This document provides an overview of acute bacterial meningitis in children. It begins with an introduction discussing central nervous system infections in children in the tropics. It then covers the epidemiology, classification, pathogenesis, clinical presentation, diagnosis, treatment, complications and prevention of acute bacterial meningitis. The main causative bacteria are Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis. Clinical features include fever, headache, vomiting, seizures and altered mental status. Diagnosis involves lumbar puncture and analysis of cerebrospinal fluid. Treatment requires prompt administration of antibiotics along with management of increased intracranial pressure and other complications. Prevention strategies include vaccination programs.
This document discusses meningitis, encephalitis, and Japanese encephalitis. It defines meningitis as an inflammatory process of the leptomeninges and CSF. It distinguishes between acute bacterial and tuberculous meningitis. It discusses the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment and complications of these conditions. It also defines encephalitis as an inflammatory process of the brain parenchyma. It specifically discusses Japanese encephalitis, describing its transmission, epidemiology, clinical features, diagnosis, prognosis and management.
Now a days TBM is super most disease in Indian children.
Tuberculous meningitis (TBM) is difficult to diagnose, and a high index of suspicion is needed to make an early diagnosis.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
Extra pulmonary tuberculosis in PediatricsGiri Nagaruru
Dr. Gireesh presented on TB lymphadenitis and CNS tuberculosis. TB lymphadenitis is the most common form of extra-pulmonary TB in children from endemic areas, usually developing within the first year of primary infection. It presents as enlarged, non-tender lymph nodes. Diagnosis is made through fine needle aspiration or biopsy. Treatment involves antitubercular medications for 6-9 months. CNS tuberculosis can manifest as tuberculous meningitis, tuberculomas, or Pott's disease of the spine. Tuberculous meningitis commonly presents with fever, vomiting, and altered sensorium. Diagnosis is challenging and treatment involves prolonged antitubercular therapy along with cort
MENINGITIS IN CHILDREN-1.pptx by John wambugu clinical officer paediatricsJohnMainaWambugu
This document provides an overview of meningitis, including its definition, causes, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Key points include:
- Meningitis is an inflammation of the meninges that surround the brain and spinal cord. It can be caused by bacterial, viral, or fungal infections.
- Bacterial meningitis requires urgent treatment with antibiotics as it can be fatal if untreated. Common bacterial causes include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b.
- Symptoms may include fever, headache, stiff neck, nausea, confusion, and seizures. Diagnosis involves examination of cerebrospinal fluid
This document provides an overview of meningitis including:
- It is an inflammation of the meninges that can be caused by bacteria, viruses, fungi or tuberculosis. Common bacterial causes are Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b.
- An outbreak in Nigeria from 2016-2017 saw over 1,400 suspected cases mostly in children ages 5-14 in certain states. Risk factors include young age, close contacts, crowding and poverty.
- Symptoms can include fever, headache, nausea, and signs of meningeal irritation like neck stiffness. Diagnosis involves CSF and blood tests. Treatment depends on the suspected cause but may include
This document discusses meningitis, encephalitis, and Japanese encephalitis. It defines meningitis as an inflammatory process of the leptomeninges and CSF. It distinguishes between acute bacterial and tuberculous meningitis. It discusses the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment and complications of these conditions. It also defines encephalitis as an inflammatory process of the brain parenchyma. It specifically discusses Japanese encephalitis, describing its transmission, epidemiology, clinical features, diagnosis, prognosis and management.
Now a days TBM is super most disease in Indian children.
Tuberculous meningitis (TBM) is difficult to diagnose, and a high index of suspicion is needed to make an early diagnosis.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
Extra pulmonary tuberculosis in PediatricsGiri Nagaruru
Dr. Gireesh presented on TB lymphadenitis and CNS tuberculosis. TB lymphadenitis is the most common form of extra-pulmonary TB in children from endemic areas, usually developing within the first year of primary infection. It presents as enlarged, non-tender lymph nodes. Diagnosis is made through fine needle aspiration or biopsy. Treatment involves antitubercular medications for 6-9 months. CNS tuberculosis can manifest as tuberculous meningitis, tuberculomas, or Pott's disease of the spine. Tuberculous meningitis commonly presents with fever, vomiting, and altered sensorium. Diagnosis is challenging and treatment involves prolonged antitubercular therapy along with cort
MENINGITIS IN CHILDREN-1.pptx by John wambugu clinical officer paediatricsJohnMainaWambugu
This document provides an overview of meningitis, including its definition, causes, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Key points include:
- Meningitis is an inflammation of the meninges that surround the brain and spinal cord. It can be caused by bacterial, viral, or fungal infections.
- Bacterial meningitis requires urgent treatment with antibiotics as it can be fatal if untreated. Common bacterial causes include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b.
