This document discusses diarrhea in infants and young children. It begins by defining diarrhea and describing common causes such as viral and bacterial infections. It then outlines key clinical features including symptoms of dehydration and complications. A case study is presented of an 18-month-old girl with diarrhea, fever, cough and vomiting, and management of her condition is discussed including use of oral rehydration solution and monitoring for dehydration. Home care and indications for hospitalization are also addressed.
Diarrhoea is passage of three or more loose stools or watery stools in a 24-hour period.
The main cause of death from acute diarrhoea is dehydration, which results from the loss of fluid and electrolytes in diarrhoeal stools.
Diarrhoea is passage of three or more loose stools or watery stools in a 24-hour period.
The main cause of death from acute diarrhoea is dehydration, which results from the loss of fluid and electrolytes in diarrhoeal stools.
Recurrent diarrhea is associated with many a number of complications. Out of them dehydration,malnutrition ,failure to thrive, electrolyte imbalances, micro nutrient deficiencies (vitamins & minerals) and severe systemic infections. Here an extensive description is given about these and the relevant management facts are given then and there.
Usually, a child suffers from diarrhea after the onset of an upper respiratory tract infection. Diarrhea is a short-term condition that may stop even without medication. Home remedies can help relieve the signs and symptoms of diarrhea in children.
DIARRHOEA IS LEADING CAUSE OF MORTALITY IN INDIA AS WELL AS GLOBALLY .THIS IS NICE PPT BASED ON WHO GUIDELINES,DIARRHOEA IS EASY TO TREAT BUT STILL IT IS IS 2ND MOST COMMON CAUSE OF CHILDHOOD MORTALITY AFTER PNEUMONIA
WHO and UNICEF recommended management of Childhood Diarrhoea.
HLFPPT has been implementing Childhood Diarrhea management programmes with UNICEF and Micronutrient Initiative.
Recurrent diarrhea is associated with many a number of complications. Out of them dehydration,malnutrition ,failure to thrive, electrolyte imbalances, micro nutrient deficiencies (vitamins & minerals) and severe systemic infections. Here an extensive description is given about these and the relevant management facts are given then and there.
Usually, a child suffers from diarrhea after the onset of an upper respiratory tract infection. Diarrhea is a short-term condition that may stop even without medication. Home remedies can help relieve the signs and symptoms of diarrhea in children.
DIARRHOEA IS LEADING CAUSE OF MORTALITY IN INDIA AS WELL AS GLOBALLY .THIS IS NICE PPT BASED ON WHO GUIDELINES,DIARRHOEA IS EASY TO TREAT BUT STILL IT IS IS 2ND MOST COMMON CAUSE OF CHILDHOOD MORTALITY AFTER PNEUMONIA
WHO and UNICEF recommended management of Childhood Diarrhoea.
HLFPPT has been implementing Childhood Diarrhea management programmes with UNICEF and Micronutrient Initiative.
Management of dehydration - diarrhea and vomiting.in pediatric patient
fluid resuscitation and correction of electrolytes according to Malaysian CPG and NICE Guideline
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pediatric Infective Diarrhoea in Developing countries
1. DIARRHOEA IINN IINNFFAANNTTSS AANNDD
YYOOUUNNGG CCHHIILLDDRREENN
Dr. Taher Y. Kagalwala
M.D., D.C.H.
Hon. Pediatrician
Saifee Hospital, Masina Hospital, Habib Hospital
Saboo Siddik Mat. And Gen. Nsg. Home
October 15, 2014 Dr.Kagalwala/Diarr 1
3. WWhhaatt iiss ddiiaarrrrhhooeeaa??
• It is the passage of liquid or watery stools
• Usually, this is more than three times a day.
• More important than this is: when there is a
recent change in the consistency, frequency or
character of the stools.
• Frequent stools in an exclusively breastfed baby
is NOT diarrhoea.
• Teething can cause a few loose stools;
diarrhoea lasting more than 24 hours is NOT
due to teething.
