Mother & Child Health
3. Conditions relating to Respiratory System
q Upper respiratory tract congestion.
q Upper respiratory infections
4. Conditions relating to Gastro- Intestinal Tract
q Epigastric Pain
q Pain abdomen
5. Conditions relating to Cardiovascular System
q Chest Pain
6. Conditions relating to Urinary Tract System
q Burning micturation / Dysuria
q Renal colic
q Urinary tract infection
7. Conditions relating to Eye
q Simple conjunctivitis – allergic
q Bacteria conjunctivitis
8. Conditions relating to ENT
q Otitis – Externa & Media
9. Conditions relating to Skin
q Allergic Rashes
– For how many days
– Continuous, high or low
– Associated with rigors or
– Associated with other systems of body
– e.g.: Respiratory, Digestive or Urinary Tract, then treat accordingly.
oUrgent Lowering of down temperature by cold sponging
according to the age of patient
Tab. Chloroquin = 4 stat and then 2x OD x 3 days
III – If pattern of fever is continuous and with evening rise of temperature daily
Diagnosis: Typhoid Fever
Blood for typhi dot and widal test.
—- Injectable upon the clinical condition
1 + 0 + 1 = 07 – 10 days for adults.
or 10 mg. / kg. / dose X BD
History of Patient:
If everything is normal then:
Cough & Flu:
Sore Throat / Tonsillitis:
Acute Tonsillitis / Streptococcal Sore Throat
o Difficulty in Swallowing
Viral Infection relating to Respiratory System
q Chicken Pox
Signs & Symptoms:
Signs & Symptoms:
Classical symptoms of measles include:
Treatment & Prevention:
Prevention: Vaccinate the child at 18 months with MMR (Measles, Mumps & Rubella)
Sign & Symptoms:
Inflammation of lung parenchyma
If condition worsen , refer to hospital
Asthma is a common chronic inflammatory disease of the airway characterized by variable and recurring symptoms, airflow obstruction and bronchospasm
Because of the spectrum of severity among asthma patients, some people with asthma only rarely experience symptoms, usually in response to triggers, whereas other more severe cases may have marked airflow obstruction at all times.
Asthma exists in two states:
The signs & symptoms are different depending on what state the patient is in:
|Alertness||May show agitation||Agitated||Agitated||Confused/Drowsy|
|Breathlessness||On walking||On talking||Even at rest|
|Accessory muscle||Usually not used||Used||Used|
|Respiratory rate (/min)||Increased||Increased||Often >30|
|Pulse rate (/min)||100||100-120||>120||<60 (Bradycardia)|
DANGER SIGNS FOR REFERRAL TO HOSPITAL
It is characterized by chronic or recurrent pain in the upper abdomen, upper abdominal fullness and it is companied by Dyspepsia.
Dyspepsia is a common problem and is frequently due to gastro esophageal reflux disease (GERD) but in small minority may be the first symptom of peptic ulcer disease and occasionally cancer. Hence unexplained newly onset dyspepsia in people over 55 or presence of other alarm symptoms may require further investigation.
Sign & Symptoms:
Diagnosis: Peptic Ulcer
H2 Receptor Beta Blocker} 4-6 weeks
Proton Pump Inhibitor} 4-6 weeks
GASTRO-ENTRITIS (DIARRHEO + VOMITING)
IN CASE OF INFANT:
Ask the mother or whoever brought the baby:
Danger signs for referral to Hospital
|Three following signs:
||Severe Dehydration||Give I/V fluids|
|Three of the following sign:
||Some Dehydration||Give ORS in clinic or Home- continue breast feeding- tell her danger signs
– follow up in two days
|No enough signs to classify as
||No Dehydration||Give ORS at Home- tell her danger signs- follow up in two days|
Nature of Pain
Continuous or Intermittent
Right Iliac Fossa
Hypo gastric Region
Association with menstruation
Any association with pregnancy —– > will be discussed in separate section
If generalized and associated diarrhea, vomiting and fever.
Then rule out:
Typhoid already explained
In case of gastroentritis and food poisoning
Rehyhrate with ORS or Intravenous Fluids
Antibiotic – Injectable / Oral (depending upon the clinical condition)
Light, Soft and chilli free diet
Epigastric region then dyspepsia and peptic ulcer (treatment already explained)
Acute / Chronic Cholecytitis depending upon the clinical condition.
Advice the patient for further investigation from hospital and refer the patient to
concerned department .
Lumber Region – Renal Colic
Antispasmodic injectable /oral depending on the condition of the patient.
1/V fluids / oral fluids
Advise Urine D/R
If it contains pus cells, then advise urine for culture / sensitivity and start antibiotics.
Right iliac fossa – appendicitis
Patient will present as:
Pain right iliac fossa
Fever low grade
If all these signs and symptoms are associated with H/O syncopal attacks or pallor then urgently refer the patient to hospital to be seen by surgeon in emergency.
Otherwise: Patient can be given:
Symptomatic treatment and can be called for follow up after 2 days with the advise that if pain or any other symptom does not subside, their report directly to the hospital in emergency department.
Pain can be due to:
Urinary tract infection
Sign & Symptoms:
Pain will be associated burning micturation or dysuria or frequency of micturation.
Treatment (as given in Renal Colic / UTI)
EYE RELATED PROBLEMS
Patient will present with:
Redness of eyes and swelling of eye lids
Excessive watering of eyes
Itching may or may not be present
Or there may be purulent discharge
Warm saline eyewash
Simple anti allergic drugs.
In case of purulent discharge local antibiotic drops to be added.
Follow up after 2 days, if no relief, then refer the patient to eye specialist.
It can easily be examined and diagnosed in the Primary Health Centre.
Cloudy or Blurry Vision.
Double Vision or Multiple Image in one Eye.
Patient suffering from Diabetes Mellitus
Personal behavior such as smoking and use of alcohol
The environment such as prolonged exposure to light.
Test to diagnose cataract in PHC:
Visual acuity test:
This eye chart test measures how will you see at various distances.
Once suspicision of cataract or diagnosed refer the patient to eye care professionals to further diagnose and treat the patient in expert hands.
EAR RELATED PROBLEM
This condition refers to nasal bleeding of any cause. Most expistaxis are minor or major and insignificant but it may be severe and life threatening and it can be indicative of more serious diseases. All bleeding occurs as a result of disruption of intact nasal mucosa.
Bleeding from Nose
OTITIS (EAR INFECTION)
It can be externa or media.
It is an inflammation of the ear canal caused by infection with bacteria or fungus.
The major symptoms are: