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Complications of Malaria in children usually occur when the infection becomes severe, especially with Plasmodium falcipa...
15/03/2026

Complications of Malaria in children usually occur when the infection becomes severe, especially with Plasmodium falciparum. Children under 5 years are particularly vulnerable because their immunity is not fully developed.

Below are the complications 👇👇

15/03/2026

Hypertension (high blood pressure) is often called a “silent killer” because many patients have no obvious symptoms for years. However, when blood pressure becomes very high or complications develop, some signs may appear.

Below are the signs👇👇

The physiology of ovulation describes the hormonal and ovarian changes that lead to the release of a mature o**m from th...
14/03/2026

The physiology of ovulation describes the hormonal and ovarian changes that lead to the release of a mature o**m from the o***y, usually around day 14 of a 28-day menstrual cycle.

The steps are below👇👇

Interpretations of Electrocardiogram for some pathology of the Heart1. Myocardial Infarction (Heart Attack)Key ECG Featu...
14/03/2026

Interpretations of Electrocardiogram for some pathology of the Heart

1. Myocardial Infarction (Heart Attack)

Key ECG Features

ST-segment elevation in contiguous leads
Pathological Q waves
T-wave inversion
Examples
ST elevation in II, III, aVF → Inferior MI
ST elevation in V1–V4 → Anterior MI

2. Atrial Fibrillation

ECG Findings

Irregularly irregular rhythm
No visible P waves
Variable R–R intervals

3. Atrial Flutter

ECG Findings

Saw-tooth flutter waves
Atrial rate about 250–350 bpm
Often 2:1 AV conduction

4. Ventricular Tachycardia

ECG Findings

Wide QRS complexes
Regular fast rhythm (>120 bpm)
Possible AV dissociation
⚠️ Medical emergency

5. Ventricular Fibrillation

ECG Findings

Chaotic, irregular waves
No identifiable P, QRS, or T waves
⚠️ Requires immediate defibrillation

6. Heart Block

First-degree AV block
PR interval > 0.20 s
Second-degree AV block
Some P waves not followed by QRS
Third-degree AV block
Complete dissociation between P waves and QRS complexes

7. Hyperkalemia

ECG Findings

Tall peaked T waves
Wide QRS
Absent P waves (severe cases)

8. Hypokalemia

ECG Findings

Flat T waves
Prominent U waves
ST depression

9. Pericarditis

ECG Findings

Diffuse ST elevation
PR segment depression

10. Pulmonary Embolism

Possible ECG Pattern
S1Q3T3 pattern
Sinus tachycardia
Right heart strain

Quick way to read any ECG
Rate
Rhythm
P waves
PR interval
QRS complex
ST segment
T waves

Diabetes mellitus is a Metabolic disorder of the Endocrine system, where there's relatively low insulin production, Abse...
14/03/2026

Diabetes mellitus is a Metabolic disorder of the Endocrine system, where there's relatively low insulin production, Absence or both..

It's of clinical important, because of the complications that arise from this disorder..

Here are the complications 👇


08/03/2026

Diarrhea in children


08/03/2026

The Anatomy of the Humerus

08/03/2026

ENURESIS (BED-WETTING)

Definition

Enuresis is the involuntary passage of urine in a child ≥5 years when bladder control is normally expected.

Types of Enuresis

1. Based on Bladder Control

Primary Enuresis
Child has never achieved dryness for 6 months

Secondary Enuresis
Bed-wetting occurs after ≥6 months of dryness

2. Based on Time
Nocturnal Enuresis
Occurs during sleep (most common)
Diurnal Enuresis
Occurs during daytime
Mixed Enuresis
Both day and night

Epidemiology
15–20% at 5 years
5% at 10 years
1–2% in adolescence
Boys affected more than girls
Causes
Developmental
Delayed bladder maturation
Small functional bladder capacity
Genetic
Strong family history
Sleep Factors
Deep sleep → child fails to wake
Hormonal
Reduced night secretion of ADH
Psychological
Stress
New sibling
School problems
Medical Causes
Urinary tract infection
Diabetes mellitus
Constipation
Neurologic bladder disorders

