Dr.Puru.: Clinical Case: DKA

Saturday, July 7, 2012

Clinical Case: DKA

A Case of Diabetic Keto-acidosis was presented on Thursday, 5th July , at the conference hall. Dr Aye, Burmese GDMO, did the case presentation.

There was a good discussion involving the participants, mainly nurses.

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MRRH In Brief!

MRRH Update

Pediatrician and Medical Specialists conducted clinic at Lhuntse Hospital
Orthopedic, Gynecologist and Radiologist to conduct clinic in S/jongkhar
HAMT meeting done on 13th October
Team from Burn Care USA visited MRRH
Minister of Health visited MRRH and met with staff
Team from JDW conducting Emergency Medical Course for medical officers at Mongar
Eye Specialist Dr Bhim transferred to JDW
Health Education Unit started adjacent to the maternity ward
General Body Meeting conducted on 10th August
External Consultant Reviews Under Five Deaths
Accountant Tashi Wangmo transferred to Trade office, Mongar
Seven fresh nurses to Join MRRH: No signs of separating NICU yet
Hospital survives a potential fire threat at wee hours today 8th August
Orientation to new nurses conducted today 8th August
Specialists visit Lhuntse Hospital: 28th July
Mortality meeting: case of a young female with acute liver failure
Conference Hall now equipped with A/V equipment and new furniture
A junior doctor from Burma doing attachment in Medicine Unit, MRRH
Visitors card system initiated to control too many visitors
Some new staff( Procurement Officer, Store Officer )to join MRRH

CME topics covered so far

22. Neonatal Resuscitation-Sis Sonam Choden and Br Thinley
21. ECG for nurses-Dr Kesang
1. Scrub Typhus-Dr P. Bhandari
2. Basics of Chemotherapy-Dr Ugen Tshomo
3. Blood Transfusion in Clinical practice-Dr B.M. Dhungel
4. Chronic Eosinophilia-Dr P. Bhandari
5. Advances in Infertility -Dr Sonam Gyamtsho
6.Baby Friendly Hospital Initiative-Kesang Wangmo
7. Clinical case of Hemolytic anemia-Dr Kesang, Medical Specialist
8.Recent advances in Labour Management
9.Where there is no Orthopedic Surgeon, Dr Ugen Thinley
10.Ophthalmological Emergencies-Dr BB Rai
11. Clinical Case of Kala-azar-Dr Namsa
12. Basic and Adanced Life Support, Dr Min
13. Management of Head Injuries-Dr Myat
14.Disaster Preparedness-Dr Hoffman
15. Approach to Coma-Dr Kesang ,MD
16.ENT Emergencies
17. Case of Leukemia, Dr Kesang, GDMO
18. Maternal Collapse-Dr Sonam Gyamtsho
19. Reduced Fetal Movements: Dr Sonam Gyamtsho
20.Evidence Based Medicine-Dr Min

Updated list of doctors at Mongar Hospital

1.Dr .......................Medical Superintendent(post vacant)
2.Dr Kesang Namgyel, MBBS, MD-Medical Specialist
3.Dr.Sonam Gyamtsho, MBBS, MD, Fellow(infertility)-Gynecologist
4.Dr Krishna Sharma, MBBS,MD, Fellow(Cytopathology),Pathologist
5.Dr P.Bhandari, MBBS, DCH, MD-Pediatrician
6.Dr. B.B Rai, MBBS,D. Ophth,DNB-Eye Specialist/Vitreo Retina Specialist.
7.Dr Ugen Thinley, MBBS, MD-Orthopedic Surgeon
8. Dr. Nidup, MBBS, MD,Radiologist
9.Dr Maung Maung Than, Surgeon.
10.Dr. Kyaw Htut Win, ENT specialist
11.Dr Tin Tin Aye, Psychiatrist
12.Dr Kyi Kyi Aye, Anaesthesiologist.
13. Dr Manjunath, Prosthodontist
14. Dr Suneeta, Periodontist
15. Dr Sangay Dorji, GDMO
16. Dr Aiye, GDMO on attachment.

