Wednesday, April 30, 2008

Case: Hematoma of the liver

Sumon, 10 yrs of age from chittagong, was admitted with the complaints of fever for 7 days and passage of blood in the vomiting and stool for 3 days. He had a h/o trauma 15 days back.

Patient was alert but irritable, no jaundice, had rapid pulse and low pressure, was moderately pale. Patient had hematomegaly(4 cm) with severe tenderness.

Initially doctors was under the impresion of hepatitis. But his clinical condition was not fully correlating with hepatic failure to explain the hematomesis and melena.

His Hb was 3.4 gm/dl, ESR 82 mm/1st hour, TC of WBC-16000/cmm, Neutrophil-76%, Lympho -10%, Platelet 400,000/cmm, pheripheral blood film shows polymorphonuclear leaucocytosis.

His serum bilirubin was 1%, SGPT-157.5 unit/L, HbsAg negative, PT -normal.

USG reveals that hematoma/Abcess in the Rt love with approx. 5 cm X 6 cm in size.

We managed the patient with 2 units of blood and antibiotics.

Dr. Badrud Doza
Dr. Saiful Islam

Link: Hematoma of the Liver

Monday, April 28, 2008

News: we observed World Malaria Day

A malaria awareness program was organised in our hospital on 27th,2008 April in observance of first World Malaria Day. Different sections of people including doctors,nurses,technicians,general staffs of the hospital, students of medical college and general public attended the program.

Prof Dr. Emran bin Yunus, a neprologist and internist and a malaria expert who is also working as monitor of malaria program in WHO international panel present the key note speech on 'World situation of malaria and Malaria Control Program in Bangladesh'. It was a nice presentation and enjoyed by all.
Dr. Abdul Mannan Bangali, National Professional Officer,Vector born control program, WHO, Dr. Musfiqur Rahman, Conultant, VBCP,WHO and Dr. Ekramul Islam, Project Manager, BRAC Operation Health, Bangladesh also spoke on the occassion. BRAC is the largest NGO in bangladesh and the world and doing good work in the health sector in rural areas.

Posters were displayed, leaflets were distributed and students of the medical college produced a Wall Paper with clips from papers and journals on the occassion.

In Bangladesh, though malaria was once 'eradicated' due to effect of DDT, it resurged back after 1971. Now 15 million people are at risk along its hilly eastern and east-northern borders. The no of cases per year is about 300,000 and deaths per year is about 2000. Malaria control program is in effect with the public and private partnership with the support of WHO and Global Fund. The target is to reduce the case and death to 50% of 2005 by the year 2012.
Bangladesh is striving hard to achieve this with success in many community programs in the bacground.

Badrud Doza
Co-ordinator, Malaria Control Program,
Chittagong Maa-Shishu O General Hospital

Related link: 1 ) Roll Back Malaria Program

Wednesday, April 2, 2008

Case: Diaphragmatic Hernia

Baby of Fatima, 2 days old male Neonate coming from Patiya , admitted in NICU with the complaint of respiratory distress since birth. The baby delivered at home by normal vaginal delivery at the gestational age of 40 weeks.
The baby was cyanosed, dyspnoic, respiratory rate- 68/m, reflex and tone –normal, length 46cm, OFC-32 cm. Chest was bulged, mediastinum shifted to the right, breath sound absent and bowel sound present in the left. Abdomen is scaphoid in shape and no organomegaly.

CXR shows bowel loops in the left side of the chest and mediastinum shift to the right.

The Baby was diagnosed as a case of Diaphragmatic Hernia.

Thoraco-abdominal laparoscopic approach with laparotomy and laparoscopic repair of the diaphragram and ileal –peritoneal approach repair was done by our Pediatric Surgery Department.

Dr. Badrud Doza
Dr. Rasel