Dr. Koto Shinryoujo - Vol. 8 Ch. 79 - Dr. Koto is Worried About
- Thread starter MangaDex
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I swear this island is cursed
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@NEETzReader It's known as the Shinichi-Holmes effect: at least here they usually survive...
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You know I don't think I've seen a shrine on this island, maybe they've pissed off the local god by ignoring it so now it's giving all the islanders a ton of diseases.
It focuses on Kuni in particular (isn't he also the appendicitis kid?) and you'd think it's because he found the old shrine and desecrated it somehow or something but it's really just because the god thinks Kuni is a pussy.
It focuses on Kuni in particular (isn't he also the appendicitis kid?) and you'd think it's because he found the old shrine and desecrated it somehow or something but it's really just because the god thinks Kuni is a pussy.
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@LoLyeah Dengue is practically nonexistant in Japan despite sitting next to its hotbed; it was 70 years between their two most recent outbreaks, and even those were of small in scale compared to the rest of the Pacific subtropics. It typically comes in from tourists from the Asian mainland, which this island is sort of depicted as having none of- they can't even pull in locals from the Japanese mainland as tourists. Also dengue hemorrhagic fever, ie the low platelet count and plasma leakage, is a rare complication, not part of the standard clinical course. The normal course is quite painful headaches and body pains (the latter being why it's also known as breakbone fever) along with the iconic measle-like rash and saddleback fever
@Brave_SJ it was Hara's son Takehiro who had appendicitis at the beginning of the series. Kuni is one of his friends typically depicted with him; as the temp mentions, he was the one impaled by an umbrella, which was when the muckraking reporter showed up to spread his unverified rumors about Dr Goto; said impaling happened when they were all caught in a mudslide due to the heavy rain.
@Brave_SJ it was Hara's son Takehiro who had appendicitis at the beginning of the series. Kuni is one of his friends typically depicted with him; as the temp mentions, he was the one impaled by an umbrella, which was when the muckraking reporter showed up to spread his unverified rumors about Dr Goto; said impaling happened when they were all caught in a mudslide due to the heavy rain.
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@TheGTF I see, I forgot that it's Japan. My country is in tropical region, so dengue is still common here. Yeah, the iconic clinical signs are measle-like rash, and sudden high fever. And I know it's rare complication, but it's Dr. Koto manga we're talking about not reality haha. Therefore that's why I suspect it's a Dengue.
For now we only got: low platelet count with bruises (first appear after "wrestling"), history of trauma (umbrella incident), was in fever before, and hematemesis (I guess it's too much for hemoptysis.)
For now we only got: low platelet count with bruises (first appear after "wrestling"), history of trauma (umbrella incident), was in fever before, and hematemesis (I guess it's too much for hemoptysis.)
@TheGTF
I'm from a country where dengue is pretty common too and in fact many patients have no symptom beside malaise and high fever. Rash may or may not develop. There are warning signs, such as abdominal pain or bone-breaking pain but absence of these symptoms does not rule out dengue fever. In fact, in patients with fever > 3 days with no obvious cause, a CBC would be taken daily until we are sure that it isn't dengue fever. A low platelet count is typically among the first obvious sign of dengue fever. All dengue fever may not proceed to dengue hemorrhagic fever but it is not that uncommon in endemic area and very much a thing I have to always be on the lookout for. If the platelet is abnormally low, we admit the patient for daily CBC and monitor for signs of complication such as rising hematocrit. The critical period, where dengue fever would most likely proceed to dengue hemorrhagic fever, would be the moment where the fever settle down for the first time (usually 3-5 days after the onset of fever but be aware of atypical presentation). After that, if all is well, the patient will enter the convalescence phase.
There was an outbreak in Thailand not long ago and many children's life were lost as a result.
