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What are the main clinical differences between healthy perifiimplant thelium is often longer and in the connective tissue zone there and periodontal tissuesfi The perifiimplant In health acne treatment for men cheap decadron 0.5mg amex, there are no visual differences between perifiimplant tissues are less vascularized in the zone between the bone crest and periodontal tissues acne genetics 0.5 mg decadron mastercard. However skin care tips in urdu generic decadron 1 mg without prescription, the probing depths are usually and the junctional epithelium when compared to acne cleanser purchase 0.5 mg decadron the connective greater at implant versus tooth sites. What clinical methods and instruments should be used to detect the presence or absence of inflammation at an implant sitefi The clinical methods to detect the presence of inflammation the main clinical characteristic of perifiimplant mucositis is should include visual inspection, probing with a periodontal bleeding on gentle probing. Does perifiimplant mucositis exist in the absence of clinical signs of oral examinationfi It is necessary to probe perifiimplant tissues to assess the presfi Clinical signs of inflammation are necessary for a diagnosis of ence of bleeding on probing, and to monitor probing depth perifiimplant mucositis. There An increase in probing depth is often observed in the presence of is evidence that probing of the perifiimplant tissue using a light perifiimplant mucositis due to swelling or decrease in probing probing force is a safe and important component of a complete resistance. What perifiimplant probing depths are compatible with perifiimplant implant mucositisfi There is strong evidence from animal and human experimental It is not possible to define a range of probing depths compatible studies that plaque is the etiological factor for perifiimplant with health; of more importance are the clinical signs of mucositis. Can perifiimplant health exist around implants with reduced bone There is limited evidence for nonplaquefiinduced perifiimplant supportfi What are the histological characteristics of a healthy perifiimplant implant mucositis can resolve. What are the environmental and patientfispecific risk indicators for plant mucosa averages 3 to 4 mm in height and is covered by perifiimplant mucositisfi The portion of the perifiimplant mufi sponse to the bacterial challenge may vary between patients. Perifiimplant mucositis is characterized by a wellfidefined inflamfi the connective tissue lateral to the sulcular epithelium harbors matory lesion lateral to the junctional/pocket epithelium with a small infiltrate of inflammatory cells. Most of the intrabony an infiltrate rich in vascular structures, plasma cells, and lymfi part of the implant is in contact with mineralized bone, while phocytes. The inflammatory infiltrate does not extend apical the remaining portion faces bone marrow, vascular structures, of the junctional/pocket epithelium into the supracrestal confi or fibrous tissue. Implants that have been placed under less than ideal circumfi Perifiimplantitis is a plaquefiassociated pathological condition stances are often encountered in dayfitofiday practice. As a refi occurring in tissues around dental implants, characterized by sult, there may be an increased prevalence of perifiimplantitis inflammation in the perifiimplant mucosa and subsequent profi associated with these situations. What is the evidence for plaque/biofilm as a principal etiological facfi such as postfirestorative presence of submucosal cement and tor for perifiimplantitisfi The role of perifiimplant keratinized mucosa, ocfi iting poor plaque control and not attending regular maintenance clusal overload, titanium particles, bone compression necrosis, therapy are at higher risk of developing perifiimplantitis. Studies overheating, micromotion and biocorrosion as risk indicators for on treatment of perifiimplantitis reveal that antifiinfective treatfi perifiimplantitis remains to be determined. Does progressive crestal bone loss around implants occur in the abfi ing on probing and/or suppuration, increased probing depths sence of soft tissue inflammationfi At sites changes at implants are typically associated with clinical signs of presenting with perifiimplantitis, probing depth is correlated with inflammation. However, there are situations in which perifiimfi bone loss and is, hence, an indicator for the severity of disease. It plant bone loss may occur due to iatrogenic factors, including is important to recognize that rate of progression of bone loss malpositioning of the implant or surgical trauma. What are the main factors associated with hardfi and softfitissue lesions are larger than those at perifiimplant mucositis sites. Are there any specific microbiological and immunological characterisfi the healing process following tooth loss leads to diminished tics of perifiimplantitisfi What is the evidence for perifiimplant mucositis being the precursor of support, endodontic infections, longitudinal root fractures, perifiimplantitisfi However, the features or conditions naturally formed bone, agenesis of teeth, pressure from characterizing the progression from perifiimplant mucositis to softfitissue supported removable prosthesis, and perifiimplantitis in susceptible patients have not been identified. The onset of perifiimplantitis may occur early during followfiup