Diarrhoea is alterad bvowel pattern , altered frequency,altered consistency & volume. Dysentery is fever+blood mucus in stool +tenesmus Management depends upon severity of diarrhoea + ?? Dehydration, Our aim should be to prevent diarrhoea by personal hygiene,hand wash, During diarrhoea maintain Rehydration by ORS for mild-to-moderate dehydration, in severe dehydration child has to be admitted for IVF. Antibiotics are generally not required in diarrhoea.c exceptions Antibiotics are needed in Dysentery eg.Shivella, Salmonella,E.coli, Usual Antibiotics are ,Septran ,cefexime, parenteral Taxim, Ceftriaxone, etc. For Cholera ....Dixycycline, For Amebiasis..&Giardiasis..Metrinidazole Probiotics& Prebiotics are used as Adjuvant Rx
DIARRHEA TREATMENT HAS FOUR COMPONENTS : 1. TREATMENT OF DEHYDRATION : (a) No dehydration :- Home fluid. Eg. Coconut water. (b) Some dehydration :- WHO recomended low osmolarity ORS in addition to home fluid. Frequent sips + extra 15-20 ml after each stool (less in young child/infant). (c) Severe dehydration :- If stool pass > vomiting then IV fluid RL is preferred but if vomiting is predominant and in diabetic IV fluid NS is given. 2. MUCOSAL HEALING : Zinc is given for mucosal healing specially in children/infant. If age is less than 6 months then 10 mg OD but if more than 6 months or adult the dose is 20 mg OD for 14 days. 3. RESTORING OF GUT FLORA : If diarrhoea is prolonged , IBS and in antibiotic associated diarrhoea floral loss is significant which needs restoration so Pre-Probiotic is given. 4. TREATMENT OF INFECTION : (a) Clinical conditions and circumstances that may indicate antibiotic therapy. i. DYSENTERIC DIARRHEA : Organisms :- Shigella, Yersinia, Campylobacter Rx :- Azithromycin, ciprofloxacin (FQs not given in young child/infant). ii. FEVER, INCREASED INFLAMMATION MARKERS :- Organisms :- Shigella Rx :- Azithromycin, ceftriaxone iii. PROLONGED DIARRHOEA : Organisms :- Gram-negative enterobacteria, Clostridium difficile Rx :- Metronidazole, co-trimoxazole iv. SIBO/IBS : Organisms :- Gram-negative enterobacteria Rx :- Metronidazole, rifaximin, co-trimoxazole v. ANTIBIOTIC ASSOCIATED DIARRHOEA : Organisms :- Clostridium difficile, others Rx :- Metronidazole, vancomycin (only if�Clostridium difficile�is detected) vi. TRAVELLER'S DIARRHEA : Organisms :- ETEC, EPEC Rx:- Azithromycin, ciprofloxacin (FQs are avoided in young children/infants). 7. TOXIC STATE : Organisms :- Gram-negative enterobacteria, Clostridium difficile Rx:- Ceftriaxone ** Watery diarrhoea or diarrhea with fever only indicate viral origin which needs no antibiotic. However loperamide (Safe in pregnancy) or Racecadotril is given in secretory diarrhoea.
this a very vague type of question . paediatric patients arent miniature adults . plus chances of infective diarrhea arises after 2 years . zinc probiotics n ors mandatory for all . but if u suspect infective diarrhea give syp o2 1/4 th weight of the child like for 20 kg 5 ml twice daily
Probiotics, ors, zinc 20mg once daily for 2 weeks Sometimes toddlers diarrhea due to sugary drinks Antibiotics are required only if there is dysentery, salmonella ,cholera, giardiasis and amoebiasis .
Depends upon the cause of diarrhea Viral, bacterial. The general treatment is Prevention of dehydration Mucosal repair Probiotics Treatment of cause of diarrhea.
Dear Dr. Nayan Baman Sir, Advice for the case. Tab. Agnitundi Vati 1 BD Bel Murabba.
