In the occasion of convulsions, a slow intravenous injection of benzodiazepine is administered.There is insufficient evidence to show that blood transfusion is useful in either reducing deaths for children with severe anaemia or in improving their haematocrit in one month. There is insufficient evidence that iron chelating agents such as deferoxamine and deferiprone improve outcomes of those with malaria falciparum infection. Resistance
Drug resistance poses a growing problem in 21st-century malaria treatment. In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Resistance is now common against all classes of antimalarial drugs apart from artemisinins. Treatment of resistant strains became increasingly dependent on this class of drugs. The cost of artemisinins limits their use in the developing world. Malaria strains found on the Cambodia–Thailand border are resistant to combination therapies that include artemisinins, and may, therefore, be untreatable. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years and the availability of substandard artemisinins likely drove the selection of the resistant phenotype. Resistance to artemisinin has been detected in Cambodia, Myanmar, Thailand, and Vietnam, and there has been emerging resistance in Laos. Resistance to the combination of artemisinin and piperaquine was first detected in 2013 in Cambodia, and by 2019 had spread across Cambodia and into Laos, Thailand and Vietnam (with up to 80 percent of malaria parasites resistant in some regions).There is insufficient evidence in unit packaged antimalarial drugs in preventing treatment failures of malaria infection.
Megalopapilla is a non-progressive human eye condition in which the optic nerve head (optic disc) has an enlarged diameter, exceeding 2.1 mm with no other morphological abnormalities. Clinical features
In megalopapilla the optic disc diameter exceeds 2.1 mm (or surface area more than 2.5 mm2) with an increased cup-to-disc ratio. Although the optic disc is looks abnormal, the disc colour, sharpness of disc margin, rim volume, configuration of blood vessels and intraocular pressure will be normal. Visual field is normal except for an enlarged blind spot. Visual acuity may be normal, or occasionally reduced. Types
There are two types of megalopapilla. Type 1, which is the most common, is bilateral with a normal configuration of the optic cup. Type 2 is unilateral with a superiorly displaced cup that eliminates the adjacent neuro-retinal rim. Diagnosis and differential diagnosis
Large disc size can be seen in fundus examination by ophthalmoscopy. Since OCT is not influenced by disc size, it can be used in differentiating normal and glaucomatous eyes with large discs.Since the clinical appearance of megalopapilla resembles that of glaucomatous optic disc, it should be differentiated from Normal tension glaucoma and other pseudo-glaucomatous diseases. Other conditions that resembles megalopapilla includes coloboma of optic disc and orbital optic disc glioma. History
Bock and Franceschetti were the first to use the term megalopapilla to describe larger-than-normal optic disks. == References ==