- Symptoms may include fever, headache, stiff neck, nausea, confusion, and seizures. Diagnosis involves examination of cerebrospinal fluid
This document provides an overview of meningitis including:
- It is an inflammation of the meninges that can be caused by bacteria, viruses, fungi or tuberculosis. Common bacterial causes are Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b.
- An outbreak in Nigeria from 2016-2017 saw over 1,400 suspected cases mostly in children ages 5-14 in certain states. Risk factors include young age, close contacts, crowding and poverty.
- Symptoms can include fever, headache, nausea, and signs of meningeal irritation like neck stiffness. Diagnosis involves CSF and blood tests. Treatment depends on the suspected cause but may include
Meningitis is an infection of the meninges that presents with fever, headache, and neck stiffness (meningism). Viral meningitis is the most common cause and usually resolves on its own, while bacterial meningitis requires prompt treatment with antibiotics to prevent high mortality. Common bacterial causes include Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. A lumbar puncture is needed to diagnose meningitis and identify the causative organism by examining cerebrospinal fluid characteristics and microbiological testing.
This document provides information about acute disseminated encephalomyelitis (ADEM). It defines ADEM as a demyelinating disease of the central nervous system that typically presents as a monophasic disorder with encephalopathy and multifocal neurological symptoms. The document discusses the pathogenesis, clinical features, diagnosis, differential diagnosis and treatment of ADEM. It states that ADEM is usually treated initially with high-dose intravenous corticosteroids over 3-5 days.
Acute disseminated encephalomyelitis (ADEM) is a monophasic, autoimmune, demyelinating disease of the central nervous system that typically presents after a viral infection or vaccination. It is characterized by encephalopathy and multifocal neurologic deficits. MRI often shows multifocal, poorly-defined lesions in the white matter and deep gray matter that enhance with contrast. While symptoms can be severe initially, most patients recover fully from ADEM.
Meningitis is a severe CNS pathology and early and appropriate intervention is needed to prevent adverse outcome including mortality and long term complications. This presentation focuses on the different types of meningitis and the appropriate management options
This document summarizes central nervous system tuberculosis (CNS TB). Key points:
- CNS TB includes meningitis, tuberculomas, and spinal arachnoiditis. It is associated with high mortality and disability.
- Risk factors include HIV infection and low CD4 count. Bacilli spread from primary sites to the brain/meninges can cause tubercles and meningitis.
- Clinical features depend on location and include headache, fever, vomiting, altered sensorium, cranial nerve palsies. Imaging shows hydrocephalus, basilar enhancement, infarcts.
- Diagnosis involves CSF analysis showing lymphocytic pleocytosis, low glucose, high protein.
Infections and salivary gland disease in pediatric age: how to manage - Slide...WAidid
The slideset by Professor Susanna Esposito aims at explaining how to manage the salivary gland infections in pediatric age, from pathogenesis, to transmission, treatments and vaccination coverage, that should be urgently increased in Italy as well as in EU Countries.
Diseases of the central nervous system.pptxEndex Tam
This document provides information on meningitis and epilepsy in children. It discusses:
1. Meningitis is an inflammation of the meninges that can be caused by bacteria or viruses. Bacterial meningitis is more serious, especially in infants and young children. Symptoms include fever, headache, and neck stiffness. Diagnosis involves lumbar puncture and CSF analysis. Treatment involves antibiotics and supportive care.
2. Epilepsy is a neurological condition characterized by recurrent seizures. It affects around 1% of children. Seizures have various causes like infections, brain injuries, or genetic factors. Generalized tonic-clonic seizures involve loss of consciousness and muscle contractions. Diagnosis is based on clinical history
1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and a bulging fontanelle in infants, while older children may present with headache, neck stiffness, and altered mental status. Lumbar punct
1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and bulging fontanelle. Diagnosis involves lumbar puncture to examine cerebrospinal fluid for presence of bacteria, white blood cells and
Central nervous system infections can cause meningitis or encephalitis. Bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type b. It presents with fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture showing pleocytosis and low glucose in CSF. Treatment involves antibiotics, corticosteroids, and supportive care to prevent increased intracranial pressure complications.
A 7-year-old boy presented with facial puffiness, decreased urinary output, and fever for one week. Examination found pallor, elevated blood pressure, and a skin lesion on his elbow. Urine tests found protein and red blood cells. Blood tests showed elevated urea and low C3 levels. Ultrasound showed enlarged pale kidneys. He was diagnosed with acute nephritis likely due to a preceding streptococcal infection based on the clinical presentation and serological tests. Treatment focused on controlling blood pressure and supporting kidney function until recovery, which generally occurs within 6-8 weeks.