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According to the World Health Organization , waterborne diseases account for an estimated 3.6% of the total DALY (disability- adjusted life year) global burden of disease , and cause about 1.5 million human deaths annually. The World Health Organization estimates that 58% of that burden, or 842,000 deaths per year, is attributable to a lack of safe drinking water supply, sanitation and hygiene (summarized as WASH ).  Overview The term waterborne disease is reserved largely for infections that predominantly are transmitted through contact with or consumption of infected water. Trivially, many infections may be transmitted by microbes or parasites that accidentally, possibly as a result of exceptional circumstances, have entered the water, but the fact that there might be an occasional freak infection need not mean that it is useful to categorise the resulting disease as "waterborne". Nor is it common practice to refer to diseases such as malaria as "waterborne" just because mosquitoes have aquatic phases in their life cycles, or because treating the water they inhabit happens to be an effective strategy in control of the mosquitoes that are the vectors . Microorganisms causing diseases that characteristically are waterborne prominently include protozoa and bacteria , many of which are intestinal parasites , or invade the tissues or circulatory system through walls of the digestive tract. Various other waterborne diseases are caused by viruses . (In spite of philosophical difficulties associated with defining viruses as " organisms ", it is practical and convenient to regard them as microorganisms in this connection.) Yet other important classes of water- borne diseases are caused by metazoan parasites. Typical examples include certain Nematoda , that is to say "roundworms". As an example of water-borne Nematode infections, one important waterborne nematodal disease is Dracunculiasis . It is acquired by swallowing water in which certain copepoda occur that act as vectors for the Nematoda. Anyone swallowing a copepod that happens to be infected with Nematode larvae in the genus Dracunculus , becomes liable to infection. The larvae cause guinea worm disease .  Another class of waterbornemetazoan pathogens are certain members of the Schistosomatidae , a family of blood flukes . They usually infect victims that make skin contact with the water.  Blood flukes are pathogens that cause Schistosomiasis of various forms, more or less seriously affecting hundreds of millions of people worldwide.  Long before modern studies had established the germ theory of disease , or any advanced understanding of the nature of water as a vehicle for transmitting disease, traditional beliefs had cautioned against the consumption of water, rather favouring processed beverages such as beer , wine and tea . For example, in the camel caravans that crossed Central Asia along the Silk Road , the explorer Owen Lattimore noted, "The reason we drank so much tea was because of the bad water. Water alone, unboiled, is never drunk. There is a superstition that it causes blisters on the feet."  Socioeconomic impact Waterborne diseases can have a significant impact on the economy, locally as well as internationally. People who are infected by a waterborne disease are usually confronted with related costs and not seldom with a huge financial burden. This is especially the case in less developed countries. The financial losses are mostly caused by e.g. costs for medical treatment and medication, costs for transport, special food, and by the loss of manpower. Many families must even sell their land to pay for treatment in a proper hospital. On average, a family spends about 10% of the monthly households income per person infected.  Infections by type of pathogen Protozoan Disease and Transmission Microbial Agent Sources of Agent in Water Supply General Symptoms Amoebiasis (hand-to-mouth) Protozoan ( Entamoeba histolytica ) (Cyst-like appearance) Sewage , non- treated drinking water , flies in water supply, saliva transfer (if the other person has the disease) Abdominal discomfort, fatigue , weight loss, diarrhea , bloating , fever Cryptosporidiosis (oral) Protozoan ( Cryptosporidium parvum ) Collects on water filters and membranes that cannot be disinfected , animal manure , seasonalrunoff of water. Flu-like symptoms , watery diarrhea, loss of appetite, substantial loss of weight, bloating , increased gas, nausea Cyclosporiasis Protozoan parasite ( Cyclospora cayetanensis ) Sewage , non- treated drinking water cramps , nausea, vomiting , muscle aches, fever, and fatigue Giardiasis (fecal- oral) (hand-to- mouth) Protozoan ( Giardia lamblia ) Most common intestinal parasite Untreated water, poor disinfection, pipe breaks, leaks, groundwater contamination, campgrounds where humans and wildlife use same source of water. Beavers and muskrats createponds that act as reservoirsfor Giardia. Diarrhea, abdominal discomfort, bloating , and flatulence Microsporidiosis Protozoan phylum ( Microsporidia ), but closely related to fungi Encephalitozoon intestinalis has been detected in groundwater , the origin of drinking water  Diarrhea and wasting in immunocompromised individuals. Bacterial Disease and Transmission Microbial Agent Sources of Agent in Water Supply General Symptoms Botulism Clostridium botulinum Bacteria can enter an open wound from contaminated water sources. Can enter the gastrointestinal tract through consumption of contaminated drinking water or (more commonly) food Dry mouth, blurred and/or double vision , difficulty swallowing, muscle weakness, difficulty breathing, slurred speech, vomiting and sometimes diarrhea . Death is usually caused by respiratory failure . Campylobacteriosis Most commonly caused by Campylobacter jejuni Drinking water contaminated with feces Produces dysentery like symptoms along with a high fever . Usually lasts 2–10 days. Cholera Spread by the bacterium Vibrio cholerae Drinking water contaminated with the bacterium In severe forms it is known to be one of the most rapidly fatal illnesses known. Symptoms include very watery diarrhea, nausea , cramps , nosebleed , rapid pulse , vomiting, and hypovolemic shock (in severe cases), at which point death can occur in 12–18 hours. E. coli Infection Certain strains of Escherichia coli (commonly E. coli ) Water contaminated with the bacteria Mostly diarrhea. Can cause death in immunocompromised individuals, the very young, and the elderly due to dehydration from prolonged illness. M. marinum infection Mycobacterium marinum Naturally occurs in water, most cases from exposure in swimming poolsor more frequently aquariums ; rare infection since it mostly infects immunocompromised individuals Symptoms include lesions typically located on the elbows, knees, and feet (from swimming pools ) or lesions on the hands ( aquariums ). Lesions may be painless or painful. 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