medicomuggle

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About blog:

Hello everyone! I am providing basic knowledge of medicine in my blog. Someone who want to enhance their basic knowledge of medicine, practical skills then do follow my blog. I am going to provide essential information regarding medical field. Medical students and new doctors will get help by my blog. In the era of fast changing medical science my blog will helpful.

About me:

Myself Dr. Anup Goutam Palsambkar. I am MBBS graduate from india. I am working as emergency medical officer at government medical college at Maharashtra. Through my blog, I will try to give best and latest basic medical information to my viewers.

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RABIES

Rabies is cause by bullet shaped virus – lyssa virus-1 of family rhabdoviridae.

Rabies – street virus: variable IP (causes disease)

                Fixed virus: fixed IP= 4-6 days

World rabies day: 28th September

Animal bite category:

1= Licks- no tissue injury- wound management

2= abrasion/laceration- wound management + ARV  (anti rabies vaccine)

3= wild animal bite/ bite on palm, sole, face, near to brain/ deep wound : wound management + ARV + rabies immunoglobulins

Management after animal bite:

Wound management:

·        Local wound management – continue for 15-20 min wash it with running water & soap

·        Put  antiseptic on wound

·        Put loose sutures for large wound

·        Do not sutures or dressing

Vaccination :

A.    Give tetanus vaccine.

B.     ARV

1.     Post exposure prophylaxis:

Intramuscular  : 0.5 ml

0,3,7,14,28

Intradermal  : 0.1 ml

on each deltoid

0,3,7,28

2.     Pre exposure prophylaxis:

0,7- intradermal = 2site

Intramuscular = 1 site

3.     Re-exposure:

a)     ID  1 site: day 0,3

b)     IM 1 site: day 0,3

c)     ID 4 site: day 0

Course of action – on dog bite:

·        Unimmunized person: post exposure prophylaxis

·        Previously immunized : <3 month= no ARV

                                           >3 month= ARV – re exposure guidelines

·        With pre exposure prophylaxis: < 3month= no ARV

                                                                     >3month= re exposure guidelines

Rabies immunoglobulin:

Rabies immunoglobulin given in category 3 dog bite. Rabies immunoglobulin should be given within 10 days after animal bite.

When should be given:

Ø Multiple bites

Ø Wild animal bite

Ø Bite on palm, sole, near to brain

Ø Deep wound

Formula for calculation of dose: weight * 40/300 = dose in ml

First give test dose, after 30 minutes give maximum dose through intralesional rout, remaining dose should be given through intramuscular.

Important:

·        Suturing of wound not recommended.

·        Rabies vaccination is not contraindicated in pregnancy and lactation.

·        Do not change brand of vaccination without any necessity.

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Acute Diarrheal Disease & Oral Rehydration Therapy

 



 

Acute Diarrheal Disease

Diarrhea- change in consistency of stool/ frequency of stool >3times a day

Types of diarrhea-

1.     Acute watery diarrhea- cholera, rota virus, E.coli infection

2.     Persistent diarrhea- diarrhea>14 days

3.     Bloody diarrhea- shigella infection

Host factors-

·        Age = 6 months to 2 years of age (predominant)

·        Environmental factors- all seasons

·        Rota virus- after summer/ early winter

Mode of transmission- feco-oral rout

Control of diarrhea:

·        Short term: ORS, clinical management

·        Long term: maternal& child health care improvement, decrease outbreak of of diarrhea by promoting health education & sanitation.

 

 

Oral Rehydration Therapy

1.     Reduced osmolarity ORS:

Composition: Na-75mmol/L

                         Glucose- 75mmol/L

                         Cl-65mmol/L

                         K-20mmol/L

                         Citrate-10mmol/L

2.     Super ORS: ORS with energy providing food product

Food products- starch(rice)

                          -starch free (glycine/ glucose polymer)

Advantage- decrease dehydration

                   - decrease stool frequency

                   - provide calories = 180kcal/L

3.     ReSomal: rehydration solution for several malnourished children.

Composition: ORS pack+ 2 litre water+ sucrose(50gm)+ mineral electrolyte solution(40 ml)[K,Cl,Mg,Zn,Cu]

Generally ORS is given at 75ml/kg+ for every stool episode add 100ml/stool

Home based ORS- salt & sugar in ratio 1:6

ORS Dose:

Weight of child(kg)

<5

5-8

8-11

11-16

16-30

>30

Age

<4months

4-12months

1-2 year

2-5 years

5-14 years

>14 years

ORS quantity

200-400

400-600

600-800

800-1200

1200-2200

2200-4000

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Typhoid

TYPHOID

·        India is endemic for typhoid

·        It is caused by salmonella typhi

·        S. typhi is gram negative flagellated

·        Determination of infection – infecting dose in the population & virulence

·        Man is the only reservoir

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COVID 19

(definition, cause, risk factors, signs and symptoms)

Today we are discuss about covid 19. New cases of covid variant found in country, therefore it is important to discuss about covid 19. What is covid 19? How it spread? How can we prevent it? How can we investigate it? How can we treat? read more

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Iron Deficiency Anemia

Iron deficiency anemia is most common nutritional deficiency anemia in world. In todays blog I am discussing about its causes, symptoms, pathology, management.

What is iron deficiency anemia?

Iron deficiency anemia is anemia cause by deficiency of iron in body.

Causes of iron deficiency anemia:

A.      Dietary lack

·         Infants who are at high risk due to the very small amount iron in milk.

·         Who can have suboptimal diet for socioeconomic reason at any age

·         Older adult who often have restricted diet with little meat because of limited income or poor dentition.

·         Teenager who subsist on junk food

B.      Impaired absorption

·         Sprue

·         Gastrectomy

C.      Increased requirement

·         Growing infants, children and adolescents

·         Premenopausal women, particularly during pregnancy.

·         Economically deprived women having multiple, closely spaced pregnancies are at exceptionally high risk.

D.      Chronic blood loss

·         Menorrhagia

·         Carcinoma of the cecum

·         Hookworm infestation

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Anemia

Anemia is disease related to our blood component. It commonly present with chief complaints of pallor, fatigue, weakness, breathing difficulty. In opd doctors told that Hb become less. Then what is anemia? How it become lethal? Lets discuss about that. read more