Common Pediatric Disorders

Acute Nephritic Sydrome

Posgt streptococcal glomerulonephritis

Acute glomerulonephritis

ETIOLOGY :

                Inflammatory complex :

1.       Infection by streptococcal beta-hemolatic

2.       Complex Ag-Ab attack of basement menbrane

3.        Toxin effect of streptococcal to basement membranous glomerula.

PATHOPHYSIOLOGY :

                karksÞH enA Glomerula eday Complex Ag-Ab eFVIeGay 

-          Inflammmation  ( Hematuria , proteinuria )

-          Bi)akeRcaH ( Edema , Oliguria )

-          Hypertesion (Increase afferent artery pressure )

CLINICAL SIGNS

·         Post Streptococcal infetion of pharynx

-          Fever

-          Sore throat

-          Malaise

-          Abdomonal Pain

·         Acute glomerular inflammation

-          Sudden onset 1-7 days

-          Oliguria ( Urine < 400ml / day prognosis to acute renal failure )

-          Edema

-          Proteinuria non selective and hematuria

-          Hypeertesion

PARACLINC

·         CBC

·         BUN (Blood Urea-Nitrogen )

·         ASLO positive

·         Urinalysis

-          Proteinuria non selective

-          Erythrocyte cast

-          Leukocyturia

-          Hyaline , glanular

·         3 Serologic markers

-          Serum C3 level

-          Anti glomerula  basement membrane antibody ( AGBM antibody )

-          Anti nucleo cytoplasmic antibody ( ANC antibody )

·         Renal ultrasonography

·         Renal biopsy

COMPLICATION

·         Anemia

·         Hyperkalemia

·         Acute renal failure

·         Chronic renal failure evolution to ESRD

DIFFERENTIAL DIAGNOSIS

·         Nephrotic syndrome

·         Henoch Schonlein purpura ( Rheumatiod purpura )

·         Lupus nephritis

·         Berger’s disease ( Ig A nephropathy )

·         Wegener’s Granulomatosis : Vasculitis associated with

-          Glomerulonephritis

-          Resporatory symptom : Cough , dyspnea , chronic sinusitis , otitis media , hemoptysis .

-          Neuropathy , purpura , arthritis , scleritis

-          Conformed diagnosis : C_ANCA , large nodular by chest x-ray , hematuric , and biopsy .

-          Treat by corticoide or cyclosporine and cotrimoxazole

MANAGEMENT

1.       Supporting diet and vitamin B

2.       Edema and hyperkaliema Furosemide 1mg / kg / dose

3.       Hypertesion ( Calcium channel blocker )

4.       Antibiotherapy

    Ceftriaxone 100mg / kg / day

5.       Follow up every  month  , ASLO test ?

      Extrancilline 2.4 millions / month

References

Current essentials of medicine

MERCK MANUAL , medicine information

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S. typhi Vi Suspension S. typhi Vi Standard Serum

Fièvre Typhoïde | Santé Diététique 

la fièvre typhoïde

S. typhi Vi Suspension

S. typhi Vi Standard Serum

 S. typhi Vi Suspension for the quantitative detection of specific Salmonella antibodies in sera S. typhi Vi Standard Serum for the standardisation of the agglutination tests using Vi suspensions

INTENDED USE

Remel S. typhi Vi Suspension (SS20/30953901) is intended for the quantitative detection of specific Salmonella antibodies in sera for epidemiological purposes to assist in the diagnosis of carriers.

Remel S. typhi Vi Standard Serum (AM30/30951401) is a freeze-dried hyperimmune horse serum intended for the standardisation of agglutination tests using Vi suspension.

REAGENTS

DESCRIPTION, PREPARATION FOR USE AND

RECOMMENDED STORAGE CONDITIONS

Remel S. typhi Vi Suspension is standardised to contain

approximately 1010 bacteria per ml and is preserved with 0.25%  formalin and 0.01%thiomersal. Each bottle contains 5 ml liquid and is ready to use.

The Remel S. typhi Vi Standard Serum is horse serum containing antibodies to S. typhi Vi preserved with 0.01% thiomersal.

