A 48 years old patient admitted with the complaints of thickening of skin and inflammation

• PATIENT NAME

• AGE

• SEX

• WEIGHT

• DEPT.

• DOA

• XXXXXXXX

• 48

• MALE

• 72

• ORTHOPEDIC

• 21/2/2014

PAST MEDICAL HISTORY :- NILPAST MEDICATION HISTORY :-NIL

SOCIAL HISTORY ALCOHOL : NO

SMOKING: NOMARITAL STATUS: MARRIED

VITAL SIGNS

DATE 7/11/2014 8/11/2014 9/11/2014 10/11/2014

TEMP. 98 100 100 102

BP 110/80 110/70 110/80 110/70

PULSE 80 76 74 80

RESPIRATORYRATE

20 20 20 20

• 74%

• 20%

• 6%

• 8%

• NEUTROPHILS

• LYMPHOCYTES

• ESINOPHILS

• MONOCYTES

• HEAMOGLOBIN

• WBC

• BLOOD SUGAR

• CREATININE

• 72%

• 6200

• 150mg/dl

• 1.0mg/dl

• The finger prick test draws blood from the capillaries of the finger tip; larger veins can be used for blood extraction

• Examples are W. bancrofti, whose vector is a mosquito; night is the preferred time for blood collection

ASSESMENT

DIAGNOSIS

AETILOGY

• The rapid and unplanned growth of cities, and the mosquito breeding grounds they can develop, may be a primary cause of the Elephantiasis that the parasitic filarial worms Wuchereria Bancrofti and Brugia Malayi, that live up to six years almost exclusively in the lymphatic system of humans, may create.

PATHOPHYSIOLOGY

• Elephantiasis is caused by WUCHERERIA BANCROFTI (it is a human parasite roundworm that is the major cause of lymphatic filariasis )

• Elephantiasis is the result of an obstruction or blockage of the lymphatic system and possibly of blood circulation

• This obstruction causes fluid to collect on the tissues of the body, which can lead to great swelling called lymphoedema

•Limb can become so massive that they resemble an elephant foreleg in size, texture and colour

• Life cycle carrys out in two stages

• Human beings as definitive host

• Mosquito as intermediatte host

• The first stage larvae, known as microfilaria are present in circulation

• Microfilaria is present in peripheral blood and can be found to be peak in between 10pm to 2am.

• During the day they present in veins and during night they migrate into peripheral circulation.

• Microfilaria is converted to vecor and continue the life cycle

• Elephentiasis is a disease that is notable for the thickening of the skin and underlying tissues, especially in the legs and male genitals

•Sometimes, the disease can cause certain body parts , such as the scrotum, to swell to the size of a basketball• More rarely, it can cause swelling in the vulva it is caused by filariasis or podoconiosis.

S. NO DRUG GENERIC NAME CLASS OF DRUG DOSE

1) STROMECTOL IVERMECTIN ANTHELMINTICS 150-250mg

2) VERMOX MEBENDAZOOLE ANTHELMINTICS 100mg

3) ALBENZA ALBENDAZOLE ANTHELMINTICS 400mg

PLAN

S. NO DRUG GENERIC NAME DOSE FREQUENCY DATE :7/11/2014 :8/11/2014

1) STROMECTOL IVERMECTIN 150mg BD + +

2) RANTAC( ANTACID)

RANITIDINE 50mg BD + +

3) AMPICILLIN(ANTIBIOTIC)

AMPICILLIN 500mg BD + +

4) VOVERON(PAIN KILLER)

DICLOFENAC SODIUM

25mg BD + +