Recent Nominations for Trainings/Workshop/Conference for Mongar Hospital

Pediatric/Neonatal Referrals to JDWNRH

80. Meningitis with acute hydrocephalous
79. Abdominal mass? TB
78.Cyanotic heart disease
77. Conjugated Hyperbilirubinemia(referred to In)dia
76. Downs with PDA( own transport)
75. TB suspect, but no focus
74. ASD and PS for Further referral to India
73. Ex premature with developmental delay secondary to hearing impairement
72.Seven year old with large PDA
71.Neonate with congenital Diaphragmatic hernia
70. Severe wasting with Recurrent abdominal pain
69. Autism suspect
68. Neuroblastoma in a neonate
67.Mucopolysaccharidoses?
66. Congenital HD( Severe PS and PDA) and Hydrocephalous
65. Prolonged Jaundice with acholic stools
64. Recurrent Wheezing, for further referral to Kolkotta
63. Hemolytic jaundice?
62. Burns with major GI Bleeding
61. Pelvi-Calyceal dilatation in an 8 year old
60. Diabetes Insipidus
59. 8 years with altered behavior( History of Head Injury)
58. 8 years RHD,AR( to cardiologist): seen and sent back
57. 8 year old with large VSD,PHT,FTT( OPD basis for further referral to India)
56. RHD, MR, AR
55. 1 month ofld with? gut malrotation/volvulus
54. 8 years old with ? ICSOL/ Neurodegenerative Disorder
53. Severe anemia, pale stools: Neonatal hepatitis? from NICU
52. Suspected Gastric Outlet Obstruction
51. Complex Congenital Heart Disease( again sent back saying no budget and need 12 kg!)
50. Meningits with raised ICT, and possible brain abcess( had a subdural empyema on CT)
49.Complex Partial Seizures with Developmental Delay
48. Child with a very thick bladder wall
47. 14 months old with multiple cysts in the liver and jaundice
46.Anasarca and Bicytopenia
45.Ebstein"s anomaly(Referred to India)
44. Bilateral hydronephrosis( seen by urologist, Ped surgeon and sent back on follow up)
43. Zygomatic Swelling( Refused Bone marrow and further referral from JDW)
42. Ig A nephropathy
41. Focal Seizures( has neurocysticercosis)
40. Cholecystitis
39. 3 year old with large ASD and failure to thrive( Operated)
38. Neonate with Wilms Tumor/Neuroblastoma(turned out to be adrenal hemorrhage)
37. Pancytopenia with Organomegaly
36.Child with acquired speech problem
35. Recurrent RTI for HRCT chest( normal CT)
34.Hemolytic anemia( sent back with plan to refer later to india)
33.Hemophilia Suspect( confirmed from Kolkotta)
32. Developmental Delay( OPD basis)
31. Downs Syndrome with Sepsis and Bilious NG aspirates( Died at MRRH)
30. CHD( VSD,PS, SA membrane)( Operated at Durgapur for VSD, SA membrane)
29. Congenital hydrocephalous( OPD basis)
28. Two cases of CHD: VSD,ASD, PDA and another one with Pulmonary atresia, VSD
27. 5 year old with Chronic Cough(OPD basis)
26. Ex-Premature with Retinopathy of Prematurity
25. Suspected Meningoencephalitis
24.Acquired Immunodeficiency(expired at JDW)
23.Pyloric Stenosis/Volvulus
22. Meningitis with focal signs
21. Meconium Ileus
20. Pyopericardium( second case in a month)
19. Cyanotic Heart Disease
18. Wilms Tumor
17. Purulent pericardial effusion( Went to Durgapur and had an anterior pericardiotomy)
16. Steroid reisistant Nephrotic syndrome
15. 7 year old with eosinophilia, pulmonary infiltrates and hemiparesis
14. 2 month old with Pyloric Stenosis( Had a band in stomach)
1. Prolonged Unconjugated Hyperbilirubinemia
2. Chronic Renal Failure
3. Psoriasis Vulgaris( diagnosed chronic Eczema)
4. Post Kasai with Portal Hypertension
5. PUO
6. Chronic Headache with Neurological Signs
7.Febrile UTI with Left sided Pelvi calyceal dilatation
8. One year old with Meningoencephalitis
9. Neonate with seizure Disorder
10. 7 year old with Pink Fallots
11.7 year old with hemiplegia
12. Child with cyanotic heart disease(TOF), brain abcess and CTEV
81. Khuru Injury with Raised ICT

Dr.Puru.

Saturday, July 7, 2012

Clinical Case: DKA

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