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PRESENTATION ON FEBRILE DISORDER

PRESENTATION ON FEBRILE DISORDER. FEVER. FEVER IS AN ELEVATION OF BODY TEMPERATURE ABOVE NORMAL WHICH RESULTS FROM AN IMBALANCE BETWEEN THE HEAT PRODUCED AND ELIMINATED FROM THE BODY . CAUSES OF FEVER . EXOGENOUS FACTOR :-. FEVER MAY BE CLASSIFIED AS :-.

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PRESENTATION ON FEBRILE DISORDER

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  1. PRESENTATION ON FEBRILE DISORDER

  2. FEVER FEVER IS AN ELEVATION OF BODY TEMPERATURE ABOVE NORMAL WHICH RESULTS FROM AN IMBALANCE BETWEEN THE HEAT PRODUCED AND ELIMINATED FROM THE BODY.

  3. CAUSES OF FEVER

  4. EXOGENOUS FACTOR :-

  5. FEVER MAY BE CLASSIFIED AS :-

  6. With the rise in body temperature above normal ( 98.4˚F or 37 ̊C ) the following metabolic occurs inside the body . These changes are in proportion to the elevation of body temperature above normal and the duration of fever. • There is a 7% increase in BMR with every 1˚F increases in body temperature or 13 % increase with every 1˚C rise in body temperature. This change is more significant in patients suffering from acute fever. • Glycogen and adipose tissue stores decrease significantly because of increased energy expenditure. • Rate of protein catabolism increases. • Loss of body fluid in the form of excessive sweat & urine formation. • Increased loss of minerals. • Absorption of nutrients decreases.

  7. Loss of appetite • Loss of weight • Headache

  8. GENERAL DIETARY CONSIDERATIONS:-GENERAL DIETARY CONSIDRATION

  9. ACUTE FEVER-TYPHOID • Infectious disease caused by a bacteria- Salmonella typhi • Salmonella schottmullericauses parathyroid B. • The infection is transmitted through the fecal-oral route.

  10. SOURCES OF INFECTION

  11. CAUSATIVE ORGANISM:-

  12. DEVELOPMENT OF DISEASE-

  13. CONTINUE…..

  14. TRANSMISSION OF DISEASE

  15. DIAGNOSIS OF TYPHOID FEVER • Diagnosis is made by any blood , bone marrow or stool cultures and with the Widal test. • The Widal test is time consuming and oftentimes when diagnosis is reached it is too late to start an antibioticregimen.

  16. SYMPTOMS AND SIGNS :- • Continued , high inflammation of the intestine. • Formation of intestinal ulcers • Loss of tissue proteins • Disturbance in water electrolyte balance • Hemorrhage • Enlargement of spleen • Payer’s patches or flat patches of lymphatic tissue. • Diarrhea or constipation • Severe stomach ache • Abdominal absorption of nutrients decrease • Feeling of headache & anorexia.

  17. TREATMENT :- Treatment of typhoid includes-: • Rest in bed • Keeping the patient warm • Antibiotic therapy • A modified diet

  18. DIETARY MANAGEMENT :- • To maintain adequate nutrition • To restore positive nitrogen balance • To provide relief from symptoms • To correct & maintain water & electrolyte balance • To avoid irritation of intestinal tract

  19. ENERGY-: • BMR increases by about 50% • Restlessness also increases the energy expenditure • Increase energy by 10-20% • PROTEIN-: • Increased to 1.5- 2 times than normal i.e. 1.5- 2g protein /kg body wt/day • Protein foods of high biological value should be included • CARBOHYDRATES-: • A liberal intake of carbohydrate is suggested • For protein sparing action

  20. Well cooked, easily digestible carbohydrates should be included. • More of glucose can be used. • DIETARY FIBRE:- • All harsh, irritating fiber should be avoided • FATS:- • Emulsified fat should be given • Fried food should be restricted • MINERALS:- • Salty soups, broths, fruit juices, milk etc should be included • Fe supplementation is also important • VITAMINS:- • Increase the amount of vitamin A & C • Requirement of vitamin B also increases

  21. FLUID:- • Liberal intake of fluid is necessary • Fluid may be included in the form of beverages, soups, juices, plain water etc.

  22. DIET AND FEEDING PATTERN:- • As the patient is actually ill and anorexic , a high energy , high protein , full fluid diet is recommended. • Small meals at frequent intervals of 2-3 hours. • Sufficient intake of fluids and salt should be ensured. • Easily digested and absorbable:- • Bland ,low fiber , soft diet should be recommended. • Adequate nutrition:- • Well cooked , well mashed , semi-sold foods should be given.