as the principal factors for recession of the perifiimplant mucosa indicated by radiographic data. Perifiimplantitis, in the absence of are malpositioning of implants, lack of buccal bone, thin soft tisfi treatment, seems to progress in a nonfilinear and accelerating sue, lack of keratinized tissue, status of attachment of the adjafi pattern. Data suggest that the progression of perifiimplantitis apfi cent teeth and surgical trauma. There is strong evidence that there is an increased risk of develfi the evidence is equivocal regarding the effect of keratinized mufi oping perifiimplantitis in patients who have a history of severe cosa on the longfiterm health of the perifiimplant tissue. It apfi periodontitis, poor plaque control, and no regular maintenance pears, however, that keratinized mucosa may have advantages care after implant therapy. Data identifying smoking and regarding patient comfort and ease of plaque removal. What is the role of the perifiimplant bone in giving form to the perifiimfi examinations. The height of the papilla between implants is determined It should be noted that visual signs of inflammation can vary and by the bone crest between the implants. Results are equivocal that perifiimplant mucositis can exist around implants with variable levfi whether the buccal bone plate is necessary for supporting the els of bone support. How do we define a case of perifiimplantitis in dayfitofiday clinical pracfi tice and teaching situationsfi The following case definitions and characteristics of perifiimplant Presence of bone loss beyond crestal bone level changes resulting health, perifiimplant mucositis, and perifiimplantitis should be viewed from initial bone remodeling. It is known that there is no generic implant and that there are In the absence of previous examination data diagnosis of perifiimfi numerous implant designs with different surface characteristics, plantitis can be based on the combination of: surgical and loading protocols. The degree of physiological remodfi eling after implant placement may vary and will determine the crfi Presence of bleeding and/or suppuration on gentle probing. Clinicians should be aware that extensive perifiimplant bone traosseous part of the implant. It should be noted that visual signs of inflammation can vary and It is recommended that the clinician obtain baseline radiographic that recession of the mucosal margin should be considered in the probfi and probing measurements following the completion of the implantfi ing depth evaluation. An additional radiograph after a loading pefi riod should be taken to establish a bone level reference following How do we define a case of perifiimplant health and perifiimplant mucofi physiological remodeling. If the patient presents for the first time sitis in epidemiological or disease surveillance studiesfi How do we define a case of perifiimplant health in dayfitofiday clinical practice and teaching situationsfi How do we define a case of perifiimplantitis in epidemiological or disease Diagnosis of perifiimplant health requires: surveillance studiesfi Diagnosis of perifiimplantitis requires: Absence of clinical signs of inflammation. Epidemiological studies need to take into account the error of measurements in relafi It should be noted that probing depths depend on the height of tion to assessments of bone level changes. Furthermore, perifiimfi reported using thresholds exceeding the measurement error plant tissue health can exist around implants with variable levels of (mean 0. Epidemiological studies should ideally include previous examfi How do we define a case of perifiimplant mucositis in dayfitofiday clinical inations performed after the first year of loading. The etiology of hardfi and softfitissue defi of interest relevant to the workshop topics, and these are kept on ficiencies at dental implants: a narrative review. The authors receive, or have received, research funding, confi 2018;45(Suppl 20):S267S277. Perifiimplant health, sultant fees, and/or lecture compensation from the following comfi perifiimplant mucositis, and perifiimplantitis: case definitions panies: BioHorizons, Dentsply Sirona, Geistlich Pharma, IntrafiLock, and diagnostic considerations. Araujo | Jan Lindhe 1Department of Dentistry, State University of Maringa, Maringa, Brazil Abstract 2Department of Objective: the aim is to define clinical and histologic characteristics of perifiimplant Periodontology, Sahlgrenska, tissues in health and describe the mucosaimplant interface. Academy at University of Gothenburg, Gothenburg, Sweden Importance: An understanding of the characteristics of healthy perifiimplant tissues facilitates the recognition of disease. Mauricio Araujo, Department of Findings: the healthy perifiimplant mucosa is, at the microscopic level, comprised of Dentistry, State University of Maringa, a core of connective tissue covered by either a keratinized (masticatory mucosa) or Maringa, Brazil. The perifiimplant mucosa averages about 3 to 4 mm high, and presents with an epithelium (about 2 mm long) facing the implant the proceedings of the workshop were surface. Small clusters of inflammatory cells are usually present in the connective jointly and simultaneously published in the Journal of Periodontology and Journal of tissue lateral to the barrier epithelium. During healing following implant installation, bone modeling occurs that may result in some reducfi tion of the marginal bone level.

