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Showing posts from November, 2011

Salmonella enterocolitis - food poisoning

It is a diarrheal disease and is commonly seen in cases of food poisoning. Pathogenesis: Man acquires this infection by ingesting contaminated water or food. Water is usually infected by feaces from an infected animal or human. Poultry and eggs also comprise an important source of salmonella. The organisms may be present on the outer shell or even in the yolk. The clinical syndromes that can occur in man includes gastroenteritis, enteric fever and septicaemia. In the case of enterocolitis, the salmonella bacilli attach themselves to the microvilli of the ileal mucosa by means of adhesins and then invade the cells. They cause massive efflux of fluids and electrolytes. Clinical presentaion: There is large volume watery diarrhea, fever, headache, chills, abdominal pain and tenesmus. In simple uncomplicated cases, the diarrhea will last for 3-7 days. Diagnosis is made by stool culture. The disease is self limited. Treatment consists only of correcting any fluid and electrolyte

I.V catheters - precautions

1. For adults requiring a peripheral catheter, upper extremity site is preferred. If it is for a child, then we can use both upper or lower extremities as well as scalp sites. 2. The catheter site should be evaluated everyday and if there is any sign of phlebitis, the catheter should be removed immediately. 3. For central catheters in adults, it is better to use the jugular or subclavian route rather than the femoral one. 4. Systemic antimicrobial prophylaxis is not essential when using I.V catheters.

Fatigue / stress fracture

It is a fracture that occurs not because of a single violent injury but results from repeated stress. It is commonly seen in athletes and new military or police force recruits. The pathology here is that the rate of microdamage from repeated stress exceeds the rate of repair. Thus there is accumulation of these microdamages and there is eventually a complete fracture across the full width of the bones. Majority of stress fractures occurs in the bones of the lower limbs, notably the metatarsals. Other sites may be the shaft of the tibia or the neck of femur.