RENAL COLIC
Written by Dr.ChrisRENAL COLIC: Renal colic is the commonest, though often a rather benign emergency of the urinary tract and is most often due to urinary calculi. The sudden onset of pain, its location in the region of the kidney (usually posteriorly in the renal angle), radiation along the line of the ureter and intense severity, all […]
Tags: hesitancy, strangury and haematuria
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HAEMATURIA
Written by Dr.ChrisHAEMATURIA: Sudden passage of blood in the urine can be extremely alarming to the patient. However, it is rarely, if ever, severe enough to constitute a threat to the patient’s life. It may be stressed that haematuria is only a symptom and not a disease by itself and can result from a variety of disorders, […]
Tags: hemolytic anemia, hepatosplenomegaly, jaundice, thrombocytopenic purpura
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ACUTE DIARRHOEAL DISEASES
Written by Dr.ChrisACUTE DIARRHOEAL DISEASES:Definition: Passage of frequent loose stools lasting more than 24 hours is termed as acute diarrhoea. This may be accompanied by vomiting or be associated with gripping pain in abdomen and blood and/or mucus in the stool. In the former setting the condition is termed as acute gastroenteritis, and in the latter, dysentery.
Etiology. […]
Tags: Diarrhoea, Enterotoxigenic E. coli, Food poisoning, vomiting
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STATUS EPILEPTICUS
Written by Dr.ChrisSTATUS EPILEPTICUS: Definition: When major (grand mal) epileptic seizures follow each other in rapid succession without allowing the patient time to regain consciousness in between the fits, the condition is described as status epilepticus. Unless interrupted by treatment, the seizures and the associated coma may continue for 24-48 hours after which the fits may cease […]
Tags: encephalomyelitis, optic neuritis, radiculitis, radiculomyelitis, transverse myelitis
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ACUTE VIRAL ENCEPHALITIS: MANAGEMENT
Written by Dr.ChrisMANAGEMENT: GENERAL MEASURES: The treatment of encephalitis is largely supportive. If the patient is lethargic or comatose, all the general principles of management as described in the section on “The Unconscious Patient” should be observed. Seizures frequently occur and should be controlled with phenytoin or phenobarbitone injections in suitable dosage. A major threat to life […]
Tags: Cerebral Arterial Thrombosis, Convulsions, Hyperpyrexia, Phenobarbitone
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ACUTE VIRAL ENCEPHALITIS
Written by Dr.ChrisACUTE VIRAL ENCEPHALITIS: Etiology: This term is conventionally used to denote invasion and destruction of brain cells by certain types of viruses such as poliomyelitis, coxsackie, herpes etc. A similar type of acute illness may also result as an allergic response to virus infection during the course of some exanthematous. diseases (measles, mumps, chicken-pox […]
Tags: encephalomyelitis, optic neuritis, radiculitis, radiculomyelitis, transverse myelitis
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TUBERCULOUS MENINGITIS: MANAGEMENT
Written by Dr.ChrisTUBERCULOUS MENINGITIS: MANAGEMENT: The chances of successful management depend to a very larg extent on the stage of the disease when the treatment is started and are very remote once coma has set in. Hospitalization is essential.
SPECIFIC MEASURES
(1) Anti-tubercular Therapy. Of the large number of antituber cular drugs currently available, isonicotinic acid hydrazide ONE is […]
Tags: Haemophilus influenzae, meningococcus, pneumococcus
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TUBERCULOUS MENINGITIS
Written by Dr.ChrisTUBERCULOUS MENINGITIS: Tuberculous infection of the meninges usually has a subacute clinical course and hence is not a medical emergency in the strict sense. However, more often than not, the exact diagnosis is delayed until the patient develops impairment of consciousness and various paralytic features, and at this stage the patient’s condition often warrants emergency […]
Tags: Haemophilus influenzae, meningococcus, pneumococcus
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Childhood Meningitis
Written by Dr.ChrisChildhood Meningitis: In majority of childern below the age of ten years (excluding infants upto three months’ age), pyogenic meningitis is most often due to Haemophilus influenzae. Less commonly, it is due to Strep.pneumonae or Neisseria meningitidis. In. such cases the best therapy is a combination of ampicillin and chloramphenicol. The drugs are administred IV […]
Tags: chloramphenicol, Meningitis, Neisseria meningitidis, pneumonae
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Adult Cases of Meningitis
Written by Dr.ChrisAdult Cases of Meningitis: The causative organism in most. of such patients is either meningococcus or Strep. pneumonae. They should be treated with very high doses of soluble penicillin, 20-24 million units daily IV in divided doses to be given every four hours. If patient is allergic to penicillin, chloramphenicol (4-6 G IV in four […]
Tags: Arthritis, endocarditis, meningo-encephalitis, pericarditis
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Diagnosis of Acute Pyogenic Meningitis
Written by Dr.ChrisDiagnosis of Acute Pyogenic Meningitis:The disease may need to be differentiated from sub-arachnoid haemorrhage,.other types of meningitis, and meningeal reaction (meningismus) associated with acute infections like enteric fever or pneumonia. While attention to clinical details will • be helpful, examination of CSF is of decisive value. A lumbar puncture must therefore, be done at the […]
Tags: Arthritis, endocarditis, meningo-encephalitis, pericarditis
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ACUTE PYOGENIC MENINGITIS: CLINICAL FEATURES
Written by Dr.ChrisACUTE PYOGENIC MENINGITIS: Clinical Features. The onset of the disease may be sudden (fulminant cases) so that florid meningitis develops within 24 hours, or it may be gradual, meningitis evolving over 1-7 days. In general, the symptoms can be ascribed to: (i) febrile illness (e.g., fever, lethargy, anorexia); (ii) meningeal inflammation (e.g., nausea, vom-iting, photophobia, […]
Tags: circulatory collapse, ecchymosis, meningococcal meningitis, pyogenic meningitis
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ACUTE PYOGENIC MENINGITIS
Written by Dr.ChrisACUTE PYOGENIC MENINGITIS: Etiology. Meningitis implies inflammation of the pia-arachnoid. When acute and pyogenic, it is commonly due to meningococcus, pneumococcus and Haemophilus influenzae but may also result from infection with enteric group of Gram-negative bacilli (E.coli, Kliebsella, Proteus and Pseudomonas aeruginosa). Not infrequently, acute meningitis may be aseptic due to certain viral infections such […]
Tags: Haemophilus influenzae, meningococcus, pneumococcus
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CEREBRAL VENOUS THROMBOSIS: MANAGEMENT
Written by Dr.ChrisCEREBRAL VENOUS THROMBOSIS: MANAGEMENT: There is no specific treatment of CVT. Some degree of cerebral oedema is invariably present in such cases, and therefore, cerebral decongestants should be used as described in the section on “Thrombotic Stroke”. Antibiotics are indicated only in cases of secondary CVT, or when there is associated calf or pelvic vein […]
Tags: intracranial haematoma, prophylactic anticonvulsant therpay, Thrombotic Stroke
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DIAGNOSIS: CEREBRAL VENOUS THROMBOSIS
Written by Dr.ChrisDIAGNOSIS:CEREBRAL VENOUS THROMBOSIS:The diagnosis is usually obvious from the clinical background of the case. In fact CVT can occur in all those clinical states known to be associated with calf and pelvic vein thrombosis, and should be suspected when appropriate neurological features develop in such ,a setting. Some degree of leucocytosis and raised ESR are […]
Tags: paranasal sinuses, thrombosis, toxaemia
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