I'm from a country where dengue is pretty common too and in fact many patients have no symptom beside malaise and high fever. Rash may or may not develop. There are warning signs, such as abdominal pain or bone-breaking pain but absence of these symptoms does not rule out dengue fever. In fact, in patients with fever > 3 days with no obvious cause, a CBC would be taken daily until we are sure that it isn't dengue fever. A low platelet count is typically among the first obvious sign of dengue fever. All dengue fever may not proceed to dengue hemorrhagic fever but it is not that uncommon in endemic area and very much a thing I have to always be on the lookout for. If the platelet is abnormally low, we admit the patient for daily CBC and monitor for signs of complication such as rising hematocrit. The critical period, where dengue fever would most likely proceed to dengue hemorrhagic fever, would be the moment where the fever settle down for the first time (usually 3-5 days after the onset of fever but be aware of atypical presentation). After that, if all is well, the patient will enter the convalescence phase.
There was an outbreak in Thailand not long ago and many children's life were lost as a result.
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@19012537 Not like I am not aware of that, but it's good for the rest of the class. I'm just saying, people act like hemorrhagic fever is the norm when it's not, severe dengue is a comparatively small percentage of the total cases per year; and dengue runs fairly rampant across mainland Pacific Asia, the total cases per year is rather high across the world, as I am sure you will affirm. But that being said, somehow Japan has stayed very insulated from it despite sitting right next to it's primary venue of spread- the last two recent outbreaks were 2014 and 1945. Isolated infections that happened between those incidents were, naturally, tied to tourism to/from the mainland. This setting doesn't have that, these people barely ever leave their remote and isolated island and hardly anybody ever comes to it.
I don't deny many cases have uncomplicated, nondescript symptoms at first; the incubation period is long enough for Kuni to have been mistaken to have just a cold 2 weeks prior and it now is blowing up. I just will hope the story as a good explanation for HOW he could have contracted it if that's the scenario it's running with. Thus far the bulk of the problems have been reasonable for the setting- appendicitis, older people with health problems caused by high blood pressure (hypertension has been the cause of problems for several of the characters thus far), allergic reactions, snake bites, cancers, physical traumas from accidents like the mudslides or cliff falls, etc. Even Shige's son's arm getting blown off wasn't THAT unbelievable because there actually is still some unexploded ordinance sitting out in the waters that get fished up in the nets from time to time- even Shige remembers fishing up a bomb before, though it was only once and a long time ago. All things considered, most of this island was established early on to be a ticking time bomb of health problems due to their distrust of doctors before Goto arrived and won them over.
To me, it being dengue for this setting is on par with all the very regionally exclusive diseases House somehow ends up treating in New Jersey, on Caucasians who don't travel; or all the people who insist the host of Cells at Work has Sickle Cell Disease despite that being a genetic disorder that is nonexistent in Japan's very homogeneous gene pool (also putting aside AE3803 is constantly shown performing without problem the things sickled cells can't do well like squeezing through narrow blood vessels). But hey, we'll find out soon enough as to what Kuni's problem is.
I don't deny many cases have uncomplicated, nondescript symptoms at first; the incubation period is long enough for Kuni to have been mistaken to have just a cold 2 weeks prior and it now is blowing up. I just will hope the story as a good explanation for HOW he could have contracted it if that's the scenario it's running with. Thus far the bulk of the problems have been reasonable for the setting- appendicitis, older people with health problems caused by high blood pressure (hypertension has been the cause of problems for several of the characters thus far), allergic reactions, snake bites, cancers, physical traumas from accidents like the mudslides or cliff falls, etc. Even Shige's son's arm getting blown off wasn't THAT unbelievable because there actually is still some unexploded ordinance sitting out in the waters that get fished up in the nets from time to time- even Shige remembers fishing up a bomb before, though it was only once and a long time ago. All things considered, most of this island was established early on to be a ticking time bomb of health problems due to their distrust of doctors before Goto arrived and won them over.
To me, it being dengue for this setting is on par with all the very regionally exclusive diseases House somehow ends up treating in New Jersey, on Caucasians who don't travel; or all the people who insist the host of Cells at Work has Sickle Cell Disease despite that being a genetic disorder that is nonexistent in Japan's very homogeneous gene pool (also putting aside AE3803 is constantly shown performing without problem the things sickled cells can't do well like squeezing through narrow blood vessels). But hey, we'll find out soon enough as to what Kuni's problem is.
