. DIFFERENTIATION BETWEEN HEAT STROKE AND HEAT EXHAUSTION

. DIFFERENTIATION BETWEEN HEAT STROKE AND HEAT EXHAUSTION - Heat stroke Heat Exhaustion Cause pulse, hypotension. (c) Due to water deficiency- Syndrome of predominant dehydration with elevated serum sodium. Usually seen during illnesses which prevent proper intake or absorption of water e.g cardiac or cerabral disease. Intense thirst main complaint. Also lethargy. fatigue. Irritability, abdominal discomfort and tingling in the limbs with ultimately mental confugion and muscular incoordination. Management - Large amounts of water by mouth. or IV 5 percent glucose. Since the total body sodium is Iikely to be raduced, sodium depletion may occur during phase of rehydration and salt-containing drinks should be administerd as soon as improvement is observed 22 ENDEMIC FLUOROSlS Definition - A disease entity resulting from ingestion of excessive quantities of fIuoride in drinking water over a prolonged period. It primary affects hard tissues of the body manifesting as mottling of enamel and osteosclerosis of the skeleton. Factors Influencing toxicity of fluoride -1 Fluoride concentration of drinking water- is the most important) factor. 2. Duration of exposure 3. Occupation and sex - Most cases of skeletal fluorosis occur in those doing hard manual labour. Incidence is higher in males 4. Nutrition - Poor nutrition particularly lack of proteins and calories. 5. Climate - Hot climate favours increased ingestion of water which may contain excess fluorine. Clinical features -1. Denial fluorosis -'Mottled enamel' due to dental hypoplasia with areas' of hypocalcification best seen on incisors of upper jaw. Besides brownish dscolouration there is pitting of enamel surface £ Skelelalfluorosis- (a) Symptoms-Pain and rigidiy of spine and later on of joints Paresthesiaa in hrnbs (b) Skeletal changes - [I) Irregular bone deposition may be keft as exostosis along anterior borders ol tibia, near tibial tubercle, olecranon and along medial border of scapula and near the vertebral spinous processes (il) Fixed llexlon deformity from ossffcation ol interosseoijs menbrane of forearm and leg (iii) Kyphcsis. 3. Neurologcal complications- (a) Due la conmpression of spinal cord -Paresthasiae