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Management of Severe Malnutrition / MedUrgent

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   Management of Severe Malnutrition Admission criteria: 1) Children 6-59 months: - Bilateral pitting oedema +++ - Severe wasting with any grade of oedema - Severe malnutrition with any of the following medical complications:   • Anorexia / No appetite • Intractable vomiting  • Convulsions • Lethargy/ Not alert • Unconsciousness • Hypoglycemia • High fever • Hypothermia • Severe dehydration • Lower respiratory tract infection  • Severe anemia  • Skin lesions  2)  Infants <6 months:  - Bilateral pitting oedema - Visible wasting - Inadequate feeding - Weight <4 kg  *Initial Phase:  1- Document:  - The presence of Wasting, Oedema and Dermatosis  - Weight-for-Height/Weight -for-Length - Z-sore (SD/%) 2- Temperature:  (check every 30 min)  - Axillary temp. <35 C, start active worming (Kangaroo position) 3- Hypoglycemia:  - Blood glucose <3 mmol/l -Alert patient:...
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VIRAL HAEMORRHAGIC FEVERS / MedUrgent

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VIRAL HAEMORRHAGIC FEVERS Viral Hemorrhagic Fever defines a syndrome caused by 4 different families of RNA viruses. Though they have constant features in common, yet there are particular clinical features associated with different viruses. They can cause disastrous epidemics with case fatality rate up to 50%. Classification 1. Arenaviruses e.g. Guanarito, Junin, Machupo and Lassa. They have rodent reservoir. Humans are infected by aerosols of rodent excreta or other close contacts with rodents. 2. Bunyaviruses e.g. Rift Valley, Criean-Congo and Hantaan. Transmission through mosquito bites, aerosols or contact with blood of domestic animals, tick bite and rodent excreta. 3. Filovirus e.g. Ebola and Marburg. Mode of transmission is by person to person through body fluids 4. Flaviviruses e.g. yellow fever, Dengue and Kyanasur forest disease. Mode of transmission is through mosquito and tick bites.  Clinical features After contracting the disease, the incubation period ...
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TETANUS / MedUrgent

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  TETANUS Tetanus is an acute toxemic illness caused by a  soluble exotoxin of the obligate anaerobic bacterium Clostridium Tetani. The toxin is produced by the vegetative forms of the organism at the site of injury and it enters the bloodstream and subsequently is fixed within the central nervous system.  It is a spore forming gram positive bacillus which converts into vegetative forms in the wounds and produce the exotoxin tetanospasmin that binds to gangliosides at the myoneural junction of skeletal muscles and on neural membranes in the spinal cord blocking the inhibitory pulses to motor neurons that leads to spastic paralytic illness.  It affects all age groups including adults as occupational hazards e.g. farmers. The incubation period varies from 2-14 days to months after the injury.  In Sudan, it has 2 peaks, the neonatal period or at the age of around 7 years in female children following circumcision. Eradication of neonatal tetanus is declared by WHO a...
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