive days where clinical suspicion of
malaria persists.
34. ADVANTAGE OF MICROSCOPY
🞭 Advantages of microscopy are:
🞭 The sensitivity is high. It is possible to detect
malaria parasites at low densities.
🞭 It also helps to quantify the parasite load.
🞭 It is possible to distinguish the various
species of malaria parasite and their different
stages
WHO Expert Committee on Malaria. Twentieth report. Geneva, World Health
Organization, 2000
35. DIAGNOSIS (CONT..)
🞭 Rapid diagnostic tests are
immunochromatographic tests that detect
parasite-specific antigens in a finger-prick
blood sample
🞭 WHO recommends that such tests should
have a sensitivity of > 95% in detecting
plasmodia at densities of more than 100
parasites per μl of blood
36. DIAGNOSIS RDT..
🞭 Current tests are based on the detection of
histidine-rich protein 2 (HRP2), (specific for
P
. Falciparum)
🞭 pan-specific or species-specific Plasmodium
lactate dehydrogenase (pLDH)
🞭 pan-specific aldolase
🞭 Commercially available kit can detect
falciparum, vivax and other malaria but
cannot differentiate ovale and malarie
malaria.
37. DIAGNOSIS RDT..
🞭 HRP-II tests can remain positive for 7-14
days following malaria treatment even when
blood doesn't show parasitemia by
microscopy
🞭 p LDH is produced by only viable parasite
so the tests detecting this antigen becomes
negative within 3-5 days of treatment
38. ADVANTAGES OF RDTS IN COMPARISON TO
MICROSCOPY
🞭 simple, straight forward ,less time
consuming, requiring no special equipment
or skill/training
🞭 They can detect P.falciparum infection even
when the parasite is sequestered
🞭 This test can exclude mixed falciparum and
vivax malaria where the former may not be
evident microscopically
39. DISADVANTAGE OF RDTS IN COMPARISON
TO MICROSCOPY
🞭 RDTs that target HRP-II of P.Falciparum is
unsuitable for assessment of treatment
failure and monitoring of drug resistance.
🞭 They do not quantify the parasite load so
they do not have prognostic value
40. DISADVANTAGES RDT CONT...
🞭 Under optimal conditions an expert
microscopist can detect even 5-10 parasite
per μl of blood, detection threshold of RDTs
are 40- 60 parasite per μl of blood
Currently, available RDT kits are required to be
stored up to or under 30ºC
41. Microscopy :
• Peripheral blood smears – Gold standard
• Thick and thin smears
Advantages
• Sensitivity is high
• Detects parasites even at low densities
• Quantify the load
• Distinguish between various species and different stages
• Requires skills to identify.
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1
42. 22-12-2014 4
2
Other tests
• QBC
• Serological test
• Parasight F,Optimal assay
• PCR
• Sternal or liver puncture
• Radioimmuno assays, Immuno fluorescence
43. TREATMENT OF UNCOMPLICATED
MALARIA
General recommendations
• Avoid starting treatment on an empty stomach. The first dose - under observation.
• Dose repeated if vomiting < 30 minutes.
• Report back, if there is no improvement after 48 hours or if the situation deteriorates.
Treatment of P. vivax malaria
• Confirmed Cases - Chloroquine in full therapeutic dose of 25 mg/kg divided over
three days.
• To prevent relapse (Hypnozoites )-Primaquine 0.25 mg/kg bw daily for 14 days
under supervision
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44.
45. 22-12-2014 45
Treatment of P. falciparum malaria
• Artemisinin Combination Therapy (ACT) should be given to all
confirmed P. falciparum cases found positive by microscopy or RDT.
• ACT --an artemisinin derivative + with a long acting antimalarial
(amodiaquine, lumefantrine, mefloquine or sulfadoxine-pyrimethamine).
• On day 2 ,single dose primaquine (0.75 mg/kg body weight).
• TheACT recommended in the National Programme of India is artesunate (4
mg/kg body weight) daily for 3days and sulfadoxine (25 mg/kg body
weight) -pyrimethamine (1.25mg/kg body weight) on Day 0.
46. 22-12-2014 46
• Presently, fixed dose combinations of artemether + lumefantrine, artesunate +
amodiaquine and blisterpack of artesunate + mefloquine are registered for
marketing in India and are available for use.
These rapidly acting drugs, if used alone, can lead to development of drug resistance.
Treatment of Malaria in pregnancy
• ACT : second and third trimesters
• Quinine : in the first trimester
• P. vivax malaria can be treated with chloroquine
Oral artemisinin monotherapy is banned
in India
47. 22-12-2014 47
Treatment of mixed infections
• Mixed infections should be treated as falciparum malaria.
• However, antirelapse treatment with primaquine can be given for 14
days, if indicated.
• Clinical malaria (clinical criteria without laboratory confirmation) is
treated with chloroquine in full therapeutic dose of 25 mg/kg body
weight over three days.
If a slide result is obtained later, the treatment should be completed according
to species.
•Suspected cases of malaria ,negative on diagnostic tests should be treated with
full therapeutic dose of choloroquine
48. 22-12-2014 52
Drug Resistance: Malaria
Major public health problem ,hinders the control of malaria
• In India resistance of falciparum to chloroquine, the first reported in the year 1973
(Diphu of Karbi-Anglong district inAssam state. )
• NVDCP monitors the response of antimalarial drug in Pf malaria parasite in the
through 13 monitoring teams located in 11 Regional Office for Health & Family
Welfares
Objectives:
• To assess the therapeutic response of P.falciparum to currently used anti-malarials
• To establish and generate information on sensitivity of local strains for formulation
of National Drug Policy and recommend needful changes in the control
49. 22-12-2014 53
Tools for monitoring
• From 2002-03 onward, new WHO protocol on "Therapeutic efficacy of anti-malarial
drugs in uncomplicated P.falciparum malaria" is being followed to assess the
efficacy of antimalarial drugs.
