Which drug and what dose is required to deworm the 13 month old baby?

Patient male, 42 years old. Sudden postoperative pain in the sternum for 3 days in the emergency department, the electrocardiogram is shown below. Emergency room BP160 / 102mmHg, symmetrical blood pressure in both upper limbs, double lungs (-), early diastolic murmur in the aortic valve area. *Discussion: * 1. ECG analysis. 2. Diagnostic considerations? 3. What to check next?

UNCOMMON MANIFESTATIONS of COVID-19 Recent findings suggest that a significant number of people with COVID-19 may experience digestive symptoms. New research data says that out of all the patients who approached for medical care half of them have come up with the symptoms of the digestive system, such as loss of appetite and diarrhea. As the world races to find the best ways to cope with the new coronavirus, researchers continue to contribute to our understanding of COVID-19, the disease that the virus causes. The exact symptoms are the main point of interest. As with many other viral infections, SARS-CoV-2 infections cause different symptoms in different people. But WHICH SYMPTOMS ARE THE MOST COMMON? According to information from the World Health Organization (WHO), three of the most common symptoms are fever, coughing, and some difficulty breathing. However, people with COVID-19 have reported many other symptoms, including digestive ones. While the WHO still consider digestive symptoms to be uncommon, a new study from the Wuhan Medical Treatment Expert Group for COVID-19 suggests that such symptoms may be more widespread than specialists had thought. Digestive symptoms in 50.5% of patients were observed. The expert group behind this new study — the findings of which appear in The American Journal of Gastroenterology — analyzed data from 204 people who received medical care for COVID-19 between January 18 and February 28, 2020. The patients had an average age of 52.9 years, and of the total, 107 were male and 97 female. When they presented to a hospital, 103 of the 204 people — or 50.5% — were experiencing digestive symptoms. The main symptom reported was diarrhea, and other symptoms included vomiting, in four individuals, and abdominal pain, in two. Moreover, the digestive symptoms among the larger group grew more severe as the severity of COVID-19 increased the researchers' report.

Hi Curofians! I'm Dr. Nasir, a Family Medicine practitioner working in Singapore. This post is regarding the zone arrangements for the patients during and after the circuit breaker in running the OPD. In patient clinic, you should have 3 zones. 1. Red zone - For Suspected cases with travel or contact history with fever, should be straight asked to go to the hospital for a swab. 2. Orange zone - URTI symptoms without fever. 3. Green zone - No fever, no URTI symptoms. -In all these 3 zones patients shouldn't mix up with each other. - Full PPE in the orange and red zone is recommended. - Partial PPE in the green zone is recommended. - You should have additional staff in PPE to segregate patients in 3 zones, another staff to make sure these 3 zones patients should not mix up with different waiting areas. - The doctor going to see the patient will know in advance what type of patient he or she going to see. I hope it helps.

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Hello everyone, Here are some important facts about COVID-19. From Clinical presentations to treatment. Please check it out and feel free to add more points. CLINICAL PRESENTATION: In a study describing 1099 patients with COVID-19 pneumonia in Wuhan, the most common clinical features at the onset of illness were: •Fever in 88% •Fatigue in 38% •Dry cough in 67% •Myalgias in 14.9% •Dyspnea in 18.7% Pneumonia appears to be the most common and severe manifestation of infection. In this group of patients breathing difficulty developed after a median of five days of illness. Acute respiratory distress syndrome developed in 3.4% of patients. Other symptoms •Headache •Sore throat •Rhinorrhea •Gastrointestinal symptoms About 80% of confirmed COVID-19 cases suffer from only mild to moderate disease and nearly 13% have the severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours). Critical illness (respiratory failure septic shock, and/or multiple organ dysfunction/failure) is noted in only in less than 6% of cases. INCUBATION PERIOD: The exact incubation period is not known. It is presumed to be between 2 to 14 days after exposure, with most cases occurring within 5 days after exposure. THE SPECTRUM OF ILLNESS SEVERITY: Most infections are self-limiting. COVID-19 tends to cause more severe illness in the elderly population or in patients with underlying medical problems. As per the report from the Chinese center for disease control and prevention that included approximately 44,500 confirmed Infections with an estimation of disease severity. • Mild illness was reported in 81% of patients. • Severe illness (Hypoxemia, >50% lung involvement on imaging within 24 to 48 hours) in 14%. • Critical Disease (Respiratory failure, shock, multi-organ dysfunction syndrome) was reported in 5 percent. • Overall case fatality rate was between 2.3 to 5%. AGE AFFECTED: • Mostly middle-aged (>30 years) and elderly. • Symptomatic infection in children appears to be uncommon, and when it occurs, it is usually mild. **The 4th version of Belgian guidance for COVID 19 is published on19th March 2020. It is one of the most precise guidelines published yet. Some points from that: 1. Chloroquine is found to have good efficacy in vitro and it reduces the duration of viral shedding. But the drug has a narrow therapeutic window and cardiac toxicity is the most limiting side effect. 2. Hydroxychloroquine is more potent and is superior to chloroquine according to the very recent Gautret’ study. 3. Azithromycin may have a viral suppressive effect, but this needs to be proved as it was noticed accidentally in 6 patients of Gautret’ study. But I think it is a good choice for coverage of bacterial pneumonia. 4. Lopinavir/Ritonavir recently shown not to provide clinical benefit in hospitalized patients with COVID-19. It may reduce ICU stay if given within 10 days of infection but not beyond. 5. Remdesivir is promising but the studies are ongoing. Also, availability is a key issue. 6. Corticosteroids are not recommended as a systemic adjunctive treatment. 7. Paracetamol is the first-line analgesic and antipyretic over NSAIDs which are used with caution. 8. No need to stop ACEIs/ARBs in non-hospitalized patients. CONSIDER changing ACEIs/ARBs to another equivalent antihypertensive in hospitalized patients. 9. Antiviral therapy is not indicated in all patients with suspected/confirmed COVID19.