Tuesday, October 30, 2012

Yang Difikirkan (paeds)

Bismillahirrahmanirrahim.....

Hari ni saya nak ajak kawan-kawan berbincang tentang suatu kes paediatric. Kesnya begini, ada seorang budak yang telah di-diagnosed sebagai penghidap nephrotic syndrome. Nenek budak ni ( penjaga) selalu mengomel/mengeluh.

Katanya, dah banyak kali keluar masuk hospital dan dah banyak rawatan yang diberi tapi masih tak ada perubahan. Tak ada pun regression of abdominal swelling. Malah, katanya cucunya itu jadi bertambah teruk dengan adanya scrotal swelling.

When I heard that, I immediately was thinking that the boy may have steroid-resistant nephrotic syndrome or persistent nephrotic syndrome. But then a friend of mine tried to find out why the boy's condition became worse by asking the nanny on how did she gave the boy his medication.

Ini ceritanya....

Dari apa yg kawan saya ceritakan, nenek dia ni pada mulanya berikan ubat kepada cucunya seperti biasa. Tapi cucunya ni selalu sahaja muntah-muntah. And the nanny thought that the vomiting is due to the medication. She thought the drugs are the cause of the vomiting. (Why do I have to mention the same thing twice? -_-")

So, she then stopped the boy's medication. For her, whether she gives the medication or not, the boy's condition are still the same. So, what's the point of giving drugs if the drugs could make him worsen? Itu apa yang nenek kanak-kanak ini fikirkan.

Gambar sekadar hiasan :P


Jadi, aku tak tahu siapa yang betul atau siapa kah yang salah.
Adakah keadaan budak tu bertambah teruk apabila mengambil ubat yang dipreskripsikan?
Adakah keadaan budak tu bertambah teruk walaupun sudah diberi rawatan?
Atau adakah keadaan budak tu bertambah teruk sebab nenek dia buat sebegitu rupa?


I'm now start to confuse. Who should be blamed for this?

The hospital? (for not treating the boy well)

The doctor? (Who prescribed the drug for the kid but did not explain the details to his guardian)

The nanny (for stopping the medication after thinking that the drug is the cause of vomiting)

or us? ( because still can not do GOOD history taking from the patient and thus causing provisional misdiagnosis?)

p/s : If you be the paediatrician, you're not only dealing with the patient, but the whole family of the patient! er...btw, who know the cause of vomiting in this patient?

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