نسولف💜
@Alnuaisi_surgerybot
@Alnuaisi_surgerybot
AL-NUIASI SURGERY
@alnuaisi
شرح المواد الطبية 👩🏻⚕️👨🏻⚕️
Press the #Hashtag to reach faster
#anatomy_references
#histology_references
#biochemistry_references
#general_anatomy
#upper_limb
📚كروب المكتبة📚…https://t.me/oxfordlibrarye
@Alnuaisi_surgerybot بوت التواصل:
AL-NUIASI SURGERY (Arabic)
AL-NUIASI SURGERY هو قناة Telegram متخصصة في شرح المواد الطبية، بمشاركة معلومات مفصلة ومحدثة حول التشريح والنسيج الطبي والكيمياء الحيوية. القناة تقدم مجموعة واسعة من المراجع والمصادر للطلاب والمهنيين في مجال الطب. يمكنك الوصول إلى المعلومات بشكل أسرع عن طريق الضغط على الوسوم مثل #anatomy_references #histology_references #biochemistry_references #general_anatomy #upper_limb. بالإضافة إلى ذلك، يمكنك الانضمام إلى كروب المكتبة لمزيد من الموارد والمناقشات. لا تفوت فرصة الاستفادة من بعض أفضل المعلومات الطبية على الإطلاق، انضم اليوم إلى AL-NUIASI SURGERY على Telegram! @alnuaisi
AL-NUIASI SURGERY
12 Jan, 21:34
🔥🔥🔥
شهر الثاني فبراير القادم لن يتكرر في حياتك مرة أخرى ، لأن فبراير هذا العام يحتوي على:
4 أيام أحد
4 أيام إثنين
4 أيام ثلاثاء
4 أيام أربعاء
4 أيام خميس
4 أيام جمعة
4 أيام سبت
وهذا يحدث مرة كل 823 سنة ويُسمى بـ "فبراير المعجزة".
شهر الثاني فبراير القادم لن يتكرر في حياتك مرة أخرى ، لأن فبراير هذا العام يحتوي على:
4 أيام أحد
4 أيام إثنين
4 أيام ثلاثاء
4 أيام أربعاء
4 أيام خميس
4 أيام جمعة
4 أيام سبت
وهذا يحدث مرة كل 823 سنة ويُسمى بـ "فبراير المعجزة".
AL-NUIASI SURGERY
07 Jan, 17:06
https://forms.gle/xXUD5n8xqgRSoipR7
شباب هذا بحث تخرجي
اذا ممكن تملونه ولكم الاجر والثواب
شباب هذا بحث تخرجي
اذا ممكن تملونه ولكم الاجر والثواب
AL-NUIASI SURGERY
07 Jan, 17:04
قد تَراها تَتعّقد وَلكِنّها تَترتبُ بِطريقَة أُخْرى لَطفهُ يِجري ، وَعبدهُ لَا يدرِي ، أطمئن🤍 .
