Monday fever-byssinosis esp. in its early stages of development (syn-Metal fume fever)
1)byssinosis
Obstructive airway disease in people who work with unprocessed cotton, flax, or hemp; caused by reaction to material in the dust and thought to include endotoxin from bacterial contamination. Sometimes called “Monday morning asthma“ since patients improve when away from work on the weekend. Syn: cotton-dust asthma, cotton-mill fever, mill fever, brown lung disease
2) Metal fume fever is an ancient occupational disease still encountered among metal workers. Potisser has been credited with first recognizing the syndrome in 1822.
This syndrome resembles a flu-like illness. Onset occurs in 4 to 6 hours, generally on the evening after exposure to fumes. Fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste, and salivation characterize this self-limited illness, with resolution of symptoms appearing in 36 hours. The chest x-ray usually is clear. Tolerance develops in workers, but may be lost over the weekend ("Monday Morning Fever"). Metal fume fever can also follow exposure to fumes of copper, magnesium, aluminum, antimony, iron, manganese, and nickel in welding, galvanizing, or smelting operations.
Other names have been used for metal fume fever including Monday fever, brass chills, zinc ague, welder's ague, smelter shakes, foundry fever, the smothers, and brass founders' ague. Various metals that have been associated with metal fume fever include cadmium, aluminum, magnesium, nickel, copper, manganese, antimony, and tin. Exposure to zinc oxide fumes occurs mainly during welding or the galvanization of steel. Other occupations at risk include smelters, shipyard workers, junk metal refiners, electroplaters, metallic pigment makers, metal polishers, and alloy makers.
The diagnosis of metal fume fever is usually made when the clinical picture is combined with history of metal fume exposure. The disorder is usually of short duration, lasting no more than 24 to 48 hours.
Monday fever-byssinosis esp. in its early stages of development (syn-Metal fume fever)
1)byssinosis
Obstructive airway disease in people who work with unprocessed cotton, flax, or hemp; caused by reaction to material in the dust and thought to include endotoxin from bacterial contamination. Sometimes called “Monday morning asthma“ since patients improve when away from work on the weekend. Syn: cotton-dust asthma, cotton-mill fever, mill fever, brown lung disease
2) Metal fume fever is an ancient occupational disease still encountered among metal workers. Potisser has been credited with first recognizing the syndrome in 1822.
This syndrome resembles a flu-like illness. Onset occurs in 4 to 6 hours, generally on the evening after exposure to fumes. Fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste, and salivation characterize this self-limited illness, with resolution of symptoms appearing in 36 hours. The chest x-ray usually is clear. Tolerance develops in workers, but may be lost over the weekend ("Monday Morning Fever"). Metal fume fever can also follow exposure to fumes of copper, magnesium, aluminum, antimony, iron, manganese, and nickel in welding, galvanizing, or smelting operations.
Other names have been used for metal fume fever including Monday fever, brass chills, zinc ague, welder's ague, smelter shakes, foundry fever, the smothers, and brass founders' ague. Various metals that have been associated with metal fume fever include cadmium, aluminum, magnesium, nickel, copper, manganese, antimony, and tin. Exposure to zinc oxide fumes occurs mainly during welding or the galvanization of steel. Other occupations at risk include smelters, shipyard workers, junk metal refiners, electroplaters, metallic pigment makers, metal polishers, and alloy makers.
The diagnosis of metal fume fever is usually made when the clinical picture is combined with history of metal fume exposure. The disorder is usually of short duration, lasting no more than 24 to 48 hours.
A sneak Preview of the Next RxPG Book Question
125) Monday Fever is
A) Tuberculosis
B) Brucellosis
C) Byssinosis
D) Malaria
Answer
C) Byssinosis
Reference
Oxford Text book of Surgery Chapter 17.10.09
Discussion
In byssinosis the first day at work is characteristically troublesome and is termed as Monday morning tightness.
In humidifier fever symptoms are often worse on a Monday which is not usually so in humidifier lung.
