training module for medical officers primary health centre - NVBDCP

3.1.6 Name of Laboratory Technician: ______________________________________3.1.7 Result: Species Stage *Density3.1.8 Date of communication of results to periphery:3.1.9 Radical treatment, if any.Date(S) Drug(s) Dosage(s)3.2 Parasitological investigation and treatment after admission of hospital:3.2.1 For each blood smear collectedSl.No. Collection Examination ResultsDate Time Date Time Positive Species Stage *Density1234* per 100 fields of thick smear3.2.2 Other biochemical/pathological investigations done (specify)3.2.3 History of case on admission to hospital3.2.4 Source of information: treating physician/case history sheet.3.2.5 Date of referral: By whom:3.2.6 Date and time of admission4. Death Date Time4.1 Cause of death in microscopically confirmed cases of malaria (Use proforma of Internationalcertificate)1.2.3.4.2 Cause of death in clinically suspected case of malariaSigns/symptoms in deceased Following excluded in differential diagnocisComaDiabetes, head injury, hepatic coma, any other conditionHyperpyrexiaHeat stroke, viral infection and septicaemia due to Urinary tractinfection etc.ConvulsionsOther conditionsShock / Circulatory collapse Other causes of shock and collapsePregnancy / abortion with pyrexia Spontaneous/induced / foetal or other abnormalitiesPulmonary oedemaCardiac / respiratory tract conditionsHaemoglubinuria / oliguria Kidney, bladder lesions, kidney dysfunction due to otherdiseasesDiarrhea / DysenteryAcute intestinal infection, cholera, gastroenteritis, bacterialdysenteryP.falciparum predominant infection in the locality? Yes / No68