Central nervous system infections can cause fever and signs of neurological dysfunction. The most common types are meningitis (inflammation of the meninges) and encephalitis (inflammation of the brain). Acute bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b. Clinical manifestations include fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture and CSF analysis. Treatment involves supportive care, antibiotics, and management of increased intracranial pressure. Complications can include hearing loss, seizures, and intellectual disability. Prevention is through vaccination and chemoprophylaxis of close contacts for certain bacteria.
This document provides information on acute encephalitis syndrome, including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, laboratory diagnosis, differential diagnosis, and management. Acute encephalitis syndrome is defined as an acute onset fever with changes in mental status or seizures. It is commonly caused by viruses and can involve inflammation of the brain tissue. Diagnosis involves examination of CSF and imaging studies. Treatment focuses on supportive care and antiviral medications like acyclovir.
This document provides information on neonatal sepsis, including:
- Sepsis is a leading cause of neonatal mortality, responsible for 30-50% of deaths in developing countries. It can be classified as early onset (within 72 hours of life) or late onset.
- Common causative organisms include group B streptococcus, E. coli, and Klebsiella pneumoniae. Late onset sepsis is often hospital-acquired.
- Risk factors, clinical features, investigations, management, and prevention of neonatal sepsis are discussed in detail. Empiric antibiotic therapy is recommended until cultures identify the specific organism. Supportive care including ventilation and IV fluids is also important.
This document provides information on acute bacterial meningitis in pediatrics, including epidemiology, clinical features, diagnosis, treatment and other types of meningitis such as tuberculous, cryptococcal and pneumococcal meningitis. It describes the typical presentation of acute bacterial meningitis in children including fever, irritability, headache and altered mental status. Diagnosis is made through lumbar puncture and examination of cerebrospinal fluid. Treatment involves administration of antibiotics such as ceftriaxone intravenously for 10-14 days. Complications, steroid use, and other types of meningitis are also summarized.
The document discusses central nervous system (CNS) diseases and disorders. It provides information on meningitis and encephalitis, including causes, symptoms, diagnosis, and treatment. For bacterial meningitis, common causes vary by age group. Symptoms of viral meningitis are also described. Diagnosis of meningitis involves lumbar puncture and cerebrospinal fluid analysis. Treatment of bacterial meningitis involves antibiotics while viral meningitis is usually treated symptomatically. Herpes simplex encephalitis commonly affects the temporal lobe and is diagnosed through cerebral spinal fluid analysis and confirmed via PCR or brain biopsy. It is treated with acyclovir administered intravenously. Brain abscesses are also discussed including their
Scrub typhus is caused by the bacteria Orientia tsutsugamushi, which is transmitted through the bites of infected chiggers (larval trombiculid mites). It causes non-specific symptoms like fever, headache, and rash. Diagnosis is made through serologic testing, PCR, or biopsy showing lymphohistiocytic vasculitis. Treatment involves doxycycline or azithromycin for mild-moderate cases. Severe cases are treated with doxycycline. Prevention focuses on avoiding chigger bites in endemic rural areas in parts of Asia and the Pacific.
This document provides an outline and overview of ischemic heart disease and acute myocardial infarction (AMI). It discusses the epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, and treatment of AMI. The key points are: AMI occurs when cardiac myocytes die due to myocardial ischemia and can be diagnosed based on clinical history, ECG changes, and elevated biomarkers. Treatment involves initial pain relief, reperfusion via PCI or thrombolysis within 12 hours, anticoagulation, and long-term therapies like antiplatelet drugs, ACE inhibitors, beta blockers, and statins to prevent future events. Complications can include arrhythmias, heart failure, or cardiac rupture. Prognosis depends on the extent
This document provides an overview of the management of acute stroke. It defines stroke and transient ischemic attack, and discusses the epidemiology, classification, risk factors, pathophysiology, clinical presentation, diagnosis, management, complications and prognosis of stroke. The management involves resuscitation, reperfusion therapies like thrombolysis and thrombectomy, treating complications, secondary prevention including blood pressure and diabetes control, and rehabilitation. The document emphasizes the importance of specialized stroke units and timely management to improve outcomes for patients with acute stroke.
Meningitis is an infection of the meninges that presents with fever, headache, and neck stiffness (meningism). Viral meningitis is the most common cause and usually resolves on its own, while bacterial meningitis requires prompt treatment with antibiotics to prevent high mortality. Common bacterial causes include Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. A lumbar puncture is needed to diagnose meningitis and identify the causative organism by examining cerebrospinal fluid characteristics and microbiological testing.
This document provides information about acute disseminated encephalomyelitis (ADEM). It defines ADEM as a demyelinating disease of the central nervous system that typically presents as a monophasic disorder with encephalopathy and multifocal neurological symptoms. The document discusses the pathogenesis, clinical features, diagnosis, differential diagnosis and treatment of ADEM. It states that ADEM is usually treated initially with high-dose intravenous corticosteroids over 3-5 days.