AL-NUIASI SURGERY
02 Jan, 08:23
توفر في متجر ضرغام
@alsafi_1999
اقلام ابل وكافة اكسسوارات وبالضمان🔥
@alsafi_1999
اقلام ابل وكافة اكسسوارات وبالضمان🔥
AL-NUIASI SURGERY
08 Dec, 20:39
السلام عليكم
شباب هذا بحث التخرج اذا تكدرون تشاركون بيه ماياخذ من وقتكم
https://docs.google.com/forms/d/e/1FAIpQLSeAzH2kQEvHwavUwqwNXZYTRXFZwtF_ku5eu8Mwd_0iGCiTrw/viewform?usp=sf_link
شباب هذا بحث التخرج اذا تكدرون تشاركون بيه ماياخذ من وقتكم
https://docs.google.com/forms/d/e/1FAIpQLSeAzH2kQEvHwavUwqwNXZYTRXFZwtF_ku5eu8Mwd_0iGCiTrw/viewform?usp=sf_link
AL-NUIASI SURGERY
25 Nov, 19:07
🚨 indication of epinephrine is “CASH”, which encompasses the main CASH:
C: Cardiac Arrest(ACLS)
اخذ من ابو 1:10,000
سيسي او نص وانطيه iv
A: Anaphylaxis
اخذ من ابو 1:1000
نص سيسي im
S: Severe Asthma
اخذ من ابو 1:1000
وانطي نص cc
Subcutaneous
H: Hypotension
اخذ من 1:100,000
وانطيه 1cc iv كل دقيقه
C: Cardiac Arrest(ACLS)
اخذ من ابو 1:10,000
سيسي او نص وانطيه iv
A: Anaphylaxis
اخذ من ابو 1:1000
نص سيسي im
S: Severe Asthma
اخذ من ابو 1:1000
وانطي نص cc
Subcutaneous
H: Hypotension
اخذ من 1:100,000
وانطيه 1cc iv كل دقيقه
AL-NUIASI SURGERY
23 Nov, 19:50
#_hypertention@AlNuaisi
#_emergency@AlNuaisi
🚨mnemonic for antihypertensive drugs that are safe in pregnancy is “Hypertensive Moms Love Nifedipine”:
1. H - Hydralazine
2. M - Methyldopa
3. L - Labetalol
4. N - Nifedipine
#_emergency@AlNuaisi
🚨mnemonic for antihypertensive drugs that are safe in pregnancy is “Hypertensive Moms Love Nifedipine”:
2. M - Methyldopa
3. L - Labetalol
4. N - Nifedipine
AL-NUIASI SURGERY
12 Nov, 16:14
#_سؤال@AlNuaisi
شاب رياضي كان يلعب طبيعي وماعنده مشاكل اللي صار فجأة توفه🚨
What’s ddx:⤵️
@Alnuaisi_surgerybot
شاب رياضي كان يلعب طبيعي وماعنده مشاكل اللي صار فجأة توفه🚨
What’s ddx:⤵️
@Alnuaisi_surgerybot
AL-NUIASI SURGERY
11 Nov, 21:57
📌مفاتيح حل كيسات الإمتحان الوزاري كل كيس بالامتحان اخذ منه فقط المهم وجاوب.
#_Cardiology@AlNuaisi
CARDIOLOGY (PROBLEM SOLVING).
#Cases
1. S1+S2 +S3 sound +tachycardia = gallop rhythm ➡️ Acute heart failure.
✨
✨
2. Asymmetric pulses in the upper extremities with absent or weak pulses in the lower extremities; harsh systolic murmur
between the scapulae
Radio radial, Radio femoral delay plus
Rib notching on CXR.
=Coarctation of the aorta
✨
3. Costochondral pain
Sharp localized pain in the anterior chest
that is reproducible with palpation
All other history, invx normal.
✨
4. Atrial flutter.
EKG showing regular undulation
(sawtooth pattern) in the baseline with an
atrial rate of 280–350/min
Heart rate more than 120 bpm
Usually asymptomatic, but may
experience palpitations, syncope, and
lightheadedness with higher heart rates
✨
5. Torsades de pointes (TdP)
A polymorphic ventricular tachycardia with QRS complexes that progressively
change direction
A prolonged QT internal.
✨
6. Narrow QRS,absence P wave, tachycardia
Heart rate more than 120 bpm.
=AVNRT
💡
7. Undulating baseline with no identifiable
P waves or QRS complexes.
=Ventricular fibrillation
💡
8. Ventricular tachycardia
EKG showing a series of 3 or more successive ventricular contractions (PVCs)
with a wide QRS (usually 120 ms) at a
rate of 100–250 bpm, absence P wave.
✨💡
9. Bee stings, consumption of nuts or shellfish presented with
acute onset generalized rash, flushing, angioedema, headache, and
near syncope, hypotension, tachycardia.
=Anaphylactic shock
✨💡✒️
10. Cool, clammy skin; oliguria; anxiety; confusion, tachycardia, increased vascular
resistance, hypotension
📌History of mi.
=Cardiogenic shock.
#Cardiology
#Cases.
#وزاري
#_Cardiology@AlNuaisi
CARDIOLOGY (PROBLEM SOLVING).
