Golwalla’s Medicine for Students

1174 Pages·2017·43.17 MB·English

by  Aspi F Golwalla, Sharukh A Golwalla, Milind Y Nadkar

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Golwalla’s
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MEDICINE for Students
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Golwalla’s
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MEDICINE for Students
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A Reference Book for the Family Physician
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e Tweenty-Fifth Edition e e
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m ASPI F GOLWALm LA MD FACC FCPS FCCP m m
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Emeritus Professor of Medicine
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. Seth GS Med.ical College and KEM Hospital . .
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Mumbai, Maharashtra, India
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o SHARoUKH A GOLWALLA MD (Med) DoM (Card) FCCP o
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Visiting Cardiologist
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Breach Candy Hospital, Jaslok Hospital and HN Reliance Hospital
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m m Mumbai, Maharashtrma, India m
m Edmited by m m
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c MILIND Yc NADKAR MD FICP FACP c c
e. Professor of Medicine & Ce.hief of Rheumatology & Emergencye .Medicine e.
e Seth GS eMedical College and KEM Hospital e e
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r Ther Health Sciences Publisrher r
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k k New Delhi | London | Panamka k
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m Jaypee Brothers Mm edical Publishers (P) Ltd m m
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd.
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Golwalla’s Meodicine for Students o o o
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Twenty-Four.th Edition: 2014 . . .
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Twenty-Feifth Edition: 2017 e e e
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ISBN:f 978-93-5152-474-8 f f f
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P
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The purpose and scope of this widely read book at times referred to as a Bible in Medicine remains the same when it
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was first published in the year 1952 namely to help the undergraduate medical students with necessary information
presented on eaosily imbibable form for the final MBoBS examination both for Theory ando Viva. o
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Over th.e years, the book has spread its w.ings. To add to this its aim is the .acceptance by the students of .
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Homeopathy, Dentistry, Physiotherapy and even Ayurveda, where the question papers in the subject of Medicine
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have fround wide approval. r r r
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The original author of the book has been aging but the younger author is aware that new vigour and fresh ideas
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oare needed to ensure that every aspeoct in the test is kept up-to-date. o o
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The authors welcome the Editor, a pupil of the senior author in yesteryears and now a distinguished head of
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e the leading monthly journal ine the country and other literary achieevements as a collaborator in this reveised edition,
m and also for such future revmisions that will be called for. m m
Illustrations have been used freely whenever it was thought they would be purposeful in pathogenesis and
diagnosis of diseases. There are more number of tables and figures introduced in this edition.
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There might be room for improvement in some aspects, notwithstanding the amount of time and labour
bestowed upon oit. o o o
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Criticism.s and suggestions are invited and w.ill be received with gratitude by th.e authors and Editor. .
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Date of Publication
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Decsember 2016 s s s
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o o o Aspi F Goolwalla
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Sharukh A Golwalla
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Edited by
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Milind Y Nadkar
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1. Gastroenterology .............................................................................................................................................1
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 Investigations of gastrointestinal disease 1
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 The tongue in diagnosis 4
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 Stom.atitis and oral ulceration 7 . . .
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 Deysphagia 7 e e e
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f Gastro-oesophageal reflux disease f11 f f
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k  Achalasia of the cardia 12 k k k
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o  Hiatal hernia 14 o o o
b  Dyspepsia 14 b b b
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m  H.pylori infections 15m m m
 Gastritis 17
 Peptic ulcer 17
 Gastric cancmer 23 m m m
 Hematemoesis and melaena 24 o o o
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 Lowe.r gastrointestinal haemorrhage 27 . . .
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 Deiarrhoea 29 e e e
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fConstipation 32 f f f
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k  Malabsorption 33 k k k
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 Coeliac disease 36
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b  Abdominal tuberculosis 3b8 b b
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 Irritable bowel syndrome 39
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 Diverticular disease 41
 Inflammatory bowel disease 42
 Ischemic bowmel disease 47 m m m
 Drug-induoced gastrointestinal disorders 48 o o o
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 Fact.itious gastrointestinal symptoms and Mu.nchausen 49 . .
