tag:blogger.com,1999:blog-10611203889119197692024-03-13T03:04:08.124+05:00A Pediatrician's NotebookNotes on the clinical cases encountered in a setup with limited facilitiesbadrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.comBlogger71125tag:blogger.com,1999:blog-1061120388911919769.post-74716937386299351222010-08-01T15:46:00.000+07:002010-08-01T15:53:14.437+07:00A boy of 14 with Wilson DiseaseHashibur rahma, 14 years of age of consanguineous parents from Bandar, Chittagong presented with progressive difficulty to walk, to work with hands and in speech. <br /><br />Birth history is normal and there is no developmental delay. <br /><br />On examination, the patient is alert, a bit emotionally labile, muscle bulk is reduced in generalized form; rigidity of muscles increased, power is reduced, reflexes are exaggerated, more on the right side. Among the involuntary movements tremor of the hand and feet is present, coarse and also of intention tremor in type. Coordination is normal. Gait though not typically fastinant, but on small base.There is no hepatomegaly.<br /> Eye Examination on slit lamp shows Kayser Flesher Ring.<br /><br /><br />In investigation: Serum cerulloplasmin is 150 ugm, Serum copper and urinary copper couldn’t be done, CBC is normal with Hb-11.2 gm/dl, ESR -10, TC-7300, DC-N-67, L-28, E-3, B-0, Urine R/E N, Serum creatiniine- 0.7 mg/dl. CT scan reveals Normal. <br /><br />The case is diagnosed as Wilson Disease – Neurological type. <br /><br />The patient was treated with Pallicillamine, Xinc and Perkinil<br /><br /> <br /> <br />badrud doza<br /><br />Link: <br /><br /><a href="http://en.wikipedia.org/wiki/Wilson%27s_disease">Wilson Disease: Wikipedia</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com1tag:blogger.com,1999:blog-1061120388911919769.post-79192567752500167142010-04-09T20:57:00.000+07:002010-04-10T00:43:41.821+07:00Case: A Posterior Fossa Tumor- ?Cellebellar AstrocytomaFarzana, a girt 7 years of old of nonconguinous parents from Hathajari, Chiitagong presented with vomiting for 2 months with morning headache, dimness of vision and irritability for 1 month.<br /><br />On examination , the patient was found irritated , OFC 54 cm, Pulse –rapid, BP –120/80 mmhg, Ant Fontanelle –open (small),pupil dilated and poorly reacting, no neck rigidity or Kerning sign and planter extensor,muscle power –poor, sensory- intact. <br /><br />CT scan reports Posterior Fossa Tumor likely Astrcytoma with grossly dilated ventricles. <br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjb0AfApyoIYW6nEVeKmzXVL575Ih21g8IvfPCabd9fg8aBIBczIyAOO8vazbE6rWb2X4kAUtPGb3rYTXPbBGDBA8MjsL60yoh52AqdwfCyidvFthFyT29p6CN-6Ysqsk_kXicCdFynMSg/s1600/Picture+068.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjb0AfApyoIYW6nEVeKmzXVL575Ih21g8IvfPCabd9fg8aBIBczIyAOO8vazbE6rWb2X4kAUtPGb3rYTXPbBGDBA8MjsL60yoh52AqdwfCyidvFthFyT29p6CN-6Ysqsk_kXicCdFynMSg/s320/Picture+068.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5458192056644825314" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMoUUqEeg0mi_kLP7Xy6nwe3OfIk9HaZOYJgLNMDvYy8OuClbHY1O8dropt64_pCRmXtd8dzxTcu7KF8qJYXULpaKO4dwJFf5mzTK7JRRK1e0a03LWoCd9n3c0f2oocv4pQmoAqAp5ick/s1600/Picture+071.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMoUUqEeg0mi_kLP7Xy6nwe3OfIk9HaZOYJgLNMDvYy8OuClbHY1O8dropt64_pCRmXtd8dzxTcu7KF8qJYXULpaKO4dwJFf5mzTK7JRRK1e0a03LWoCd9n3c0f2oocv4pQmoAqAp5ick/s320/Picture+071.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5458194606919165362" /></a><br />Pt was referred to the Neurosurgey Center for operation and further management.badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com2tag:blogger.com,1999:blog-1061120388911919769.post-40085754158163586742010-03-07T01:01:00.001+07:002010-03-07T01:01:40.331+07:00World Kidney Day // Bloggers Unite<a href=http://www.bloggersunite.org/event/world-kidney-day>World Kidney Day // Bloggers Unite</a><br /><br />Posted using <a href="http://sharethis.com">ShareThis</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-67355039550263757422009-10-23T21:57:00.001+07:002009-10-23T21:57:08.718+07:00"This is International Infection Prevention Week<div xmlns='http://www.w3.org/1999/xhtml'><p>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'.<br/><br/>They have created a site that information for both healthcare professionals and healthcare consumers.<br/><br/>Following is the website:<br/> <br/><br/><a href='http://haiwatchnews.com'>http://haiwatchnews.com</a><br/><br/><br/>badrud doza</p>in reference to: <a href='http://www.google.com/toolbar/ie/done.html'>Google Toolbar Installed</a> (<a href='http://www.google.com/sidewiki/entry/111357217480122012496/id/HNwrL7WcjsQgIKL9YvYmzfco5zc'>view on Google Sidewiki</a>)</div>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-50038719800429353832009-05-06T13:16:00.000+07:002009-05-06T15:22:04.784+07:00Case: A girl with hydrophobia<OBJECT class=BLOG_video_class id=BLOG_video-607a3ee7b952f85b height=266 width=320 contentId="607a3ee7b952f85b"></OBJECT><br /><OBJECT class=BLOG_video_class id=BLOG_video-42f4d368a3199859 height=266 width=320 contentId="42f4d368a3199859"></OBJECT><br /><br />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.<br /><br /> 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.