#Cases
1. S1+S2 +S3 sound +tachycardia = gallop rhythm ➡️ Acute heart failure.
✨
✨
2. Asymmetric pulses in the upper extremities with absent or weak pulses in the lower extremities; harsh systolic murmur
between the scapulae
Radio radial, Radio femoral delay plus
Rib notching on CXR.
=Coarctation of the aorta
✨
3. Costochondral pain
Sharp localized pain in the anterior chest
that is reproducible with palpation
All other history, invx normal.
✨
4. Atrial flutter.
EKG showing regular undulation
(sawtooth pattern) in the baseline with an
atrial rate of 280–350/min
Heart rate more than 120 bpm
Usually asymptomatic, but may
experience palpitations, syncope, and
lightheadedness with higher heart rates
✨
5. Torsades de pointes (TdP)
A polymorphic ventricular tachycardia with QRS complexes that progressively
change direction
A prolonged QT internal.
✨
6. Narrow QRS,absence P wave, tachycardia
Heart rate more than 120 bpm.
=AVNRT
💡
7. Undulating baseline with no identifiable
P waves or QRS complexes.
=Ventricular fibrillation
💡
8. Ventricular tachycardia
EKG showing a series of 3 or more successive ventricular contractions (PVCs)
with a wide QRS (usually 120 ms) at a
rate of 100–250 bpm, absence P wave.
✨💡
9. Bee stings, consumption of nuts or shellfish presented with
acute onset generalized rash, flushing, angioedema, headache, and
near syncope, hypotension, tachycardia.
=Anaphylactic shock
✨💡✒️
10. Cool, clammy skin; oliguria; anxiety; confusion, tachycardia, increased vascular
resistance, hypotension
📌History of mi.
=Cardiogenic shock.
#Cardiology
#Cases.
#وزاري
AL-NUIASI SURGERY
11 Nov, 21:55
📌مفاتيح حل كيسات الإمتحان الوزاري كل كيس بالامتحان اخذ منه فقط المهم وجاوب.
#_Cardiology@AlNuaisi
CARDIOLOGY (PROBLEM SOLVING).
#Cases
Ddx of Chest pain + ST segment
Elevation
• Transmural myocardial infarction
• Prinzmetal angina.
• Pericarditis.
✒️✒️✒️✒️✒️✒️
1) ANGINA PECTORIS
Old male, smoker or e' hyperlipidemia.
retro-sternal chest pain, ↑ e' exercise,↓ by nitrates and rest, <30 min.
ECG = ↓ST segment.
ST depression
S. Troponin negative
💡💡💡
2) VARIANT ANGINA
Prinzmetal angina=
Young age, no risk factor.
Retro-sternal chest pain not related to exertion.
ECG = ↑ ST segment.⬆️
ST elevation
S. Troponin negative
📌📌📌
3) MYOCARDIAL INFARCTION
old male, smoker + sever chest pain at rest + ↑ ST segment.
ST elevation +-
S. Troponin positive ⬆️⬆️
📌• If complicated with Pulmonary odema dyspnea, orthopnea, pink frothy sputum, sense of impending death.
Bubbling crepitation all over the chest.
💡💡💡💡
4) RHEUMATIC FEVER
5-15 yrs old pt, sore throat (tonsillitis)
after 2-3 wks he developed asymmetrical arthritis, tachycardia, muffling of heart sounds, diastolic murmur.
Or 📌
Pansystolic Murmur ( Rheumatic Fever)
ECG↑ PR interval.
Prolonged PR interval ⬆️
📌📌📌📌
5) IEC = (FEVER + MURMUR)
Infective endocarditis
After a surgery or tooth extraction.
Fever in cardiac Patient . Rheumatic Activity / IEC/Chest Infections.
💡💡💡💡
6) VIRAL PERICARDITIS Viremia (flu like
History of flu or sore throat then after weeks patient with chest pain aggrivated by cough,sneezing
Relieve by rest.
