MedUrgent

DYSENTERY  Dysentery is an acute inflammation of the large intestine characterized by diarrhea with blood and mucus in the stools. Differential diagnosis of acute dysentery: 1. Acute amoebic dysentery: Has a slow insidious onset. No fever is present and the patient's condition is generally good (Walking dysentery). It is the bacillary dysentery which requires lying down. In the chronic cases, patients may even be normal. Abdominal pain if present is of a grumbling nature. Stools are offensive, watery and rather bulky. They give an acid reaction and may contain blood and mucus. Under the microscope, they are seen to contain RBC's, a few pus cells and the trophozoite form may be found. On sigmoidoscopy, the classical flask-shaped ulcer may be seen. 2- Food poisoning: The patient presents with vomiting, diarrhea and abdominal pain within 48 hours of intake of contaminated food. There may or may not be toxicity, body pains, fever or other systemic manifestations. The time a...

  MALNUTRITION   Introduction Nutrition is the process by which the organism utilizes food. The purpose is to maintain life, growth, normal functioning of organ, energy, and reproduction of species. Malnutrition is any form of disordered nutrition with a span from obesity to Protein Energy Malnutrition (PEM). The latter can be endogenous due to of utilization, or exogenous due to defective intake or both. The PEM is range of pathological conditions arising from coincident lack in varying of protein and calories, occurring most frequently in infants and young children and commonly associated with severe recurrent infection. PEM includes a variety of closely related syndromes resulting from different deficiencies of calories and /or protein and is governed by the age of the child and severity and duration of the deficiency. The typical severe forms of PEM are known as Kwashiorkor and Marasmus, however, intermediate or combined forms in different stages of development are a...

     MANAGEMENT OF DEHYDRATION   Degree of dehydration: Dehydration secondary to diarrheal disease is a major cause of death in the tropics. The degree of dehydration is graded according to the clinical features. There will be no signs or symptoms if the loss of fluid in diarrhea and vomiting is less than 5% (No signs of dehydration). Some dehydration Presents with restlessness, irritability, thirst and examination shows sunken eyes, loss of skin turgor i.e. skin pinch goes back slowly, dry mucous membranes, depressed anterior fontanel in infants and crying with no tears. Severe dehydration manifests with more pronounced features as above and the patient may develop signs of hypovolemic   shock, impaired consciousness and, if untreated, death may follow   Types of Dehydration:  ISOTONIC DEHYDRATION The loss of water and electrolytes is in similar proportion to plasma (ECF). Serum sodium and osmolality are normal. HYPERTONIC DEHYDRATION The ...

 DIARRHOEAL DISEASES watery diarrhea is defined as abnormally loose or fluid stools more than 3 times per day. mothers opinion regarding diarrhea onset is more important than the number of motions.  Diarrheal disease is the 3rd highest cause of death due to infection in the world with 1-2 million deaths each year globally  and 80% of deaths occur among those less than 2 years of age. it is divided according to the presence or absence of blood in the stools since the underlying causes are generally  different. Persistent diarrhea (lasting for more than 14 days) needs special consideration. Patients with acute diarrheal disease should have the   following laboratory test done: Stools microscopy and culture, CBC, U&E, Blood Glucose BF for Malaria and RotaVirus Antigen. ACUTE DIARRHEA WITH BLOOD IN THE STOOLS The Infective causes of acute diarrhea with blood include:  . Bacillary Dysentery (shigellosis)  • Enterohemorrhagic E.coli  • Camp...