ENTERIC FEVER

Enteric fevers include typhoid fever caused by Salmonella typhi (or known as Salmonella enterica serovar Typhi) 

The incubation period of typhoid fever is about 10–14 days

These organisms are transmitted by faecal-oral route, usually by carriers, often food handlers, through contaminated food milk water

Clinical Features

The disease usually presents with fever associated with headache, malaise and chills.

temperature to 40-41°C ("step-ladder" pattern) is seen in some cases. 

Early intestinal manifestations include constipation, especially in adults or mild diarrhoea in childs

The characteristic rose spots or "rose-red spots" may be seen on the chest and abdomen during the Ist week 

Intestinal complications may  occur in the 3rd or 4th week of illness.

treatment --------

general bed rest fluids intake 

antibiotics therapy

amoxicillin 

ciprofloxqcin

cefixime

azithromycine

aztreonam

prevention -------

good hygiene 

proper sewage 

proper disposibel

drink clean water 

vaccine ty21a live attenuated for s.typhe

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dengue fever

DENGUE FEVER

or back bone fever ,dengue haemorrhagic fever 

cause-

dengue virus (rna virus)

type 1,2,3,4 

spreading-

aedes aegypti mosquito biet to human 

Type of dengue viral infection-

1.classic dengue 

2.haemorrhageic fever

3.undifferentiated fever

incubation period is 5 to 8 days

clinical feature-

1 febrile phase 

pt. developers high grade fever 

with myalgia, artralgia, severe back ache (back bone fever) , retroo orbital pain ,headache 

-children mey have febrile seizure 

-mucosal membrane bleeding may be seen

-liver may inlarge 

2 critical phase

after defervescence of fever an inc. in capillary permeability along with inc haematocrit level may occure this begain of crital phase the degree of inc above the baseline haemotocrit reflect severty of plasma leakage

-shock may  occur

3. recovery phase

it may take 24 to 28 hr  

diagnosis 

- leucomia thrombocytopenia and liver enzymes elivate 

-serum ns1 antigen 

-rtpcr to amplification of viral rna 

- rise viral antibody 

-usg for other complications 

treatment of group a mild case

-Adiquate volume of oral fluids like juice froots or ors solution etc 

-paracetamol for fever

-sponging bath for fever 

  

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shock(defination,type,managment ) review

SHOCK

defination _state in which sevior reduction in tissu perfusion leads first to irreversable and then to irreversable cell injury it is due to inadiquate oxygen supply to cells

Classification 

1 hypolaemic shock (cause-diarrhoea, hemerage, sevior vomationg ,dk  etc)

2 cardoogenic shock (causes-acute mi, acute mitral regurgitation, cardiomyopathy, cardic tumer)

3 neurogenic shock (causes-head injury, spinal injury etc)

4 anaphylatic shock (causes-dugs ,insects bite etc)

5  septic shock  ( causes-gram positive gram negative infections)

 cardinal features of shock

trachypenea

urine output<30ml /hr

cold skin

hypotenson systolic less then 90mmhg

managment

pt. moniter

clinical moniter (bp , pulse, respritaton )

ecg ( rate,rythm,)

abg(ph)

 urine output( cathater)

general measure

care of  airway breathing circulation bowel bladder 

pt. put on horigontal position leg elivated

correction of hypoxia 

correction of hypovolumia 

correction of acidosis

treatment of arrathmia 

theatmet of sepsis 

10 most comman cause of hypertension

most comman causes of hypertension

1 obisity 

2 inc. salt in dite 

3 

4 alchol consumption in excess

5 lessof physical activity

6 smoking

7 older age

8 eat more jung or oily food 

9 less potassium  in dite

10 genitic and family history 

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