<br /><br />badrud doza<br /><br />Link:<br /><br /><a href="http://www.cdc.gov/RABIES/">Rabies:CDC</a><br /><br /><a href="http://en.wikipedia.org/wiki/Rabies#Symptoms">Rabies: Wikipedia</a><br /><br /><a href="http://www.worldrabiesday.org/">World Rabies Day</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com2tag:blogger.com,1999:blog-1061120388911919769.post-25688296814128141722009-03-07T12:52:00.000+07:002009-03-07T14:58:14.122+07:00Case: Mucopolysaccharidosis with cardiomyopathy and repeated respiratory infectionsA 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.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhva90MAcioqntuBTRet31js-1nMCph5MSm6jL1_VEy4IRgAfxSb6npX8kuMoMz3d1FHggSfyuYzI-t8vdVCvtuAbbwyJsyl7yo3xVEH5-iW3Y9rCmGoVpoZxXXqDRzor0XbJefETIMHBY/s1600-h/Hurler's+syndrome.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhva90MAcioqntuBTRet31js-1nMCph5MSm6jL1_VEy4IRgAfxSb6npX8kuMoMz3d1FHggSfyuYzI-t8vdVCvtuAbbwyJsyl7yo3xVEH5-iW3Y9rCmGoVpoZxXXqDRzor0XbJefETIMHBY/s320/Hurler's+syndrome.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5310341680235384258" /></a><br /><br />He has cardiomegaly and initially had murmers which later disappeared and has moderate hepatospenomegaly, kyphoscoliosis.Visoin and hearing not impaired. <br /><br />His blood picure is normal. Radiology shows cardiomegaly,spatula shaped ribs and diaphysial broadening of the long bones.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVBXgaBl_jfr1fjLpzOQ6uOQBdujH2UH6hlbPQtuXcYoVt262t5d-PVj1py-IXkIAVimZTwCwnIb_UbN_r2jrt15YhnkjEbhQXNfZ4_1ukqfU7YnsYGg_zI_PLOj2F1jY8HMyamVt_Mqc/s1600-h/HS-7.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVBXgaBl_jfr1fjLpzOQ6uOQBdujH2UH6hlbPQtuXcYoVt262t5d-PVj1py-IXkIAVimZTwCwnIb_UbN_r2jrt15YhnkjEbhQXNfZ4_1ukqfU7YnsYGg_zI_PLOj2F1jY8HMyamVt_Mqc/s320/HS-7.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5310341684873097570" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1ldYHf_w3Vp4DGDeDhEu9iETuXPjGWycp9IVx6k6fla7Duvg4PgEOtgusWS-FbRZpRpsi4EE1kxSifUqbbsCQYelxXvbl27gEmkZKVD11-0TQHDvkaDgFDfgAeYTegG_6cQ_Fw2tdRHo/s1600-h/HS-6.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1ldYHf_w3Vp4DGDeDhEu9iETuXPjGWycp9IVx6k6fla7Duvg4PgEOtgusWS-FbRZpRpsi4EE1kxSifUqbbsCQYelxXvbl27gEmkZKVD11-0TQHDvkaDgFDfgAeYTegG_6cQ_Fw2tdRHo/s320/HS-6.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5310341692148159026" /></a><br /><br /><br />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.<br /><br />Enzyme assay is not available in Bagladesh and patient could not afford to go abroad for further evaluation and better managment. <br /><br />Patient is diagnosed as Mucopolysaccharidosis likely Hurler's syndrome. <br /><br />Patient is on symptomatic treatment.<br /><br />badrud doza<br /><br />Link: <br /><br /><a href="http://en.wikipedia.org/wiki/Mucopolysaccharidosis">Wikipedia- Mucopolysaccharidosis</a><br /><br /><a href="http://emedicine.medscape.com/article/944816-overview">E-medicine - Mucopolysaccharidosis Type I/H</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-62462197932006798392009-02-15T11:07:00.001+07:002009-02-25T13:36:54.125+07:00Case: Thalassemia with severe anaemia with pericardial effusionI 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. <br /><br />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. <br /><br />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.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgF1MVu79VxNYcJ6aNyg3Y5Ps74BAQzvp_WIwuvQMBqJMr8NGjS5lqZqXyTaJaHyKg7Ryw512s5WNkpgz7DYgNS3UkYquDc31WQ3RGE3qpyTC16EHkF9NwMaA6rsHSEpnAtiMBVXO0qtDo/s1600-h/Pericardial+effusion-2.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgF1MVu79VxNYcJ6aNyg3Y5Ps74BAQzvp_WIwuvQMBqJMr8NGjS5lqZqXyTaJaHyKg7Ryw512s5WNkpgz7DYgNS3UkYquDc31WQ3RGE3qpyTC16EHkF9NwMaA6rsHSEpnAtiMBVXO0qtDo/s320/Pericardial+effusion-2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5306619658736760818" /></a><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEZ34HgpiMT_h2B7sY2NkSeweMX-MAe5zm1ToiHg_BF1G2rn7s-s8w0i2lTdK8YAisk86p3X-Sr0ZYNrlqQZDRWfDgHnaJE-uC4qHdVhKVWk7pgkyciYzUjlAV6qQhvCxGKlerk8a6u8s/s1600-h/Pericardial+effusion-echo-2.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEZ34HgpiMT_h2B7sY2NkSeweMX-MAe5zm1ToiHg_BF1G2rn7s-s8w0i2lTdK8YAisk86p3X-Sr0ZYNrlqQZDRWfDgHnaJE-uC4qHdVhKVWk7pgkyciYzUjlAV6qQhvCxGKlerk8a6u8s/s320/Pericardial+effusion-echo-2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5306619659013807634" /></a><br /><br />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.<br /><br />For pericardiocentesis and further evaluation he was refered to a cardiac centre. The delay takes place because of beaucratic complicacy of the sponsoring agencies. <br /><br />badrud doza <br /><br />Post script: The patient was untimately given antitubercular drug.badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-64931490480795671022009-01-24T14:07:00.000+07:002009-01-26T13:46:59.327+07:00Case:Rheumatic Fever with Caridits and Arthritis<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizm7yFIhxg7_yIcv3PlF9mJ9D_800zFnLWIa9F9rJfjQqtubEUgXKhtOCSsjpx8qNjq35d2gJV9-juMznjJFOyBWK6Z14uvP895v6ooNt5vi35PHqLLGm2iAvOZ2w9q2gCGQcjnbw4gXI/s1600-h/Pt+carditis.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizm7yFIhxg7_yIcv3PlF9mJ9D_800zFnLWIa9F9rJfjQqtubEUgXKhtOCSsjpx8qNjq35d2gJV9-juMznjJFOyBWK6Z14uvP895v6ooNt5vi35PHqLLGm2iAvOZ2w9q2gCGQcjnbw4gXI/s320/Pt+carditis.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5295484887674734674" /></a><br />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.