IPHREHAB : INFECTION, TYPHOID

IPHREHAB

TYPHOID

• Very common disease in our country
• Outbreaks are known to occur from time to time
• Pollution & Insanitary condition
• Present in animals except S.Typhi
• Transmitted by food, water, Milk
•  May be directly from one person to another

AETIOLOGY

• Caused by Salmonella Group of Organisms
• Reservoir are animals except for S.Typhi which is seen only in human beings
• There are 2000 Serotypes
• Faeco-oral route
• Tranmission through food, Flies & Fomites
• It involves Payer’s patches of small Intestines

CLINICAL PICTURE

• Fever is most common presenting symptom
• Fever is step ladder pattern
• Onset is insidious
• There is Malaise, Headache, Cough,  Drowsiness & Bodyaches
• Constipation common
• Relative Bradycardia
• Rash may appear on fifth day
• Toxaemia is Max. in 2nd Week
• Spleen is palpable
• Toxaemia increases in 3rd Week
• Coma may set in & may lead to death
• Antibiotics give the best results
• Carriers are well known

INVESTIGATIONS

• Complete Blood Leukopenia Increase in Lympho
• Blood Culture +ve  first week
• Widal’s  Test  2nd Week Rising titer is diagnostic
• Urine & Stool Culture

COMPLICATIONS

• Perforation
• Haemorrhage
• Osteomyelitis
• Meningitis
• Myocarditis
• Pneumonia
• Nephritis
• Hepatitis

MANAGEMENT

• General Management :- Analgesics for fever, Antiemetics (Perinorm) for vomiting
• Antibiotics Ciproflxacillin 500mg BD
• Cotrimoxazole 
• Amoxycillin
• Carrier Ciproflox for 4 weeks
• Prevention - Vaccination

IPHREHAB : INFECTIONS, MEASLES AND MUMPS

IPHREHAB

INFECTIONS

MEASLES

• It is caused by Virus ( Paramyxo)
• It is usually seen in children
• One attack give permanent immunity
• It is in in severe form in malnourished person ( in our country)
• Very high mortality
• Incubation period is 10 days

CLINICAL  PICTURE

• Catarrhal Stage    High Fevere    Severe Nasal Catarrh Sneezing, Redness of Eyes- Conjuctivitis Kapolick Spots in mouth
• Cough Hoareseness of Voice Photophobia
• Child is very irritable & in Miserable Stage
• Exanthematous stage  Koplik  spots disappear  Rash appear on 2-4 day  Rash is maculo papular initially on back of   ear
• It rapidly spread over the body – become blotchy
• Rash settle down in one week Fever subside

COMPLICATIONS

• Stomatitis Entertitis Pneumonia Keratitis
• Otitis Media, Conjunctivitis
• Brochopneumonia
• Encephalitis
• Malnutrition Vitamin A deficiecy
• Severe weight loss

MANAGEMENT

• Bed Rest No schooling for 10 days
• Symptomatic Treatment
• Antibiotics
• Prevetion – active immunisation
• Passive immunisation in serious cases  250 mg IM

MUMPS

• Common disorder in our country
• Caused by virus
• Incubation period 18 days
• Spread by droplet infection
• Not very virulent
• Infectivity ver low
• May remain subclinical

CLINICAL  PICTURE

• Fever
• Pain in the jaw
• Trismus
• Swelling of Parotid Gland subside in 2-3 days
• Meningitis Encephalitis
• Pancreatitis
• Orchitis

MANAGEMENT

• Treat the symptoms
• Antibiotics if bact. Infection is present
• In orchitis cases give predisolone 40 mg daily
• Vaccination for prevention- MMR

IPHREHAB : INFECTIONS, DIPHTHERIA

IPHREHAB

INFECTIONS

DIPHTHERIA

• It is disease caused by Gram + Bacteria
• Bacteria produces Exotoxin – which damages Heart & Nervous system
• It is common in India usually affecting children
• Sore Throat is presenting symptom
• Disease spread by droplet Infection

CLINICAL PICTURE

• Incubation period is 2-4 days
• Infection can occur over the Conjunctiva, Genital tract, Wounds & Abrasions
• Fever is high
• Grayish Green Membrane on Tonsils
• Membrane is firm & adherent
• Swelling of Neck (Bull’s Neck)
• Nasal Infection Common 
• Nasal Discharge ++ – May be Bloody in nature
• Husky voice due to Laryngitis
• Respiratory Infection can lead to death
• ECG may show tachycardia & T-wave changes
• Palatal Paralysis
• Accommodation may be paralysed
• Polyneuritis is seen in few cases

MANAGEMENT

• Inform the Public Health Department
• Give anti-toxin 4000-32000 IM
• Benzyl Penicillin -4 lacs Units 6 hourly for one week
• Treat Complications -  Resp. & Cadiac
• Protect Close relatives Erythromycin Immunization.

IPHREHAB: SEXUALLY TRANSMITTED INFECTION IN MEN

IPHREHAB


Why Syndromic Management has specific relevance to RTIs/STIs?

• STI clients hesitant to approach doctors
• Often choose far-off doctors
• Do not prefer to revisit
• First visit may be the last chance
• If opportunity missed the first time- is like pushing client towards HIV
• Dealing with 1 STI case is an opportunity to treat at least 1 more case
• IT IS PUBLIC HEALTH PROBLEM, not about one individual

RTI / STI Syndromes in Men

ä(Sexually transmitted infections , 

Reproductive tract infections )

ä

Symptoms	Syndrome	RTIs/STIs
Urethral Discharge	Urethral/Vaginal discharge syndrome	Gonorrhoea, chlamydia, trcichomonas,
Genital ulcers	Genital ulcer syndrom,	Chancroid, syphilis, genital herpes
Inguinal bubos	Inguinal bubo syndrome	Lymphogranuloma venerium, Chancroid
Scrotal swelling	Painful Scrotal Swelling	Gonorrhoea, chlamydia
Genital skin conditions	Genital skin conditions	Genital warts, molluscum contagiosum, pediculosis pubis, scabies

Male Syndromes 

Genital Ulcer

Genital Ulcer

Scrotal Swelling

Inguinal Bubo