Clinical Guidelines for Diagnosis and Treatment of Common Conditions in Kenya Table of Contents Clinical Guidelines for Diagnosis and Treatment of Common Conditions in Kenya..................................1 FOREWORD..........................................................................................................................................3 PREFACE...............................................................................................................................................4 ACKNOWLEDGEMENTS.......................................................................................................................5 ABBREVIATIONS...................................................................................................................................5 1. ACUTE INJURIES AND TRAUMA & SELECTED EMERGENCIES..................................................7 1.1. Anaphylaxis & Cardiac Arrest...................................................................................................7 1.2. Abdominal Trauma....................................................................................................................8 1.3. Bites & Rabies.........................................................................................................................10 1.4. Burns.......................................................................................................................................13 1.5. Disaster Plan...........................................................................................................................16 1.6. Head Injury..............................................................................................................................19 1.7. Multiple Injury Patient..............................................................................................................21 1.8. Pneumothorax & Haemothorax...............................................................................................21 1.9. Shock......................................................................................................................................22 1.10. Tracheostomy.......................................................................................................................26 2. AIDS & SEXUALLY TRANSMITTED INFECTIONS.........................................................................27 2.1. HIV/AIDS in Kenya..................................................................................................................27 2.2. HIV Transmission & Prevention..............................................................................................28 2.3. Stages of Infection & Diagnosis of AIDS.................................................................................30 2.4. HIV Testing & Patient Education.............................................................................................36 2.5. Gonorrhoea & Urethral Discharge...........................................................................................38 2.6. Genital Discharge in the Female.............................................................................................38 2.7. Dysuria in the Female.............................................................................................................45 2.8. Lower Abdominal Pain in the Female.....................................................................................45 2.9. Genital Ulcer Disease.............................................................................................................46 2.10. Buboes or Swollen Inguinal Glands......................................................................................48 2.11. Genital Warts........................................................................................................................48 3. CARDIOVASCULAR DISEASES.....................................................................................................48 3.1. Congenital Heart Disease.......................................................................................................48 3.2. Deep Vein Thrombosis............................................................................................................51 3.3. Heart Failure...........................................................................................................................52 3.4. Hypertension...........................................................................................................................54 3.5. Pulmonary Oedema................................................................................................................58 3.6. Acute Myocardial Infarction.....................................................................................................59 3.7. Acute Rheumatic Fever (ARF)................................................................................................60 3.8. Rheumatic Valvular Heart Disease.........................................................................................61 4. CENTRAL NERVOUS SYSTEM......................................................................................................62 4.1. Cerebral Palsy.........................................................................................................................62 4.2. Seizure Disorders....................................................................................................................63 5. DENTAL AND ORAL CONDITIONS.................................................................................................68 5.1. Abscess, Periapical.................................................................................................................68 5.2. Acute Necrotizing Ulcerative Gingivitis (ANUG)......................................................................68 5.3. Alveolitis (Dry Socket).............................................................................................................69 5.4. Cellulitis (Oral).........................................................................................................................69 5.5. Gingivitis..................................................................................................................................70 5.6. Neoplasms, Salivary Gland & Hereditary/Developmental Disorders.......................................71 5.7. Pericoronitis............................................................................................................................71 5.8. Periodontitis............................................................................................................................72 5.9. Pulpitis.....................................................................................................................................72 5.10. Temporomandibular Joint Disorders.....................................................................................73 5.11. Trauma..................................................................................................................................74 6. EAR, NOSE AND THROAT CONDITIONS......................................................................................75 6.1. Acute Otitis Media...................................................................................................................75 6.2. Otitis Externa...........................................................................................................................76 6.3. Chronic Suppurative Otitis Media (CSOM).............................................................................76 6.4. Epistaxis..................................................................................................................................77 6.5. Foreign Bodies in the Ears......................................................................................................78 6.6. Foreign Bodies in the Nose.....................................................................................................79 6.7. Mastoiditis...............................................................................................................................80 i Table of Contents Clinical Guidelines for Diagnosis and Treatment of Common Conditions in Kenya 6.8. Wax in Ear...............................................................................................................................80 6.9. Foreign Body in the Oesophagus............................................................................................81 6.10. Laryngotracheal Trauma.......................................................................................................81 6.11. Allergic Rhinitis......................................................................................................................81 6.12. Parotid Masses.....................................................................................................................82 6.13. ENT Manifestations of HIV/AIDS..........................................................................................83 6.14. Hearing Impairment...............................................................................................................83 6.15. Tracheostomy.......................................................................................................................83 7. ENDOCRINE SYSTEM CONDITIONS.............................................................................................83 7.1. Diabetes