Educative Information On Diabetes Mellitus

<div><div dir="ltr"><h2><b><span style="font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif; font-size: large;">Overview Of Diabetes Mellitus, Complications, Diagnosis, Management And Treatment </span></b></h2></div><div dir="ltr">Do you all know that, after Cancer and Heart Disease, Diabetes Mellitus is the 3rd of leading cause of death in the world? </div><div dir="ltr">Yes, diabetes is very deadly and its starts frm our infantile stage.</div><div dir="ltr">Now, the question we should ask ourselves is, "<b><i>WHAT IS DIABETES MELLITUS</i></b>". <br><br></div><div dir="ltr">The answer that will pop up to the mind of many of us is, "diabetes is excess "sugar" in the body". </div><div dir="ltr"><b>What do sugar in this scenario stands for? </b><br>Majority of us refer to sugar as;</div><ul><li>substance added to tea to sweeten it</li><li>Sweetners and sweetened items. </li></ul><br><div dir="ltr"><span style="font-family: sans-serif;">Well, the above answer above is substantially correct and at the same time is 70% wrong. </span></div><div dir="ltr">It may interest you to know that sugars are not only restricted to the aforementioned above. </div><div dir="ltr"><br></div><div dir="ltr">The appropriate definition of sugar ranges from food reach in monosaccharide to polysaccharides carbohydrates. </div><div dir="ltr">Do we know that the RICE we consume is rich in sugar? </div><div dir="ltr">Yea. Its contains starch which is composed mainly of glucose as its backbone (monosaccharide). Thes e glucose are linked by alpha </div><div dir="ltr"><br></div><div dir="ltr">Diabetes </div><div dir="ltr">Types Of Diabetes. </div><div dir="ltr">It should be beared in mind that there are two main types or classifications of diabetes. They include;</div><div dir="ltr">1) Diabetes Insipidus. </div><div dir="ltr">2) Diabetes Mellitus </div><div dir="ltr"><br></div><div dir="ltr">Diabetes Insipidus. </div><div dir="ltr">This is neurological disorder that is characterised by increased and persistent excretion of water as a result of malfunctioning of Aldosterone. </div><div dir="ltr">Diabetes insipidus doesn't tend to impend much clinical complications as compared to diabetes Mellitus (which will be discussed in full below). </div><div dir="ltr"><br></div><div dir="ltr">My Granny will always say, "WITHOUT THE NECK, WHERE WILL THE HEAD BE PLACED and vice versa". So also, before proceeding to discussing diabetes Mellitus in full, its important to talk about some of crucial terms that might be encountered as the class goes on. </div><div dir="ltr">What are some of these terms? Here they are below;</div><div dir="ltr" style="font-family: sans-serif;"><h4><b>Hormones Produced By The Pancreas</b></h4>1) Glucagon which is secreted by the alpha cells of the islet of Langerhans. <br>2) Insulin which is secreted by the beta cells of the islet of Langerhans. <br>3) Somatostatin which is secreted by the delta cells of the islet of Langerhans.</div><div dir="ltr" style="font-family: sans-serif;">Glucagon is secreted when there is decreased production of GLUCOSE by the body.</div><div dir="ltr" style="font-family: sans-serif;">The body cells (most especially the brain cells) depends mainly only on Glucose for survival.</div><div dir="ltr" style="font-family: sans-serif;">Glucagon production triggers metabolic pathways such as "GLUCONEOGENESIS (ie synthesis of glucose frm non-carbohydrate moieties such as lipids and proteins) , GLYCOGENOLYSIS( ie breakdown of stored glycogen to release glucose) , LIPOLYSIS (ie lipid breakdown which could lead to ketoacidosis) etc.</div><div dir="ltr" style="font-family: sans-serif;">Insulin is secreted when there is elevated level of glucose in the blood. This insulin secreted is anabolic in nature in the sense that, it promotes glycogen formation and allow uptake of glucose by the cells brain, RBCs, Cornea and Skeletal Muscle.</div><div dir="ltr" style="font-family: sans-serif;">Insulin is also a hormone responsible for growth. (this will not be discussed)<br></div><div dir="ltr"><span style="font-family: sans-serif;">Somatostatin also will not be discussed as it has no relevance to today's discussion.</span></div><div dir="ltr"><span style="font-family: sans-serif;"><br></span></div><div dir="ltr"><b style="font-family: sans-serif;">Insulin </b></div><div dir="ltr"><span style="font-family: sans-serif;">Now, insulin was mentioned above while defining diabetes.  </span><br></div><div dir="ltr" style="font-family: sans-serif;"></div><ol style="font-family: sans-serif;"><li>What is this insulin?</li><li>Where is it produced? </li><li>What are its effects?</li></ol><div dir="ltr" style="font-family: sans-serif;"><b>Insulin</b> is a hormone that is produce in the pancreas by the islet of Langerhans.</div><div dir="ltr" style="font-family: sans-serif;">Anatomy & Detailed physiology of the pancreas won't be discussed.</div><div dir="ltr" style="font-family: sans-serif;"><br></div><div dir="ltr" style="font-family: sans-serif;">The site(gland) of production, specific mainly for insulin is the pancreas. This is the gland which is responsible for regulation of elevation and decreasing of glucose level in the system by secreting several hormones.</div><div dir="ltr" style="font-family: sans-serif;">These hormones are responsible for "blood glucose homeostasis".</div><div dir="ltr" style="font-family: sans-serif;">Now, which the little written above, the three questions asked above could now be answered without stress.<br></div><div dir="ltr" style="font-family: sans-serif;">1) <b>What is insulin? </b><br>Is a hormone produced by the beta cells of islet of Langerhans. <br>2) <b>Where is insulin Produced?</b> <br>In the beta cells of islet of Langerhans of the pancreas. <br>3) <b>What are its effect?</b> <br>Allow glucose uptake by the cell. Decrease blood glucose level. Serves as a hormone for growth. </div><div dir="ltr" style="font-family: sans-serif;">All the above been known. Insulin will now be discussed in details. </div><div dir="ltr" style="font-family: sans-serif;"><br></div><div dir="ltr" style="font-family: sans-serif;">Diabetes Mellitus.</div><div dir="ltr"><b><u style="background-color: white;">What is diabetes Mellitus?</u></b><br></div><div dir="ltr"><b><i>Diabetes Mellitus</i></b> is a metabolic clinical disorder characterised by inefficient or insufficient level of INSULIN to regulate blood glucose level thereby allowing glucose to spill into urine.. </div><div dir="ltr"><br></div><div dir="ltr"><h3>Hormones That Affect Blood Glucose Level</h3></div><div dir="ltr">Aside insulin, all other hormones listed below increase blood glucose level during starvation. </div><div dir="ltr"></div><ul><li> Glucagon </li><li> Adrenocorticotropic Hormone (ACTH) </li><li> Epinephrine </li><li> Thyroxine </li><li> Glucocorticoid </li><li> Growth Hormone </li></ul><br><div dir="ltr"><br></div><div class="separator" style="clear: both; text-align: start;">When there is decreased glucose level in the blood, the body secrete the above hormone to increase its level to maintain life. </div><div class="separator" style="clear: both; text-align: start;"><br></div><div class="separator" style="clear: both; text-align: start;">A discussion and class on diabetes wont be complete if two terms are not briefly explained. </div><div class="separator" style="clear: both; text-align: start;">These terms are as follows:</div><div class="separator" style="clear: both; text-align: start;">1) Hypoglycemia. </div><div class="separator" style="clear: both; text-align: start;">2) Hyperglycemia. </div><h3 style="clear: both;"><span style="font-size: large;"><b><u>HYPOGLYCEMIA</u></b></span></h3><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;"><b>HYPOGLYCEMIA</b> literally means <span style="font-size: x-small;">low blood sugar</span> (hypo = low, gly = sugar, emia = blood). </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">When blood glucose concentration falls to less than 45 mg/dl(approx 4.44mmol/L), the symptoms of hypoglycemia appear. </div><div class="separator" style="clear: both;"><br></div><h3 style="clear: both;">Manifestations of Hypoglycemia</h3><div class="separator" style="clear: both;">The manifestations include; </div><div class="separator" style="clear: both;"></div><ol><li> headache, </li><li> anxiety, </li><li> confusion, </li><li> sweating, </li><li> slurred speech , </li><li> seizures and coma, </li><li> death (if not corrected early in time). </li></ol><br><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">All these symptoms are <b>directly</b> and <b>indirectly</b> related to the deprivation of glucose supply to the central nervous system (particularly the brain) due to a fall in blood glucose level. </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">The mammalian body has developed a well regulated system for an efficient maintenance of blood glucose concentration (details already described above.).