A small and young doctor who tries to gain knowledge and share it to other people.
[ MAY 15, 2019 ]
“Public health doctors and primary care physicians now recognize that appropriate initial bacteria colonization of the gastrointestinal tract, and good nutrition from the time of conception until the second year of life (the first 1,000 days), may profoundly affect our health during infancy and childhood through adulthood.”
health.harvard.edu From the time of conception until the second year of life, appropriate bacteria colonization of the digestive tract affects long-term health and plays a role in whether a person will be healthy or will develop a chronic disease.
[ May 02, 2019 ]
FDA approves first vaccine for Dengue Fever, with restrictions.
We have waited for this for so long, haven’t we? 🙂
medscape.com Dengvaxia is for the prevention of dengue disease caused by all dengue virus serotypes in people aged 9 to 16 years who have previously had laboratory-confirmed dengue infection and who live in endemic areas.
[ May 2019 ] - Pediatrics in Review
ideas.ted.com If we want children to thrive in our complicated world, we need to teach them how to think, says educator Brian Oshiro. And we can do it with 4 simple questions.
[ March 05, 2019 ] - Harvard Health Blog
What to do if your child is constipated
health.harvard.edu It’s not unusual for a child to be constipated once in a while, and when it happens there are several things parents can do to relieve the situation.
Taken by me in Singapore.
“When I was two, we fled to Iran to escape the Iraqi uprising against Saddam Hussein. We had to leave all our belongings behind, so we really struggled in the first few years. Coming from a wealthy family, it was hard to be suddenly poor. My dad eventually found work as a taxi driver. But it wasn’t enough to feed the family.
Because we did not have Iranian citizenship, we could never go to university or get a legal job, so there was no future for us there. Eventually, my dad decided to try to come to Australia by boat, because we had a lot of relatives here.
Unfortunately, he couldn’t afford to pay for all of the children to go, so he made the hard decision to leave 4 of the 6 children with my grandparents, including me. But at the last minute they felt I was too young to be separated from my mother, so it was decided that I would go too. That decision changed my life dramatically.
It was heartbreaking to see my mom saying goodbye to my sisters and my brother, as we had heard stories of people who drowned trying to get to Australia by boat, and we did not know what lay ahead of us.
People smugglers organised for us to fly on fake passports to Malaysia, and then to Indonesia, where we stayed for a few months. Every day for 3 months, we were told that we were going to catch the boat ‘tomorrow’. Eventually, our money ran out, and we had nothing to eat except rice and then there were three days when we had absolutely nothing to eat.
Finally, we were told it was time to go. We went to the beach at night-time, so it was really dark, and the boat was old and small, with around 60 people all squashed together. As soon as the engine started, everyone started vomiting from the smoke of the engine and motion of the sea. I remember I just felt numb and ended up going to sleep. When I woke up, big waves were washing over our boat, and I heard one of the women saying to my mother that we were going back to Indonesia as the boat was sinking. I didn’t know if everything was real or a dream.
The smugglers left us on an island for two weeks, where we lived in tree houses with the local people. I remember Mum was crying the whole time about my sisters and brother who we had left behind, and Dad was very sad that he had taken the rest of his family to possibly die in a boat.
The second boat was bigger but we were still squashed up, and everyone vomited again. Then after two days, the captain got lost. People lit a fire on the ship hoping someone could see us, but big waves were coming, and everybody was basically just preparing to die. On the third day, I heard people yelling because there was a plane above us. But the plane just passed and everyone started crying again.
Then, on the fourth day, the Australian Coast Guard arrived. They told the captain off for putting everyone in danger, as he was actually taking us into the middle of the Pacific Ocean, and then towed us to Australia. Everyone was happy, and thanked God we were alive and finally on land.
We were taken to the detention centre on Christmas Island. It was horrible there, like living in a prison. People didn’t know when they were going to be released, and some had been there for years. There were kids too. Everyone was just sitting around waiting for their number to be called and their visa to be granted so they could be released.
We were lucky we were released after just 3 months, and flown to Melbourne to be with our relatives. I was so happy to see free people, and to have the opportunity to go to school, get a good education, and do whatever I wanted afterwards.
But it was also difficult because we didn’t have permanent residency for 7 years so we couldn’t travel, and were separated from my siblings for all that time. My mum ended up going into a deep depression. Finally, during Kevin Rudd’s time, we were allowed to travel back to Iran to visit and then, soon after, we got our citizenship, which meant we could apply for the whole family to come to Australia.
I had always dreamed of being a doctor and being able to help people. After school, I did a Bachelor of Biomedical Science and Honours, and then I got accepted into Medical school at the University of Melbourne.
I did my internship at the Northern Hospital, which I loved because it was very multicultural and supportive, and I felt it was a place I belonged. I’m still working there now, doing 6 months as a surgical resident and next I’ll do 6 months as an Obs & Gyn resident. After that, I’ll see which path I would like to take!
The journey has been tough. But I feel privileged to be a doctor now, and to be able to help people at the most vulnerable time of their life.”