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During a cleansing treatment skin care diet purchase decadron with paypal, I dip the instrument into the oil to acne practice buy genuine decadron online lubricate and numb the tissue acne 404 nuke book download discount 0.5 mg decadron fast delivery. Most patients feel soothed and nurtured after a treatment skin care in your 20s purchase decadron 0.5 mg otc, and end up asking to come back. If you feel pain on a particular tooth, dab a Q-tip into the clove oil and swab the oil onto the tooth surface. However, if you see a dentist or hygienist regularly, a painful situation like this will occur much less frequently. Abscess Another cause of mouth pain may be an abscess, which is a localized infection of either the gums or a decayed tooth. A raw or abscessed gum can cause pain, and may even feel like a toothache or a nerve dying. The painful sensation will probably come on when you are drinking or eating cold food. Remedies: If your gum is raw and swollen and you see a bump on the gum that might be an abscess, rinse with warm sea salt water to draw the infection out. Remove the tea bag from the water, let it cool, and place the bag on the source of the pain. The tannic acid in the tea bag will reduce the swelling and calm the irritation until you see your dentist or hygienist. Because of crowding, the area around the wisdom tooth may be hard to reach for cleaning purposes. Then place the tea bag over the wisdom teeth that are causing you problems and bite down. Trigeminal Neuralgia There are only three to five cases per year per 100,000 people with this condition, and it is more common in those over fifty years of age. In this condition, you may think that you have a toothache when the pain isnt really related to a tooth. Still, to rule out the possibility that its not a toothache, seek professional dental advice. A symptom of this condition may be that you have pain-free intervalsthe pain comes and goes without reason. If a dental condition or a tooth problem causes your pain, you will have a continuous aching, throbbing pain. With trigeminal neuralgia, you feel only intermittent, brief, electric shocklike pain. Phantom Pain (Atypical Facial Pain) Phantom pain is a persistent pain in the teeth, face, or alveolar process (bone) following a root canal therapy, an apicoectomy (surgical removal of an infection or cyst), or a tooth extraction. Three to six percent of those who undergo a root canal therapy have a phantom pain sensation in the area of the treated tooth. Phantom pain also is often experienced in people who have lost limbs; they can still feel the presence of the limb and pain that does not diminish in that area. Remedies: Check with your dentist, who will try to determine the source of your pain and proceed with the professional treatment of choice. Burning Mouth Burning mouth is an intraoral chronic pain disorder that is usually without associated mucosal or oral signs. You may feel a burning sensation on your tongue, and stinging and itching in the front and back regions of your tongue. It can be caused by a geographic tongue (infiammation sporadically mapped out on your tongue) or an infection such as candidiasis. A person can have burning of the tongue or surrounding areas if he or she is anemic; with this condition there is a reddened area on the tongue called glossitis. This condition is either continuous or intermittent, and typically worsens as the day progresses. It is estimated that 8 percent of males and 6 percent of females suffer from this condition. This joint can become arthritic, much as any joint in your body can, and can cause you pain. Usually people complain about arthritis in their knees or in the joints of their fingers. But every joint is composed of synovial fiuid and ligament attachment, and thus is subject to arthritis. This will not cure the condition, however, if the joint itself is arthritic, only ease the discomfort. These open sores in the mouth can also occur after antibiotic therapy and during recovery from infiuenza. When the bodys immune system experiences much stress, the normal ecology of the mouth is compromised. Remedies: A mouthwash made with red sage leaves or echinacea by Bioforce will usually reduce the pain. Children and Pain in Dentistry Luckily, there is usually little pain experienced by children who have gum problems. The child first realizes something is wrong when he or she sees blood on his or her toothbrush, which is usually due to sore tissue. The pressure of the pus and diseased gum may cause discomfort and some pain in children as much as in adults. Use of a tea bag can be helpfulafter steeping a tea bag in hot water, let it cool and place it on the abscess. If the problem persists after a dental cleaning, then 65 Reversing Gum Disease Naturally seek the advice of a physician. Tooth Decay From treating many children in dental hygiene, Ive noticed that children seem to experience less pain with tooth decay than adults do. I have worked on many children with rampant decay, and their parents, as well as the children themselves, were unaware of any problems. Most decay is noticed only when the teeth are darkened with severe amounts of decay. Then make an appointment