</div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Hypoglycemia, therefore, is not commonly observed. But when a case of patient is been reported to be hypoglycemic, accurate measures, treatments and managements should be ensured. </div><div class="separator" style="clear: both;"><br></div><h3 style="clear: both;">Types Of Hypoglycemia </h3><div class="separator" style="clear: both;">The following three types of hypoglycemia are encountered by physicians.</div><div style="clear: both;">1 . <b>Post-prandial hypoglycemia</b>: This is also called reactive hypoglycemia and is observed in subjects with an elevated insulin secretion following a meal. This causes transient hypoglycemia and is associated with mild symptoms. The patient is advised to eat frequently rather than the 3 usual meals.</div><div class="separator" style="clear: both;">2. <b>Fasting hypoglycemia</b>: Low blood glucose concentration in fasting is not very common. However, fasting hypoglycemia is observed inpatients with pancreatic B-cell tumor and hepatocellular  damage.</div><div class="separator" style="clear: both;">3. <b>Hypoglycemia due to alcohol intake</b>: Insome individuals who are starved or engaged inprolonged exercise, alcohol consumption may cause hypoglycemia. This is due to the accumulation of NADH (during the course of alcohol metabolism by alcohol dehydrogenase)which diverts the pyruvate and oxaloacetate(substrates of gluconeogenesis) to form, respectively, lactate & malate. </div><div class="separator" style="clear: both; text-align: start;">4. <b>Hypoglycemia due to insulin overdose.</b> </div><div class="separator" style="clear: both; text-align: start;"><br></div><h3 style="font-family: sans-serif; clear: both;"><span style="font-size: large;"><b><u>HYPERGLYCEMIA</u></b></span></h3><div class="separator" style="font-family: sans-serif; clear: both;"><br></div><div class="separator" style="font-family: sans-serif; clear: both;"><b>HYPERGLYCEMIA</b> also literally means <span style="font-size: x-small;">high blood sugar</span> (hyper = increased/elevated/high, gly = sugar, emia = blood). </div><div class="separator" style="font-family: sans-serif; clear: both;"><br></div><div class="separator" style="font-family: sans-serif; clear: both;">When blood glucose concentration rises to above 100 - 120 mg/dl (approx 8.88 - 10.00mmol/L), the symptoms of hyperglycemia is said to manifest. </div><div class="separator" style="font-family: sans-serif; clear: both;">When the blood glucose level exceed this limit, the kidney tries to reabsorb and regulate glucose from spilling into the urine. When glucose spill into urine, its known to be that the RENAL THRESHOLD of the kidney has been exceeded (blood glucose above 180mg/dl. Greater than 10.00mmol/L). </div><h3 style="font-family: sans-serif; clear: both;">Manifestations of Hyperglycemia</h3><div class="separator" style="font-family: sans-serif; clear: both;">The manifestations include; </div><div class="separator" style="font-family: sans-serif; clear: both;"></div><ol style="font-family: sans-serif;"><li> Polyuria, </li><li> anxiety, </li><li> confusion, </li><li> sweating, </li><li> slurred speech , </li><li> seizures and coma, </li><li> death (if not corrected early in time). </li></ol><div class="separator" style="clear: both; text-align: start;">Classifications Of Diabetes Mellitus. <br></div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Basically, there are <b>three</b> classifications of diabetes Mellitus. Among which first  two impose very severe clinical complications. </div><div class="separator" style="clear: both;"></div><ul><li> Insulin dependent diabetes Mellitus. </li><li> Non insulin diabetes Mellitus. </li><li> Gestational diabetes Mellitus. </li></ul><br><div class="separator" style="clear: both;"><br></div><h3 style="clear: both;">Insulin Dependent Diabetes Mellitus </h3><div class="separator" style="clear: both;">IDDM, also referred to as Type I diabetes or (more & less frequently) Juvenile Onset Diabetes. This mainly occurs during childhood (particularly between the age range of 2 - 15years). IDDM is known to  accounts for about 