  23. FOODS TO BE USED IN RESTRICTED AMOUNTS OR AVOIDED • HIGH FIBRE FOODS LIKE- WHOLE GRAIN CEREALS, & THEIR PRODUCTS, e.g. Whole wheat flour, & cracked wheat, whole pulses & pulses with husk. • All raw vegetables & fruits • Fried fatty foods • Chemical irritants such as- condiments, spices, pickles, relishes, chutneys, & strongly flavored vegetables like cabbage, capsicum etc.

  24. FOODS TO BE INCLUDED:- • Plenty of fluids like- juices & soups • Milk & milk based beverages • Low fiber foods such as- refined cereals, & their products, dehusked pulses, well cooked fruits, vegetable in soft & puree form & potatoes • Foods providing protein of high biological value e.g.- eggs, fish, poultry • Plain gelatin based desserts, sugars, honey, jam.

  25. MALARIA: CAUSATIVE ORGANISM

  26. MALARIA :- • Is transmitted from human to human by the bite of female anopheles mosquitoes. • Induced malaria occurs due to congenital transmission or transmission by blood transfusion. • MALARIA SIGNS AND SYMPTOMS :- • Typical malarial attacks show sequentially over 4-6 hrs. • Shaking chills, fever to 41°C or higher & the sweating stage. • Fatigue, headache, dizziness, GI symptoms, myalgia, backache & dry cough.

  27. CHRONIC FEVER-TUBERCULOSIS TUBERCULOSIS Is a chronic infectious disease Major cause of illness & death in the underdeveloped countries Caused by a bacteria Mycobacterium tuberculosis.

  28. CAUSE :-

  29. CAUSATIVE ORGANISM:- • The bacteria most affects the lungs, leading to pulmonary tuberculosis. • Infection may be localized in other organs like- lymphnodes or kidneys or may be generalised. • Small, non-motile, aerobic organism • Gram positive

  30. CLINICAL FEATURES :- • Pulmonary tuberculosis is accompanied by wasting of tissues , exhaustion , cough, expectoration ( cough with respiratory secretion ) and fever.

  31. CONT….. • As the disease progresses the patient begins to exhibit loss of appetite , pain in chest ,fatigue , weight loss , night sweats and a persistent , worsening cough. • If the blood vessel is eroded in the lungs , the sputum coughed up by the patient may become streaked with blood , also the tubercle bacilli may gain access to the blood and transported to various part of the body, establishing numerous secondary foci of infection. • Death ultimately results when sufficient damage has occurred in the lungs or other vital organs. • Lymphnodes and kidneys can also be affected. • There is increased catabolism of tissue protein and increased loss of water from the body due to perspiration, increased loss of sodium chloride and potassium salt from body.

  32. TRANSMISSION :-

  33. DIAGNOSIS :- • Diagnosis relies on • Radiology (commonly chest X-rays), a tuberculin skin test, • blood tests, as well as microscopic examination and • Microbiological culture of bodily fluids.

  34. TREATMENT :- • Refampicin , isoniazid , Pyrazinamide, & ethambutol are the drugs used • These drugs are supplied free to the patients • Treatment lasts for a minimum period of nine months • Rest, antibiotic therapy & fresh air along with nourishing food. • Social contacts are also screened and treated if necessary. • Antibiotic resistance is a growing problem in (extensively) multi-drug-resistant tuberculosis. • Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Guérin vaccine.

  35. DIETARY MANAGEMENT :- Objectives of dietary management are-: • To reduce mortality by providing nutrients required by the body’s immune mechanism • To control weakness & loss of weight • To accelerate convalescence

  36. ENERGY:- • Energy needs are increased to minimize weight loss • Energy intakes are increased by 300-500kcal/day • PROTEIN:- • Increase the protein intake • Protein foods of high biological value should be included • About 1.2-1.5 of protein/kg body weight/day must be included

  37. CARBOHYDRATES & FAT:- • Enough carbohydrate is required to meet the energy • Abundant carbohydrate help in protein sparing action • Too much fat should be avoided. • MINERALS:- • Liberal amount of Ca should be included in the diet. • Fe supplements should be given. • VITAMINS:- • Liberal amount of vitamins should be provided. • Diet should provide as much as retinol as possible. • Additional amount of ascorbic acid is recommended

  38. Good amount of vitamin D is included. • B- complex vitamins need also increase. • Provide supplements of vitamin B-6 & foliate.

  39. DIET & FEEDING PATTERN:- • A high protein, high energy, full fluid diet is given. • Meals should be simple, easily digestible, well prepared & tempting • Force feeding is harmful • Too much fat should be avoided. • All pulses should have a cereal-pulse combination • Cheap sources of vitamin C must be given • Seasonal vegetables must be given.

  40. REFRENCES :- • NUTRITION AND DIETETICS BY KUMUD KHANNA • NORMAL THERAPUTIC NUTRITION BY PROUDFIT,F.T AND REVISED BY ROBINSON • DIETETICS BY B.SRI LAKSHMI

  41. THANK YOU

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