Wednesday, January 21, 2009

Punctured wound , oil palm's worker's occupational hazard

Few days ago , a guy walk in to my consultation room with pain and swelling of his right foot for 3 months.He says the pain comes on and off, but the swelling is always there.He gave history of kicking a bunch of oil palm's leaves , and hence the leg became painfull the next day.He has no history of gout or family history of gout.

He had minor aberation on the foot, which is bloodless and heal up in two days.He ignores it, didn't get any treatment from any doctor.A week or two later, he had some discharge from the site of aberation wound.It heals after he cleans up the wound.Yet it comes again after a week or two later.

When i saw him, there was a small wound and discharge on the dorsal of the right foot.It was painfull.I assure him there was something inside the wound. He allows me to do some digging work.There was a piece of oil palm's 'torn' as big as rice seed at the end of the 'tunnel'.

It was common to see oil palm's torn punctured through under the skin and left behind is because they are very very brittle, yet sharp at the end of it so when enough force applied it can punctured through the skin, and snapped.Un suspecting medical personnel can missed it and the patient will suffer of non healing wound.Some how the body will attack this foreign body and produce puss ,as a mechanism of rejecting it.

Usually, after the foreign body removed, the wound cleanned, and some antibiotic given, the wound will healed up in a few days.Pain killer may help the patient , to keep up in mobility.

Sunday, January 18, 2009

Chikugunya Fever

I fall sick for almost three weeks now. It was started as fever and body ache when i was in Beijing.That day we just visiting the tianmen square and the forbidden city. Our tour guides says we walked past 7 kilometer that day.No wonder i was dead tired.

The next day we tried to buy fever medicine from the pharmacy around the corner.However we cannot find any medicine on English labels. All in Mandarin.We end up buying fever medicine with strange name . We I took it ,it doesn't cure my fever, yet it caused my heart to run faster.The moral of the story is, next time, when you travel, bring along some medicine with you. just in case you need it.

My fever was never subsided when I reach home. The whole body become painful. My joints also painful.I feel nauseated and felt very dry. I can't swallow anything,I can't move around so i just choose to sleep.There was rashes on my both hands and feet.But starangely there was no sweat at all.Usually when i got fever, sweat will come after I took some paracetamol.I choose to treat my ownself. [well, being a doctor, I always thought i know more about my self]

Chikugunya fever is a viral infection. The virus was distributed by mosquitoes[ aedis agepty], ie the same mosquitoes that distribute denggi fever.In medicine, we call it vector.Last months was the highest incidence of chikugunya fever in our country. Probably i got infected when i was at my kampong. Our neighbour claimed there were almost everybody in the village get the same symptoms of fever joint pain and rashes.

Unfortunately there is no specific treatment for chikugunya fever.We give paracetamol to reduce the fever, alot of water, pain killer, and prednisolone and most importance is to have bed rest.I found it is releiving after drinking air zam zam[ holy water usually taken along by hajj pilgrimage]. i don't have enough stock, but i managed to buy from petronas petrol station along the kesas highway.So my advice for those who have the same symptom like me, buy zamzam water, and drink it as much as you can.It may cure you..