Chikitsa Sutra

 Typhoid Fever treatment Suspect when fever is high , continuous , lasting for over a week. Patient looks ill, with mild splenomegaly , relative bradycardia (no tachycardia), Leukopenia, and Wild test is positive. Treatment  Bed rest. Small frequent feeds. Soft diet - Avoid chillies , spicy and oily foods. Maintain oral hygiene. IV. Ciplox 200 mg bd * 2-4 days, Then Tab. Ciplox 500 mg bd for 10-15 days (Ciprofloxacin) OR IV. Oflox 200 mg 12hrly * 2-4 days, then Tab. Oflox 500 mg bd for 10-15 days (Ofloxacin) OR IV. Chloromycetin 1 mg 6 hrly * 2-4 days, then cap. Chloromycetin 500 mg  6 hrly for 2 wks. (Chlor-amphenicol). Tab. Ultragin 6 hrly or S.O.S. when there is fever. (Paracetamol). Tab. Rantac 150 mg bd (Acid inhibitors). Tab. Wysolone 10 mg tds * 5 days, if the patient is toxic (Steroid ). Tab. Perinorm 1 tds - if there is vomiting (antiemetic) IV. Fluids - during acute phase, as and when necessary. If there is no response after 4-5 days Probably there is resistance to quinolones

 Fever with Chills Think of Malaria and Urinary Infection In endemic areas, Rule out filariasis, (and if no cause is apparent, think of hidden abscess) Ask for Blood smear for M.P., Urine, Hb% & WBC. A. If chills & shivering is severe, OR If fever comes on alternate days, or at the same time everyday OR If spleen is palpable, suspect malaria. Tab. Resochin 4 stat, 2 after 6 hrs, then 2 daily * 2 days To be taken after food , with antacids ( Chloroquine ) Tab. Reglan 1 tds, if nausea & vomiting due to chloroquine ( Metoclopramide ) Tab. Primaquine 7.5mg * 2 tabs daily * 14 days (for radical cure in PI. Vivax infection ).  If  P. Falciparum Malaria Tab. Resochin 4-2-2-2 as above ( Chloroquin ) with antacid & antiemetic. To take care of chloroquine Resistance, add two of the following drugs- Tab. Falcigo 50mg 2 bd * 1, then 1 od * 4. OR Cap. Larither 40mg bd * 1 , then 1 od * 4 ( Artemether ) Tab. Quininga 300mg 1 tds * 10days ( Quinine) Tab. Amlar 3 tabs stat-single dose

 FEVER When a patient presents with fever, check the temperature with thermometer. It is an important record. Most fevers encountered in General Practice are viral, self limiting and require only symptomatic treatment. Symptomatic treatment Tab. Crocin 1 (Paracetamol) Inj. Febrex 2cc IM if fever >100⁰C or 38⁰C  Tab Trap 1 BD or TDS of bodyache (Tramadol ) or combinations with NSAIDs. , Ibuprofen + Paracetamol eg. Ibuflamar . P., Tramadol + Paracetamol eg. Ultracet, Calpol-T Tab. CZ-3 1OD if colds (Anti-histaminics ) General measures cold compresses or icebag - over forehead, axillae, neck etc. (fore detail , contact us ) bed rest with blanket. semi solid or liquid diet, Avoid cold water, Avoid exposure to wind. Avoid bath - only sponging. Before  labeling a fever as viral, you must look for (as a compulsory routine) pallor, jaundice, Neck stiffness, Abdomen for liver & spleen and auscultate the chest. If there is a running epidemic eg. Malaria, influenza, viral hepatitis or typh