10% to 20% of the known diabetics. </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Causes Of IDDM</div><div class="separator" style="clear: both;">IDDM is characterized by;</div><div class="separator" style="clear: both;">1) Almost total deficiency of insulin due to destruction of B-cells of pancreas. </div><div class="separator" style="clear: both;"><span style="font-family: sans-serif;">The beta-cell destruction may be caused by drugs, viruses or autoimmunity. </span></div><div class="separator" style="clear: both;">2) Due to genetic variations. <br></div><div class="separator" style="clear: both;"><span style="font-family: sans-serif;">Due to certain genetic variations, the Beta-cells are recognized as non-self and they are destroyed by immune mediated injury.</span></div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Irrespective of what might have brought about the cause of IDDM, usually, the symptoms of diabetes appear when 80-90% of the Beta-cells have been destroyed. This leads to inability of the pancreas ultimately secrete insulin in response to glucose ingestion. </div><div class="separator" style="clear: both;"><br></div><h4 style="clear: both;">Management of IDDM</h4><div class="separator" style="clear: both; text-align: start;">The patients of IDDM require insulin therapy.</div><div class="separator" style="clear: both; text-align: start;"><br></div><div class="separator" style="clear: both; text-align: start;"></div><h3 style="clear: both;">Non Insulin Dependent Diabetes Mellitus. </h3><div class="separator" style="clear: both;">NIDDM, also referred to as  type II diabetes or (less frequently also) adult-onset diabetes, is the popular and most common reported case of Diabetes Mellitus. </div><div class="separator" style="clear: both;">It accounts for about 80% to 90% of the diabetic population. NIDDM occurs in adults(usually above 35 years) but is less severe than Insulin Dependent Diabetes Mellitus (IDDM) because there is no gland destruction. Therefore insulin is produced but its functionality is inefficient to regulate the body blood glucose level. </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Causes Of NIDDM</div><div class="separator" style="clear: both;">NIDDM could be caused as a result of the  following viz;</div><div class="separator" style="clear: both;">1) Genetic Inheritance or Induction  and </div><div class="separator" style="clear: both;">2) Environmental factor. </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">It should be noted that NIDDM is occurs mostly in Obesed individuals. Obesity could be as a result of Over-eating coupled with underactivity leading to associated development of NIDDM. </div><div class="separator" style="clear: both;"><br></div><div class="separator" style="clear: both;">Obesity acts as a diabetogenic factor in genetically predisposed individuals by increasing the resistance to the action of insulin. This is due to a decrease in insulin receptors on the insulin responsive (target) cells. The patients of NIDDM may have either normal or even increased insulin levels. lt is suggested that over-eating causes increased insulin or reduction but decreased synthesis of insulin receptors.</div><div class="separator" style="clear: both;"><br></div><h4 style="clear: both;">Correction Of NIDDM. </h4><div class="separator" style="clear: both;">This is based on the fact that weight reduction by diet control alone is often sufficient to correct NIDDM. Also, sufficient exercise should be carried out by the individual. </div><h2 style="clear: both;">Complications of Diabetes Mellitus. </h2><div class="separator" style="clear: both;">The complications of diabetes Mellitus can be divided and discussed under two headings namely;</div><h4 style="clear: both;">1) Acute complications of Diabetes Mellitus - which include;</h4><div class="separator" style="clear: both;"></div><ul><li> hypoglycemia </li><li> diabetic ketoacidosis (DKA) </li><li> diabetic foot</li></ul><br><div class="separator" style="clear: both;"><br></div><h4 style="clear: both;">2) Chronic complications of diabetes mellitus - which include;</h4><div class="separator" style="clear: both;"></div><ul><li> retinopathy </li><li> atherosclerosis </li><li> cataract</li><li> neuropathy </li><li> nephropathy</li></ul><br><h2 style="clear: both;">Laboratory Relationships Of Diabetes Mellitus.