<br /><br />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. <br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieF-qTk97XD6D5BXoNCYy_P8Bdfbymh6xkaFRE6YBgHl5pajzeIvf6MQSGYAqkogGa738PjCePhpRz4IObSOWyYdDZZ9xeSj3WPWGAPGOMfGAod1serzDzvvU2dPf7LnZpbIuLUcSgNhw/s1600-h/Pt-carditis-Xray2.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieF-qTk97XD6D5BXoNCYy_P8Bdfbymh6xkaFRE6YBgHl5pajzeIvf6MQSGYAqkogGa738PjCePhpRz4IObSOWyYdDZZ9xeSj3WPWGAPGOMfGAod1serzDzvvU2dPf7LnZpbIuLUcSgNhw/s320/Pt-carditis-Xray2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5295484887729130322" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhR1KiP82b-R2b0ItKTGutHHjdsHOWCCCm55Znk5ubQF0U1qMvM93Obxo9EyVwfzSS36v0Nj9d91mORvAV65eENfpM2BTi0WjwhuxZF2o3w3HLF8eyx6pXPaFamkcUZNHNNnNj-jmKbuaY/s1600-h/Pt-carditis-ECG+4.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhR1KiP82b-R2b0ItKTGutHHjdsHOWCCCm55Znk5ubQF0U1qMvM93Obxo9EyVwfzSS36v0Nj9d91mORvAV65eENfpM2BTi0WjwhuxZF2o3w3HLF8eyx6pXPaFamkcUZNHNNnNj-jmKbuaY/s320/Pt-carditis-ECG+4.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5295484892768674530" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXt1HIBdycrlm20PIi4Wct3fRmIYnlsEBq925Q-VdclrPx18UvSPsfZtm9jz3r7djS5CKRCAktNmGSXyCY2LERQ-IZjG5Qal-ed8ptpKT5mLVZqZqTvotFERJvubsFqzMQ-OJWxyHgL9c/s1600-h/Pt-cardits=3.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXt1HIBdycrlm20PIi4Wct3fRmIYnlsEBq925Q-VdclrPx18UvSPsfZtm9jz3r7djS5CKRCAktNmGSXyCY2LERQ-IZjG5Qal-ed8ptpKT5mLVZqZqTvotFERJvubsFqzMQ-OJWxyHgL9c/s320/Pt-cardits=3.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5295486743378584690" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK8xkkD2KyxoUSFFH92GsKmyzyHEysJoJZSWAjygRydRDiMYr7pRjo5czg6BfZgr4pwknysi3sIxvM8XUUqgXtuiLkXy57Mu673dRLOD4si0TiEBj3Dc6sjY1eZfrC3-h9YuiCMD1wDNI/s1600-h/Pt-carditis2.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK8xkkD2KyxoUSFFH92GsKmyzyHEysJoJZSWAjygRydRDiMYr7pRjo5czg6BfZgr4pwknysi3sIxvM8XUUqgXtuiLkXy57Mu673dRLOD4si0TiEBj3Dc6sjY1eZfrC3-h9YuiCMD1wDNI/s320/Pt-carditis2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5295486736738377922" /></a><br /><br /><br />Clinically the patient was diagnosed as Rheumatic Fever with Carditis & Arthritis<br /><br />His ESR was 80 mmhg, had neutrophilia, Raised ASO titre, Xray with cardiomegaly, ECG with tachycardia and Echo showing mitral incompetence.<br /><br />Investigation confirms the clinical impression. <br /><br />The patient was hospitalized, given short term Penicillin, prednisolone which will be followed by aspirin and is given long term penicillin as prophylaxis. <br /><br />Patient is now improved and waiting for discharge. <br /><br /><br />Badrud Doza<br /><br />Link: <br /><a href="http://emedicine.medscape.com/article/891897-overview">Rheumatic Heart Disease- e-medicine </a><br /><a href="http://circ.ahajournals.org/cgi/content/full/100/14/1576">Diagnosis of Active Rheumatic Carditis</a> -Circulationbadrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-5102348145935385512008-12-22T13:17:00.000+07:002008-12-23T13:45:58.194+07:00Case:Congenital Hypothyroidism<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5rH239cBEWZ40NwDTJa1NT4wA7RlY6ms8655bMmawXuFob2Fnf3jqKF67TWmle79YpZWwbQLrvVXhX389AEArnLM1nm73UyCyZmLf-6nu2b7lN4aQ1bN5qc3AAlPKmTMOmnw7CffVf4E/s1600-h/21122008(001).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5rH239cBEWZ40NwDTJa1NT4wA7RlY6ms8655bMmawXuFob2Fnf3jqKF67TWmle79YpZWwbQLrvVXhX389AEArnLM1nm73UyCyZmLf-6nu2b7lN4aQ1bN5qc3AAlPKmTMOmnw7CffVf4E/s320/21122008(001).jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5282520349733851874" /></a><br />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. <br /><br />On examination, in addition to coarse facies and horse cry, the patient has lathergy, rough skin, mild anaemia, abdominal distention and least interaction.<br /><br />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. <br /><br />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.<br /><br />Dr. Badrud Doza<br /><br />Links: <br />Congenital hypothyroidism-<a href="http://emedicine.medscape.com/article/919758-overview">e-medicine</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-16983192394793292252008-12-17T11:28:00.000+07:002008-12-17T12:55:29.306+07:00Guest Post: Common Birth Defects and Their CausesThe 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:<br /><br />• Is my baby ok?<br />• What’s wrong with him/her?<br />• Is it our fault or is it something we did that our child was born like this?<br />• Is there anything we can do now to make things right?<br />• How soon can any correctional procedure be done?<br />• How much will it cost?<br />• What are our child’s chances of coming through it successfully?<br />• Will our child be able to lead a normal life?<br />• If not, what can we do to make it as normal as possible? <br /><br />Of course, the questions differ from family to family, and the decisions vary accordingly too. <br /><br />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. <br /><br />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. <br /><br />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. <br /><br />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.<br /><br /> <br />• 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. <br />• The third most common kind of defect affects the spinal cord, such as spina bifida. <br />• 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.<br />• 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).<br /><br />By-line:<br /><br />This article is contributed by <strong>Sarah Scrafford</strong>, who regularly writes on the topic of <a href="http://radiologytechnicianschools.net/">Radiology Technician Schools</a>. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-9661811496994727572008-12-13T14:01:00.000+07:002008-12-14T14:24:43.493+07:00Case: A newborn with nasty hemangioma<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgW_5AvkUk3OGabf3cRUQt7mZxtIkjbj1dTZAiZLYgF5T7WtiW14OXM2udu69V5InlTlppKAKnhFc7f3AJQbT7io9AOZl0gHsv_v07qUAlHYltOjJrh9W5O-jeV15qx6nFjDqdKZ1-DJ78/s1600-h/22112008.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgW_5AvkUk3OGabf3cRUQt7mZxtIkjbj1dTZAiZLYgF5T7WtiW14OXM2udu69V5InlTlppKAKnhFc7f3AJQbT7io9AOZl0gHsv_v07qUAlHYltOjJrh9W5O-jeV15qx6nFjDqdKZ1-DJ78/s320/22112008.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5279540955205424386" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwkSlV40cAmC09_MZ3NtCxSG0O2Ac8JByuXhuc3ApMIwfWgBXDYpDU5fsbnzBsaYAMfNh_MqzSM1gvPXgi9LpAitbGPUXcDTkTUDqu3l6GzTrYGL2HrkKSbOEXALoTMuKEDGwoGuFXwL8/s1600-h/22112008(004).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwkSlV40cAmC09_MZ3NtCxSG0O2Ac8JByuXhuc3ApMIwfWgBXDYpDU5fsbnzBsaYAMfNh_MqzSM1gvPXgi9LpAitbGPUXcDTkTUDqu3l6GzTrYGL2HrkKSbOEXALoTMuKEDGwoGuFXwL8/s320/22112008(004).jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5279540948991419890" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtxUIz7c54O-C2DTGISW78qjv3odKT5fFfqVjzC4Z-AE_1ZWFR1hx5tGKgbcEs76qzVZc4eNrDHtabo9i5WB7EbNvMiLxPaP0FUrYmeC874kvtAXvCff-P2TuQgdQ9i4p7NGydzA3kFWc/s1600-h/22112008(005).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtxUIz7c54O-C2DTGISW78qjv3odKT5fFfqVjzC4Z-AE_1ZWFR1hx5tGKgbcEs76qzVZc4eNrDHtabo9i5WB7EbNvMiLxPaP0FUrYmeC874kvtAXvCff-P2TuQgdQ9i4p7NGydzA3kFWc/s320/22112008(005).jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5279540945666703762" /></a><br />I was called in by a Obstetrician to attend a baby immediately after birth in a clinic. <br />The baby was delivered at 35 weeks by caesarian section.wt was 2.3 kg. <br />She had a gross extensive hemangioma on the right leg extending from the foot almost completely covering upto the knee and then extending into the thigh. The overlying skin was devitilised and turns to black.The baby had tendency to bleed at points. <br /><br />My pediatric surgeon collegue was also called in. A light pressure bandage was put on the hemangioma to stop the bleeding which was later released when the bleeding stopped.<br /><br />The right leg was also grossly abducted, an orthopedician lebelled it as Unilateral congenitakl dislocation of Hip joint.<br /><br />The baby overcame the initial difficulties and the pediattric surgeopn suggested for skin grafting for the area after child grow a little more. <br /><br /><br />Dr.Badrud Doza <br />Dr.Tahera<br /><br />Link: <br />Infantile hemangioma-<a href="http://emedicine.medscape.com/article/1083849-overview">e-medicine </a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-72692401876250120262008-11-23T13:10:00.000+07:002008-11-26T15:40:45.600+07:00Case: A boy of 4 yrs with Langerhans Cell HistocytosisMushfiq, a boy of 4 yrs presented with fever for 7 days, gradual pallor for 2 months, and multiple swelling over the scalp for 1 month. <br /><br />On admission, he was febrile, toxic and pale. He was undernourished, his pulse was 110/m,BP -105/65 mmHg,respiration 25/m, temp-103 degree F, anaemia +++, jaundice-absent,no bleeding tendency, no lymphadenopathy, no bony tenderness and no hepatosplenomegaly. <br /><br />The swelling over the skull are multiple,firm, non tender and fixed with the underlying structure. <br /><br />on investigation, Hb-4.5 gm/dl, RBC-2.06m/cmm, MCV-85.4 fl, MCH 21.8 pg, MCHC 25.6 g/dl, WBC-7500/cmm, Neutrophil-60%,Lymphocytes -32%,Monocytes-04%,Eosinophil-04%. PBF shows anisosytosis and anisocromia with roulex formation, WBC mature with a few myelocytes, platelet suggestive of chronic disorder/infection.<br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaBC2HC_pvVLTx-IKGA2et2_WPWJLJekdxlJ6A7vnKQ9NQ1gnFwK9nzXV0D_9550zHQsY-v-svLWgLYA1IsNQWp2VcOxJ0FhDrjA2Ozb1b980qGp9rxeUq8B97xJc_Z7NIXn58xHhsIaU/s1600-h/LH3.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaBC2HC_pvVLTx-IKGA2et2_WPWJLJekdxlJ6A7vnKQ9NQ1gnFwK9nzXV0D_9550zHQsY-v-svLWgLYA1IsNQWp2VcOxJ0FhDrjA2Ozb1b980qGp9rxeUq8B97xJc_Z7NIXn58xHhsIaU/s320/LH3.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5272879159081579554" /></a><br />X-ray of the skull shows focal scalp swelling in frontal and parietal region, pepper-potlucencies in the vault and subtle erosion on the outer tables of vault underneath the swelling and sutural diastasis suggestive of Langerhans cell histocytosis with raised intracranial pressure. <br /><br />FNAC from the scalp growth shows hypercellualr material containing small round to oval cells having lobulated and folded nuclear with opened up chromatin;these cells are arranged diffusely and the cells show mild cellular atypia; the backgrond shows necrotic tissue debris suggestive of 'small round cell tumour' where Langerhans cell histocytosis may be considered.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib9L0_ZwZmWIsT2zCtHNA1Nk-1ZoIkyps3RmO1x4u_z4Gb4G-vg5WI11GJbd8tSPQkpHEXNDr-G5Yc8Rw2zFyD5c6IilGLbK3geIhTkRtUpzG-ZLAs4waXvty2hrlOs2avXqUiEexGpVk/s1600-h/LH1.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib9L0_ZwZmWIsT2zCtHNA1Nk-1ZoIkyps3RmO1x4u_z4Gb4G-vg5WI11GJbd8tSPQkpHEXNDr-G5Yc8Rw2zFyD5c6IilGLbK3geIhTkRtUpzG-ZLAs4waXvty2hrlOs2avXqUiEexGpVk/s320/LH1.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5272879149822204994" /></a>CT scan of the brain shows extensive intracranial hyperdense massesshowing distribution along dura and frontal parenchyma. No mass effect or midline shift is present; there are multiple scalp swelling , some of them show underlying outer table erosion; there is splitting of sagital and coronal suture. The impression is of Langerhans cell histocytosis. <br /><br />The patient was refered to special cancer center for further management.<br /><br /><br />Dr. Badrud Doza <br />Dr. Harun<br /><br /><strong>Link</strong>:<br />Langerhan's Cell Histocytosis- <a href="http://www.childrenshospital.org/az/Site1101/mainpageS1101P0.html">Boston Children Hospital </a><br />Langerhan's Cell Histocytosis-<a href="http://www.medscape.com/viewarticle/440966">Medscape.com</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-11116858427718090972008-11-02T13:56:00.000+07:002008-11-03T14:20:51.263+07:00Case: Ewing's Sarcoma with metastsis to the lung in a boy of 7 yrs<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtTzxSG6pniKx-7BG7WBrKYtpbMX0aFKUuZSYvfqOfVjRQ-iW6r0FaLzx0L2pBZqql7gXtc3_NKc3w5AxNk8F9xxYiW8WktnF6_iHf9nQtsFodgfNt4igRkCzxpidG4NHtVLgzRmS7wQc/s1600-h/DSC00693.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtTzxSG6pniKx-7BG7WBrKYtpbMX0aFKUuZSYvfqOfVjRQ-iW6r0FaLzx0L2pBZqql7gXtc3_NKc3w5AxNk8F9xxYiW8WktnF6_iHf9nQtsFodgfNt4igRkCzxpidG4NHtVLgzRmS7wQc/s320/DSC00693.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5264321734815541314" /></a><br /><br />Child Abu Bakhr, 7 yrs male child was admitted into our hospital on 24/10/08 with the complaints of cough for 15 days , low gradw fever for the same period and respiratory distress for last 4 days and swollen edematous right leg for 3 months. <br /><br />On admission, the child was dyspnic , ill-, pulse -100/m, Respiratory rate-30/m, Temparature -99 d f . on auscultation, pt had bilataeral crepitations all over the lung.<br /> <br />On local examination, skin was erythematous,swollen and tender without any discharging sinus or pus point- the child was a previously diagnosed case of Ewing’s Cell Carcinoma of the tibia and histopathological report was suggestive.<br /><br />The Child received one cycle of chemotherapy and Radiotherpy 3 months back. On admission, CXR was done which showed wooly ball appearance.<br /><br />The patient is lebelled as Ewing's Sarcoma with Metastasis to the Lung.<br /><br /><br />badrud doza<br />fahim<br /><br />Link: <br />Ewing's Sarcoma- <a href="http://en.wikipedia.org/wiki/Ewing_sarcoma">Wikipedia</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-49612589927027023742008-10-25T13:14:00.000+07:002008-12-04T15:09:29.969+07:00Case: Tubereculoma of the brainThe patient, a boy of 3 years presened with low grade fever for 2 months , neck bending for a week and convulsion for a few times in the last 48 hours. <br />There was history of contact with the open case of tuberculosis. <br /><br />On examination, the patient was drowsy, malnourished, neck rigidity and kernig's sign are positive, reflexes are exxagerated.<br /><br />CSF studies show mild lymphocytosis, sligtly increased protein and decreased noraml sugar.Gm stain and AFB staiin were negative. <br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgg3vYR6HmkYHoPTWHtHBdf7_WksvS0uc8ovU_6LpEGg_spQMRYomlNqduHOSJtqv2qUmCkNnejxXXy1A5OnpwCgqgz4h3apXzb4pyIFnMkIEo1HmP98UkymbnTjz1gNLM0EUCBW_SpvWk/s1600-h/tuberculoma+5.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgg3vYR6HmkYHoPTWHtHBdf7_WksvS0uc8ovU_6LpEGg_spQMRYomlNqduHOSJtqv2qUmCkNnejxXXy1A5OnpwCgqgz4h3apXzb4pyIFnMkIEo1HmP98UkymbnTjz1gNLM0EUCBW_SpvWk/s320/tuberculoma+5.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5275842215028099298" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaWHnDkojLebYyV6wWOagVl1HOZHyHH4RXUYaF29vGnrR-rDM-JPdZqEQKWWFZPwvkQfSOM3652tni7xjLe7NfdQdPHFPJSh5WWAgUh_4b2-xY3tTfiFONm1jg-Mma7Vwo36Mm_Zh-C7A/s1600-h/tuberculoma+3.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaWHnDkojLebYyV6wWOagVl1HOZHyHH4RXUYaF29vGnrR-rDM-JPdZqEQKWWFZPwvkQfSOM3652tni7xjLe7NfdQdPHFPJSh5WWAgUh_4b2-xY3tTfiFONm1jg-Mma7Vwo36Mm_Zh-C7A/s320/tuberculoma+3.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5275842208628565090" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhF6lZjuW-vRdDoEC8D2nRLNbLck3-Cbs3RGz2zx2_IiPfNhmdmrnKU9AozYqX6iVIuubJeefQCBogZRv1kUrc4Pi8PBM6RCs99PNoq_W3jChWJwMNtAGUT4MfQuEk1QQX29CrnQyK9ABc/s1600-h/tuberculoma+8.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhF6lZjuW-vRdDoEC8D2nRLNbLck3-Cbs3RGz2zx2_IiPfNhmdmrnKU9AozYqX6iVIuubJeefQCBogZRv1kUrc4Pi8PBM6RCs99PNoq_W3jChWJwMNtAGUT4MfQuEk1QQX29CrnQyK9ABc/s320/tuberculoma+8.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5275843302707459026" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg03DuyHJR8sWV_2f4yQU-2X8QV26LhllzXq6cuM6wChU58x_Dr36EbMRY7jl3RxNKSyil09QjclfFq__lIWgE5RGlWrnPGc_VBhrShhkHFdxlOF5QoG5FkOIbH_IfZSpxJT5gr6B1ymTg/s1600-h/tuberculoma+6.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg03DuyHJR8sWV_2f4yQU-2X8QV26LhllzXq6cuM6wChU58x_Dr36EbMRY7jl3RxNKSyil09QjclfFq__lIWgE5RGlWrnPGc_VBhrShhkHFdxlOF5QoG5FkOIbH_IfZSpxJT5gr6B1ymTg/s320/tuberculoma+6.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5275843295657717810" /></a><br /><br /><br />The CT scan of the patient reveals multiple small cercular shadows of the brain , the radiologist identified them as Tuberculoma. <br /><br />The patient was lebelled as a case of Tuberculoma of the brain. <br /><br />He was given 4 drug antitubercular regimen and gradually improved and dischsrged after 1 month staying in the hospital.<br /><br />badrud doza<br /><br />Link: <br />Tuberculoma of the brain <a href="http://openmed.nic.in/803/01/June55A.pdf">by Bhaskara Reddy & V. Kameswararao</a><br />An interesting account on Tuberculoma of the brain <a href="http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1582231&blobtype=pdf">by Maurry H. Cambell MD</a> writhhen in 1945badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-60857211183968406022008-09-18T13:14:00.000+07:002008-11-04T11:24:14.776+07:00Case: a girl of 4 months with osteogenesis imperfecta<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-mJsnLriFVHyLPRJJmC_ZUBhyphenhyphenuy4s9vXsFaJ-yMt-3zLy3LH-U5D0w7BetAf6Sc6p0eV1YanIrF6yi3rzxT2HmZxvsD-hL1B8Yu7aGHS0DlTsLbiyM9w7wpgPk1h0lH9UrgcmxK6c8xA/s1600-h/07092008.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-mJsnLriFVHyLPRJJmC_ZUBhyphenhyphenuy4s9vXsFaJ-yMt-3zLy3LH-U5D0w7BetAf6Sc6p0eV1YanIrF6yi3rzxT2HmZxvsD-hL1B8Yu7aGHS0DlTsLbiyM9w7wpgPk1h0lH9UrgcmxK6c8xA/s320/07092008.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5248755341256329186" /></a><br />The girl, 4 months of age admitted in our hospital for Pneumonia. But her history reveals # of the rt upper arm at the age of 7 days for which she was taken admission in the other hospital of the city. They made multiple x-rays and found # in other sites also.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhufH57u-fPpvjTphaWRAP51ALvwpnFo3wwqg0xPo3LusYlprQ6WRi8DEJrIbmkwRtdGItDxXhIYK_QjWZLpN1ePcs4gMeIkSV1vl67-dvGzoJl4IdRC2YU6E73U5Fj42yarSo9Gm_ndp4/s1600-h/07092008(002).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhufH57u-fPpvjTphaWRAP51ALvwpnFo3wwqg0xPo3LusYlprQ6WRi8DEJrIbmkwRtdGItDxXhIYK_QjWZLpN1ePcs4gMeIkSV1vl67-dvGzoJl4IdRC2YU6E73U5Fj42yarSo9Gm_ndp4/s320/07092008(002).jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5248759504795024562" /></a><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiF0shnwH6v9Ux5t4qeNXD7xLlZQuRuBHZVBO7IwC0BhMclFTDFGKF8piJmUix-hLJwcT72IDbWaMtuaRNB52wh6Uyv0HKq-0rpJnCJtk9O4RoFiiDWn-MD2dV78wpjcbEY3WMUKc7rLHA/s1600-h/07092008(003).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiF0shnwH6v9Ux5t4qeNXD7xLlZQuRuBHZVBO7IwC0BhMclFTDFGKF8piJmUix-hLJwcT72IDbWaMtuaRNB52wh6Uyv0HKq-0rpJnCJtk9O4RoFiiDWn-MD2dV78wpjcbEY3WMUKc7rLHA/s320/07092008(003).jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5248757922940470258" /></a><br /><br />She was labelled as a case of Osteogenesis imperfecta and advised the parents to take precaution to handle the baby and provide necessary counselling.<br /><br /><br /><br />badrud doza<br /><br />Link:<br /><br /><a href="http://www.oif.org/site/PageServer?pagename=OIF_MedicalProf">Osteogenesis Inperfecta Foundation</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com1tag:blogger.com,1999:blog-1061120388911919769.post-38091484639296290512008-09-07T10:52:00.000+07:002008-11-04T11:29:40.413+07:00Case: Neuroblastoma with severe anaemiaAtunu Acharjee, 1 yr 4 months from Chittagong admitted in our hosspital for severe anemia. On examination , a huge mass on the left side of the abdomen, firm, non tender with no notch likely kidney and multiple small masses all over the abdomen were found . Liver was also enlarged 6 cm from the costal margin, firm and non tender.<br /><br />On evaluation of history, it was found that the patient was consulted in Kolkata 2 months back and CT scan there suggest abdominal neuroblastoma, diffuse tumour infiltration of the left kidny and encasement of large vessels like aorta by the tumor mass.<br /><br />Laparotomy was done in a hospital there and excised leftsided mass including part of the left kidney.The histopathology suggests Neuroblastoma. Patient was discharged on palliative treaatment from there.<br /><br />In our ward, we have given the patient blood transfusion and refered the patient to oncologist.<br /><br /><br />Dr. Badrud Doza<br />Dr. Abu Sayeed<br /><br />Link:<br /><br />Neuroblastoma in <a href="http://www.cancerbackup.org.uk/Cancertype/Childrenscancers/Typesofchildrenscancers/Neuroblastoma">Children in Cancerbackup/Uk</a><br />Neuroblastoma <a href="http://www.nlm.nih.gov/medlineplus/neuroblastoma.html">in NIH</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-56359898648268454262008-08-16T15:27:00.000+07:002008-11-04T11:33:05.384+07:00Case: a boy of 11 months with sclerodermaMinhaj, aged 11 months, Male baby was lying stiff on the bed. On first look , I first mistook it as a case of cerebral palsy –spastic quadriplegia.<br /><br />But his birth history is normal and the spasticity is of 7 months duration and gradually progressing. Both the extremities are markedly affected and the facial muscles are also affected and it could not cry with his full mouth open.<br /><br />His skin is thick like sclerema but in almost all the body and he has no sign of infection.<br />.<br />Clinically we suspect the case as “Scleroderma’.<br /><br />We arranged skin biopsy for him. The sample was taken the thigh. The report narrates increased fibrosis and moderate numbers of chronic inflammatory cells around the periappendigeal region in the dermis. The subcutaneous fat is partly replaced by collagen. The overlying epidermis shows no significant changes and concludes that the features are compatible with scleroderma.<br /><br />Dr. Badrud Doza<br />Dr. Fahim<br /><br />Link:<br /><a href="http://www.scleroderma.org/">Screloderma Foudation</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-54803972259859804962008-07-09T13:29:00.000+07:002008-07-09T13:32:25.983+07:00Case: Solid mass in the left Iliac fossa with acute abdomenThe patient was seen at my chamber in practice. The girl of 11 years presented with severe abdominal pain and intermittent fever of two days duration.<br />Menustartion yet not started. <br /><br />On examination, moderate tenderness was present in the left iliac fossa but no mass could be palpated. The patient was admitted on emergency and given conservative treatment for Acute Abdomen. Later, on evaluation a solid mass of 5cmX 4 cm was found in the left Iliac fossa on ultrasonography. <br />The patient was improved on conservative treatment of antibiotic, fluid, antipyretic and analgesic.<br />The follow up X-ray also showed a solid mass pushed the uterus to upward and to the right. <br />Laparotomy was done. The mass was found to be of ovarian origin and brown in color.<br />The change of color and solidity of the mass is likely due to haemorrhage into the overy due to torsion of the ligament of the overy.badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-14064070198176095792008-06-21T13:01:00.000+07:002008-06-21T13:24:15.281+07:00News: we organised workshops on management of severe malariaWe have organised training programs for the physicians of the malaria prone areas in our hospital from 1st June 2008 in three batches, each bach having 5 day course. About 60 doctors from mainly from government health centres and some of our hospital attended the program. <br /><br />The program was sponsored by GFATM and cordinated by the Malaria Control Program of Bangladesh Health Directorate and supported by WHO. <br /><br />In the program, case defination of malaria, clinical presentation, diagnosis and assessment, management, recovery and follow up of severe malaria were elaborately discussed.<br /><br />In addition, picture quiz were interesting and also there was multiple case studies. In the hospital real cases were seen,examined and recoded and then presented by the participants. <br /><br />There was special session for microbiology- microscopic identification of malarial parasite, Rapid diagnostic test and preparation of thickand thin film. <br /><br />The whole program was in micro-teaching format and participatory in nature. <br /><br />Professor Emran bin Yunus, who is working as monitor in different countries of Africa and Asia on Malaria Research Program was focal person of the programs in our hospital, a private one and Chittagong Medical College Hospital, the public hospital.<br /><br />I worked as the resouce person and the co-ordinatorof the program that is organised in our hospital. <br /><br />We are happy that the program ended successfully on 18th June, 2008.badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com2tag:blogger.com,1999:blog-1061120388911919769.post-2952953430460179832008-05-22T14:19:00.000+07:002008-05-26T11:41:50.654+07:00Case: Near DrowningA boy of 13 months admitted in our hospital after 4 days of drowning with unconsciousness and repeated convulsion.<br /><br />He was drowned in salt water pond four days back and stayed drowned for half an hour. After recovery from the pond, he was admitted in the local health centre but with no improvement.<br /><br />On admission in our hospital he was unconscious and hypotonic. his GCS score was 4/15,<br />Hr-136/m, BP-120/70 mmHg, He was dysnoec but there was no other chest finding.<br />Opthalmoscope finding was normal.<br /><br />His CBC, electrolytes was found normal.X-ray chest -normal.<br /><br />He was labeled as a case of Near Drowning.<br /><br />His convulsion was difficult to control. After repeated trial with Inj Phenobarbitone, Phenytoin and mannitol , it was controlled after after 2 days. By the next, few days though he regained his consciousness, but he developed spasticity of the limbs, visual impairment and hearing defect.<br /><br /><br />Dr. Badrud Doza<br />Dr. Fahim<br /><br />Link: <a href="http://www.emedicine.com/emerg/topic744.htm">Drowning</a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-68473206506633735382008-05-18T10:51:00.000+07:002008-05-22T11:21:06.756+07:00Case: Ectodermal dysplasia-anhydrotic typeThe mother with worry in her face told me in the outdoor setting that the boy, 10 months old, has no sweating and shoots to high rise of temperature especially in hot environment.<br /><br />He was normally delivered, breast fed, immunized with normal milestone development, first child of a non-consanguineous parents of a upper middle class family, had no other major illness in the past.<br />On examination, the child is otherwise healthy, alert, well nourished. But his hair is sparse, scant eyebrow, no eruption of tooth, dry skin, little deformed nail. IQ normal.<br />His systemic examination reveals normal.<br />Provisionally we diagnosed the patient as Ectodermal Dysplasia-anhydrotic type<br /><br />His skin biopsy was done which indicates the absence of epidermis and absence of sweat glands that conforms to the diagnosis.<br /><br /><br />Badrud Doza<br /><br />Selected links for ED : 1) <a href="http://www.nfed.org/">National Foundation for Ectodermal Dysplasia </a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-61338077587939307692008-05-15T11:01:00.000+07:002008-05-28T14:03:51.631+07:00Case: Spleenectomy with postoperative convulsion and impaired consciousness in a case of ThalassemiaA boy of 11 years was suffering from <span class="blsp-spelling-error" id="SPELLING_ERROR_1">Thalassemia</span> major. He was advised for spl<span style="font-size:0;"></span>eenectomy as the huge spleen was causing respiratory embarrassment.<br /><br />He was operated without any trouble. But he developed convulsion in the mid night which was focal in the right hand. He was given anticon<span style="font-size:0;"></span>vulsants and I<span style="font-size:0;"></span>nj Calcium. His electrolytes and the calcium show normal level. His convulsion was continuing intermittently. His convulsion become generalized and he G<span style="font-size:0;"></span>CS falls to 8. He was given I<span style="font-size:0;"></span>nj phe<span style="font-size:0;"></span>nobarbitone and Sodium Valpr<span style="font-size:0;"></span>oate orally.<br /><br />Convulsions were controlled and his consciousness was gradually improving. His speech was initially slurred which was also later improved.<br /><br />We had a plan for CT scan but as the patient improved completely patient took the discharge.<br /><br />We level the case as <span class="blsp-spelling-error" id="SPELLING_ERROR_9">Thalassemia</span> major with post operative convulsion due to emb<span style="font-size:0;"></span>oli.<br /><br /><span class="blsp-spelling-error" id="SPELLING_ERROR_11">Dr. Badrud</span> <span class="blsp-spelling-error" id="SPELLING_ERROR_12">Doza<span style="font-size:0;"></span></span><br /><span style="color:#ffff00;"></span>Dr. Shoma Chowdhury<br /><span style="font-size:0;">Related link: </span><br /><span style="font-size:0;">1) <a href="http://www.thalassemia.org/">Thalassemia Foundation </a></span><span style="font-size:0;"></span><br /><span style="font-size:0;">2)<a href="http://www.thalassaemia.org.cy/">International Thalasemia Foundation </a></span>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-66346353336593596112008-05-10T14:10:00.000+07:002008-05-22T11:27:17.274+07:00Case: Pulmonary atresia with VSD and PDAA girl of 8 years admitted in our hospital with hyperpyrexia of 3 days duration.<br /><br />She is well built, of good nutrition, no pallor, but had cyanosis and clubbing<br />Precordial examination reveals cardiomegaly and a murmur in the pulmonary area with both systolic and diastolic in component with radiation to the clavicle. Other systems found normal<br /><br />Her X-ray shows cardiomegaly with right vetricular enlargement. ECG shows right ventricular hypertropy and Echo shows Pulmonary Atresia, VSD and PDA.<br /><br />The patient traveled to India earlier and was seen by great cardiac surgeon Dr. Devi Sethi.<br />The fever was of viral origin. After it subsided, patient was discharged and the parents were taking preparation to have the operation done at Bangalore shortly.<br /><br /><br />Dr. Badrud Doza<br />Dr. Fahim<br /><br />Link : <a href="http://www.americanheart.org/presenter.jhtml?identifier=1303">Pulmonary Atresia </a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-67145083509781352952008-04-30T13:57:00.000+07:002008-05-22T11:30:18.712+07:00Case: Hematoma of the liverSumon, 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.<br /><br />Patient was alert but irritable, no jaundice, had rapid pulse and low pressure, was moderately pale. Patient had hematomegaly(4 cm) with severe tenderness.<br /><br />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.<br /><br />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.<br /><br />His serum bilirubin was 1%, SGPT-157.5 unit/L, HbsAg negative, PT -normal.<br /><br />USG reveals that hematoma/Abcess in the Rt love with approx. 5 cm X 6 cm in size.<br /><br />We managed the patient with 2 units of blood and antibiotics.<br /><br />Dr. Badrud Doza<br />Dr. Saiful Islam<br /><br />Link: <a href="http://www.emedicine.com/Radio/topic397.htm">Hematoma of the Liver </a>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0tag:blogger.com,1999:blog-1061120388911919769.post-74322578330278583922008-04-28T10:49:00.000+07:002008-05-20T13:31:54.140+07:00News: we observed World Malaria Day<span style="font-size:+0;"></span><span style="font-size:+0;">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.<br /><br />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.<br />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.<br /><br />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.<br /><br />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.<br />Bangladesh is striving hard to achieve this with success in many community programs in the bacground.<br /><br /><br />Badrud Doza<br /><span style="font-size:+0;"><span style="font-size:+0;">Co-ordinator, Malaria Control Program,<br />Chittagong Maa-Shishu O General Hospital </span></span></span><br /><p><span style="font-size:+0;"><span style="font-size:+0;"><span style="font-size:+0;">Related link: 1 ) Roll Back Malaria Program <a href="http://www.rollbackmalaria.org/worldmalariaday/">http://www.rollbackmalaria.org/worldmalariaday/</a></span></span></span></p><p><span style="font-size:+0;"><span style="font-size:+0;"><span style="font-size:+0;"> </p><br /><br /><br /></span></span></span>badrud dozahttp://www.blogger.com/profile/06709429211888673735noreply@blogger.com0