leukaemic patient that refused treatment

newly diagnosed in 31/1/2007 at a local university hospital. stayed one week at hospital as preparation for chemotherapy. Somehow the child was very apprehensive/afraid of needle. I think must be needle phobia.

Then the parents made decision to bring her back without chemotherapy.

presented to me 1 months later with extreme pallor. advised again by so many people for chemotherapy. yet parents still refused.
all they want is to blood transfusion and then discharged.

true enough to my prediction. they came in again in another months time. extreme pallor, with lots of bruises. transfused blood again. being told that their illness is very critical.

White cell count of 173 x 10^9/L.

Discharged after blood transfusion.

readmitted one week later with sudden loss of consciousness. collapsed at home.

sent to ICU one day. died after 8 hours of admission.

parents said i want chemotherapy now......

misdiagnosis

one patient with 3 episodes of fitting. came to me.

A CT brain was done, it showed a small 1cm x 0.5cm at frontal cortex. subsequently radiologist reported as a small meningioma over the left frontal cortex.

Urgent referral was made to Mahkota Medical Centre. No such brain lesion was noted from the 2nd scan.

Patient's father called and said why i told him that there is a brain tumour. Since the radiological report say so, i have to tell them such thing.

Any discrepancy have to be born by the respective radiological doctor. and not me.

:)

premature baby twin

32 weeker premature baby were delivered via LSCS.
1st twin at 1.97Kg, 2nd twin 2.07kg. Apgar score for both were 9 at 1 minutes and 10 at 5 minutes.
both require minimum oxygen.

feeding were stepped up slowly. eventually touching full feeding at day 5.

sucking reflex establised at day 6.

discharged at day 7 of life.

The World's Fourth Smallest Baby Born in Miami

Miami, FL) - A child believed to be the most premature baby ever to survive is expected to go home from the hospital Tuesday.Amillia Taylor was born only 21 weeks and six days into her mother's pregnancy.She has spent nearly four months in the Neonatal Intensive Care Unit at Baptist Children's Hospital in Miami.Amillia overcame a number of problems ranging from under-developed lungs to lacerations on her skin. Her caregivers call her a miracle baby.She also happens to be the world's fourth smallest baby, weighing just under 10 ounces.

incredible.

new year still working

hope to wish all of you here Happy chinese new year

Juvenile Rheumatoid Arthritis

one 1 year + child presented with prolong fever for more than 1 month. Developed maculopapular rash over the neck, trunk. Diagnosed as JCA by my Professor.

I have high regard to my former teacher and he taught me to be through in my work as a professional.

thank you

baby sitting

my baby was delivered in august 2006. lovely girl.

weight 3.6kg. via caesarian section.

name her catherine.

Admiring and caring for her daily.

wish she will grow up well

spider lily

plumeria obtusa

bruises in ITP

ITP

saw one child with itp. 1 year plus presented with spontaneous bruises. increasing in severity. presenting platelt count 18 x 10^9/L. no hepatosplenomegaly. blood film normal.

give him 2g/kg of iv Ig. One vial 2.5g. total 12 vials as his weight is 15kg.
one vial per hour with iv lasix in between.

plumeria grew from seeds

banana is growing

plumeria cutting

after a thunder strom my plumeria obtusa crack and it form a cutting about 2 1/2 feet long.

I put the plumeria cutting into a sandy soil (mix 1/2 perlite 1/2 soil) and put some sand on top of the pot. And i layer a bed of river stone on top to prevent the cutting from moving.

i think rooting will occur in 2 to 3 weeks time. Just wait and see.

adenium

ravenala

Plumeria

recently i developed a special interest in Plumeria.

Therefore started a hobby of planting plumeria (frangipani). I have plumeria rubra (red colour), obtusa (white), and pink, and yellow.

the white variey i have two variant. one with bigger flower, the other one is smaller flower. Out of the 4 plumeria. The white one has very nice fragrant. The pink one has a sweet fragrant. Red one smell like rose.

Incidently i have spotted plumeria seeds in my old pink plumeria. Then i plant it in small pots. It has germinates within 2 weeks. I used 50% sand and garden soil. Plan to transplant it into larger pots when it is bigger.

my garden

White plumeria with very nice fragrant

pluemria seed