October 15, 2014 Dr.Kagalwala/Diarr 3
4. CCoommmmoonn EEttiioollooggiiccaall CCaauusseess
1. Infectious causes:
• Viral – esp. rotavirus, respiratory and
enteroviruses
• Bacterial – esp. E. coli (ETEC, EPEC)
• Others – fungal, protozoal, helminthic and
miscellaneous
2. Non-infectious causes:
• Intussusception
• Endocrine – hyperthyroidism
• Secondary to a remote cause – e.g.
pneumonia
October 15, 2014 Dr.Kagalwala/Diarr 4
5. CClliinniiccaall FFeeaattuurreess -- 11
1. Symptoms and signs of the primary
illness.
2. Symptoms and signs of dehydration.
3. Symptoms and signs of
complications and side-effects of
treatment.
October 15, 2014 Dr.Kagalwala/Diarr 5
6. CClliinniiccaall FFeeaattuurreess -- 22
1. Primary Illness:
• Bacterial – dysentery and not diarrhoea –
marked by high fever, toxicity, tenesmus and
sometimes rectal prolapse while defecating;
stool will show mucus, visible or occult blood
and at times, frank blood.
• Viral – watery stools with absence of most of
the above findings, though there may be
mucusy stools. Slight to moderate fever and
presence of cough/cold, conjunctivitis and
recurrent vomiting are all compatible.
October 15, 2014 Dr.Kagalwala/Diarr 6
7. CClliinniiccaall FFeeaattuurreess –– 33aa
2. Dehydration (1 of 2):
Grade of
dehydration/Sym
ptoms
Mild
5 – 7% wt loss
Moderate
7 – 9 % wt loss
Severe
10% or more wt.
loss
Fontanelle and
eyes
Normal to mildly
sunken
Moderately
sunken
Severely sunken
Pulses Normal but fast Faster, slight low
volume
Thready,
peripheral pulses
not palpable
Mucous
membranes
Moist but sticky Slightly dry Dry
Skin turgor Normal Recoil 1-3
seconds
Recoil > 3
seconds
October 15, 2014 Dr.Kagalwala/Diarr 7
8. CClliinniiccaall FFeeaattuurreess –– 33bb
2. Dehydration (2 of 2)
Grade of
dehydration/Sy
mptom
Mild Moderate Severe
Capillary refill
time
Normal (< 3
sec)
Normal (< 3
sec)
Delayed 3 or >
3 sec
Urine Output Normal Slightly less
(anuria < 4
hours)
Definitely less
(anuria > 4
hours)
Mental status Normal but
thirsty
Irritable Irritable to
lethargic
October 15, 2014 Dr.Kagalwala/Diarr 8
9. CClliinniiccaall FFeeaattuurreess -- 44
3. Symptoms and signs of complications:
• Hypovolemic shock
• Acute renal failure (pre-renal)
• Venous thrombosis
• Septicemia
October 15, 2014 Dr.Kagalwala/Diarr 9
10. CCaassee SSttuuddyy -- 11
18 – month old female child from a middle-class
family presents with:
• Fever , mild – 4 days
• Red eyes, running nose and a mild to mod.
cough – 3 days
• Vomiting – 2 days ( frequent, whitish yellow)
• Loose motions – yellow, 13 – 15 since the last
24 hours, curdy smell, with mucus
• Not passed urine since the last four hours, with
h/o passing concentrated urine earlier too.
October 15, 2014 Dr.Kagalwala/Diarr 10
11. CCaassee SSttuuddyy –– 22aa
On examination (1 of 2):
• Average child, 9.5 kg, fever 99.2* F
• Crying continuously, eagerly drinks water if
offered by the mother
• P 120/min, RR 34/min, nonacidotic, BP not
taken
• AF closed, eyes look okay but reduced tears
while crying
• Oral mucosa is moist
October 15, 2014 Dr.Kagalwala/Diarr 11
12. CCaassee SSttuuddyy –– 22bb
On examination (2 of 2):
• CRT 3 seconds
• Skin turgor – slightly prolonged (3
seconds)
• Per abdomen – normal to increased
peristalsis. No other findings of note.