Acute disseminated encephalomyelitis (ADEM) is a monophasic, autoimmune, demyelinating disease of the central nervous system that typically presents after a viral infection or vaccination. It is characterized by encephalopathy and multifocal neurologic deficits. MRI often shows multifocal, poorly-defined lesions in the white matter and deep gray matter that enhance with contrast. While symptoms can be severe initially, most patients recover fully from ADEM.
Meningitis is a severe CNS pathology and early and appropriate intervention is needed to prevent adverse outcome including mortality and long term complications. This presentation focuses on the different types of meningitis and the appropriate management options
This document summarizes central nervous system tuberculosis (CNS TB). Key points:
- CNS TB includes meningitis, tuberculomas, and spinal arachnoiditis. It is associated with high mortality and disability.
- Risk factors include HIV infection and low CD4 count. Bacilli spread from primary sites to the brain/meninges can cause tubercles and meningitis.
- Clinical features depend on location and include headache, fever, vomiting, altered sensorium, cranial nerve palsies. Imaging shows hydrocephalus, basilar enhancement, infarcts.
- Diagnosis involves CSF analysis showing lymphocytic pleocytosis, low glucose, high protein.
Infections and salivary gland disease in pediatric age: how to manage - Slide...WAidid
The slideset by Professor Susanna Esposito aims at explaining how to manage the salivary gland infections in pediatric age, from pathogenesis, to transmission, treatments and vaccination coverage, that should be urgently increased in Italy as well as in EU Countries.
Diseases of the central nervous system.pptxEndex Tam
This document provides information on meningitis and epilepsy in children. It discusses:
1. Meningitis is an inflammation of the meninges that can be caused by bacteria or viruses. Bacterial meningitis is more serious, especially in infants and young children. Symptoms include fever, headache, and neck stiffness. Diagnosis involves lumbar puncture and CSF analysis. Treatment involves antibiotics and supportive care.
2. Epilepsy is a neurological condition characterized by recurrent seizures. It affects around 1% of children. Seizures have various causes like infections, brain injuries, or genetic factors. Generalized tonic-clonic seizures involve loss of consciousness and muscle contractions. Diagnosis is based on clinical history
1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and a bulging fontanelle in infants, while older children may present with headache, neck stiffness, and altered mental status. Lumbar punct
1) Pyogenic meningitis is an inflammation of the membranes surrounding the brain and spinal cord caused most commonly by bacterial infection in infants and young children.
2) The causative agents vary by age but include Escherichia coli, Group B Streptococci, Staphylococcus aureus, and Listeria monocytogenes in infants under 2 months. Haemophilus influenzae type b and Streptococcus pneumoniae are common causes in children from 2 months to 2 years.
3) Clinical features include fever, irritability, vomiting, seizures, and bulging fontanelle. Diagnosis involves lumbar puncture to examine cerebrospinal fluid for presence of bacteria, white blood cells and
Central nervous system infections can cause meningitis or encephalitis. Bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae type b. It presents with fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture showing pleocytosis and low glucose in CSF. Treatment involves antibiotics, corticosteroids, and supportive care to prevent increased intracranial pressure complications.
A 7-year-old boy presented with facial puffiness, decreased urinary output, and fever for one week. Examination found pallor, elevated blood pressure, and a skin lesion on his elbow. Urine tests found protein and red blood cells. Blood tests showed elevated urea and low C3 levels. Ultrasound showed enlarged pale kidneys. He was diagnosed with acute nephritis likely due to a preceding streptococcal infection based on the clinical presentation and serological tests. Treatment focused on controlling blood pressure and supporting kidney function until recovery, which generally occurs within 6-8 weeks.
Central nervous system infections can cause fever and signs of neurological dysfunction. The most common types are meningitis (inflammation of the meninges) and encephalitis (inflammation of the brain). Acute bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b. Clinical manifestations include fever, headache, neck stiffness, and altered mental status. Diagnosis involves lumbar puncture and CSF analysis. Treatment involves supportive care, antibiotics, and management of increased intracranial pressure. Complications can include hearing loss, seizures, and intellectual disability. Prevention is through vaccination and chemoprophylaxis of close contacts for certain bacteria.
This document provides information on acute encephalitis syndrome, including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, laboratory diagnosis, differential diagnosis, and management. Acute encephalitis syndrome is defined as an acute onset fever with changes in mental status or seizures. It is commonly caused by viruses and can involve inflammation of the brain tissue. Diagnosis involves examination of CSF and imaging studies. Treatment focuses on supportive care and antiviral medications like acyclovir.
This document provides information on neonatal sepsis, including:
- Sepsis is a leading cause of neonatal mortality, responsible for 30-50% of deaths in developing countries. It can be classified as early onset (within 72 hours of life) or late onset.
