Diphtheria

Acute bacteria infection caused by gram-positive bacillus corynebacterium diphtheriae.
Through the incidence of diphtheria has decreased remarkable following increase immunization, cause do occurs in unvaccinated children and adults who have lost their immunity.
Etiopathogenesis-
 The secretions and discharge from infected person or carrier are the main source of infection.
The infection is transmitted by contact or via droplets of secretion.
The portal of entry is commonly the respiratory tract.
Incubation period-
2 to 5 days
Clinical features-
Acute with fever
Malaise and headache
The commonest from is faucil or tonsillopharyngeal diphtheria in which there is redness and swelling over the fauces.
Cervical lymph nodes are enlarge leading to a bull neck appearance.
Sore throat,dyshagia and muffled voice frequently present.
In nasal diphtheria there is unilateral or bilateral serosangunineous discharge from the nose and excoriations of upper lips.
In laryngotracheal diphtheria,the members over the larynx leads to brassy cough,stridor and respiratory distress.
Diphtheritic lesion may occasionally also be found in skin and conjunctivita.
The commonest compilation is respiratory failure due to occlusion of the airways by the members.
     Myocarditis,cardic failure, arrhythmias and sudden death.
Neurological compilation-
   Palatal palsy.  -  which occurs in second weeks and clinically manifested by nasal twang and nasal regurgitation.
  Occurs palsy in 3rd weeks.
  Loss of accommodation, manifested by visual blurring and inability read.
Generalized polyneuritis occurs by oliguria and proteinuria.
Diagnosis-
There should be a high index of suspicious.
Rapid diagnosis is enabled by Albert stain of a swab From the oropharynx or larynx.
Culture...etc

Management-
The most important component of therapy is Neutralization of bacterial toxin by administration of antitoxin.
Diphtheria antitoxin IM/IV.
Anitbiotics such as penicillin or erythromycin .
Immunization as clinical disease does not confer active immunity.

टिप्पणियाँ

एक टिप्पणी भेजें

इस ब्लॉग से लोकप्रिय पोस्ट

Third Complications of labor

चित्र
All women who deliver are at risk of complications in third stage of labor.These complications include Post partum Hemorrahege Retention of placenta (Retained placenta) Inversion of uterus Plumonary embolism Obsteric shock Injurier of birth canal     Retained placenta Management 1) Fundal pressure 2) Controll word traction 3) Manual remove of placenta under Genearl Anesthesia 1) Fundal pressure After seperation of placenta Pressure=Dounword and backward pressure on funda part and pull out the umblical word 2) Controll card traction  placenta separate Pressure on symphysis punia upword and backward Pull out with umblical word 3) Manual remove of placenta under general anesthesia Placent not seperat Female=General Anesthesia (Thiopentel sodiyam 4 to 5 mg/kg) Wear the gloves and insert hand in cone shape manner And reach hoti placenta margin Slicing movemen
और पढ़ें

Anatomy and physiology of Vagina to prevent infection

चित्र
In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female. Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection. Physiological vaginal discharge..... Clear, white and flocculent odourless discharge. Smear contains epithelial cells, lactobacillus pH ranges from 3.8 to 4.2 pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal If pH increase in primenopausal woman, investigation for other effects of excess oestrogen. This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and c
और पढ़ें

Antepartum Heamorrhage APH

चित्र
Antepartum haemorrhage APH APH is usually define as bleeding form the birth canal after the 24 to 28 weeks of  pregnancy.It can occur at any time until the second stage of lobour is complete; bleeding following the birth of the baby is postpartum haemorrhage=Miscarriage Or  Any ammount of bleeding from genital tract after 28 weeks to before of bleeding 28wk ..... Delivery time....6wk APH_________IPH_________PPH ETIOLOGY  --- Idiopathic/unknown 2types    1) Placenta previa (pp) 2) Abrupto previa (AP) Placenta previa=in lower uterin segement Implantation posterior wall of bady of uterus near the fundus Abrupto precisa=premature separation of placenta Most common risk of APH Dropping down theory= Drop down in lower uterine segments Implantation Due to less endometrial reactions Increase that cilliary active of fallopian tube A)Types of placenta previa 1)Types 1 (PP)  low lying place
और पढ़ें