It's a united nation !

The malaysia is known in the world as a multiracial country with the main 3 races -malay,chinese and indian. In this week, i found out in Malaysia nowadays, we are not only populated by malay, chinese and indian only but also by other nation of people too. It is now become one the nation with a lot of alien. Not the alien in the movies who swallow people but the alien who become host of many disease.
This week , in the side in charge by me , it is populated by majority of alien from all the nation. The famous neighbor country who speak the similar language-Malay , A indonesian with very good clinical sign, jaundice, fever, with prominent pansystolic murmur and early diastolic murmur plus splenomegaly. Yes , a infective endocarditis patient confirmed by echocardiography. 2 days ago, a Vietnamese patient with fever for 4 days with rash , stay in the black area of dengue fever , with gum bleeding and haemoconcertration . Yes, a vietamese fever with dengue hemorrhagic fever. At the same day, a Pakistani patient with fever for 3 weeks ,deny high risk behaviour seeks treatment for GP tried on antibiotic but failed. No splenomegaly ,lymphadenopathy without bleeding tendency. Based on alien treatment experience, sent blood for BFMP, thyphoid screening anf PBF. Results came back Plasmodium vivax positive.So treated for malaria.
The most headache part, a bangaladesh who step in Malaysia for 3 month , not knowing malay, english and Tamil. Super language barrier , scratching every body head to get urine , stool sample for culture sensitivity. When asked whether understand english or not, the answer is a little. Actually know nothing . Showed him urine bottle for collection . He always say yes but result is not given coming bottle. Chest x ray clear lung field. Temperature spiking, negative for abdomen,lung and other system examination.Blood C& S(culture and sensitivity)result preliminary gram negative. Started on rocephine seems to response. Full results , salmonella typhi. Yes a atypical presentation for typhoid with limited history and based solely on investigation.
In summary, this week , i got a young Indon with infective endocarditis, a vietnamese with dengue, a pakistani with malaria and a Bangaladesh with typhoid. All is at the age 20-30. Occasional ,we do got indon with epilepsy ,acute leukaemia.
Malaysian now already is declare as a alien nation as our ringgit grow stronger and our hospitality with our good hospital backup. They all come here to earn money. To them, Malaysia is a gold mine. To me, they are the potential host to transmit the infectious disease . Maybe, some day , i would got the change to see Kala azar disease.
I think i might need to learn simple Bangaladesh language some day and some time.