- Common causative organisms include group B streptococcus, E. coli, and Klebsiella pneumoniae. Late onset sepsis is often hospital-acquired.
- Risk factors, clinical features, investigations, management, and prevention of neonatal sepsis are discussed in detail. Empiric antibiotic therapy is recommended until cultures identify the specific organism. Supportive care including ventilation and IV fluids is also important.
This document provides information on acute bacterial meningitis in pediatrics, including epidemiology, clinical features, diagnosis, treatment and other types of meningitis such as tuberculous, cryptococcal and pneumococcal meningitis. It describes the typical presentation of acute bacterial meningitis in children including fever, irritability, headache and altered mental status. Diagnosis is made through lumbar puncture and examination of cerebrospinal fluid. Treatment involves administration of antibiotics such as ceftriaxone intravenously for 10-14 days. Complications, steroid use, and other types of meningitis are also summarized.
The document discusses central nervous system (CNS) diseases and disorders. It provides information on meningitis and encephalitis, including causes, symptoms, diagnosis, and treatment. For bacterial meningitis, common causes vary by age group. Symptoms of viral meningitis are also described. Diagnosis of meningitis involves lumbar puncture and cerebrospinal fluid analysis. Treatment of bacterial meningitis involves antibiotics while viral meningitis is usually treated symptomatically. Herpes simplex encephalitis commonly affects the temporal lobe and is diagnosed through cerebral spinal fluid analysis and confirmed via PCR or brain biopsy. It is treated with acyclovir administered intravenously. Brain abscesses are also discussed including their
Scrub typhus is caused by the bacteria Orientia tsutsugamushi, which is transmitted through the bites of infected chiggers (larval trombiculid mites). It causes non-specific symptoms like fever, headache, and rash. Diagnosis is made through serologic testing, PCR, or biopsy showing lymphohistiocytic vasculitis. Treatment involves doxycycline or azithromycin for mild-moderate cases. Severe cases are treated with doxycycline. Prevention focuses on avoiding chigger bites in endemic rural areas in parts of Asia and the Pacific.
This document provides an outline and overview of ischemic heart disease and acute myocardial infarction (AMI). It discusses the epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, and treatment of AMI. The key points are: AMI occurs when cardiac myocytes die due to myocardial ischemia and can be diagnosed based on clinical history, ECG changes, and elevated biomarkers. Treatment involves initial pain relief, reperfusion via PCI or thrombolysis within 12 hours, anticoagulation, and long-term therapies like antiplatelet drugs, ACE inhibitors, beta blockers, and statins to prevent future events. Complications can include arrhythmias, heart failure, or cardiac rupture. Prognosis depends on the extent
This document provides an overview of the management of acute stroke. It defines stroke and transient ischemic attack, and discusses the epidemiology, classification, risk factors, pathophysiology, clinical presentation, diagnosis, management, complications and prognosis of stroke. The management involves resuscitation, reperfusion therapies like thrombolysis and thrombectomy, treating complications, secondary prevention including blood pressure and diabetes control, and rehabilitation. The document emphasizes the importance of specialized stroke units and timely management to improve outcomes for patients with acute stroke.
Management of common dyselectrolytaemias in obstetrics.pptxDr. Adamu Ibrahim
Electrolyte levels undergo changes during pregnancy to support fetal growth and development. Sodium levels decrease slightly due to increased fluid retention driven by hormones. Bicarbonate levels also decrease mildly due to respiratory alkalosis. Magnesium requirements increase and deficiencies can impact placental development and fetal growth. Calcium transfer to the fetus is actively mediated by placental hormones against a concentration gradient. Deviations from the normal electrolyte ranges can impact both mother and fetus, so identifying abnormal changes is important for prevention and treatment.
This document provides an overview of shock in pediatrics, including epidemiology, classification, pathogenesis, clinical manifestations, and principles of management. It begins with an introduction defining shock and its causes. It then discusses the main types of shock - hypovolemic, cardiogenic, distributive, and septic shock. The document reviews the epidemiology of shock in developing countries and the United States. It also provides details on the pathophysiology, clinical features, diagnosis, and management approaches for different shock types. The goals of treatment are outlined as restoring circulatory volume and blood flow while monitoring the patient.
Hydrocephalus is an excessive accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain that results in enlarged ventricles and increased intracranial pressure. It can be caused by obstruction of CSF flow, overproduction of CSF, or impaired absorption of CSF. Common symptoms include an enlarged head size, vomiting, and headaches. Treatment options include the use of shunts to divert CSF from the brain to the abdominal cavity or endoscopic procedures. Prognosis depends on severity but can include long-term neurological and developmental issues if not treated effectively.