to have the decay removed and a filling or proper tooth restoration applied. Teething the earliest and most common pain in a child is related to teething, when the baby tooth pushes up and breaks through the gum. The symptoms of teething are excessive saliva in the mouth, sometimes a fever, crankiness, and sleeplessness. In response to teething pain, a child will grab almost anything and start chewing on it. As the pressure of the new teeth erupting causes discomfort, the counterpressure created by using objects or fingers will alleviate some of the pain. Teething occurs in all children, and the immune system sometimes becomes involved during the creation of excess mucus in children. An unpleasant past experience, or hearing about negative experiences from other people, is probably a major cause of dental disease and gum disease. Children who have had a negative experience in a dental office may harbor negative thoughts for a lifetime. As children often do not understand what is happening to them in the dental chair, they feel out of control. Negative experiences during childhood then become magnified over time and are hard to forget, creating an atmosphere of fear every time an adult thinks about going to the dentist or hygienist. If you are an adult who carries fears from childhood, sometimes eliminating your fear can be as easy as remembering (and perhaps discussing! Discuss with 67 Reversing Gum Disease Naturally your dentist or hygienist the various methods that might work for you during treatment to alleviate pain, and remember that the less pain you experience, the better it is for you and your professional. If you tense up with fear, it becomes more difficult for your professional to do the best job possible. So it is in everyones best interests that you are less fearful and do not have to contend with pain. There is a child in all of us, and if a strong foundation has been built first, we can become healthy and fearless adults. If as a child we were unexpectedly hurt in the dental chairwe didnt expect to have a needle or a drillthen as adults we remain fearful of the dentist. So educate your children in dental care, and explain to them why they must fix their teeth. It is important to have your child understand the need to see a dentist and dental hygienist. It would be advantageous to have your child visit the dentist with you and let him or her look at the equipment.

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Any departure from a standard method should be fully documented and should be considered when interpreting results and developing strategies acne hairline 1 mg decadron free shipping. Undertaking environmental-surface sampling* the following factors should be considered before engaging in environmental-surface sampling: Background information from the literature and present activities skin care questions buy decadron 0.5 mg mastercard. Surface sampling is used currently for research skin care 2013 1mg decadron, as part of an epidemiologic investigation skin care guide order decadron on line amex, or as part of a comprehensive approach for specific quality assurance purposes. Meaningful results depend on the selection of appropriate sampling and assay techniques. For quantitative assessment of surface organisms, nonselective, nutrient-rich agar media and broth. Further sample work-up may require the use of selective media for the isolation and enumeration of specific groups of microorganisms. Qualitative determinations of organisms from surfaces require only the use of selective or non-selective broth media. Effective sampling of surfaces requires moisture, either already present on the surface to be sampled or via moistened swabs, sponges, wipes, agar surfaces, or membrane filters. If disinfectant residuals are expected on surfaces being sampled, specific neutralizer chemicals should be used in both the growth media and the dilution or rinse fluids. Lists of the neutralizers, the target disinfectant active ingredients, and the use concentrations have been published. The inclusion of appropriate control specimens should be included to rule out both residual antimicrobial activity from surface disinfectants and potential toxicity caused by the presence of neutralizer chemicals carried over into the assay system. Examples of eluents and diluents for environmental-surface sampling* + Solutions Concentration in water Ringer 1fi4 strength Peptone water 0. Several methods can be used for collecting environmental surface samples (Table 25). Last update: July 2019 111 of 241 Guidelines for Environmental Infection Control in Health-Care Facilities (2003) Table 25. However, these sampling methods are the most prone to errors caused by manipulation of the swab, gauze pad, or sponge. Last update: July 2019 112 of 241 Guidelines for Environmental Infection Control in Health-Care Facilities (2003) If sampling is conducted as part of an epidemiologic investigation of a disease outbreak, identification of isolates to species level is mandatory, and characterization beyond the species level is preferred. Environmental surfaces should be visibly clean; recognized pathogens in numbers sufficient to result in secondary transfer to other animate or inanimate surfaces