• The classification of response according to new protocol is interpreted into three
categories as per the WHO criteria i.e Adequate Clinical and Parasitological
Response (ACPR), Early and Late Treatment Failure (LTF).
• Adequate response : if no fever or parasitaemia till Day 28.
50. Early treatment failure (ETF):
Development of danger signs or
22-12-2014 54
• severe malaria on Day 1, 2 or 3, in the presence of parasitaemia;
• PARASETIMIAon
•
•
Day 2 > on Day 0, irrespective of axillary temperature;
Day 3 with axillary temperature>37.5°C;
Day 3, >25% of count on Day 0.
Late clinical failure (LCF):
Development of danger signs or
•Severe malaria in the presence of parasitaemia on any day between Day 4 and
Day 28 (Day 42)
•Presence of parasitaemia on any day between Day 4 and Day 28 (Day 42) with
axillary temperature >37.5°C
51. Late parasitological failure (LPF):
• Presence of parasitaemia on any day between Day 7 and Day 28 with axillary
temperature <37.5°C in patients who did not previously meet any of the criteria of
early treatment failure or late clinical failure.
Alternative treatment -Alternative ACT or quinine with Doxycycline.
• To combat the drug resistant in malaria, the National Drug Policy on Malaria
recommends the use of combination therapy in chloroquine resistant areas,
surrounding cluster of Blocks and 117 high endemic districts
• Criteria for change of drug policy
Drug policy is changed for the area/Block PHC reporting 10% or more total
treatment failure (ETF+LTF) to the currently used antimalarials in a sample of
minimum 30 P.falciparum test cases.
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53. Management of Complicated malaria
Requirements for management of complications
Health facilities should be equipped :
•Parenteral antimalarials, antipyretics,
antibiotics,anticonvulsants
• Intravenous infusion facilities
• Special nursing for patients in coma
• Blood transfusion
• Well-equipped laboratory
• Oxygen
22-12-2014
24
54. Management of other signs and complications
Hyper pyrexia (rectal temp >39 c) •Tepid sponging
•Cool environment
•Para 5mg/kg/bw
•IV fluids
•Monitor I/O
Dehydration
Acute renal failure(with
anuria/oliguria/blackwaterfever)
Hyperkalemia
•IV fluids
•Furosemide IV or IM
•Dialysis
•Watch on urea/creatinine/k levels
•Alkanize the urine
•>7mmol
•Ca charged resins 15-30gms TDS
•If >60mol NaHco3 infusion with insulin
•10 cc KCl in 24 hrs
Hypo2
k2
-
a1
l2
e-
2
m0
1
i4
a 25
55. Pulmonary edema •Prop up 45 ,oxygen
•Fluid balance and diuretics
GIT symptoms •IV fluids, chlorpromazine IV or IM
Shock
•IV plasma expanders
•Corticosteriods
•Dopamine
Anemia(PCV <20, HB <7), bleeding •Whole blood /Packed cell transfusion
•Vit K (bleeding)
Convulsions •Diazepam (0.2 mg/kg/Bw)IM or IV 8hrly
•Phenytoin sodium 5 mg/kg/bw
•Phenobarbitone 5-10 mg/kg/Bw
Hypoglycemia •IV glucose 50% followed by 5-10% glucose
•Monitor blood sugar levels
•Exchange transfusion
Hype2r2p-1a2-r2a01s4aitemia 26
56. Specific antimalarial treatment of severe malaria
• Parenteral artemisinin derivatives or quinine should be used irrespective of
chloroquine sensitivity.
DRUG DOSE
• Artesunate: 2.4 mg/kg body weight i.v. or i.m. given on admission (time=0),
then at 12 hours and 24 hours, then once a day (Care should be
taken to dilute artesunate powder in 5% Sodium bi-carbonate
provided in the pack).
Artemether: 3.2 mg/kg body weight i.m. given on admission then 1.6 mg/kg
body weight per day
• Arteether:
22-12-2014
150 mg daily i.m. for 3 days in adults only(not recommended
for children)
28
57. 22-12-2014 62
Quinine:
20 mg quinine salt/kg body weight on admission
• (i.v. infusion in 5% dextrose/dextrose saline over a period of 4 hrs)
followed by maintenance dose of 10 mg/kg bodyweight 8 hrly;
• infusion rate should not exceed 5mg/kg body weight per hr
• Loading dose of 20 mg/kg body weight should not be given, if the
patient has already received quinine.
• NEVER GIVE BOLUS INJECTION OF QUININE.
• If parenteral quinine therapy needs to be continued beyond 48 hours,
dose should be reduced to 7 mg/kg body weight 8 hourly
58. 22-12-2014 63
Once the patient can take oral therapy, further follow-up treatment should be as
below:
• Patients on parenteral quinine should be treated
• oral quinine 10 mg/kg body weight TDS to complete a course of 7 days,
• Along with doxycycline 3 mg/ kg body weight per day for 7 days. (If
contraindicated, Clindamycin 12 hourly for 7 days should be used).
• Patients receiving artemisinin derivatives should get full course of oral
ACT. However, ACT containing mefloquine should be avoided in cerebral
malaria due to neuropsychiatric complications.
59. 22-12-2014 64
• IV prefered over IM , should be given for min of 24 hours once
started.
•
Severe malaria due to P. Vivax
• Rare in India
• Treated like severe P. falciparum malaria
First trimester Parenteral quinine (DOC)
Artemisinin derivatives
In Second and Third trimester Parenteral Artemisinin