Muhammad Zahid Iqbal

6 months old Indian Girl with underlying obstructive hydrocephalus secondary to Arnold-Chiari malformation and ruptured lumbosacral myelomeningocele, repaired on Day 2 of life (19/12/13) with problem of gross hydrocephalus block VP shunt associated with CONS, for removal of VP shunt and Omaya reservoir on Saturday with Day 26 post-revision of VP shunt. Child completed IV Cefazolin 280mg QID for 14days, CSF C&S x3 shows Staphyloccus Aureus coagulase negative, currently on IV Vancomycin 85mg 8hourly (15mg/kg/dose). Child developed facial puffiness and periorbital edema after last IV Vancomycin dose. No reaction after latest dose of IV Vancomycin.

The patient was with known diagnosis of diabetes mellitus type 1 with a headache and giddiness at the time of admission. We herein describe a case of the 14 years old patient with the plasma glucose level had given negative results to DM, as well as her laboratory tests also showed that she had poorly controlled DM and minor ear wax problem. Patients present with diabetic ketoacidosis after several days of polyuria, polydipsia, polyphagia and weight loss. The patient was found underweight due to her low BMI and she had multiple admissions of diabetic ketoacidosis and DM. Her RBS was too high until out of normal range. Furthermore, the lab result showed the glucose was found presence in her urine test. The effective patient counselling was given to diabetes mellitus along with the insulin treatment and along with other relative drugs to increase the patient’s quality of life. Our case emphasizes that early recognition and appropriate patient counselling by the pharmacists may significantly overcome the symptoms and prevent complications of diabetes mellitus which may enhance the quality of life in patients at any age.