Photographer: David Brewster www.davidbrewsterphotography.com
New Humans of Australia
FEVER WITHOUT LOCALIZING SIGNS
[ Vietnamese ]
( Dịch từ Nelson Textbook of Pediatrics 20th Edition 2016 - trang 1280. Mình sẽ up dần những bài mình đã dịch. )
Định nghĩa: Sốt khởi phát và kéo dài < 1 tuần và không có dấu hiệu khu trú ( ổ nhiễm ), là một chẩn đoán phổ biến ở trẻ nhỏ hơn 36 tháng tuổi. Nguyên nhân và sự đánh giá đối với sốt không dấu khu trú phụ thuộc vào lứa tuổi của trẻ.
🔺 Sơ sinh
Dấu hiệu nhiễm trùng hạn chế, khó phân biệt trên lâm sàng giữa nhiễm vi khuẩn/ virus nghiêm trọng ( ví dụ Herpes Simples virus [ HSV] ) hay nhiễm virus tự hạn chế.
Đáp ứng miễn dịch chưa hoàn thiện trong vài tháng đầu sau sanh cũng làm tăng nguy cơ sốt ở trẻ nhỏ.
Sơ sinh sốt + nhìn khỏe vẫn có 7% nguy cơ có tình trạng nhiễm khuẩn nghiêm trọng, bao gồm nhiễm trùng huyết, viêm màng não, viêm phổi, viêm tủy xương, viêm khớp nhiễm khuẩn, viêm ruột và nhiễm trùng tiểu.
✔️Các tác nhân hay gặp:
Vi khuẩn: Group B Streptococci, E.coli, Listeria monocytogenes
Virus: Herpes simplex virus (HSV)
Nếu nghi ngờ sốt giả tạo do mặc nhiều quần áo hay đắp nhiều chăn/mền, bỏ bớt quần áo, chăn/mền => đo lại nhiệt độ sau 15-30 phút.
✔️Vì ở trẻ sơ sinh các dấu hiệu lâm sàng không rõ ràng, cộng thêm hệ miễn dịch chưa trưởng thành, tất cả trẻ sơ sinh sốt nên được nhập viện. Máu, nước tiểu, dịch não tủy nên được cấy. Trẻ nên được cho kháng sinh dựa theo kinh nghiệm. Xét nghiệm dịch não tủy nên bao gồm đếm tế bào, glucose, protein, nhuộn gram và cấy. HSV và enterovirus PCR nên được cân nhắc. Cấy phân và X-quang ngực cũng có thể là một phần của việc đánh giá. Kháng sinh kết hợp, ví dụ như Ampicillin + Cefotaxime hoặc Ampicillin + Gentamycin được khuyến cáo. Acylovir nên được cho nếu nghi nhiễm HSV vì có co giật, hạ huyết áp, tăng men gan, tăng bạch cầu dịch não tủy, mẹ nhiễm HSV sinh dục lúc mang thai, đặc biệt là lúc sanh.
Dr. Steve Bryan
April 2019 - Pediatrics in Review
[ April 01, 2019 ]
" The number of individual measles cases is at its second highest in the United States since the disease was eliminated in 2000, according to the latest data from the US Centers for Disease Control and Prevention (CDC)"
medscape.com The number of individual measles cases is at its second highest in the United States since its elimination in 2000, according to the latest data from the Centers for Disease Control and Prevention.
For 12 years, this man has been volunteering in a hospital - as a “baby buddy” for newborns.
[ March 11, 2019 ]
“ Infants born to women who smoked even one cigarette per day during pregnancy had more than twice the risk for sudden unexpected infant death (SUID) compared with those whose mothers did not smoke, and that risk increased with each cigarette, a large study found. The risk fell when women reduced or quit smoking. “
medscape.com The risk for sudden unexplained infant death was more than double among infants whose mothers smoked even one cigarette a day while pregnant, but fell when they reduced or quit, a study found.
"I wanted to die. And I said, it’s not easy to die. I don’t have a gun, I don’t have enough pills. But I really did want to and it was horrible.”
"I fell and broke my collarbone on May 15th of last year. I had never been in the hospital in my life except to have my two children, and it was terrible. It was really terrible. All I could do was lay there, and it was so horrible that I wanted to die.”
“Now I’m 93 years old, I work 7 days a week and I think that’s the secret. I call this 'The Store' and I’m here every day. When I’m finished working and I have my meal, I’ll go back and rest. But I’ve been out of my room all day. What happens if you’re in your room too much, you really become a sick person. You don’t bother to put makeup on, you don’t bother to comb your hair and you just lay there."
“I turn 94 soon and I have no fear of death. I just don’t want to go through that torture again."
"I’ve had a good life. I like meeting people; I get a lot of compliments and I like that."
Humans of Los Angeles
[ March 5, 2019 ]
“The measles, mumps, and rubella vaccine does not increase the risk of autism and does not trigger autism in children who are at risk, according to a new study of over 650,000 children.”
cnn.com A study of all children born in Denmark from 1999 through 2010 concluded that the measles, mumps, and rubella vaccine does not increase the risk of autism, does not trigger autism in susceptible children and is not associated with clustering of autism cases after vaccination.