Clinical Features
Repeated bed-wetting at night
Possible daytime frequency
Urgency
Dysuria (if infection)
Constipation
Emotional distress
Evaluation

History

Age of onset
Primary vs secondary
Frequency of wetting
Fluid intake before sleep
Family history
Psychological stress
Examination
Growth parameters
Abdomen (bladder distension)
Spine abnormalities

Neurological exam
Investigations
Urinalysis
Urine culture
Blood glucose (if diabetes suspected)

Management
1. Reassurance
Do not punish the child
Explain condition to parents
Encourage support

2. Behavioral Therapy
Reduce evening fluids
Void before bedtime
Regular daytime urination
Night waking

3. Enuresis Alarm
Alarm rings when bed becomes wet
Most effective long-term treatment

4. Medications

Desmopressin
Reduces nighttime urine production

Imipramine
Alternative therapy (less commonly used)

Complications

Low self-esteem
Embarrassment
Family stress
Social withdrawal

Prognosis
Spontaneous resolution ~15% yearly
Most children become dry with age

Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD)1. Rheumatic Fever (RF)DefinitionRheumatic fever is an acute, immu...
08/03/2026

Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD)

1. Rheumatic Fever (RF)

Definition
Rheumatic fever is an acute, immune-mediated inflammatory disease that occurs 2–3 weeks after untreated throat infection caused by Group A Streptococcus.
It mainly affects children aged 5–15 years and can involve:

Heart
Joints
Brain
Skin

Repeated attacks can lead to permanent heart valve damage, called Rheumatic Heart Disease (RHD).

Pathogenesis

Child develops streptococcal pharyngitis.
Body produces antibodies against streptococcal antigens.
These antibodies cross-react with host tissues (molecular mimicry).

Inflammation occurs in:
Heart
Joints
CNS
Skin.

Important lesion in the heart: Aschoff bodies.
Clinical Features
Symptoms usually appear 2–3 weeks after sore throat.

Major Manifestations (Jones Criteria)
Carditis
Polyarthritis
Chorea (Sydenham chorea)
Erythema marginatum
Subcutaneous nodules

Minor Manifestations
Fever
Arthralgia
Elevated ESR/CRP
Prolonged PR interval on ECG

Jones Diagnostic Criteria
Diagnosis requires:
Evidence of preceding streptococcal infection PLUS
Either:

2 Major criteria, or

1 Major + 2 Minor criteria

Evidence of Streptococcal Infection
Positive throat culture
Elevated A*O titre
Positive rapid strep test
Recent scarlet fever

Major Manifestations Explained
1. Carditis
Most serious complication.
Features:
Tachycardia
New murmur
Cardiomegaly
Heart failure
Pericardial friction rub

The Rheumatic Heart Disease results from repeated carditis.

2. Polyarthritis
Migratory
Large joints affected:
Knees
Ankles
Elbows
Wrists
Responds well to aspirin.

3. Sydenham Chorea
Also called St. Vitus dance.
Features:
Involuntary movements
Emotional instability
Poor handwriting
Muscle weakness
Occurs late (months after infection).

4. Erythema Marginatum
Non-itchy rash
Serpiginous border
Mainly on trunk
Rare in dark-skinned children.

5. Subcutaneous Nodules
Small painless nodules
Over extensor surfaces
Associated with severe carditis

Investigations
ESR / CRP – elevated
A*O titre – raised
Throat culture
ECG – prolonged PR interval
Chest X-ray – cardiomegaly
Echocardiography – valve involvement
Treatment of Acute Rheumatic Fever

1. Eradication of Streptococcus
Drug of choice:
Benzathine Penicillin G
Dose:

Address

Fetha 2 EBSUTH

840021

Telephone

+2347060890286

Website

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