Stored in the dark at 2 to 8°C the suspension and freeze-dried Standard Serum will retain their reactivity at least until the date shown on the bottle label.

The freeze-dried Standard Serum should be reconstituted for use in 1 ml of distilled water and

further diluted with 3 ml saline.

Suitable aliquots of this 1/4 dilution may be stored at –15°C to      –25°C until required.

ANALYTICAL PRECAUTIONS
1. Do not use the reagents beyond the stated expiry date. 

Microbiological and serological contamination must be avoided as this may cause erroneous results and
reduce product life.
2. Do not modify the test procedure, incubation times or temperatures.
3. Allow all reagents and samples to come to room temperature
(18 to 30°C) before use. After use return to 2 to 8°C in the dark.
4. Do not expose reagents to strong light during storage and incubation times.
5. Care must be taken not to cross-contaminate reagents.
6. If the suspension becomes rough or fails to agglutinate with its
homologous specific serum it should be discarded.
7. The suspension must be shaken thoroughly before use to ensure
that organisms are evenly suspended.

SPECIMEN COLLECTION, TRANSPORT AND STORAGE
     SPECIMEN COLLECTION
  Serum samples may be used.
Blood collected by venous puncture should be allowed to clot naturally.
Care should be taken to ensure that the serum samples
  are fully clotted. Do not inactivate serum samples.

SPECIMEN TRANSPORT AND STORAGE
Store samples at 2 to 8°C.

TEST PROCEDURE
1. Set up a row of eight tubes for each serum tested,
    including the Standard Serum.
nPipette 1.8 ml of saline into the first tube in each row and 1.0 ml into every other tube.
nAdd 0.2 ml of test serum or diluted Standard Serum to the first tube of the appropriate row.

nMix the contents of tube 1 and transfer 1 ml to tube 2.
nRepeat for each tube up to but not including tube 8, finally discarding 1 ml from tube 7.

fievre-typhoide-titre.jpg

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White Blood Cell WBC

How White Blood Cells Work

Test	Name	Increased/decreased
WBC	White Blood Cell	May be increased with infections, inflammation, cancer, leukemia; decreased with some medications (such as methotrexate), some autoimmune conditions, some severe infections, bone marrow failure, and congenital marrow aplasia (marrow doesn't develop normally)
% Neutrophil	Neutrophil/Band/Seg/Gran	This is a dynamic population that varies somewhat from day to day depending on what is going on in the body.  Significant increases in particular types are associated with different temporary/acute and/or chronic conditions.  An example of this is the increased number of lymphocytes seen with lymphocytic leukemia. For more information, see Blood Smear and WBC.
Lymphs	Lymphocyte
% Mono	Monocyte
% Eos	Eosinophil
% Baso	Basophil
Neutrophil	Neutrophil/Ban/Seg/Gran
Lymphs	Lymphocyte
Mono	Monocyte
Eos	Eosinophil
Baso	Basophil
RBC	Red Blood Cell	Decreased with anemia; increased when too many made and with fluid loss due to diarrhea, dehydration, burns
Hgb	Hemoglobin	Mirrors RBC results
Hct	Hematocrit	Mirrors RBC results
MCV	Mean Corpuscular Volume	Increased with B12 and Folate deficiency; decreased with iron deficiency and thalassemia
MCH	Mean Corpuscular Hemoglobin	Mirrors MCV results
MCHC	Mean Corpuscular Hemoglobin Concentration	May be decreased when MCV is decreased; increases limited to amount of Hgb that will fit inside a RBC
RDW	RBC Distribution Width	Increased RDW indicates mixed population of RBCs; immature RBCs tend to be larger
Platelet	Platelet	Decreased or increased with conditions that affect platelet production; decreased when greater numbers used, as with bleeding; decreased with some inherited disorders (such as Wiskott-Aldrich, Bernard-Soulier), with Systemic lupus erythematosus, pernicious anemia, hypersplenism (spleen takes too many out of circulation), leukemia, and chemotherapy
MPV	Mean Platelet Volume	Vary with platelet production; younger platelets are larger than older ones

 The study white blood cell in the body