"This is International Infection Prevention Week

This is International Infection Prevention Week. Burbara Dunn has informed that Kimberly-Clark HeathCare is in the forefront of protecting patients from Heath care associated infection (HCAI) and has put together a campaign dedicated to that prevention called HAI Watch- 'Not on my watch'.

They have created a site that information for both healthcare professionals and healthcare consumers.

Following is the website:


http://haiwatchnews.com


badrud doza

in reference to: Google Toolbar Installed (view on Google Sidewiki)

Case: A girl with hydrophobia

A 2 year old girl presented with agitation, hydrophobia and airophobia to a public hospital in our locality. Our post graduate students on their weekly scheduled visit to the hospital witnessed the child. The child or parents couldn't recollect any incident of dog bite or any other bite to the child.

The patient has no fever or no other neurological sign. The typical presence of hydrophobia and airophobia indicates the development of Rabies in the child. She was refered to the Infectious Disease Hospital for quarantine and treatment.

badrud doza

Link:

Rabies:CDC

Rabies: Wikipedia

World Rabies Day

Case: Mucopolysaccharidosis with cardiomyopathy and repeated respiratory infections

A boy of 5 years of consanguinous parents from Chittagong presented with dysmorphic facies, gross developmental delay, growth failure, deformity of the limbs and repeated respiratory infections.


He has cardiomegaly and initially had murmers which later disappeared and has moderate hepatospenomegaly, kyphoscoliosis.Visoin and hearing not impaired.

His blood picure is normal. Radiology shows cardiomegaly,spatula shaped ribs and diaphysial broadening of the long bones.




Echo showed on 27/8/06 AV canal defect(partial), cleft AML and grade II MR. Later on 3/10/07 it shows normal finding.

Enzyme assay is not available in Bagladesh and patient could not afford to go abroad for further evaluation and better managment.

Patient is diagnosed as Mucopolysaccharidosis likely Hurler's syndrome.

Patient is on symptomatic treatment.

badrud doza

Link:

Wikipedia- Mucopolysaccharidosis

E-medicine - Mucopolysaccharidosis Type I/H

Case: Thalassemia with severe anaemia with pericardial effusion

I was called in a clinic to see a girl of 5 years of consanguinous parents of Rohingya origin,the family staying in a Refugee camp in Tekhnaf, waiting for migration to Ireland.

The patient has growth failure(wt 10 kg),severe pallor, mild respiratory distress, malar prominence, huge hepatospenomegaly and intermittant fever of 22 days with no history of contact with tuberculosis. Clinically she also seems to have cardiomegaly, a soft systolic murmer, no basal creps and the liver was not tender.

Her investigation shows Hb-2.7 gm/dl, ESR-60, TC,DC-normal range. TT, Urine R/E is noram. Hb electrophoresis shows Hb-E Beta Thalassemia disease. X-ray has huge cardiomegaly-pear shaped with oligamic lung field, Echo shows gross pericardial effusion.




She was given two unit of blood, antibiotic and oral steroid. Fever was subsided after 7 days of traatment,Hb eleveated and respiratory distress subsided.

For pericardiocentesis and further evaluation he was refered to a cardiac centre. The delay takes place because of beaucratic complicacy of the sponsoring agencies.

badrud doza

Post script: The patient was untimately given antitubercular drug.

Case:Rheumatic Fever with Caridits and Arthritis

A boy of 7 years with low socioeconomic background presented with intermittent fever migrating polyarthritis( Rt hip- Rt Knee – Rt ankle) and anorexia for 5 weeks with a history of sore throat week from the onset joint pain.

On examination, the patient was toxic, had active swelling and tenderness of the Rt Keen joint grossly and of the left foot mildly, had cardiomegaly,palpable p2, loud second sound and a pansystolic murmur in mitral area of grade III with radiation to the axilla. The patient has no basal creps, hepatomegaly or ankle oedema.