Or 📌
Chest Pain when Taking Breath , FHMA [ Fever , Headache , Malaise , Anorexia ] , Pericardium Rub ,
(Elevated ST concave shape in All Leads ( Viral Pericarditis
✒️✒️✒️✒️✒️✒️
7) . CONSTRICTIVE PERICARDITIS
Patient past history of T. B
dyspnea, orthopnea, (neck veins)
+pulsus paradoxus.
📌📌📌📌📌
8) HOCM = Young Athlete + Sudden Death after Exercise. (Autosomal dominant + murmur ↑ )
Ddx Aortic stenosis 📌
MI
Mitral valve prolapse
Arhythmiogenic RIGHT ventricular cardiomyopathy
✒️✒️✒️💡💡
9) PULMONARY EMBOLISM
Cough, dyspnea, sudden chest pain (pleurisy) unexplained tachypnea pulmonary embolism.
Tachycardia
History of prolonged sitting no movement
In Ecg tachycardia or RBBB or S1 Q3 T3
D. Dimer high ⬆️⬆️
📌📌📌📌📌
10) DISSECTING AORTIC ANEURISM
Old male, un-controlled HTN.
Severe acute chest pain radiating to the back.
unequal pulse volume on both sides.
unequal blood pressure on both sides
11) Left atrial MYXOMA = Young female e' recurrent
syncopal attacks.
In Echo thrombus in left atrial.
🔖🔖🔖
12) MV PROLAPSE = Young female e' atypical
chest pain, recurrent arrhythmiae'
palpitation.
Fever + Murmur + Any thromb- embolic manifest. eg. Hemi-plegia
📌📌📌
13.) Diabetic Patient , Epigastric Pain Not Relieved by Antacids , Nausea , Vomiting ( Inferior MI).
St elevation in leads II, III, AVf
💡💡💡💡
14.) Murmurs
✒️✒️✒️✒️✒️
Mitral valve stenosis = mid diastolic localized to apex.
✒️✒️✒️✒️
MR = Systolic ("pan Systolic murmur and radiating to Axilla.
💡💡💡💡💡
AR = early Diastolic murmur in 2nd Aortic Area & AS = ejection Systolic murmur Radiating to Carotid Apex + Syncope
🔖🔖🔖🔖
Irregular Pulse & Stroke = atrial fibrillation
💡💡💡💡
Ischemic Pain ( If > Half hour = MI ... If < Half hour = Angina)
✒️✒️✒️✏️✏️
15.)
Persistant ST Elevation in Patient with MI
( Myocardial Aneurysm [ Late Complication . of MI ]
🖊️🖊️🖊️
16. )
Symptoms of Low Cop + Muffled Heart sound + Low voltage ECG ( Pericardial Effusion).
Or cardiac tamponade if with Severe chest pain, SOB.
💡💡💡
17. )
Multiparus Female + Dyspnea & Chest Pain +.
Loud S2 ( Pulmonary HTN “ Repeated Showering.
🔖🔖🔖🔖
18. )
Chest Pain + Cough + Dyspnea + Hemoptysis + tinge of jaundice ( Pulmonary Infarction).
🔖🔖🔖
19.)
Acute Shock + Cyanosis + Dyspnea + Low cop ( Massive Pulmonary Embolism).
🧩🧩🧩
20. )
Long Standing “ severe ” HTN + Disturbed Conscious Level Without Lateralization
( Hypertensive Encephalopathy).
✨✨✨
21. Anorexia , Nausea , Vomiting & Blurring of Vision in Patient with HF ( Digitalis toxicity).
#وزاري
#_Cardiology@AlNuaisi
CARDIOLOGY (PROBLEM SOLVING).
#Cases
Ddx of Chest pain + ST segment
Elevation
• Transmural myocardial infarction
• Prinzmetal angina.
• Pericarditis.
✒️✒️✒️✒️✒️✒️
1) ANGINA PECTORIS
Old male, smoker or e' hyperlipidemia.
retro-sternal chest pain, ↑ e' exercise,↓ by nitrates and rest, <30 min.
ECG = ↓ST segment.
ST depression
S. Troponin negative
💡💡💡
2) VARIANT ANGINA
Prinzmetal angina=
Young age, no risk factor.
Retro-sternal chest pain not related to exertion.
