Dr Chan 日記

Since one of my colleagues is taking his sick leave, I was urgently called to attended the Out-patient Clinic for him. Hope he will soon get better.
The diagnosis of the PUO girl is still unknown, it's likely to be rheumatological cause. However, further testings are still in progress for the exact diagnosis. She was seen by the Professor in the University
Hospital and there was appearance of Malar rash. Repeated bone marrow examination seems to have ruled out for malignancy. The Autoimmune markers were repeated and all the markers were negative. The Anti-ds DNA were not raised. One particular interesting thing is that her ANA pattern was quite special and the ANA test was now sent to Australia for further testing. She was started on oral systemic steroid therapy and fever subsided. She will be back to us this month for follow up clinic in the rheumatology clinic. By that time, I hope there may be some break through in her exact diangosis.
There was recently a number of child abuse cases in our ward. Some of the kids are ok but some are very naughty. Almost most of the time, I found that the kid are naughty and the parents were giving physical punishment to them. Sometimes, the parents loss their temper and beat the child for 1-2 stroke with cane/hand only. However, due to the presence of physical signs (even very mild one), child abuse conference was held and ended with the outcome of 'high risk of child abuse'. I don't know whether it's reasonable or not, we seems to over use our power to activate this mechanism in this way. For those having multiple bruises, severe injuried cases, I have no reservation to make the diagnosis of Abuse, but for these 'grey' cases, I have some reservation.
May be this is due to my past experience. When I was young, some degree of physical punishment is still accepted. Even the school use physical punishment to teach those naughty students to behave. But things had changed with times, I understand from the current point of view that any way of physical punishment is not allowed. That's why we had so many child abuse cases. I personally think that if a very detailed enquiry to the kids were made in the local population, most of the kids would reported that they had been physically punished before. Then, child abuse would be suspected from every single kid.
Afterall, we could not catered for child abuse conference and social investigation on all the kids. I do believe that there was very caring parents whom never beat their children in their lifetime.

Today, really busy and busy.... The server of the hospital network is infected by a worm... the W32/sasser.... all the terminal was downed. Need to use hand entry for all the medical records. The problem was not solved even it was dealed with by the IT department for the whole day... Just don't know why they are so useless.... (they got really good paid afterall!)
I need to do almost all the things in my team as one of my team members is in-house today and another one was so senior that I didn't dare to ask him to do more.... That's is problem inside the medical profession here (or even in other part of the world). I have seen almost all the patients within my team. Luckily, I am not on-call today and I could get off from my duty after 5pm and enjoyed my dinner made by myself today!