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 (Sulfadoxine + Pyrimethamine)

B. If associated Burning micturition , cloudy urine , or loin pain - suspect Urinary Infection.

Tab. Norflox 400mg bd * 5-10 days (Urinary antibiotic)
Cital * 1 tsp in glass of water * tds (Alkaliniser)
Tab. Pyridium 1 tds * if burning sensation ( Phenazo - pyridine ) OR Tab. Flavoxate.
Plenty of water & fluids.

C. In Endemic areas of filariasis, think of filarial infection , especially if associated with edema of leg or inguinal lymphadenopathy.

Tab. Banocide 100 mg tds * 21 days (Diethylcarbamazine)
Tab. Wysolone 5 mg bd * 10- 15 days * after food (Prednisolone).

Comments

Common Cold (Rhinitis)

Common Cold (Rhinitis) Common Cold is a self Limiting condition, the aim is symptomatic relief. Steam inhalations. Vicks Inhaler, Vicks or halls lozenges. Tab. Disprin 1 tds (Aspirin ) OR Tab Crocin 1tds (Paracetamol for relief from bodyache, feverishness). Tab. Foristal 1 tds (Anti histaminics ). OR Combination drugs eg. -Tab. Rinostat 1/2-1 tds. or -Tab. Wikoryl 1 tds. Otrivin nasal drops if blocking of nostrils (Xylometazolin ). Tab. Celin 500 mg OD * 6-10 days (Vit-C). If it progresses to Pharyngitis or Bronchitis, then add antibiotics. Tab L-cin 500 mg od * 5 days or Ampicillin/Amoxycillin/Erythromycin/Ciprofloxaxin etc. IF Attacks are frequent, (Allergic Rhinitis). Tab CZ3 1 od * 30 days (Cetirizine). Tab Telekast 10/ Telekast-L1 od * 30 days (Monteleukast + Levocetrizine). High Protein diet and Regular exercises. Inj. Neurobion 2 cc IM daily * 5 Cap. Becadex bd * 30 days (Multivitamin). Tab. Ativan 1mg bd if anxiety / tension (Lorazepam) If sneezing ...

Typhoid Fever treatment

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...

Chikitsa Sutra

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