Explanation
A) Tuberculosis produces evening rise of temperature
B) Brucellosis is characterized by “undulant fever”
C) Monday fever is Byssinosis
D) Malaria can produce fever every 48 hours or every 72 hours
Comments
Metal fume fever is a common, acute, and self-limiting febrile illness that characteristically recurs on re-exposure after brief absence from work; it is another Monday morning fever. It can occur on the first day of exposure. It results from alveolar deposition of very fine particulate metal oxides (fumes) released in processes such as welding, melting, and smelting of metal. It particularly, but not exclusively, involves zinc, copper, and magnesium. Within some 6 hours of exposure, there is sudden onset of thirst, a metallic taste in the mouth, cough, tightness in the chest, and chills, with fever, headache, myalgia, and leucocytosis. There is resolution within 24 hours without ill effect, and this benign course distinguishes the condition from acute cadmium inhalation and poisoning.
Tips
Failure of the alcohol dehydrogenase system in workers of the lead industry that results in very prolonged hangovers termed as the Monday morning colic.
Other chemicals such as nitroglycerine are potent vasodilators and the effect is greatest after a period away from exposure, the so called “Monday morning death” syndrome in the makers and users of explosives.
Question
277. Essential components of RCH Programme in India include all of the following except:
1. Prevention and management of unwanted pregnancies.
2. Maternal care including antenatal, delivery & post-natal services.
3. Reduce the under five mortality to half.
4. Management of reproductive tract infections & sexually transmitted infections.
Answer
3. Reduce the under five mortality to half.
Reference
RCH Module for Medical Office (Primary Health Centre) - Page XVIII
Quality
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Status
New Question
QTDF
?? RCH Module for MO (PHC)
Discussion
On the recommendations of the International Conference on Population and development held in 1994 at Cairo (Egypt), the Government of India launched the Reproductive and Child Health (RCH) Programme on 15.10.1997 for implementation during 9th Plan period by integrating and strengthening all the existing interventions under the Child Survival and Safe Motherhood (CSSM) interventions of fertility regulation and adding the component of Reproductive Tract Infection (RTI) and Sexually Transmitted infections (STI). The concept of RCH Programme is to provide need based, client centres, demand driven, high quality and integrated RCH services to the beneficiaries. The programme is being implemented on a differential approach basis and in a phased manner.
All the districts of the country have been covered under the programme during 1999-2000. The main highlights of the RCH Programme are:
1. The Programme integrates all interventions of fertility regulation, maternal and child health with reproductive health of both men and women.
2. The services to be provided will be client centered, demand driven, high quality and need based.
3. The programme envisages upgradation of the level of facilities for providing various interventions and quality of care. The First Referral Units (FRUs) being , set up at subdistrict level will provide comprehensive emergency obstetric and newborn care. Similarly RCH facilities in PHCs will be substantially upgraded.
4. It is proposed to improve facilities for obstetric care, IMTP and IUD insertion in the PHCs and for IUD insertion in subcentres.
Explanation
1. Prevention and management of unwanted pregnancies is an essential component.
2. Maternal care including antenatal, delivery & post-natal services is an essential component..
3. Reduce the under five mortality to half is NOT an essential component.
4. Management of reproductive tract infections & sexually transmitted infections is an essential component.
Comments
The Integrated package of Services are
Services for mothers during pregnancy, child birth and post natal period including safe abortion services when required
Services for children including new born care, immunization, Vitamin A Prophylaxis, Oral Rehydration Therapy (ORT), for Diarrhoea, management of Acute Respiratory Infections (ARI), Anemia control
Services for Eligible couples through promotion of use of contraceptive methods as well as infertility services when required
Prevention and management of Reproductive Tract Infections (RTIs)
Adolescent Health Services including counsellling on family life and reproductive health
Tips
Other fancy terms with respect to RCH are
CNNA - Community Need Assessment Based Approach
AGT - Awareness Generation Training
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