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Dysentery

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Pengenalan asas mengenai DYSENTERY

Publié dans : Santé & Médecine
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Dysentery

  1. 1. DANGER SIGN:
  2. 2. DYSENTRY Disediakan Oleh : Nassruto.
  3. 3. LEARNING OBJECTIVE: • Define the meaning of Dysentery. • Explain the etiology of Dysentery. • Describe the pathofisiology of Dysentery infection. • Describe the clinical manifestation of Dysentery. • Explain the management of Dysentery treatment.
  4. 4. DEFINITION: • Dysentery is diarrhea presenting with loose frequent stools containing blood. • WHO – 2000. • An inflammation of the intestine, especially of the colon, that may be caused by chemical irritants, bacteria, protozoa, parasites. • Mosby’s Dictionary. • Characterized by frequent and bloody stools, abdominal pain and tenesmus. • ( Jangkitan akut ke atas usus besar yang disebabkan oleh shigella yang bercirikan cirit-birit dan najis mengandungi darah ).
  5. 5. ETIOLOGY: • Causes agent is by bacteria: • Shigella dysenteriae. • Shigella Flexneri. • Shigella sonnei.
  6. 6. ETIOLOGY: • Agent is bacteria. • Route is mouth. • Factor is contaminated food and H20 with faeces. • Direct transmission via Oral faecal route or by vectors. • Mostly easy infected to the children and food providers.
  7. 7. PREVALEN: • Spread to world wide. • Endemic plague to the poor country, highly population / crowded, World war / Disaster, Sanitation unstructured. • Common case infected to the children.
  8. 8. PREVALEN: • Window period is 1 – 4 days, Short time. • Period of infected is from the first expose until no more bacteria Shigella detection in the feaces. • Sign of diarrhea is the active time to be infected.
  9. 9. PATHOFISIOLOGI: • Contaminate food & H20 by infected faeces. • Bacteria Shigella enter to the gut. • Growth in the small intestine. • Spread to the colon, inflame the epithelium mucosa cell and produce or secrete toxin. • Break through the colon wall & necrosis the epithelium cell causes haemorrhage, more mucus, purulent at the epithelium surface. • At the end, ulcer colon occurs.
  10. 10. MANIFESTATION: • Sudden onset, had headache, malaise, anorectic and mild fever. • Abdominal discomfort, more severe pain & cram, at last colicky pain. • 4 - 5 x diarrhea sign in the first day infected. • Frequency of diarrhea increase 1-2 days.
  11. 11. MANIFESTATION: • Watery stools. • Brown-yellowish color. • Less stools but more mucus & blood. • Diarrhea will continuously in period of time - 1/52 or more. • Tenesmus.
  12. 12. Tenesmus: • Persistent spasms. • Internal pressure and burning sensation intra abdomen and opening anus. • After past motion. • Ineffectual to empty the bowel. • Common in inflammatory bowel disease and irritable bowel syndrome.
  13. 13. MANIFESTATION: • Tenderness abdomen. • Convulsions. • Lethargy. • Dehydration: • Dry mouth, tongue, skin terger high, sunken eye etc. • Rectal prolapse.
  14. 14. DETACTION: • If have diarrhea: ( Look and feel ). • Look general condition: • Lethargic/ restless / irritable / unconscious. • Eyes. • Able to drink. • Pinch the skin. • Is there blood in the stool?. • Investigate.
  15. 15. Investigation: • Swab rectal for culture: To fine out the causes agent.
  16. 16. DIFFERENT DIAGNOSIS: • Ameobiasis. • Ulcerative colitis. • Crohn’s colitis. • Ischaemic colitis. • Diverticulitis. • Karsinoma colon.
  17. 17. Complications: • Intestinal hemorrhage. • Perforation. • Peritonitis. • Prolaps rectum. • Arthritis. • dehydration – to children.
  18. 18. TREATMENT AND MANAGEMENT. • Admitted for barrier nursing, complete rest. • Soft diet / fluid diet- less fiber to reduce burden function of intestine. • Encourage to increase fluid intake. • Intravenal infusion to control the electrolyte balance.
  19. 19. TREATMENT AND MANAGEMENT: • Medication: • ORS. • Antibiotic: • Ampicillin. • Adult : 500mg qid x 5/7. • Children : 125mg / 5 ml. – 62.5 mg. • co-trimoxazole / Metronidazole • Cephalosporins ( cefalexin, cefamandole ). • Symptomatic treatment.
  20. 20. TREATMENT AND MANAGEMENT: • Health Education: • Personnel hygiene. • Environmental hygiene. • Good sanitation / purification water supply. • Food Handling care. • Complete cooking.
  21. 21. PROGNOSIS: • Early treatment is important to prevent complication occur and safe life. • Common mortality in infant / children / old age. • Effect to less body immune response due to less nutrition.
  22. 22. S.1 Kanak-kanak 9 tahun dibawa ke klinik anda mengadu mengalami diarrhea bercampu darah dan merasa pedih selepas membuang air besar. MRK. A. Senaraikan empat ( 4 ) agen penyebab berlaku disenteri. 4 mrk. B. Jelaskan tiga ( 3 ) aspek pendidikan kesihatan yang perlu ditekankan kepada kes di atas. 6 mrk. GERAK KERJA 1

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