Obstructed labour occurs when progress of labour stops due to mechanical factors despite adequate uterine contractions. It is a leading cause of maternal and fetal morbidity and mortality worldwide. Risk factors include cephalopelvic disproportion, malnutrition, osteomalacia, teenage pregnancy and macrosomia. Prolonged obstructed labour can result in uterine rupture, obstetric fistula, maternal death and stillbirth. Treatment involves relieving obstruction through caesarean section if fetus is alive or craniotomy/caesarean if not. Prevention strategies include good antenatal care, early referral and use of a partograph during labour.
This document discusses the management of unconscious patients. It begins with an introduction that defines consciousness and the causes of unconsciousness. It then describes the primary and secondary survey in managing unconscious patients, which involves assessing the airway, breathing, circulation, disability and exposing the patient. Specific treatments depend on the underlying cause, such as giving glucose for hypoglycemia or antibiotics for meningitis. Prognosis depends on factors like the cause, depth and duration of impaired consciousness. The document emphasizes that treatment should precede diagnosis in unconscious patients.
Mr. D.T., a 54-year-old hypertensive nurse, was admitted to the hospital with cough, fever, difficulty breathing, and diarrhea after returning from India. On examination, he had a fever, rapid breathing, fast heart rate, high blood pressure, and low oxygen levels. Tests showed positive for COVID-19 and images of his lungs showed signs of the infection. He was given treatments like oxygen, fluids, and medicines to fight the virus.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
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3. OVERVIEW
• Infections of the central nervous system (CNS) are among the most
common neurologic disorders in children in the tropics
• These infection are divided into 2: those affecting meninges primarily
and those confined to the parenchyma
is inflammation of the leptomeninges including
subarachnoid space leading to constellation of signs and symptoms
• It is a life-threatening medical emergency that requires prompt
recognition and treatment.
Superficial cortical structures and blood vessels are not spared
4. OVERVIEW
is a form of
purulent meningitis and one of the
most challenging of pediatric
emergencies anywhere in the
world
• Its importance world-wide derives
principally from its neurologic
sequelae
7. INTRODUCTION
• Bacterial meningitis is of the cranial and spinal
leptomeninges with evidence of a bacterial pathogen in the CSF
• There are basically 2 clinical entities of ABM
- Neonatal meningitis
- Meningitis in older children
• Effective immunization with H. influenza type b conjugated vaccine
has dramatically reduced the incidence of Hib meningitis in developing
countries.
8. EPIDEMIOLOGY
• Globally >1.2 million cases occur each year
• 80% to 95% of cases involve infants and children <5 yr old
with the greatest risk in 3-8 months olds
• About 135,000 treated cases die (11%)
• Case-fatality rate up to 70% (without treatment)
• One in five survivors may be left with permanent
sequelae
• In Africa, it constitutes 1-6% of paediatrics admission and
8-40% die from the disease
9. EPIDEMIOLOGY
- Infants
- Male sex
- Poor socioeconomic conditions and overcrowding
- Congenital and acquired deficiencies in host defense mechanisms
- Blacks race
- Lack of immunization
- Genetically susceptibility
- Household contacts and group day care centre contacts
- Contiguous infection e.g. Otitis media
10. EPIDEMICS
• Due to Neisseria meningitides
• Highest in “meningitis belt” in sub-Saharan Africa
• Extends from Senegal (west) to Ethiopia (east)
• Characterised by seasonal epidemics in dry season
• Punctuated by explosive epidemics in 8-12 yrs cycle (1000 cases
per 100,000 population)
• During epidemics: 350 million people at risk
• Epidemics generally caused by Serotype A, sometimes C
Latest epidemic in Nigeria
12. AETIOLOGY
• Causative pathogens of
meningitis are largely age
dependent
• Generally, S. pneumoniae is
the commonest organism in
the southern parts of Nigeria
and N. meningitidis in the
northern parts while the
prevalence of H. influenzae is
variable
Age Agents
Neonate or < 2months Generally, organisms causing
neonatal sepsis
Klebsiella sp
Staphylococcus aureus
Escherichia coli
Group B & D Streptococci
2 months – 5 year Haemophilus influenza
Streptococcus pneumoniae
Neisseria meningitides
M. Tuberculosis
6 - 12 years Streptococcus pneumoniae
Neisseria meningitidis
13. PATHOPHYSIOLOGY
• Bacterial meningitis commonly follows a haematogenous spread,
bacteraemia precedes the condition or occurs at the same time
• May arise from a contiguous focus or direct invasion of the CSF by
bacteria e.g instrumentation
• After gaining entry into the CSF there is rapid bacterial proliferation
• Release of immunogenic fragments by bateria triggers cytokine release
• The pathophysiological consequence of the cytokine-induced damage
include cerebral edema, vascular thrombosis and intense focal
inflammatory response
The mechanism of oedema is multifactorial
14. causes raised intracranial pressure, manifesting
with headache, vomiting and altered consciousness
• May be absent in infant
• The increased vascular permeability allows leakage of albumin into
the CSF causing increase in CSF proteins
• The CSF glucose level is reduced due to increased metabolic
demand, reduced glucose transport and shift to anaerobic
metabolism
PATHOPHYSIOLOGY
15. occurs as a result of local damage to
vessels.