should be absent from the surface being sampled. Properly collected control samples will help rule out extraneous contamination of the surface sample. General Information Laundry in a health-care facility may include bed sheets and blankets, towels, personal clothing, patient apparel, uniforms, scrub suits, gowns, and drapes for surgical procedures. When the incidence of such events are evaluated in the context of the volume of items laundered in health-care settings (estimated to be 5 billion pounds annually in the United States),1246 existing control measures. Therefore, use of current control measures should be continued to minimize the contribution of contaminated laundry to the incidence of health-care associated infections. The control measures described in this section of the guideline are based on principles of hygiene, common sense, and consensus guidance; they pertain to laundry services utilized by health-care facilities, either inhouse or contract, rather than to laundry done in the home. Epidemiology and General Aspects of Infection Control Contaminated textiles and fabrics often contain high numbers of microorganisms from body substances, including blood, skin, stool, urine, vomitus, and other body tissues and fluids. Through a combination of soil removal, pathogen removal, and pathogen inactivation, contaminated laundry can be rendered hygienically clean. Hygienically clean laundry carries negligible risk to health-care workers and patients, provided that the clean textiles, fabric, and clothing are not inadvertently contaminated before use. Experts are divided regarding the practice of transporting clothes worn at the workplace to the healthcare workers home for laundering. Health-care facility policies on this matter vary and may be inconsistent with recommendations of professional organizations. However, if health-care facilities require the use of uniforms, they should either make provisions to launder them or provide information to the employee regarding infection control and cleaning guidelines for the item based on the tasks being performed at the facility. Health-care facilities should address the need to provide this service and should determine the frequency for laundering these items. In a recent study examining the microbial contamination of medical students white coats, the students perceived the coats as clean as long as the garments were not visibly contaminated with body substances, even after wearing the coats for several weeks. In this study, however, surveillance was not conducted among patients to detect new infections or colonizations. The students did, however, report that they would likely replace their coats more frequently and regularly if clean coats were provided. In the latter, the textiles may be owned by the health-care facility, in which case the processor is paid for laundering only. Alternatively, the textiles may be owned by the processor who is paid for every piece laundered on a rental fee. The laundry facility in a health-care setting should be designed for efficiency in providing hygienically clean textiles, fabrics, and apparel for patients and staff. Guidelines for laundry construction and operation for health-care facilities, including nursing facilities, have been published. Collecting, Transporting, and Sorting Contaminated Textiles and Fabrics the laundry process starts with the removal of used or contaminated textiles, fabrics, and/or clothing from the areas where such contamination occurred, including but not limited to patients rooms, surgical/operating areas, and laboratories. Handling contaminated laundry with a minimum of agitation can help prevent the generation of potentially contaminated lint aerosols in patient-care areas. Loose, contaminated pieces of laundry should not be tossed into chutes, and laundry bags should be closed or otherwise secured to prevent the contents from falling out into the chute. Sorting after washing minimizes the exposure of laundry workers to infective material in soiled fabrics, reduces airborne microbial contamination in the laundry area, and helps to prevent potential percutaneous injuries to personnel. Additionally, if work flow allows, increasing the amount of segregation by specific product types will usually yield the greatest amount of work efficiency during inspection, folding, and pack-making operations. Parameters of the Laundry Process Fabrics, textiles, and clothing used in health-care settings are disinfected during laundering and generally rendered free of vegetative pathogens. Clean linens provided by an off-site laundry must be packaged prior to transport to prevent inadvertent contamination from dust and dirt during loading, delivery, and unloading. The antimicrobial action of the laundering process results from a combination of mechanical, thermal, and chemical factors. Soaps and detergents function to suspend soils and also exhibit some microbiocidal properties. The rapid shift in pH from approximately 12 to 5 is an effective means to inactivate some microorganisms. Chlorine bleach is an economical, broad-spectrum chemical germicide that enhances the effectiveness of the laundering process. Traditionally, bleach was not recommended for laundering flame-retardant