Clinically the patient was diagnosed as Rheumatic Fever with Carditis & Arthritis

His ESR was 80 mmhg, had neutrophilia, Raised ASO titre, Xray with cardiomegaly, ECG with tachycardia and Echo showing mitral incompetence.

Investigation confirms the clinical impression.

The patient was hospitalized, given short term Penicillin, prednisolone which will be followed by aspirin and is given long term penicillin as prophylaxis.

Patient is now improved and waiting for discharge.


Badrud Doza

Link:
Rheumatic Heart Disease- e-medicine
Diagnosis of Active Rheumatic Carditis -Circulation

Case:Congenital Hypothyroidism

A boy of 7 months, 4.9 kg wt of nonconguinous parents presented with coarse facies,horse cry and constipation. He has also history of prolong jaundice after birth. The pateint has developmental delay- he has social smile but no neck control.

On examination, in addition to coarse facies and horse cry, the patient has lathergy, rough skin, mild anaemia, abdominal distention and least interaction.

X-ray of the lower end of the femur has shown the presence of epiphysis but the hormone assay shows TSH 100 mIU/L(N:0.7-64mIU/L) and T4 3.0 microgm/dl( N: 6.1-14.9 microgm/dl.The blood Hb 10gm/dl,TC DC ESR normal.

The patient is given thyroxine which will be gradually increased and will be continued throughout life. The patient is showing sign of improvement even after few days treatment.

Dr. Badrud Doza

Links:
Congenital hypothyroidism-e-medicine

Guest Post: Common Birth Defects and Their Causes

The birth of a baby is a joyous occasion, one that brings smiles to the faces of the parents, friends and family and cheer all around. But there are times when things go wrong and children are born with some defect or the other and the parents are devastated. The questions that are normally asked include:

• Is my baby ok?
• What’s wrong with him/her?
• Is it our fault or is it something we did that our child was born like this?
• Is there anything we can do now to make things right?
• How soon can any correctional procedure be done?
• How much will it cost?
• What are our child’s chances of coming through it successfully?
• Will our child be able to lead a normal life?
• If not, what can we do to make it as normal as possible?

Of course, the questions differ from family to family, and the decisions vary accordingly too.

The most common birth defects are those related to missing, extra or deformed limbs – some children are born with a club foot, deformed hands/legs, and missing or extra fingers. The next highest occurring defect relates to the heart with children being born with holes in their heart. Other common defects include those that affect the spinal cord, the face (cleft lip and palate), the intestines and stomach, sexual organs, and chromosomal problems like Down’s and Klinefelter’s syndromes where the presence of an extra chromosome or the absence of an essential one contribute to make the child different.

Birth defects are mainly caused by genetic factors, with known conditions causing 25 percent of all abnormalities. The parents may not have the same affliction because they may be just carriers, and depending on various factors, the symptoms manifest themselves in the newborn child.

Some defects are caused by environmental factors like drugs, exposure to radiation and chemicals, smoking (by the mother), the age of the mother, and illnesses. Sometimes, it’s a combination of the environment and genes – people with some genes, when exposed to a certain kind of environment, are likely to give birth to special needs children. The same gene, away from the environment that augments the possibility of the deformity, is passive and does not manifest in the child as an abnormality.

Pregnant women can reduce their risks of giving birth to babies with defects by getting themselves tested in each trimester and by avoiding exposure to environmental factors that are known to cause abnormalities.


• Heart abnormalities represent the next most common category of defect. Common heart defects include 'holes in the heart' where blood can pass from one side of the heart to the other. Again, these may not all be detected at birth.
• The third most common kind of defect affects the spinal cord, such as spina bifida.
• Other defects commonly observed include those affecting the face (such as cleft lip and palate), problems with the development of the intestines and stomach, and problems affecting the sexual organs.
• Major chromosomal problems such as Down's syndrome (Trisomy 21) are found in about 0.15 per cent of births (about three babies in every 2000).

By-line:

This article is contributed by Sarah Scrafford, who regularly writes on the topic of Radiology Technician Schools. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.