</h2><h3 style="clear: both;"><br></h3><h3 style="clear: both;"><br></h3><div><span style="font-family: sans-serif;">By And Large, lots have been discussed in full about diabetes, insulin, hypoglycemia and hyperglycemia etc.</span><br></div><h3 style="clear: both;">Laboratory Diagnosis. </h3><div>Sample, Type Of Test and Lab recommendations is included while discussing the laboratory diagnosis of DM. </div><div>Sample Required For Diabetes Mellitus diagnosis. </div><div>The two main types of samples required in the diagnosis of D.M are;</div><div>1) Urine. </div><div>2) Blood. </div><div><br></div><div>These two samples are test specific depending on the type of investigation to be carried out. </div><div>Urine Sample. </div><div>The urine sample is used mainly for qualitative analysis in the detection for presence or absence of glucose in urine. </div><div><br></div><div>Urine Test Strip</div><div>The kit used for this analysis is called a URINE TEST STRIP pad. </div><div>This method of using URINE TEST STRIP for the qualitative determination of URINE CONSTITUENTS is called URINALYSIS. </div><div><br></div><div>Principle Of The Test (Urinalysis Principle). </div><div>The strip is impregnated with various chromogens and immobilised enzymes such that when the particular analytes to be detected comes in contact with the CHROMOGEN, series of reactions tend to occur immediately which then leads to change in colours on the test pad. </div><div><br></div><div>This strip is designated in different forms known to as COMBI. These COMBIs range from COMBI-9 to COMBI-12.</div><div><br></div><div>Analytes To Detected Using Various Urine Test Strip COMBIs. </div><div>The number of analytes a test strip can estimate depends on the suffix number affixed to the COMBI. </div><div>If "11" is attached as suffix to the COMBI, (ie COMBI-11), it means the strip can detect the presence and absence of 11-different analytes. </div><div>Analytes detected by strips include;</div><div>1) blood</div><div>2) citrate</div><div>3) ketone (or ketone bodies namely beta-hydroxybutyrate, acetoacetate and acetone). </div><div>4) Glucose</div><div>5) Proteins</div><div>6) Urobilonogens</div><div>7) Bilirubin </div><div>8) </div><div><br></div><div class="separator" style="clear: both; text-align: start;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5F45ywqxDhgCM8ZmWoGcBSSlVJkWmQoLdguhSlN6L_cMKqkkxW87ylAzRwAYMljn10d3B7FbugEvCtDjLyM_x2oq8I1rg85nPX4n9_P5HBJMFaeduU44onZvDMnjztIW5RKnHf16kUwgM/s1600/20160925102620.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5F45ywqxDhgCM8ZmWoGcBSSlVJkWmQoLdguhSlN6L_cMKqkkxW87ylAzRwAYMljn10d3B7FbugEvCtDjLyM_x2oq8I1rg85nPX4n9_P5HBJMFaeduU44onZvDMnjztIW5RKnHf16kUwgM/s640/20160925102620.jpg"></a></div></div>

Malaria Infection And Treatment

<div><p dir="ltr"><b>Overview, Complications and Treatment Of Malaria Infection. </b></p><p dir="ltr"><b>Introduction</b></p><p dir="ltr">As we all know, malaria is an epidemic disease which is responsible for most death of individuals in Africa and Nigeria.</p><p dir="ltr">Plasmodium is a parasite of class <b>Sporozoans</b> or  <b>Apicomplexas</b> because of their complex lifecycle. <br>For the full development of the parasite, two hosts are involved namely;<br>1) <b>Intermediate Host</b> been man in which the Asexual stage of its cycle occur<br>2) <b>Definitive Host</b> been the mosquito where the sexual stage occurs. </p><p dir="ltr"><b>Types Of Plasmodium Species</b>.<br>There are <b>five</b> species of these plasmodium which are responsible for bring about malaria. These species is as viz;<br>1) Plasmodium Falciparum<br>2) Plasmodium Vivax<br>3) Plasmodium Ovale<br>4) Plasmodium Malariae<br>5) Plasmodium Knowlesi... </p><p dir="ltr">Emphasis will be laid much on P. Falciparum and P. Vivax as the are the species of Plasmodium that cause the most deadly infection</p><p dir="ltr"><b>Pathogenesis Of Malaria Infection</b>.</p><p dir="ltr">Malaria infections occurs as a result of parasitemia when female mosquito called Anopheles infected with the plasmodium parasite transmit its saliva into the blood stream.