"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


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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.

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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.

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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.

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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.


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