Prognosis, Biology

Assignment Help:

The course and ultimate prognosis of ARF is usually directly related to the severity of carditis. The course and prognosis also depends upon recurrence of rheumatic fever. In pre-penicillin era, recurrences of ARF were seen in upto 70 per cent of patients. There is always a tendency to develop rheumatic fever with repeated GAS infections. There is greater chance for recurrence in young children and in the first 3 years after the first attack and in patients with established rheumatic heart disease. If patient had carditis in first attack of ARF, there is always a tendency to have carditis in subsequent attacks. With each recurrence, there is progressive deterioration in valvular lesions and myocardial function. However, if patient is managed well after first attack of ARF and proper prophylaxis is carried out, the recurrent attacks can be prevented. In the UK-USA collaborative study, only 6 per cent of patients with no carditis during first attack of ARF were having murmur after 10 years of first attack.  But in patients who developed carditis during first attack of ARF as evidenced by apical systolic murmur, basal diastolic murmurs, CCF, pericarditis, heart disease was present in 30 to 68 per cent at follow up.

Patient is advised bed rest preferably in the hospital. Patient must take bed rest till fever, leucocytosis, ESR, CRP are settled (see Table 1.3 for guidelines of bedrest). If patient develops heart failure due to acute carditis, he should be given digitalis and diuretics with low salt diet. GAS infection should be treated even if throat culture is negative by either single IM injection of benzathine penicillin (1.2 mega units) or oral penicillin for 10 days. If patient is allergic to penicillin, Macrolides or cephalosproins should be given for 10 days. For polyarthritis, high doses of salicylates are used.  Aspirin in the dose of 100 mgm/kg/day to maintain a serum level of 20 mg per cent are required. Gradually the dose should be tapered as clinical and laboratory features of inflammation (ESR, CRP) subside.


Related Discussions:- Prognosis

Uses of plural embryos, Uses of Plural Embryos Although the basic tha...

Uses of Plural Embryos Although the basic that trigger causes polyembryony are not fully understood, there has been no dearth of interest in exploiting supernumerary embryos.

Explain about the weight imbalance, Explain about the Weight Imbalance? ...

Explain about the Weight Imbalance? You are aware that obesity is one of the major public health problems of the world, Earlier a problem of the developed nations; it is now in

Sequence for the beta actin gene, The sequence for the Beta Actin gene (ACT...

The sequence for the Beta Actin gene (ACTB) is given below. Which pair of primers (designed to amplify the entire sequence below) could be used to successfully produce the beta act

Compare the modes of intercellular communication, Compare the modes of inte...

Compare the modes of intercellular communication used by the endocrine and nervous systems and discuss the functional significance of the differences between the two systems.

What are the three main types of trophic pyramids, What are the three main ...

What are the three main types of trophic pyramids studied in Ecology? The three types of trophic pyramids studied in Ecology are the numeric pyramid, the biomass pyramid and th

Estimation of protein by growth and body, Define Estimation of Protein by G...

Define Estimation of Protein by Growth and body, weight changes? The methods under this category include Protein efficiency ratio (PER) Net protein ratio (NPR)

Argument, do you can write argument i will send you the article you want wr...

do you can write argument i will send you the article you want write from with rules please call me at 623-552-8532

Neurons, how does sodium and potassium ions maintain the resting petential ...

how does sodium and potassium ions maintain the resting petential of neurons

Does the fish heart pump venous or arterial blood, Does the fish heart pump...

Does the fish heart pump venous or arterial blood? The venous blood coming from the tissues enters the atrium and passes to the ventricle that then pumps the blood towards the

Define nitrogen estimation - kjeldahl''s method, Define Nitrogen Estimation...

Define Nitrogen Estimation - Kjeldahl's Method? Nitrogen in the protein is estimated by a method referred to as Kjeldahl's method. Although over a period of time many other met

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd