This document summarizes the medical case of a 7-year old boy named Arif who presented with facial swelling for 10 days, passing small amounts of reddish urine for 7 days, and respiratory distress for 1 day. On examination, he was found to have puffy face, ankle edema, tachycardia, and hepatomegaly. Laboratory tests showed hematuria, proteinuria, and low serum albumin. Ultrasound found hepatomegaly and increased renal parenchymal echoes bilaterally. He was diagnosed with acute post-streptococcal glomerulonephritis with heart failure and treated supportively with diuretics, antibiotics, and blood pressure control, showing improvement over his hospital stay
Rh Incompatibility I Hemolytic Disease of the NewbornSwatilekha Das
Rh Incompatibility I Hemolytic Disease of the Newborn-
Hi All,
I am Swatilekha Das, B.Sc, M.Sc Nurse and working as Assistant Professor of Nursing in a Nursing college. I worked as Clinical Instructor, nursing educator, nursing trainer, Nursing Tutor at hospitals, nursing schools and colleges.
ABOUT THIS ppt-
In this ppt I discussed about definition of rh incompatibility, cause, pathophysiology, diagnostic tests, treatment and screening and prevention of Rh incompatibility.
To know about it check the ppt till end.
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Rh Incompatibility in Pregnancy. Rh incompatibility occurs when a pregnant woman whose blood type is Rh-negative is exposed to Rh-positive blood from her fetus, leading to the mother's development of Rh antibodies
Rh Incompatibility I Hemolytic Disease of the NewbornSwatilekha Das
Rh Incompatibility I Hemolytic Disease of the Newborn-
Hi All,
I am Swatilekha Das, B.Sc, M.Sc Nurse and working as Assistant Professor of Nursing in a Nursing college. I worked as Clinical Instructor, nursing educator, nursing trainer, Nursing Tutor at hospitals, nursing schools and colleges.
ABOUT THIS ppt-
In this ppt I discussed about definition of rh incompatibility, cause, pathophysiology, diagnostic tests, treatment and screening and prevention of Rh incompatibility.
To know about it check the ppt till end.
I hope you enjoy this ppt and if you do then please click on the like button and share the with your friends too . Don't Forget to follow to see more such ppt. Thank you for checking the ppt.
@All Rights Reserved..
Rh Incompatibility in Pregnancy. Rh incompatibility occurs when a pregnant woman whose blood type is Rh-negative is exposed to Rh-positive blood from her fetus, leading to the mother's development of Rh antibodies
Neonatal jaundice occurs in 60% of term and 80% of preterm babies. Despite Neonatal jaundice is one of the commonest neonatal conditions, there are no national practice guidelines for its management in our country. Lack of uniform guidelines and standard practice parameters for diagnosis and management of neonatal jaundice often leads many babies to develop unnoticed hyperbilirubinemia causing kernicterus and long term poor neurological sequelae. This review after briefly discussing the epidemiology and pathophysiology of neonatal jaundice provides evidence-based pragmatic guidelines for the diagnosis and management of neonatal jaundice in resource-limited countries like Afghanistan
Rh incompatibility or iso-immunization is very uncommon. This presentation deals with some basics about blood groups and pathogenesis of it. This will be useful for under and postgraduates in the field of obstetrics.
Apnea (AP-nee-ah) is a pause in breathing that lasts 20 seconds or longer for full-term infants. If a pause in breathing lasts less than 20 seconds and makes your baby's heart beat more slowly (bradycardia) or if he turns pale or bluish (cyanotic), it can also be called apnea.
Neonatal jaundice occurs in 60% of term and 80% of preterm babies. Despite Neonatal jaundice is one of the commonest neonatal conditions, there are no national practice guidelines for its management in our country. Lack of uniform guidelines and standard practice parameters for diagnosis and management of neonatal jaundice often leads many babies to develop unnoticed hyperbilirubinemia causing kernicterus and long term poor neurological sequelae. This review after briefly discussing the epidemiology and pathophysiology of neonatal jaundice provides evidence-based pragmatic guidelines for the diagnosis and management of neonatal jaundice in resource-limited countries like Afghanistan
Rh incompatibility or iso-immunization is very uncommon. This presentation deals with some basics about blood groups and pathogenesis of it. This will be useful for under and postgraduates in the field of obstetrics.
Apnea (AP-nee-ah) is a pause in breathing that lasts 20 seconds or longer for full-term infants. If a pause in breathing lasts less than 20 seconds and makes your baby's heart beat more slowly (bradycardia) or if he turns pale or bluish (cyanotic), it can also be called apnea.
Weekly Case Presentation. Department of Medicine. EMCH.
Case: Tuberculous Pleural Effusion.
Our case this week (Nov. 5th, 2017) was 19 year old male presenting with fever, weight loss and cough for a prolonged duration. By means of proper history taking, physical evaluation and clinical investigation we have tried to adequately manage the case and it was presented before an audience comprising of clinical students to professors at our institute.
P.S. This presentation was made by interns of the institute. Hope any mistakes or faults will be met with constructive criticism as we look forward to improving ourselves.
Thank you.
2137ad Merindol Colony Interiors where refugee try to build a seemengly norm...luforfor
This are the interiors of the Merindol Colony in 2137ad after the Climate Change Collapse and the Apocalipse Wars. Merindol is a small Colony in the Italian Alps where there are around 4000 humans. The Colony values mainly around meritocracy and selection by effort.
Explore the multifaceted world of Muntadher Saleh, an Iraqi polymath renowned for his expertise in visual art, writing, design, and pharmacy. This SlideShare delves into his innovative contributions across various disciplines, showcasing his unique ability to blend traditional themes with modern aesthetics. Learn about his impactful artworks, thought-provoking literary pieces, and his vision as a Neo-Pop artist dedicated to raising awareness about Iraq's cultural heritage. Discover why Muntadher Saleh is celebrated as "The Last Polymath" and how his multidisciplinary talents continue to inspire and influence.
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2. Particulars of the patient
Name: Arif.
Age: 7 years.
Sex: Male.
Address: Modhukhali,
Faridpur.
Date of Admission:
03.04.2016.
Date of Examination:
03.04.2016.
3. Chief Complaints
Swelling of face for 10 days.
Passage of scanty reddish colour urine
for 7 days.
Respiratory distress for 1 day.
4. History of present illness
According to the statement of mother, her
child developed swelling of face specially
around the eyes for 10 days. Mother also
stated that her child was passing small volume
of reddish colour urine 3-4 times per day for 7
days which was not associated with burning
sensation. He also had respiratory distress for 1
day. He had no H/O same type of illness
previously, no H/O fever, headache, convulsion,
loss of conciousness or blurring of vision.
5. Cont..
On query, mother stated that her child has H/O
skin infection about 1 month prior to this
illness. With these complaints they consulted a
local doctor who advised some oral medication
and then referred to Dhaka Shishu Hospital for
further evaluation & better management.
6. History of Past illness
Nothing significant.
Treatment History
He was treated with some oral medication
advised by the local doctor, but mother
could not mention the name.
7. Birth History
He was delivered normally at term without
any complication.
Feeding History
He is on family diet.
8. Developmental History
He is developmentally age appropriate.
Immunization History
He is immunized as per EPI schedule.
9. Family History
He is the 2nd issue of his non-
consanguineous parents. His other family
members are healthy.
Socio-economic History
He belongs to a middle income family.
16. Systemic Examination
Abdominal Examination:
Inspection:
Abdomen is mildly distended.
Flanks are not full.
Umbilicus is centrally placed & inverted.
17. Cont..
Palpation :
Abdomen is soft, non tender.
Liver is palpable 3 cm from right costal margin
along the mid clavicular line which is non
tender, surface is smooth, regular border. Upper
border of liver dullnes present at right 5th
intercoastal space.
Spleen: Not palpable.
Kidneys: Not ballotable.
Renal angle: Not tender.
Fluid thrill: Absent.
19. Cont..
Cardiovascular System:
Pulse: 110/min, regular, high volume,
No radio-femoral delay.
Blood pressure: 130/90 mmHg.
Precordium:
Inspection:
Shape of chest: Normal.
Visible pulsation: Absent.
Engorged vein: Absent.
20. Cont..
Palpation:
Apex beat: Left 5th ICS, lateral to mid-clavicular
line.
Thrill: Absent.
P2: Not palpable.
Lt. parasternal heave: Absent.
Auscultation:
1st & 2nd heart sounds are audible in all 4
areas.
Added sound: Absent.
Basal crepitation: Present (bilateral).
21. Cont..
Respiratory system :
Inspection :
Respiratory rate: 32/min.
Shape of the chest is normal & movement is
bilaterally symmetrical.
Mild subcostal indrawing is present.
Palpation :
Trachea is centrally placed.
Chest expansion : Normal.
Vocal fremitus is normal in mid clavicular, mid
axillary & post. scapular line.
22. Cont..
Percussion:
Percussion note is resonant in MCL, MAL &
PSL in both lung field.
Auscultation:
Breath sound is vesicular and vocal resonance
is normal in MCL, MAL & PSL in both lungs.
Basal crepitation is present in both lung fields.
23. Nervous System Examination
Higher psychic Function :
Conscious & oriented to surroundings.
Cranial nerves examination :
No facial asymmetry.
Pupillary size and shape is normal, light reflex
is present.
Eye balls moves in all direction.
24. Cont..
Motor function :
Muscle bulk: Normal
Muscle tone: Normal in all 4 limbs.
Muscle power: 5/5
Reflexes: Normal
Planter response: Bilaterally flexor.
Sensory function : Intact.
Fundoscopy : Normal.
Other Systemic examination: No abnormality.
25. Salient feature
Arif, 7 years old immunized boy has
presented with facial puffiness for 10 days,
oliguria and hematuria for 7 days and
respiratory distress for 1 day. He has H/O
skin infection about 1 month prior to this
illness. He is dyspnoeic, mildly pale, having
puffy face and ankle oedema. There are
multiple blackish healed scar present in
both legs and hands.
26. Salient feature (cont..)
He is hypertensive & tachypnoeic; there is
tachycardia, apex beat lies in left 5th ICS lateral
to the mid-clavicular line, bilateral basal
crepitation is present in both lungs. There is
hepatomegaly without ascites. Other systems
reveal normal findings.
30. Cont..
B. Urea: 8.0 mmol/L.
S. Creatinine: 88.4 µmol/L.
S. Electrolytes:
Na+: 137.0 mmol/L.
K+: 4.8 mmol/L.
Cl-: 100.0 mmol/L.
S. Albumin: 29.10 mmol/L.
S. Cholesterol: 4.1 mmol/L.
31. Cont..
Complete Blood Count :
• Hb: 9.3 gm/dl.
• WBC: Total count: 9,600/mm3.
Differential count:
o Neutrophil: 58%
o Lymphocyte: 36%
o Monocyte: 02%
o Eosinophil: 04%
o Basophil: 00%
32. Cont..
o RBC: Normocytic normochromic.
o WBC: Mature with above
distribution.
o Platelet: Adequate.
• Platelet: 209,000/mm3.
• PBF:
Complement 3 (C3): 0.27 g/L.
ASO titre: <200 IU/ml.
33. Cont..
USG of W/A:
Liver: Enlarged in size (14.3 cm). Shows uniforn
parenchymal echotexture.
Kidneys: Bipolar length of Right kidney is 8.1 cm
& of left kidney is 7.9 cm.Both are normal in size
according to age. Raised renal parenchymal echo
of both kidneys. Pelvicalyceal systems of both
kidneys are not dilated. Cortex & medulla of
both kidneys are well differentiated.
Comment: Hepatomegaly.
Bilateral raised renal parenchymal
echo.
36. Management
Counseling to the parents.
General supportive & symptomatic
management:
• Bed rest.
• Propped up position.
• O2 inhalation.
37. Management (cont..)
• Control of blood pressure & management of
heart failure:
Salt & fluid restriction.
Inj. Frusemide 20 mg 12 hourly.
Tad. Nifidipine (20 mg): ½ tab 12 hourly.
• Inj. Ceftriaxone 1 gm 12 hourly.
38. Follow up (In hospital)
Date Subjective Objective
Respi.
distress
Hemat-
uria
Oedema RR
/min
Pulse
/min
BP
mmHg
Intake
ml
Output
ml
Weight
kg
Day 2 Present Present Present 30 110 140/90 950 650 22.5
Day 3 ↓ " " 28 104 120/90 1000 2100 21.0
Day 4 Absent " ↓ 28 100 110/90 250 1300 19.5
Day 5 " " Absent 26 80 95/60 620 750 19.0
Day 6 " " " 28 100 110/80 1050 1300 20.0
Day 7 " ↓ " 26 100 110/70 550 700 20.0
Day 8 " ↓ " 26 80 110/70 800 1070 19.0
Day 9 " Absent " 24 80 105/60 1100 1650 18.5
39. On 7th day
Patient is dischared on
11.04.2016 with –
• Tab Frusemide (20 mg)
1 tab daily for 7 days.
• Urine R/M/E after
• Follow up 2 weeks.
• S. C3 level after 6-8
weeks.