2931 - Management of severe falciparum malaria Dr SK...

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Management of severe falciparum malaria Dr SK Mishra,MD Ispat General Hospit al, Rourkela 769005 India
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Falciparum malaria is a potentially fatal disease Successful treatment completely cures without disability Early diagnosis and prompt treatment prevents fatal complications 2
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Severe malaria 1. Cerebral malaria 2. Acute renal failure 3. ARDS 4. Severe anaemia (Hb < 5g%) 5. DIC 6. Haemoglobinuria 7. Hypotension, Shock 8. Hyperparasitemia 9. Repeated seizures 10. Hyperpyrexia 11. Haemolysis (Sr bil. >3 mg%)
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Diagnosis of malaria 1. History and clinical features * locality , travel history * fever * spleno-hepatomegaly * presence of complications 2. Laboratory diagnosis 3
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* Drug history * Anti malarials * Blood transfusion History of - haemoglobinopathy - diabetes - alcoholism/ jaundice 4
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Specifically ask / look for - fever with duration - headache - vomiting, diarrhoea - urine output and colour - cough / dyspnoea/ bleeding - altered sensorium / seizures - pregnancy 5
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Clinical examination Pallor, icterus bleeding signs early signs of pulm oedema consolidation arrhythmia hepatosplenomegaly uterus 6
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CNS Examination Sensorium /coma score - Glasgow coma score - Blantyre coma score - decerebration Pupils, Fundus examination Neck stiffness Plantar reflex 7
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2931 - Management of severe falciparum malaria Dr SK...

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