• The thrombotic process and inflammatory infiltration of blood vessels
cause luminal narrowing leading to ischaemia and infarction
• Infarctions may cause focal or generalized seizures, with further
deterioration of consciousness
can cause cerebritis or ventriculitis
• Inflammatory reaction around spinal nerves causes meningeal signs
PATHOPHYSIOLOGY
16. • Acute or sudden onset which is most frequently associated with NM
• Subacute with an insidious onset preceding non-specific febrile illness
(with URI or GIT symptoms) usual with Hib and SP
• Typically, young infants initially have minimal and subtle manifestations
which lead to difficulty with early clinical diagnosis
• Nonspecific findings include
• Fever, anorexia and poor feeding
• Symptoms of upper respiratory tract infection
• Myalgias, arthralgias, tachycardia, hypotension
• Cutaneous signs, such as petechiae, purpura, or an erythematous
macular rash
CLINICAL PRESENTATION
17. • Increased ICP
-
• Seizures (focal or generalized) due to cerebritis, infarction, or
electrolyte disturbances occur
The fontanel may not be raised or tense in the dehydrated infant even if the CSF pressure is raised
CLINICAL PRESENTATION
18. • Alterations of mental status - include irritability, lethargy, stupor,
obtundation, and coma
• Meningeal irritation is manifested as nuchal rigidity, back pain, Kernigs
sign, and Brudzinski sign
• In some children, particularly in those younger than 12-18 mo, Kernigs
and Brudzinski signs are not consistently present
• In neonates, they may presents with fever, high pitched cry, seizures,
change in alertness, vomiting, poor feeding, paradoxic irritability,
hypertonia/hypotonia, bulging fontanels & opisthotonos
Meningismus refers to meningeaI irritation especially nuchal rigidity, not due to CNS infection
CLINICAL PRESENTATION
19.
20. • Subdural effusion manifest in infants <18mo with
-
• Anaemia due to sudden hemolysis is not uncommon in children
with H.i.b. meningitis
• In N.M meningococcaemia, petechiae and purpura, shock and DIC
may be observed
CLINICAL PRESENTATION
21. DIAGNOSIS
• The first essential in diagnosis is a high index of suspicion
• Investigations
- Lumbar Puncture
- E/U/Cr
- FBC with differentials
- Blood/Urine cultures
- LFT
- Coagulation profile – if DIC is suspected.
- CT/MRI
22. Lumbar Puncture
Clear Cloudy/turbid/
Purulent
Clear/turbid/xantho-
chromic
Clear Clear/cloudy
< 180 Raised >200 Usually raised normal/raised Usually raised
< 5, predominantly
lymphocytes upto
30 in neonates
↑↑↑ 1000s mainly
polymorphs or
pleocytosis
↑↑ 100s
Mainly lymphocytes
↑ mainly
lymphocytes
Usually ↑ (PMN
predominates)
No organism seen Positive No organism seen No organism seen Negative
Negative Positive Negative, but +ve in LJ
medium
Negative Negative
10 – 40 upto 30 in
neonates
↑↑ ↑↑↑: early 100-300
Late: >1000
Normal or slightly
↑: 50-150
Usually ↑
1/2 - 2/3rd of
concurrent RBS
< ½ -concurret 2/3rd
of nt RBS
< ½ -concurret 2/3rd of
nt RBS
Normal Normal or
decreased
24. TREATMENT
• Treatment of acute bacterial meningitis is aimed at sterilization of the
CSF by the use of appropriate antibiotics and management of
associated life-threatening complications.