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2. Hrepatobiliary and Pancreatic Disearse .....................................................r..................................................51 r
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s Investigating and imaging the liver, bsiliary tract and pancreas 51 s s
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 Viral hepatitis 55
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o  Autoimmune liver disease 6o1 o o
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 Metabolic liver disease 64
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m  Hepatic encephalopathmy 67 m m
 Acute liver failure 69
 Jaundice 71
 Cirrhosis of lmiver 78 m m m
 Ascites o84 o o o
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 Porta.l hypertension 90 . . .
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 Heepatomegaly 92 e e e
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k  Drug-induced liver disease 95 k k k
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o  Liver transplantation 95 o o o
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e  Gallstones 97 e e e
m  Pancreatic disease 9m9 m m
3. The Respiratory System ..............................................................................................................................103
 Investigationms of respiratory disease 103 m m m
 Cough and expectoration 110
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 Haemocptysis 112 c c c
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 Inflaemmation of the bronchial tree 114 e e e
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 Bronchial asthma 119
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sf Chronic obstructive pulmonary diseassfe (COPD) 124 sf sf
k  Cystic fibrosis 129 k k k
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o  Pneumonia 130 o o o
b  Lung abscess 136 b b b
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 Pulmonary tuberculosis 139
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 Pulmonary eosinophilia 147
 Lung cancer 150
 Pulmonary omedema 154 m m m
 Pulmonaory thromboembolism 155 o o o
 Fungalc infections of the lung 157 c c c
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 Airweay problems in children 160 e e e
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 Pulmonary sarcoidosis 161
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sf Diffuse parenchymal lung disease s1f62 sf sf
k  Occupational lung disease 166 k k k
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o  Lobar collapse of the lung 1o68 o o
b  Sleep apnoea syndrome 1b69 b b
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m  Respiratory failure 17m1 m m
 Acute lung injury and acute respiratory distress syndrome 173
 Severe acute respiratory syndrome (SARS) 175
 Systemic dismeases and the lungs 176 m m m
 Pleural doisease 178 o o o
 Therapceutic aerosols 192 c c c
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 Druegs and the lungs 193 e e e
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 Respiratory problems in immunosuppressed patients 193
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s Lung transplantation 193 s s s
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 Miscellaneous 195
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b 4. The Cardiovascular Systebm .....................................................b.........................................................b..........196
e  Investigations in cardiovaescular diseases 196 e e
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 Pulse 204
 Cardiac arrhythmias 207
 Cardiac murmurs 230
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 Congenital heart disease 233
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 Valvulacr heart disease 249 c c c
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 Infeective endocarditis 265 e e e
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 Cardiovascular syphilis 270
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sf Ischaemic heart disease 271 sf sf sf
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 Cardiac arrest 289
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Contents ix
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o  Heart failure 291 o o o
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e  Shock 296 e e e
m  Hypertension 298 m m m
 Heart muscle disease 307
 Neurocirculatory asthenia 312
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 Pericardial disease 313
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 Pulmonary hypertension 319
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 Hear.t disease and pregnancy 321 . . .
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 Pearoxysmal dyspnoea 322 e e e
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f Diseases of vessels 324 f f f
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o 5. Haematology ...........................o.........................................................o.........................................................o...335
o  Laboratory diagnosis in haemoatology 335 o o
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e  Haematopoiesis 342 e e e
m  Anaemias 345 m m m
 Bone marrow failure 363
 Amegakaryocytic thrombocytopenia 366
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 Porphyrias 366
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 Disorders of haemostasis 366
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 Antic.oagulant drugs 376 . . .
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 Meyelodysplastic syndromes 378 e e e
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f Leukemias 382 f f f
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k  Lymphomas 391 k k k
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 Blood transfusion 400
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b  Antiplatelet drug therapy 4b02 b b
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 The spleen 403
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 Bone marrow transplantation 409
 The blood in systemic disease 410
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6. Endocrine Disorders ....................................................................................................................................412
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 Pituitarcy gland 412 c c c
 Obees.ity 421 e. e. e.
 Tehyroid disease 424 e e e
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f Thyroid goiter 433 f f f
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k  Parathyroid disorders 435 k k k
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o  The adrenals 439 o o o
b  Pancreas 445 b b b
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 Hypoglycaemia 466
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 Multiple endocrine neoplasia men 468
 Carcinoid syndrome 468
 Miscellaneoums 470 m m m
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7. Neurologcy .....................................................c.........................................................c.......................................471 c
 Invees.tigations in neurology 471 e. e. e.
