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Fever

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Fever

  1. 1. FEVER An evil or a boon… Dr. Shelly Arora Medical Officer (Homoeopathy) Dte. Of AYUSH Govt. of NCT of Delhi
  2. 2. Body Temperature  The body temperature refers to the temperature of the viscera and tissues of the body.  It is kept within the normal level by maintaining a balance between the heat gain and heat loss, which is regulated by hypothalamus.  The normal body temperature varies from 36.6ºC – 37.2ºC (98-99ºF).  There is normally a diurnal variation of 1ºC.
  3. 3. What is Fever  Body temperature above the usual range of normal i.e. 36.6 – 37.2ºC (98-99ºF).  It is caused by an elevation in thermo-regulatory set-point i.e. due to a disturbance of heat regulation, the thermostatic mechanism controlling heat gain and loss is set at a level higher than normal.
  4. 4. Result of increase in temperature regulatory set-point The body attempts to counteract the newly- perceived hyperthermia and reach the new thermo- regulatory set-point by:  Increase in muscle tone  Increase in heart rate  A feeling of cold, resulting in greater heat production  Body’s effort to conserve heat  Shivering
  5. 5. Classification of Fever GRDE CELSIUS FAHRENHEIT Normal temperature 36.6-37.2 98-99 Low Grade 37.2-37.8 99-100 Moderate 37.8-39.4 100-103 High Grade 39.4-40.5 103-105 Hyperpyrexia >40.5 >106 Hyperpyrexia is a medical emergency because it approaches the upper limit compatible with human life.
  6. 6. Causes of Fever Fever is caused by an abnormality in Body’s Temperature regulation, which results from:  An abnormality in the brain itself.  Toxic substances that affect the temperature regulating centre.
  7. 7. Some Causes of Fever are:  Infections: bacterial, viral, rickettsial, fungal, parasitic etc  Neoplasms  Vascular: acute MI, pulmonary embolism  Immunological: Sarcoidosis, IBD, RA, Drug disease  Tissue destruction eg. Hemolysis, surgery  Metabolic: Gout  Heat Stroke, radiation sickness etc.  Unexplained - PUO
  8. 8. Fever is not a Disease Fever is not itself a disease but the body’s response to a disease. It is considered as one of the body’s immune mechanism to attempt a neutralization of a perceived threat inside the body, be it bacterial or viral.
  9. 9. Various Studies Various studies suggest:  The patient recovers more rapidly from infections or critical illness due to fever.  There is reduced mortality in bacterial infections when fever is present. Fever was found beneficial in some diseases like cancer, neurosyphillis etc. Fever was often induced in these diseases by injection of milk protein or BCG vaccine.
  10. 10. Usefulness of Fever It has been suggested that fevers may be useful to some extent since:  They allow the body to reach high temperature, where some pathogens with strict temperature preferences can be hindered.  Fever aids in Host defence by-  Increased proliferation of WBCs, which help fight off the harmful pathogens and microbes that invade the body.  Enhanced Leukocyte phagocytosis  Endotoxin efects decreased  Increased proliferation of T-cells  Enhanced activity of interferon
  11. 11. Treatment Both aggressive treatment of fever and too little fever control can be detrimental. This depends on the clinical situation. Therefore, careful assessment is needed.
  12. 12. Treatment  With the exception of very high temperature, treatment to reduce fever is often not necessary.  It is rare for an untreated fever to exceed 40.6 C (105 F).  Damage to Brain generally doe not occur until temperatures reach 42 C (107.6 F).  Most people recover without specific medical treatment.  Fever is an important sign of an illness in the body. It should be used to govern the medical treatment and guage its effectiveness.
  13. 13. Management Even when treatment is not indicated, general measures should be taken in a case of fever:  Keep patients adequately hydrated as dehydration produced by a mild fever can be more dangerous than the fever itself.  Facilitate Heat-loss by-  Wet clothes, usually applied to forehead, bathing body in tepid water.  Perspiration
  14. 14. Homoeopathic perspective “Treat the Patient, not the Disease” According to Samuel Hahnemann (in Organon of Healing Art) all kinds of Fevers should be treated in the same manner as any other disease.
  15. 15. Homoeopathic Prescribing in Fever A medicine should never be prescribed simply to control Fever. Rather, a similimum has to be found according to the totality of the case.  The patient should be observed carefully, taking note of all the changes in the health of the body and mind since the current illness (fever).  The totality of the symptoms should be perceived, embracing the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease; and the most similar remedy found.  The Fever – its name / type is just one of the symptoms and is of the least value in selection of the remedy, being the general (common) symptom.
  16. 16. Homoeopathic Prescribing in Fever  Our Materia Medicas and Repertories are full of symptoms associated with Fever, which characterize the case of fever - indicating the type, sensations associated, time, modalities, concomitants etc.  Hahnemann has given special instructions in his Organon of Healing Art regarding the treatment of intermittent fevers (§ 321-244).  Various stalwarts have written books with instructions on treatment of fevers:  Intermittent Fever by H.C.Allen  Repertory to the Symptoms of Intermittent Fever by W.A.Allen
  17. 17. Bibliography  Guyton, Arthur C. Textbook of Medical Physiology, Eighth edition  Mehta,P.J. Practical Medicine for Students and Practitioners, Thitteenth edition, 1998  Hutchinson’s Clinical Methods, Twentieth edition  Hahnemann, Samuel. Organon of Medicine, translated from the fifth edition with an appendix by R.E.Dudgeon;with additions and alterations as per sixth edition translated by William Boericke  Khan L.M., Pleasure of Prescribing  en.wikipedia.org/wiki/fever  wikidoc.org/index.php/Fever_usefulness_of_fever  www.webmd.com/first-aid/fevers-causes-symptoms-treatments  www.ncbi.nlm.nih.gov/pubmed

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