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STG-2018.Pdf elfare TMENT 2018 GUIDELINES Government of Odisha ANDARD TREA ST Department of Health & Family W STANDARD TREATMENTGUIDELINES 2018 . Press .W Printed at S.I.H. & F STANDARD TREATMENT GUIDELINES FOR ODISHA STATE 2018 Dept. Of Health & Family welfare Govt. Of Odisha, Bhubaneswar DISCLAIMER Medical science is ever changing and advancing subject. To formulate a guideline is to document the prevailing recommendations of experts in the field at the present time. The publishers and authors take no responsibility for the changes that will be made to these guidelines in current or future point in time. The readers are advised to consult authentic referral guidelines/manuals in case of need. Phone : 0674-2536931 (O) 0674-2508569 ® Email: [email protected] PRATAP JENA D.O. No. ..................../MHFWLIPR Minister Health & Family Welfare, Law, I & PR BHUBANESWAR Odisha Date .........................20 MESSAGE I am extremely happy to know that the Standard Treatment Guidelines- 2018 have been prepared by the State Drug Management Unit, Directorate of Health Services, Odisha, Bhubaneswar in consultation with specialists of all Medical Colleges and peripheral health institutions of Odisha to rationalise medical practice and reduce costs for the public health system. With the publication of this book, the Government affirms its commitment to the level of diagnostics and the package of services that are available at different health institutions of our State. The Guidelines cover all common diseases. The adoption of Standard Treatment Guidelines should be recognised as a significant milestone for providing quality health care and services to the people of our state. I am sure the guidelines will be useful to the health professionals of our State in making rational clinical decisions. (Pratap Jena) Minister Health & Family Welfare, Law, I & PR Odisha Dr. Pramod Meherda, IAS Commissioner-cum-secretary to Govt. Health & F.W. Deptt. MESSAGE The Standard Treatment Guidelines (STG)-2018 are a huge step forward in treatment of patients in Goverment hospitals of our State. For want of standard guidance, it becomes challenging for clinicians in Government Health Facilities to observe common treatment protocols demanded by health policies and programmes implemented from time to time. With this objective in mind, the State Drug Management Unit, Directorate of Health Services, Odisha, along with experts and specialists from Government Medical Colleges and peripheral health institutions has done a commendable job in bringing out standard guidelines for treating a majority of common ailments. The STG-2018 are meant to reach out and guide health professionals to manage their routine clinical decisions. Another important objective of STG-2018 is to rationalise use of drugs and optimise the expenditure on treatment of patients, while preserving the much needed quality of care. I take this opportunity to extend my sincere gratitude and appreciation for the SDMU team & the experts for their valuable input in bringing out an excellent document on treatment guidelines. Shalini Pandit, IAS Mission Director, NHM Odisha, Bhubaneswar MESSAGE The Standard Treatment Guidelines - 2018 have been prepared by the State Drug Management Unit, Directorate of Health Services, Odisha, Bhubaneswar in consultation with specialists of all Medical Colleges and peripheral health institutions of Odisha with a purpose to rationalise medical practice across the public health system. The adoption of these Guidelines will ensure quality health care services across the state. I hope the Guidelines prove useful to healthcare professional and set new standards for health service delivery in the State. (Shalini Pandit) Mission Director, NHM Odisha, Bhubaneswar GOVERNMENT OF ODISHA Dr. BRAJA KISHORE BRAMHA Bhubaneswar Special Secretary to Govt. (MS) Health & Family Welfare Department Odisha, Bhubaneswar MESSAGE I am extremely happy to note that after much awaited, the Standard Treatment Guideline-2018 for different diseases is getting published. This will focus on scientific treatment of diseases with specific drugs. It will be very much beneficial to all Doctors of Medical Colleges as well as peripheral Health Institutions of the State. I extend my warm greetings and best wishes for the publication of the STG-2018. (Dr. Braja Kishore Bramha) Special Secretary to Govt. (MS) Health & Family Welfare Department Odisha, Bhubaneswar SH ODI A OSMC Tel : 0674-2380600 Fax : 0674-2380662 Email : [email protected] Ms. Archana Patnaik, IAS Website : www.osmcl.nic.in Managing Director Odisha State Medical Corporation Ltd. MESSAGE I express my heartfelt congratulations to the State Drug Management Unit, Directorate of Health Services, Odisha for preparing the Standard Treatment