Prulifloxacin 600mg (Percin 600)can give thyroid fever pt.

24 yr old 16 wk pregnant pt having following investigation....Rx for it

A woman in first week after delivery has high grade fever with rigor and chills after blood transfusion.Her blood smear is positive for P.vivax parasite. Her baby is healthy and she is nursing her child.what treatment is indicated ?

Very often we come across this situation ! MUST the patient be Fasting for a Lipid profile ? The answer, certainly depends upon what we want to measure. ! Surprised. ? Need not be! Let me explain ! Eating raises plasma triglycerides but only has a minimal impact on total cholesterol or HDL-C or apo-B. But LDL-C is a calculated number that depends on the level of plasma triglycerides and therefore requires a Fasting specimen. Yes , the patient must be Fasting if we want LDL-C. A Fasting sample is needed for the classical lipid profile ( total cholesterol, triglycerides, HDL-C and LDL-C ) because the treatment goals and proven benefits of treatment are targeted at LDL-C. But the patient need not fast if we want total cholesterol, HDL-C, non- HDL-C, or apo-B. Total cholesterol and HDL-C are the only Measurements we need to know to determine non- HDL-C. And non HDL-C includes All of the Cholesterol in all of the potentially atherogenic lipoproteins containing apo-B ( any lingering Chylomicron remnants, VLDL-C, IDL-C, LDL-C and Lp (a) ). Non HDL-C is useful Measure to consider when the triglycerides are in the range of 200 - 499 , but then cannot be calculated when the triglycerides exceed 500.

CAUSES OF SECONDARY AMENORRHEA. DISORDERS ASSOCIATED WITH LOW OR NORMAL FSH : 66 % of cases . 1. Weight loss /Anorexia. 2. Chronic Anovulation including PCOS 3. Hypothyroidism. 4. Cushing syndrome. 5. Pituitary tumor , empty sella syndrome. Sheehan syndrome. DISORDERS ASSOCIATED WITH HIGH FSH. 12 % of cases. 1. 46,XX spontaneous POF. 2. POF due to abnormal karyotype ( 45,X mosaic / ring chromosome ). 3. Pure gonadal dysgenesis. 4. Hyperprolactinaemia. 5. Asherman syndrome. DISORDERS ASSOCIATED WITH HYPERANDROGE- NISM : 1. PCOS. 2. Ovarian tumor. 3. Non classical CAH. IATROGENIC. 1. Anti psychotics. 2. Cancer chemotherapy. 3. Anti depressants. 4. Anti hypertensive.

TRICHOMONIASIS. Trichomoniasis is a sexually transmitted infection caused by the motile parasitic protozoan "TRICHOMONAS VAGINALIS". Humans are the only known host of T.vaginalis. Transmission occurs predominantly via sexual intercourse.The organism is most commonly isolated from vaginal secretions in women and urethral secretions in men. ETIOLOGY. Women who engage in higher-risk sexual activity are at a greater risk of infection. Risk factors are: 1.Multiple partners and new partners. 2.History of STD. 3.Current STD. 4.Sexual contact with an infected partner. 5.Using injection drugs. 6.Not using barrier contraception. CLINICAL PRESENTATION: WOMEN Frothy /bloody / purulent vaginal discharge. Abnormal vaginal odour (musty ) Vulvovaginal pruritis. Burning and soreness of the vulva and vagina. Dyspareunia and dysuria. TV cervicitis is characterised by purulent discharge in the endocervical canal and easily induced endocervical bleeding. MEN: Can be asymptomatic. Symptoms include purulent urethral discharge, dysuria and pruritis. PHYSICAL EXAMINATION: COLPITIS MACULARIS OR STRAWBERRY CERVIX is diffuse ,macular,erythematous lesion of the cervix.THIS IS A SPECIFIC SIGN FOR TRICHOMONIASIS. COMPLICATIONS Trichomoniasis can lead to Pelvic inflammatory disease and tubo-ovarian abscess. Increases the risk of HIV transmission. Increases the susceptibility to other infections like herpes and human papilloma virus. Increased risk of post hysterectomy vaginal cuff cellulitis and abscess. In pregnant women,there is increased risk of preterm labour,LBW and intrauterine infection. DIAGNOSIS: 1.Saline wet mount evaluation of vaginal discharge shows flagellated pyriform protozoan TRICHOMONAS. 2.CULTURE IS THE CURRENT CRITERION STANDARD FOR TRICHOMONAS DIAGNOSIS. 3.Pap smear in trichomoniasis shows coating of intermediate squamous cells with neutrophils often referred to as "CANNONBALL or POPCORN BALL "cells. TREATMENT AND MANAGEMENT. Treatment should be instituted immediately of the patient and the sexual partners. Metronidazole is the treatment of choice. 500 mg/bd/1 week. Tinidazole is also used. Partners should abstain from sexual intercourse until both have completed therapy and are asymptomatic.