 Deisorders of speech 480 e e e
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sf The cranial nerves 483 sf sf sf
k  Pupillary disorders 491 k k k
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o  Sensory impairment 493 o o o
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e  The reflexes 494 e e e
m  Neurological disturbanmces of bladder and bowel 495 m m
 Involuntary movements 497
 Gaits 501
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 Headache 503
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 Epilepscy 507 c c c
 Ceree.brovascular diseases 514 e. e. e.
 Ceoma and brainstem death 530 e e e
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sf Neurosyphilis 537 sf sf sf
k  Tuberculosis of the central nervouks system 539 k k
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o  Intracranial tumours 542 o o o
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 Disorders of the spinal cord 546
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m  Deficiency disorders omf the nervous system 561 m m
 Extrapyramidal syndromes 562
 Hereditary and degenerative disorders 567
 Cerebellum amnd its disorders 571 m m m
 Myopathioes 574 o o o
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 Myas.thenia gravis 580 . . .
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 Meuscular wasting 583 e e e
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f Peripheral neuropathy 584 f f f
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k  Root and plexus syndromes 592k k k
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8. Renal Disorders ...........................................................................................................................................597
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e  Investigations in renal diseease 597 e e
m  Hematuria 606 m m m
 Glomerular diseases 608
 Acute renal failure (ARF) 615
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 Chronic kidney disease (CKD) 619
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 Urinaryc tract infection (UTI) 627 c c c
 Poley.cystic disease of kidneys 630 e. e. e.
 Teubulo-interstitial disorders 631 e e e
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f Urinary calculi 633 f f f
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k  Incontinence of urine 634 k k k
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o  Kidney in systemic disease o636 o o
b  Adverse effects of drugs onb the kidney 637 b b
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 Renal disease and pregnancy 637
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 Urinary catheterization 639
 Stem cell therapy for kidney disease 641
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9. Rheumatology ..............................................................................................................................................642
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 Investicgations 642 c c c
 Rheeu.matoid arthritis 645 e. e. e.
 Sepondyloarthropathies 653 e e e
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sf Joint and bone infections 660 sf sf sf
k  Osteoarthritis 662 k k k
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Contents xi
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o  Metabolic and crystal athropaothies 664 o o
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e  Autoimmune diseases e669 e e
m  Vasculitides 680 m m m
 Bone disorders 686
 Miscellaneous 691
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10. Infectious oDiseases and Infections ...............o.........................................................o....................................693 o
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 Diphtheria 693
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 Meningitis 695
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r Viral infections 698 r r r
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s Acute childhood exanthemas 708s s s
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o  Mumps 714 o o o
o  Whooping cough (pertussis) o715 o o
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 Enterovirus infections 716
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m  Toxoplasmosis 720 m m m
 Tetanus and other clostridial diseases 720
 Lyme disease 724
 Legionnairesm’ disease 724 m m m
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11. Tropicalc Diseases .........................................c.........................................................c.......................................727 c
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 Proetozoal infections 727 e e e
 Perotozoal GI infections 736 e e e
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sf Gastroenteritis 741 sf sf sf
k  Plague 746 k k k
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o  Brucellosis 747 o o o
b  Leprosy 749 b b b
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 Rickettsial diseases 752
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 Rabies 753
 Dengue 755
 Chikungunyam 757 m m m
 Hantavirus infection 758
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 Japanecse B encephalitis 758 c c c
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 Rate-bite fever 759 e e e
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 Leptospirosis 759
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sf Anthrax 760 sf sf sf
k  Filarial infections 761 k k k
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o  Tropical polymyositis 763 o o o
b  Intestinal helminths 763 b b b
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 Schistosomiasis (bilhariziasis) 768
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 Hydatid disease 770
 Dracunculiasis (guinea-worm disease) 772
 Tropical sprume 773 m m m
 Effects ofo heat 774 o o o
 Endemcic fluorosis 775 c c c
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12. Diseeases of Children ...........................e.........................................................e...............................................777 e
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f Newborn infants 777 f f f
s s s s
k  Diseases of the newborn 780 k k k
o o o o
o o o o
b b b b
e e e e
m m m m
m m m m
o o o o
c c c c
. . . .
e e e e
e e e e
r r r r
f f f f
s s s s
k k k k
o o o o
o o o o
b b b b
e e e e
m m m m