• Other systems – normal.
October 15, 2014 Dr.Kagalwala/Diarr 12
13. CCaassee SSttuuddyy –– 33
• What is the likely diagnosis?
• Is the girl dehydrated? How much? Why are
there inconsistencies (mucosae are moist, for
example)?
• What investigations are needed?
- CBC?
- Stool routine?
- Serum electrolytes?
- Any other?
• Will she need hospitalisation?
October 15, 2014 Dr.Kagalwala/Diarr 13
14. CCaassee SSttuuddyy -- 44
Management (1 of 4):
ORS: Sip by sip, at least 40-50 ml/kg as
deficit plus about ¼ to ½ of a 200-ml glass
for every medium to large stool passed
plus 3 - 5 ml/kg/vomit to replace losses in
vomiting.
October 15, 2014 Dr.Kagalwala/Diarr 14
15. CCaassee SSttuuddyy -- 55
Management (2 of 4):
• The child’s mother should be asked to continue
breastfeeding her (if she is doing so); continue
nourishing her with khichdi, rice-dal, soft bananas,
grated apples, vegetables etc. There is no need to ban
any food except food that is too spicy.
• She can be taught how to check the hydration status
from time to time (urine output, AF tension, eyeball
tension, skin turgor, etc. )
• ORS substitutes may be used only to give “variety” to the
child’s intake of liquids. (Buttermilk, rice water, dal soup,
etc.)
October 15, 2014 Dr.Kagalwala/Diarr 15
16. CCaassee SSttuuddyy -- 66
Management (3 of 4):
What is the role of :
• Anti-diarrhoeals – norflox +metro, for example
• Anti-motility agents – atropine derivatives
• Anti-secretory agents - racecadotril
• Stool binding mixtures – pectin + kaolin
• Starvation
• Probiotics – lactobacilli, saccharomyces
• Antibiotics – cefixime, gentamicin
October 15, 2014 Dr.Kagalwala/Diarr 16
17. CCaassee SSttuuddyy -- 77
Management (4 of 4):
• When will you refer for hospitalisation?
• What home-based fluids are NOT useful?
(coffee, tea, arrowroot kanji)
• How often will you see the child?
• What supportive medications will be needed?
(anti-emetics, anti-pyretics)
• Perianal excoriation and rashes will need topical
antifungal and protective creams.
October 15, 2014 Dr.Kagalwala/Diarr 17
18. SSoommee rreecceenntt iinnffoo oonn OORRSS
ORS :
• Presence of salt and sugar together facilitate the
reabsorption of water from the gut-lumen along with the
salt and sugar.
• We have moved from a sweetish, high osmolar liquid to
a salty, high Na+ ORS to ORS’s having probiotics,
prebiotics, amino-acids, etc. to the most recent “LOW
OSMOLAR ORS” that is approved by the WHO for use
all over the world in all age groups for all types of
diarrhoeal illness including cholera.
• This new ORS has only 245 mOsm/L as compared to
the higher osmolarity of the previous WHO-approved
formula.
October 15, 2014 Dr.Kagalwala/Diarr 18
19. TTaakkee--hhoommee mmeessssaaggeess
• Monsoon diarrhoeas may be bacterial in origin,
but winter diarrhoeas are almost always viral.
• Most children with watery diarrhoea do not need
metronidazole.
• Most children with typical diarrhoea do not need
any investigations.
• ORS is the mainstay of therapy.
• IV therapy is only recommended for kids with
uncontrolled vomiting, very frequent diarrhoea,
grade II dehydration or more and those with
altered sensorium or any other complications.
October 15, 2014 Dr.Kagalwala/Diarr 19
21. TThhiiss bbooookk iiss oonn ssaallee!!
• This comprehensive book
on parenting is written for
the layman.
• It is priced at Rs. 395/=,
but is available to doctors
at a special price of Rs.
300/= only.
• It carries detailed
information for the care of
children from 0 – 18
years.
• Thank you – Dr. Taher
October 15, 2014 Dr.Kagalwala/Diarr 21