“The absolute best thing in the world that can happen to me is telling a parent that their child’s tumor is benign. I live for those moments. And the worst thing that can happen to me is telling a parent that I’ve lost their kid. It’s only happened to me five times in thirty years. And I’ve wanted to kill myself every single time. Those parents trusted me with their child. It’s a sacred trust and the ultimate responsibility is always mine. I lose sleep for days. I second-guess every decision I made. And every time I lose a child, I tell the parents: ‘I’d rather be dead than her.’ And I mean it. But I go to church every single day. And I think that I’m going to see those kids in a better place. And I’m going to tell them that I’m sorry. And hopefully they’ll say, ‘Forget it. Come on in.’” - Dr. La Quaglia
Humans of New York
[ February 11, 2019 ]
No Increase in Cancer Among Children Conceived by IVF
The first generation of children conceived through assisted reproductive technology (ART) — including in vitro fertilization (IVF) — show no increased risk of cancer compared with the general population or those conceived using other fertility methods, in the largest study of its kind in which offspring were followed from birth for a mean of 21 years.
medscape.com With a follow-up of 21 years, a large cohort of Dutch children conceived through assisted-reproductive technology such as IVF show no significant increases in cancer compared with the general population.
[ February 16, 2019 ]
Nearly 1,000 Madagascar Children Dead of Measles Since October - WHO
medscape.com (Corrects fifth paragraph to refer to vaccination of 2.2 million children, not 22 million people, following clarification by WHO, and makes clear those receiving booster are also children.)
Bugs ( harmful microorganisms ) affecting unvaccinated children
Some countries in Asia are celebrating Lunar New Year.
Wishing you good health, happiness and success in the coming year and always.
Photo: ( taken at my home )
*Ochna integerrima, popularly called yellow Mai flower, is the must-have flower in most of families in South of Vietnam at Lunar New Year ( Tet )
[ January 31, 2019 ]
Measles outbreak in Washington state is fueled by unvaccinated individuals, experts say.
medscape.com The states of Washington and New York are seeing the worst measles outbreaks in a generation; officials say failure to vaccinate children against the disease is responsible.
Have you ever seen a situation like this in your country?
Pediatrics in Review
Rationale for the Immunization Schedule: Why Is It the Way It Is?
pedsinreview.aappublications.org 1. Varun U. Shetty, MD* 2. Parul Chaudhuri, MD† 3. Camille Sabella, MD‡ 1. *Department of Internal Medicine–Pediatrics 2. †Department of Internal Medicine, Case Western Reserve University–MetroHealth Medical Center, Cleveland, OH 3. ‡Center for Pediatric Infectious Diseases, Cle...
Photos from Pediatrics Essentials's post
After graduating from medical school overseas, I came to the United States hoping to get a spot in residency. A few years went by with no luck. At that time, I had just started a family and was forced to take on odd jobs to help support them. Every year, I saved up a few thousand dollars to apply but was met with constant rejection. Ten years had gone by, and I still had not matched into a residency program - but I never lost hope. In 2012, I was living in Chicago when I got a phone call for a Psychiatry interview in New Jersey. I was really excited. But two days before the interview, I found out out that all flights to New Jersey were cancelled due to Hurricane Sandy. I was dismayed. Feeling horrible, I lay in my bed for a few hours. All of a sudden something inside me told me that I needed to get up and go. Maybe it was a sign from God, I am not really sure. I woke up my wife and told her that we needed to drive to New Jersey. She called me crazy for trying to drive through a hurricane. Eventually she came around and we set off with our daughter. My wife was seven months pregnant at that time. As we got closer and closer to New Jersey, the weather got crazier - there was debris flying in the air and all the exits were rerouted due to the weather. Eventually, by some miracle, we arrived at a motel in New Jersey. There was no electricity but a comfortable bed and a hot shower were good enough for us. The next day, I went to my interview only to find that no one was in, except the senior resident. The other two applicants that day had not shown up. The resident called the program director and explained the situation to him. A little while later, I came to find out that the program director came all the way to the hospital just to see me - he was shocked that anyone would drive all the way from Chicago to New Jersey in the middle of a hurricane. He wanted to see me in person. As soon as he walked up to me, he offered me a spot in their residency program! He said that the kind of dedication I displayed is exactly what he would want in a resident in the program. I was extremely thankful for this opportunity. To show my appreciation and gratitude, I worked extremely hard every day as a resident, going above and beyond of what was expected of me. I eventually became chief resident and won the Best Resident Award for never taking a single day off. And so, Hurricane Sandy was a low point for many people, but for me, it changed my life completely for the better. And it taught me an important lesson - never give up on a dream.
Interview: Saira Akhtar
From: Humans of Downstate.
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Trung Cấp Y Sài Gòn, Thông Báo Tuyển Sinh, tư vấn tuyển sinh, tuyển sinh liên tục
Chuyên bán mỹ thẫm thấn,son.Quần áo rá rẻ và sĩ&lẽ.Túi sách.Dầy dép.Rá rẻ
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