</p><p dir="ltr"><b>Life Cycle Of Malaria Parasite. </b></p><p dir="ltr">The Lifecycle of most Sporozoan as mentioned above is very complex. It may involve one or more hosts. </p><p dir="ltr">Basically, the Lifecycle of malarial infection can be divided into;<br>1) <b>Sexual Lifecycle</b> is the stage of gamete formation (gametogony)<br>2) <b>Asexual Lifecycle</b>; the developmental formation of schizonts (schizogony). </p><p dir="ltr">The <b>asexual lifecycle</b> consist of <b>three</b> subgroup which include;<br>1) Pre-erythrocytic stage <br>2) Erythrocytic stage <br>3) Exo-erythrocytic stage. </p><p dir="ltr">The <b>Pre-erythrocytic stage</b> is the stage that when the mosquito comes for blood meal and transmit the parasite into the blood. <br>On entrance into the body, the parasite moves within milliseconds to milli hours to the LIVER CELLS(hepatocytes). </p><p dir="ltr">In the hepatocytes, the proliferate into <b>trophozoites</b> and mature to <b>schizonts</b>. This schizonts quickly burst and release about 30,000 <b>merozoites</b> which wanders into the red cells to continue the Erythrocytic stage of asexual cycle.</p><p dir="ltr">The <b>Erythrocytic stage</b> sets in. <br>The ruptured merozoites parasitize the RBCs. Falciparum been the most deadly parasitize both new, old and matured red cells while other species are red cell specific. </p><p dir="ltr">ThESE <b>merozoites</b> in RED CELLs undergo another series of development from schizonts to merozoites until they invade all the red cells of the system... </p><p dir="ltr">When eventually all red cells have been invaded, profuse sweating is experienced along with <b>CHILLS</b> due to rapid bursting to the schizonts to merozoites. Some of the schizonts hibernates to form <b>Hypnozoites</b> which could later transform to take down host.</p><p dir="ltr">The <b>Exo-erythrocytic stage</b> is the stage when the Hypnozoites develop back start the <b>ERYTHROCYTIC</b><b> STAGE</b></p><p dir="ltr"><b>Laboratory Diagnosis Of MP</b>.<br>The lab diagnosis of malaria is based on using blood as sample to prepare smears to identify the presence of <b>Chromatin Dot</b> called <b>Schnuffer's Dot</b> for most Falciparum strains. </p><p dir="ltr">Two smears used in diagnosis are as follows;<br>1) Thin Smear to detect the exact parasite species<br>2) Thick smear for number of parasitemia (severity of invasion) </p><p dir="ltr"><b>Staining Techniques For MP TEST</b><br>The most prepare staining technique for detection of MP is <b>FIELD STAINING METHOD</b>.<br>Other staining technique include;<br>* <b>Giemsa Method</b> <br>* Romanowsky Staining Techniques (eg leishman stain) </p><p dir="ltr"><b>Giemsa is used in most used tropic regions and even Nigeria.</b></p><p dir="ltr">Finally, as a medical laboratory <u>personnel</u>, its would interest you to knw that you could be the doctor of yourself in treating MALARIA. </p><p dir="ltr"><b>Chemotherapeutic Drugs For MP</b></p><p dir="ltr"><b>Monotherapy is not adviceable</b> as most starins of parasites have developed resistance to these drugs. <br>Secondly, most Falciparum malaria are resistant to virtually all malarial drugs. </p><p dir="ltr">Here are the list of combination therapy to malaria<br>1) Artemether + Lumefanthrine (also called coartem, or trade names include Amatem) is the best. <br>2) Sulphonamides + pyrimethamine (also called Fansidar) used only as chemoprophylaxis. Not effective against Falciparum strains. <br>3) Artesunate + Amodiaquine (for chemoprophylaxis) <br>4) Chloroquine (best for pregnant women but has now developed resistance) <br>5) Proguanil<br>6) Mefloquine<br>7) Primaquine <br>8) Quinine<br>9) Halofanthrine</p><p dir="ltr">Please and please, dont no administer Primaquine to pregnant mothers as the fetus is 100% likely to come down with Glucose 6-phosphate dehydrogenase deficiency. </p><p dir="ltr">Also, avoid unnecessary consumption/ingestion of the listed drugs above so as to prevent  Resistance. </p><p dir="ltr">Also, malarial drugs have toxic side effects which range from nausea to vomitting, deafness, G6PD DEFICIENCY, Pruritus etc. </p><p dir="ltr">If symptoms persist after three(3) days of taking COARTEM, consult the doctor 😷...</p><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7YxtuTNGoQHTWCLskjMZiIytUB_qE0Mo_KQxp6ouzvvJy4RiSNbqdK_58JkzVZJe5CYxUpFGHUt_91JMpA5cgisRtex3MxyMSq18qycNh1eBlMgAaFQsWAkVf8E_sBWFE1NuLI-ljL9a5/s1600/20160925102537.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7YxtuTNGoQHTWCLskjMZiIytUB_qE0Mo_KQxp6ouzvvJy4RiSNbqdK_58JkzVZJe5CYxUpFGHUt_91JMpA5cgisRtex3MxyMSq18qycNh1eBlMgAaFQsWAkVf8E_sBWFE1NuLI-ljL9a5/s640/20160925102537.jpg"> </a> </div></div>