The document summarizes the activities and case presentation of a pediatric intern at a hospital department, including following 11 cases and providing drug information for 6 cases, with a focus on the case of a 13-year old male patient diagnosed with rheumatic fever and rheumatic heart disease who presented with swelling, chest pain, and breathlessness. The patient's medical history, lab results, echocardiogram findings, assessments, treatment goals, medications, and standard treatment for rheumatic fever and rheumatic heart disease are outlined.

1. PEDIATRIC DEPARTMENT
PRESENTED BY: Deepali P.Liman
Vineeth Thomas
(Pharm.d intern)

2. Summary of activities chart
Activity Participation
Ward round Attended from 1/6 /2015 to 2/7/2015
Number of cases followed 11
Number of case solved in SOAP format 4
Number of drug information provided 6
Number of DI monitored 1
Number of history interview taken 1
Assignment from preceptor and solved 3
Assignments from physician 7
Clinical trials participitation Observed vaccination, clinical trial study,
SAE form report documentation
Number of Dose division done 6

3. Case presentation on
Rheumatic Fever and Rheumatic Heart Disease
• 13 years male patient
• Wt : 25.46 kg
• Came with c/o swelling over hands since 1 ½ months, mild non-progressive
chest pain since 2 months ( on and off ), breathlessness on exertion on
walking 2 stairs
• Past medical history: child was diagnosed to have RA with RHD since 11
years of age (14/3/2014), child was also admitted for 7days & diagnosed of
RA with RHD and moderate mitral regurgitation, bronchitis (3/6/15), child
was on regular OPD follow up 19/6/15
• Prescription medication history:
• Inj pencom 1.2 millions units every 21 days
• T.omnacortil
• T. aspirin
• T.claven
• T.vamol

4. Objective
Physical examination Febrile, pallor, oedema, swelling, redness over
carpometacarpal joints of both the hands
Vitals HR: 90/min
RR:24/min
BP:100/67mmHg
CVS S1S2 heard, S2 loud, grade 3 pansystolic murmur +
RS AEBE clear
CNS Conscious oriented

5. Laboratory investigations
Lab reports 1st day 2nd day
ESR 125 mm/hr 127 mm/hr
CRP 23.66mg/dl
Neutrophils 56 %
Lymphocytes 34 %
Monocytes 6 %
Hb 10.1 gm/dl
Specialiased diagnostic tests
Echo-cardiography and doppler report : RHD, mild MR, trivial AR,
mild PAH, normal LA function

6. ASSESSMENT
• Subjective & objective data correlates that child was diagnosed with
Rheumatic fever with Rheumatic Heart Disease
PLAN
Goals of therapy
• Diagnosis and management of rheumatic fever
• Management of cardiac complications of rheumatic fever
• Provide prophylaxis treatment of RHD
• Provide patient counselling

7. Medication given
Brand
name
Generic
name
Dose Frequency Start
date
Stop
date
Indication
T. Disprin Aspirin 350
mg
1-1-1 23/6 25/6 To decrease
inflammation in
rheumatic fever
T. Pan Pantopraz
ole
40mg 1-1-1 23/6 25/6 To protect the GI
lining, to
decrease acid
secretion
Inj.
Pencom
(IM)
Benzathin
penicillin
G
1.2
lakhs
units
1-0-0 23/6 23/6 Secodary
prophylaxis
treatment for
rheumatic fever
and RHD

8. Standard treatment for Rheumatic fever &
Rheumatic Heart disease

9. Patient counselling