fabrics, linens, and clothing because its use diminished the flame-retardant properties of the treated fabric. Flame-retardant fabrics, whether topically treated or inherently flame retardant, should be thoroughly rinsed during the rinse cycles, because detergent residues are capable of supporting combustion. Studies comparing the antimicrobial potencies of chlorine bleach and oxygen-based bleach are needed. Health-care workers should note the cleaning instructions of textiles, fabrics, drapes, and clothing to identify special laundering requirements and appropriate hygienic cleaning options. They consume 50%75% of the total hot water,1280 representing an average of 10%15% of the energy used by a hospital. Several studies have demonstrated that lower water temperatures of 71F77F (22C25C) can reduce microbial contamination when the cycling of the washer, the wash detergent, and the amount of laundry additive are carefully monitored and controlled. The selection of hotor cold-water laundry cycles may be dictated by state health-care facility licensing standards or by other regulation. Regardless of whether hot or cold water is used for washing, the temperatures reached in drying and especially during ironing provide additional significant microbiocidal action. After washing, cleaned and dried textiles, fabrics, and clothing are pressed, folded, and packaged for transport, distribution, and storage by methods that ensure their cleanliness until use. Clean/sterile and contaminated textiles should be transported from the laundry to the health-care facility in vehicles. Clean/sterile textiles and contaminated textiles may be transported in the same vehicle, provided that the use of physical barriers and/or space separation can be verified to be effective in protecting the clean/sterile items from contamination. Clean, uncovered/unwrapped textiles stored in a clean location for short periods of time. Such textiles can be stored in convenient places for use during the Last update: July 2019 116 of 241 Guidelines for Environmental Infection Control in Health-Care Facilities (2003) provision of care, provided that the textiles can be maintained dry and free from soil and body-substance contamination.

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Nephrotic Suggested by: weight gain over weeks to skin care khobar discount decadron 1mg without a prescription months skin care 2 in 1 order 0.5mg decadron free shipping, generalized syndrome oedema acne gluten discount 1 mg decadron free shipping, pufy eyelids skin care buy cheap decadron 0.5mg online, abdominal distension, weight gain may be sudden and rapid. Also Smoking cessation, alcohol excess, menopause, klinefelter syndrome, Other endocrine disorders: hypopituitarism, acromegaly, insulinoma, hypogonadism. Hypothalamic disorder: craniopharyngioma, Congenital disorders: Prader Willi syndrome, LaurenceMoonBiedl syndrome. Ask about the amount, frequency, and nature of vomitus red blood, cofee-ground, timing of vomit, i. Oesophageal Suggested by: undigested solid food and fuid in vomitus, stricture heartburn. Confrmed by: barium swallow, oesophagogastroscopy showing food residue and fxed narrowing. Oesophageal Suggested by: dysphagia to solid food frst, then semisolid, carcinoma and fnally fuid. Confrmed by: barium swallow showing flling defect, fbreoptic gastroscopy with biopsy of tumour. Achalasia Suggested by: vomiting after large meals, undigested solid food and fuid, nocturnal regurgitation. Oesophagitis Suggested by: retrosternal pain, heartburn, dyspepsia, and ulceration waterbrash. Pharyngeal Suggested by: no pain, regurgitation of undigested food, pouch aspiration pneumonia. Achalasia Suggested by: vomiting after large meals, undigested solid food and fuid, dysphagia to fuid, nocturnal regurgitation. Confrmed by: barium swallow demonstrating the absence of peristaltic contractions, oesophagogastroscopy showing dilatation. Gastric outlet Suggested by: intermittent vomiting fifih after eating, obstruction abdominal fullness or bloating, distended upper abdomen. Small intestinal Suggested by: abdominal pain, anorexia, bilious vomitus, tumour. Gastroparesis Suggested by: intermittent vomiting, occurs fifih after eating, due to diabetes abdominal fullness or bloating, distended upper abdomen, mellitus succussion splash, history of diabetes. Confrmed by: oesophagogastroscopy, double contrast barium meal showing normal mucosa but dilatation. Acute Suggested by: nausea and vomiting after fatty food with cholecystitis colicky abdominal pain. Initial investigations (other tests in bold below): test urine, examine stools (and send for culture, etc). Food poisoning Suggested by: within hours of ingestion, associated with (from toxins diarrhoea eating companions afected. Urinary tract Suggested by: dysuria, frequency, dipstick indicating blood, infection protein, and nitrites (if Gram ve infection). Confrmed by: cultures of blood, stool, vaginal swab, for staphylococcus and toxin. Malaria Suggested by: recent travel to malaria zone, periodic (Plasmodium paroxysms of rigors, fever, sweating, nausea. Confrmed by: iblood glucose, dpH, ketonaemia or ketonuria or dplasma bicarbonate

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