Guideline - 2018 in consultation with specialists of all the Medical Colleges and peripheral health institutions of our State. It contains guiding principles for health professionals in better treatment of common diseases. It will not only set standard protocols but also ensure rational use of drugs. Managing Director Odisha State Medical Corporation Ltd. Dr. Hara Prasad Patnaik Director of Health Services, Odisha Bhubaneswar MESSAGE I convey my heartfelt congratulations to the State Drug Management Unit, Directorate of Health Services, Odisha for preparing the Standard Treatment Guideline-2018 in consultation with different Specialists of Medical Colleges and peripheral Health Institutions of our State to rationalize medical practice and make the cost less for the public health system. It will be highly beneficial for all health professionals of our State delivering better health care to the patients using the available resources. (Dr. Hara Prasad Patnaik) Director of Health Services, Odisha Bhubaneswar Prof. Dr. Sonamali Bag Director of Medical Education & Tr. Odisha, Bhubaneswar MESSAGE The State Drug Management Unit, Directorate of Health Services, Odisha has done a praise worthy-work in preparing the Standard Treatment Guideline-2018 in consultation with different specialist of all medical colleges and peripheral health institutions of our State. It contains the guiding principles for teatment of common diseases. I hope this guideline will help in guiding all the professionals for better treatment of diseases. (Prof. Dr. Sonamali Bag) Director of Medical Education & Tr. Odisha, Bhubaneswar PREFACE It’s not practically possible to implement the standard recommended treatment provided in the text books or high standard journals in resource constraint settings. This leads to significant variation in practice of medicine in prevalent health care set up. Standard treatment guidelines or protocols provide consensus on evidence based practice that is practicable and feasible at ground level. Present version of standard treatment guideline (STG) has been prepared after thorough consultation among different levels of health care of the state. The interactive sessions were initiated by two state level workshops conducted at two different occasions on 15-17 November 2016 and 5.8.2017.Many important changes have been incorporated from the last version of STG Odisha. This includes incorporation of many new chapters in trauma and emergency care, chapters from nephrology and neurology depending upon the high prevalence of the disease or conditions in recent years. Though the guideline has been prepared by most experienced and sort out clinicians of the state, this needs to be balanced with other available information and in the context of individual patient. Thus the books neither restricts clinical flexibility nor prevent any health care personnel form replacing his clinical judgement. Though the broad objective is to develop consensus based on evidence based practice in the different health care level, expert opinion has been sorted for few clinical situations where there is paucity of evidence or not available. The unique features of STG Odisha 2018 is its presentation style with different sections comprising of clinical features, Lab investigations, Non drug treatment, drug treatment patient education and referral criteria. Reference chapter has been incorporated, in the present edition to provide authenticity of information. We are hopeful the book will provide a reference material for the health care personals who are working in the remote areas of the state. We are hopeful. Standard Treatment Guidelines of Odisha 2018 Editorial Board Advisers: 1. Special Secretary (MS), Health & FW Department. 2. Special Secretary (PH), Health & FW Department. 3. DMET, Odisha, Health & FW Department. 4. DHS, Odisha, Health & FW Department. Editor : Prof. (Dr) Sidhartha Das (Dean & Principal) Associate Editors Prof. Dr Shyama Kanungo Prof. Dr. Biswa Mohan Mohanty Dr. Truptirekha Swain, Nodal Officer Members Prof R.K Jena Prof Manoranjan Pattanaik Prof S.P Singh Prof A.K Mallick Prof Chittaranjan Kar Prof Dr A.K Baliarsinha Prof Dr P.K Nanda Prof Dr S.K Behera Prof. Dr Bidyut Das Prof. Dr. J.M. Mishra Prof Dr Prasenjeet Mohanty Prof Dr S.N. Routray Dr. Pravat Thatoi Prof Dr B.K Behera Prof Dr J M Mishra Prof Dr Saroj Satapathy Prof Dr I.B Kar Dr Nilamadhab Rath Prof Dr Srikanta Mohanty Prof Dr Datteswar Hota Coordinators : Dr. R.C. Garnayak, SDMU, Odisha Dr. R.K. Paty, SDMU, Odisha Dr. Subhranshu Pradhan, SDMU, Odisha 1 Standard Treatment Guidelines of Odisha 2018 CONTENTS Sl.No. Topic Page No. MEDICINE 1. Shock 07 2. Fluid And Electrolyte Imbalance and Replacement (In Adults) 10 3. Jaundice 13 4. Lymphatic Filariasis 15 5. Malaria 16 6.
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