FAMILY HEALTH REPORT

BLOOD AND IMMUNOLOGY BLOCK MDP 10306 Year 1 MD Programme Kg. Empila, Kota Samarahan 4 December 2010
Group members

Hazimin Syahir bin Jamil Noor Azila binti Alias Fung Mei Jiun
Prepared for : Mrs. Zainab Bt. Tambi Faculty :

Matrix Number 26403 27291 26334

Medicine and Health Science 2010

Introduction
In this third block visit, which is Blood and Immunology (MDP 10306) was held at Kg. Empila on 4th December 2010. There are a few objectives that we are supposed to achieve during the visit. First, identify the family history of the family members for congenital or chronic, or hereditary diseases, for examples hypertension, leukemia and etc. We identify it by completed the questionnaires, and asked for them to answer each question given. This objectives is very important because by that history, we can identify and we also can give some tips and advice for them on how to take a good care of some disease. Second is, identify the causes of the family members seeking treatment or death for the past 6 months. Next objective is, practice the skill of doing blood film staining and examination. In this objective, we need to have specimen by taking the blood from the foster parents. We done it at the Dewan Mesra, Kampung Empila. This skill have been practice in the practical session during the class, and we applied it in this visit. At the laboratory at the faculty, we stain it with the correct methods to achieved the next objective. Next is, examine and identify the abnormalities from the collected specimens. The abnormalities of the specimen can be measured by looking at the structure of the red blood cells and the white blood cells whether it normal or abnormal. Last objectives is, practice their communication skill in respect of specimen collection.

Methods
In this Blood and Immunology block visit, data needed was achieved mainly by interviewing the respondent, through the questionnaire and observations while visiting the foster family home. Other than that is taking the blood specimen from the foster parents. When taking the blood specimen, we need to give the consent paper and have the signature from the foster parent. Before that, we need to inform them the purpose and objectives to take the blood specimen. After taking the specimen, we need to make it as the blood film and stain it at the laboratory at the faculty. The blood film is observed whether it is normal or abnormal. Other method is questionnaires. The questionnaires is completed at the foster parent home. The questionnaires is asked about the family history of the family members for congenital or chronic, or hereditary diseases. It also identify the causes of the family members seeking treatment or death for the past 6 months. Lastly, in the questionnaire also we need to know about the family tree of this family. We all done it with successful.

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Results
The aim for the third block (blood and immunology) visit to Kampung Empila is to reveal that whether there are any congenital or inherited or chronic disease in our foster family and also to know that whether any of their family members have passed away, sick or undergo any form of treatment and need to be admitted into hospital. The respondents are our foster parents Tuan Haji Koted bin Arip and Miri bt Bajuri. There are two family members that have asthma. This is considered inheritance disease as the mother(Hajijah bt Koted) and the son(Ramji bin Nik) have asthma. They are respondents children and grandchildren respectively. The mother realized about the disease after she grown up but the exact period of time is unknown while her son had asthma about one year ago. Besides that, there is another family member, the grandchildren(Madini bin Mat) that had genital problems, but the exact name for the disease is unknown. He had this condition since he birth so we classify this under congenital disease. Moreover, the grandchildren that is Madini had a surgery within the past six months and he was admitted to hospitals for a few days. Besides, Ramji had an asthma attack during the same period of time but he was not admitted into hospital and he had the inhaler to control the asthma. Our foster mother herself was also went to the government hospital to see the doctor regarding to her tender and swollen legs. Next, the interesting part of this visit was that we are required to perform peripheral blood film using our foster parents blood sample. Each family need to collect two blood sample from foster families (adults), but for our group we just did the blood smear for our foster father because he was the one who present at the hall when blood smear has to be done after we reach Kampung Empila and our foster mother was unable to attend due to some reasons. Three of us cooperate well to perform the blood smear and Mr. Albert was the one who supervised and assist us. One of use responsible to collect blood sample from father, another one standby for blood smear and one more person prepare the container to place the smear while waiting the smear to dry. We followed the procedure and used all the materials provided which includes lancets, slides, swabs etc. The process is done successfully. We do take a written consent before the blood taking. We went to foster family home after the blood smear session and proceed with the questionnaires as described above while chit chat with our foster parents.

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After came back from the visit, we performed blood smear staining and then observe the smear under the microscope. Staining process was done successfully. We noticed that there are some abnormalities from the blood smear. Some of the red blood cells are

echinocytes and there are rouleaux formation in addition to the normal red blood cells. We are unsure that this findings were due to our faulty drying technique or our foster father has some health problems. However, the white blood cells observed under microscope were normal. The white blood cells mentioned include lymphocytes, neutrophils, eosinophils and basophils.

Tuan Haji Koted

Miri

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Discussion
Basically, the only inherited disorder that Tuan Haji Koteds family member has is asthma problem. His daughter and grandchild have the asthma problem. Besides, his grandchild, Madihi has the congenital problem which refers to defect of genitourinary part since birth and having treatment now. From the blood smear, we have observed that there was presence of anisopoikilocytosis of red blood cells from Tuan Haji Koteds blood smear. Nevertheless, the white blood cells seem normal in size and shape.

Recommendations
Most of Kampung Empila villagers have a large number of family members. This may lead to high number of villagers inherited certain disorder for example asthma. We suggest that Health of Department in Sarawak should provide some free medication like inhaler to help them. Besides, villagers should be advised that they should marry with a person that from outside the village to decrease the probability getting offspring with a disorder.

Conclusion
In conclusion, the Blood and Immunology visit provide us a very good opportunity to practice the things we have learn in the lecture especially the blood sample taking through hand pricking and also blood smear technique. This give us a real scenario that we need to face in the future while taking any sample from the patients. By looking under the

microscope the morphology of blood cells, helps us to differentiate the normal and abnormal morphology of blood cells for instance we have a chance to see under the microscope the real rouleaux formation. It is crucial to know all the medical terms used in heamatology as this will help us to understand the medical report prepared by the laboratory technician in order to help in diagnosis in the future time. Besides that, we also become closer with our foster family as we are provided with a chance to communicate with each other.

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