• Antibiotics of choice should be bactericidal, excellent CSF
pharmacokinetics and broad spectrum
• Empirical treatment while awaiting cultures is recommended then
modified based on the sensitivity pattern
• A balance is sought between what is ideal and what is available and
affordable and still reasonably effective
25. • In the neonatal period, and up to the age of 2 mo, a 3rd generation cephalosporin
- or 100mg/kg/day -is combined with 100-
200mg/kg/day If not responding, consider 5mg/kg/day
• A less frequently recommended treatment is high dose 300-400
mg/kg/day and 100 mg/kg/day
• Use of the 3rd generation cephalosporins e.g 100mg/kg/day avoids
the problem of increasing resistance to AMP/CHL
• 300,000IU/kg + 100mg/kg
• In epidemics, a single dose of long-acting oily chloramphenicol given l.M is
effective
Ceftrixone is not recommended in the neonatal period
TREATMENT
26. • IVF restriction to 1/2-1/3 of requirement = 50-60 ml/kg/d for the first
48-72. However, fluid restriction can only be instituted in absence of
hypovolaemia and shock
Treat Septic shock
Raised intracranial pressure
• Hyperventilation
• IV mannitol 0.5-1g/kg; may be repeated after 6 hours
• Nurse head up at 300
TREATMENT
27. • Vital signs: PR, BP, RR, T
• Intensive nursing
• Management of unconscious patient
• Complete neurologic evaluation on admission and daily thereafter
• Serum electrolytes, serum and urine osmolality
• Monitor head circumference
TREATMENT
28. Seizures
• Diazepam IV or rectally
• Phenobarbitone 10-15 mg/kg stat then 5 mg/kg
• Phenytoin IV 15-20 mg/kg over 30-45 min; then 5 mg/kg
• Phenytoin is advantageous because it inhibits ADH and does not
depress level of consciousness
Dexamethasome therapy
• Modulation of the inflammatory response
• IV dexamethasone 0.15mg/kg
Phenytoin is more advantageous
TREATMENT
29. COMPLICATIONS
SIADH & Shock Seizure disorder
Cerebral oedema Intellectual impairment
Cranial nerve palsies Deafness
Hydrocephalus Cortical blindness
DIC Behavioural abnormalities
Patients with raised intracranial pressure may also have poor peripheral circulation because of altered brain stem
function. Shock may then be confused with raised intracranial pressure
30. PREVENTION
• Hib conjugate vaccine
• Pneumococcal conjugate Vaccine
• Meningococcal polysaccharide vaccine (ACWY135)
• Bivalent A & C vaccine
• A single IM dose is effective but short-lived
• Meningococcal: Rifampicin 10mg/kg/dose B.D for 2 days
• H.influenza: Rifampicin 20mg/kg for 4days
e.g SCA, Splenectomy
• PCV & Meningococcal Vaccine( ACWY135)
31. PROGNOSIS
• Prognosis depends on age, duration of illness and immunologic status
of the individual
• On the whole, it is estimated that about 40% of children may develop
neurologicaI abnormalities
• Deafness is common sequalae of bacteria meningitis. Overall, 10% of
children have persistent bilateral or unilateral hearing loss
• Deep coma, meningococcaemia, shock are poor prognostic signs
33. • Aseptic meningitis refers to a syndrome consistent with sign and
symptoms of meningeal inflammation but with negative routine CSF
culture
• It is an acute inflammation of the meninges due mainly to a variety of
viruses
• Most of cases are benign and self-limiting and complete recovery
without sequelae occurs in 95% of the children.
INTRODUCTION
35. CLINICAL MANIFESTATION
• Child is usually febrile, irritable, nauseated and may vomit feeds
• Headache or back pain may be present
• There may be an associated exanthematous rash suggesting
enterovirus infection
• Nuchal rigidity
• Convulsions are rare
• Progressive loss of consciousness as in bacterial meningitis is
uncommon.
36. INVESTIGATIONS
: The CSF is usually clear with moderate
lymphocytosis. The glucose level is within normal limits with the
exception of aseptic meningitis following mumps, where the CSF sugar
is somewhat raised. The CSF protein is usually normal or slightly raised
• Specific viral studies may be necessary with throat swabs, urine and
stool specimens. Antigenic or genomic PCR methods also help to
determine the aetiology if facilities are available.
37. TREATMENT
• There is no specific treatment for viral meningitis
• May be admitted to observe or for symptomatic management
• It is wise to start proper antibiotic treatment bearing in mind that
partially treated bacterial meningitis has CSF changes suggestive of
aseptic meningitis
• In addition, some centres treat all cases of aseptic meningitis with
acyclovir, fungal with amphotericin B
38. CONCLUSION
• Meningitis is a medical emergency once suspected
• It is a reportable disease under IDSR
• Despite better antimicrobial agents and advances in medical intensive
care technology, the mortality and long-term morbidity rates for
children is still significantly high
• In poor countries, the problem is compounded by increasing level of
poverty, overcrowding, poor immunization coverage etc.
39. REFERENCES
•Jonathan C. Azubuilke, Kanu E. Nkanginieme, Paediatrics and Child
Health in a Tropical Region 3rd edition
• Nelson Textbook of Paediatrics 19th Edition
• Robert M. Kliegman, Bonita F. Stanton, Joseph W. St. Geme III, Nina F.
Schor, & Richard E. Behrman Pediatric Textbook 4th Edition
• Website: http://www.emedicine/medscape.com/shock578763.
Accessed on Saturday, 2-10-2022, 3:36pm