Alopecia

Yesterday's lecture was about Alopecia; Alopecia means loss of hair. It is classified into congenital and acquired, further divided into diffuse and localized. The localized is either cicatrical or non cicatrical.

Forget about the classification, I wanna share with you a story that causes me to update this blog today.

By description, I was a naughty little girl when I was a kid. I just loved to climb up the wall, fought with other kids and the list continues..

One day I intentionally hit my younger sister with something(I dont know how to describe) without realising the presence of small metal rod inside it. The hit was so strong that leave my sister(Ayu) crying her lung out and suddenly I saw blood oozing from the site of the trauma. Everyone was panic at that time and without waiting any longer, abah took Ayu to our family's clinic.

The injury left Ayu's head with a scar. A small one. (In medical term it is known as cicatrical localized alopecia.) Due to the scarring from the deep trauma, it damaged the hair follicles inside the skin leaving a small bald area on Ayu's head. And surely the hair will never regenerate due to the damage it caused to the hair follicles. :'(

During the lecture, I cant stop my mind to keep recalling this story. I still vividly remember the moment I saw the blood coming out from her. I am not sure if Ayu still remember this story, but surely I will not forget!!

My Father My Hero

Abah is so eager to learn Jawi right now. Stating that he has no opportunity to study Jawi back then, makes him works so hard in answering Jawi exercise book he bought last year. Deep in my heart, I am proud to watch him consistently trying to learn new thing despite his age turning 60 this year.

I remember that one time abah pushed himself very hard just to memorize a simple duaa in arabic, he recited the duaa everytime he free, especially after came back from work also before he go to sleep. and yes, until now he still reciting the same duaa that he memorized ages ago.

O abah, you might not know how much I love you, how much I respect you and how much proud of you, simply because it beyond infinity and may Allah makes you among as solihin. ameen

being humble

Being humble is so huge in the eyes of Allah that He even stated that in Quran surah Al Furqan verse 63.

I used to look down on other people simply because I feel that I am superior than others. :( Naaa, I have a new resolution then ;) Be humble!

kakak will be graduating soon

I am proud to say my beloved akak has finished her study and now back home for good. how time flies.. only us know how hard she struggled since from the very beginning of her academic year haha..

and ibu always love to recall the story about how akak confidently answer her teacher's question and unfortunately the answer is totally wrong. haha

How come she always thought that the aeroplane was tiger when she was little.

Congratulations akak for your excellent achievement. you just make us PROUD!

KERNICTERUS

            There is a topic that I studied, that profoundly caused me to write something about it. It’s about KERNICTERUS. Kernicterus is  bilirubin-induced brain dysfunction. Apart from some diseases like phenylketonuria (PKU), galactosemia, and cretinism, that can cause mental retardation in babies, Kernicterus can also do the same. Fortunately, all the diseases that have been mentioned above are totally preventable. PKU, galactosemia, and cretinism can be prevented simply by screening the baby right after the delivery. But it is not the same with Kernicterus.

Kernicterus is caused by very high levels of bilirubin. Bilirubin is a yellow pigment that is created in the body during the normal recycling of old red blood cells. High levels of bilirubin in the body can cause the skin to look yellow (which is called jaundice).

In some cases when there are extremely high levels of bilirubin in the body or the baby is extremely ill, the substance will move out of the blood and collect in the brain tissue. This can lead to serious neurological complications, including brain damage and hearing loss.

Kernicterus usually develops in the first week of life, but may be seen up until the third week. Newborns with Rh hemolytic disease that may lead to hydrops fetalis are at high risk for severe jaundice that leads to this condition. However, kernicterus has been seen in apparently healthy babies. –  an excerpt from the medlineplus website.

look to the yellowish-stained brain(basal ganglia)

yellowish-stained basal ganglia

MRI shows hyperintense basal ganglia

             In my NICU round today, my friends and I encountered a case that profoundly touched our hearts. The baby presented to us with Kernicterus. He was a home-birth delivery baby. His mother came to hospital after 5 days of delivery complaining that her baby refused to feed. And the baby at that time was lethargic with very ill-looking. The baby was diagnosed with ABO hemolytic disease of newborn. It occurs when the mother with blood group O, pregnant to a baby with different blood group. So the mother will produce IgG antibody that pass through the placenta, and begins to attack the fetal RBC. The RBC hemolysed, and start to give out bilirubin resulting in hyperbilirubinemia. But this condition, if managed properly does not bring the child to Kernicterus. Simply the management is phototherapy and if the bilirubin level is so high, blood transfusion is indicated.

             Due to failure of the mother to bring the baby earlier to the hospital, the baby suffered permanent mental retardation with loss of hearing. The baby was born normal, became mentally retarded due to his mother mistake and ignorance.

a boy suffering with Kernicterus

             In developed countries, Kernicterus is rarely happen. My NICU professor said that recent conference he attended came with idea to eradicate Kernicterus, and he bravely said that this is hardly to happen in Egypt. This may be due to ignorance and low mentality of some mothers about the importance of antenatal checkup and giving birth in hospital.

So lessons that we get by this story are: 

1.       Knowledge can save lives.

2.       The importance of antenatal check up in pregnant woman.

3.       Every human has his/her own destiny and fate.

4.       Allah is The-all Just.