31 January, 2009

Adenovirus infection in child (3 year old)

Dr. Linda Stannard, Department of Medical Microbiology, University of Cape Town.
A case of acute tonsillitis due to adenovirus.

||||||| 3-year-old.
||||||| November 10th. at noon, came to Clinic.
||||||| BT:39.1 ℃. No cough & running nose.
||||||| Tonsil and pharynx were reddish.
||||||| ------- Rapid adenovirus test(+)
||||||| Rx) 1. acetaminophen suppository 200mg(3/4)
||||||| at high fever.
||||||| 11th. high fever and sore throat.
||||||| 12th. high fever.
||||||| 13th. high fever.
||||||| 14th. Morning ~ noon, no fever. raised at night 38.5℃.
||||||| 15th. no fever.

Any questions: write to Keiji Hagiwara, MD

Tamifu dry syrup for influenza virus type A infection in child

------- A case record of 5-year-old girl ---------
January 12th: at noon, notice the fever, cough and running nose.
came to Clinic at late evening. BT:39.5℃.
Rapid influenza Test(A+).
prescribed Tamiflu dry syrup, anti-cough drug & acetaminophen fine granules.

13th: at noon, fever up to 40.3℃.
14th; no fever.
15th; no fever.
16th; slight fever 37.6℃

Any questions: write to Keiji Hagiwara, MD

24 January, 2009

Tamiflu: a drug for influenza A & B virus infection

The cost of this drug is relatively high. One capsule is 31 points (=310 yen) by
public insurance price. Taking 2 capsules/day for 5 consecutive days cost
3,100 yen (patient pay 30% of it, 930 yen in drug store since 70% is covered by

February 2001, Tamiflu (Trade name from Roche, Oseltamivir) was covered by
Public Health insurance in Japan. It is the main reason why Tamiflu are so
much prescribed in Japan.

Tamiflu capsule

Tamiflu Dry syrup for child.

1) Tamiflu and abnormal behavior:
The abnormal neurological symptoms(abnormal behavior) in children were noted
who took Tamiflu. Mass media picked up the typical case; a teenager who diagnosed
as influenza A infection by rapid antigen test and prescribed this drug by a practitioner.
After several hours taking Tamiflu, he/she jumped into the ground from the 10th's
mansion floor.

But the real causal relationship is remain obscure, since in some cases, influenza
virus infection itself cause the neurological complications, such as febrile convulsion
in infant (frequent), hallucination in children(sometimes) and acute encephalopathy
(rare) or hemorrhagic shock encephalopathy(very rare).

Before this drug was available in Japan, I also experienced the abnormal behavior
cases. For instance, 10 year old boy had high fever at morning and rest at bed.
Afternoon, he suddenly raised up the bed and rush to the outdoor. He lived in the
countryside and small river along in his house. So he run and jumped into the river.
The local doctor referred the boy to the University hospital. He was semi comatose
state at admission.The Electroencephalograph and Cerebral spinal fluid were normal.
Next morning, his consciousness returned to normal.

2) do not prescribed to one year old or younger ;
This recommendation is based the mouse experiment by the researchers of Hoffmann
La Loche announced that there are abnormally high CSF concentration of Tamiflu
in young rats.

Any questions: write to Keiji Hagiwara, MD

Amantadine for influenza A virus infection

Amantadine tablets(50mg)

In 1966, Amantadine was approved By FDA for the treatment for influenza A infection 
in USA. Accidentally, the patients with Parkinson disease who took this drug improved
the tremor symptom.  thereafter also approved.  In Japan, this drug was first approved for 
the treatment for Parkinson disease and then for influenza A virus infection.

Amantadine granules(10%).
Trade name: Symmetrel fine granules

Dosage of Amantasine
1~9 year ---------- 5mg/kg/day(max.150mg). in 1 or 2 divided doses.
10 year older (body weight 40kg> )  -------  200mg/day. 1 or 2 div.

8-year-old boy of influenza A virus infection, treated with Symmetrel.  

Any questions:  write to Keiji Hagiwara MD.

Relenza: inhalation drug for influenza virus A & B infection

Relenza (Trade name from GlaxoSmithKline, common name = Zanamivir hydrate) is a 
inhalation drug for influenza virus A or B infection.   Here, show a case of influenza 
virus A infection and the use of it. It seems excellent effect in this case.

inhalation drugs.

A case record of influenza A
18 year old, male
Red arrow indicate the intake of drugs.

Jan 19th;  started fever at night
Jan 20th;  came to Clinic.
                 Rapid test for influenza: A(+)B(-)
                 Rp) 1. Relenza 
                             inhale 2 times at morning & evening.
                 2. Anti-cough tablets  9 tab.
                                  div. 3
                 3. Acetoaminophen(200mg) 2 tab.
                                  at one time,
Jan 21th;  fever fell down.

Any questions: write to Keiji Hagiwara, M.D.

Measles & Rubella vaccine

Measles & Rubella combined vaccine.

of mumps virus. So, Measles-Rubella combined vaccine is used.

The schedule of MR vaccine in Japan.

1) 1st dose : 1 year or older
2) Second dose: 5~7 year old

What is Measles ? see ----- http://keiji-hagiwara.blogspot.com/2008/08/measles.html

Any questions: write to Keiji Hagiwara, MD

22 January, 2009

Haemophilus influenzae type-b vaccine

Haemophilus influenzae type b vaccine , Now available in Japan.
This vaccine is imported from French company"Sanofi Pasteur".

As the name implies, this bacteria (former name=Pfeiffer's bacillus)
was thought to be causative microbe of Flu(influenza) at the time
of Spanish Flu era.

1) Preventable diseases: Infections due to Haemophilus influenzae
type b , such as purulent meningitis, pneumonia and epiglottis.
2) Inactivated component vaccine.
3) Age : 2 month old and after. 3 times at 3~8 weeks interval.
4) Cost: no public expenditure. 7,500 Yen.

What is H. influenzae?
----- see 2) http://keiji-hagiwara.blogspot.com/2009/02/haemophilus-influenzae2.html

Any questions: Keiji Hagiwara, MD
Kami-Ube Pediatric Clinic
Ube 755-0097, Japan.
E-mail: keijihagiwara@gmail.com
Tel: 0836-29-1155

13 January, 2009

A cat

Photo 1)
    In August, 2007 one day, my son picked up a little cat, 
    who crying in a park, and bought to home.  
    The age was around 2~3 month old.
Photo 2)
Photo 3)

Photo 4)  On the top of kitchen. She have a good appetite
                 But dislike exercise.   
                 Accidentally ! 
                 She put into his head to the small basket.

09 January, 2009

Chrismas Camellia ( Camellia SAZANQUA )

The flowers of Christmas Camellia(= Camellia SAZANQUA) are blooming in 
my house. This plants grow in south of Japan, Taiwan, china and Indonesia.

02 January, 2009

first shrine visit of New Year(2)

First shrine visit of New Year(2)
Photo 5)
photo 6)Photo 7) Omikuji ; 
               a small paper strip in which described 
               the prediction of one's future, such as health, 
               disease, fortune, romance, human relationship, 
               business, childbirth, travel and more -------

Photo 8) Omikuji ; 
              if the prediction is bad, it's paper strip is bind 
              to the tree or board.

photo 9)

First shrine visit of the New Year(1)

First shrine visit of the New Year(初詣)

During the first~third January, we Japanese visit to 
Shrine for worship. People pray to God for their 
wishes and good future.

I am not so religious, but, Today I went to the Shrine.

Photo 1)   琴崎八幡宮
Photo 2) a line of worshiper
Photo 3) a line of worshiper
Photo 4)