ECG = ↑ ST segment.⬆️
ST elevation
S. Troponin negative
📌📌📌
3) MYOCARDIAL INFARCTION
old male, smoker + sever chest pain at rest + ↑ ST segment.
ST elevation +-
S. Troponin positive ⬆️⬆️
📌• If complicated with Pulmonary odema dyspnea, orthopnea, pink frothy sputum, sense of impending death.
Bubbling crepitation all over the chest.
💡💡💡💡
4) RHEUMATIC FEVER
5-15 yrs old pt, sore throat (tonsillitis)
after 2-3 wks he developed asymmetrical arthritis, tachycardia, muffling of heart sounds, diastolic murmur.
Or 📌
Pansystolic Murmur ( Rheumatic Fever)
ECG↑ PR interval.
Prolonged PR interval ⬆️
📌📌📌📌
5) IEC = (FEVER + MURMUR)
Infective endocarditis
After a surgery or tooth extraction.
Fever in cardiac Patient . Rheumatic Activity / IEC/Chest Infections.
💡💡💡💡
6) VIRAL PERICARDITIS Viremia (flu like
History of flu or sore throat then after weeks patient with chest pain aggrivated by cough,sneezing
Relieve by rest.
Or 📌
Chest Pain when Taking Breath , FHMA [ Fever , Headache , Malaise , Anorexia ] , Pericardium Rub ,
(Elevated ST concave shape in All Leads ( Viral Pericarditis
✒️✒️✒️✒️✒️✒️
7) . CONSTRICTIVE PERICARDITIS
Patient past history of T. B
dyspnea, orthopnea, (neck veins)
+pulsus paradoxus.
📌📌📌📌📌
8) HOCM = Young Athlete + Sudden Death after Exercise. (Autosomal dominant + murmur ↑ )
Ddx Aortic stenosis 📌
MI
Mitral valve prolapse
Arhythmiogenic RIGHT ventricular cardiomyopathy
✒️✒️✒️💡💡
9) PULMONARY EMBOLISM
Cough, dyspnea, sudden chest pain (pleurisy) unexplained tachypnea pulmonary embolism.
Tachycardia
History of prolonged sitting no movement
In Ecg tachycardia or RBBB or S1 Q3 T3
D. Dimer high ⬆️⬆️
📌📌📌📌📌
10) DISSECTING AORTIC ANEURISM
Old male, un-controlled HTN.
Severe acute chest pain radiating to the back.
unequal pulse volume on both sides.
unequal blood pressure on both sides
11) Left atrial MYXOMA = Young female e' recurrent
syncopal attacks.
In Echo thrombus in left atrial.
🔖🔖🔖
12) MV PROLAPSE = Young female e' atypical
chest pain, recurrent arrhythmiae'
palpitation.
Fever + Murmur + Any thromb- embolic manifest. eg. Hemi-plegia
📌📌📌
13.) Diabetic Patient , Epigastric Pain Not Relieved by Antacids , Nausea , Vomiting ( Inferior MI).
St elevation in leads II, III, AVf
💡💡💡💡
14.) Murmurs
✒️✒️✒️✒️✒️
Mitral valve stenosis = mid diastolic localized to apex.
✒️✒️✒️✒️
MR = Systolic ("pan Systolic murmur and radiating to Axilla.
💡💡💡💡💡
AR = early Diastolic murmur in 2nd Aortic Area & AS = ejection Systolic murmur Radiating to Carotid Apex + Syncope
🔖🔖🔖🔖
Irregular Pulse & Stroke = atrial fibrillation
💡💡💡💡
Ischemic Pain ( If > Half hour = MI ... If < Half hour = Angina)
✒️✒️✒️✏️✏️
15.)
Persistant ST Elevation in Patient with MI
( Myocardial Aneurysm [ Late Complication . of MI ]
🖊️🖊️🖊️
16. )
Symptoms of Low Cop + Muffled Heart sound + Low voltage ECG ( Pericardial Effusion).
Or cardiac tamponade if with Severe chest pain, SOB.
💡💡💡
17. )
Multiparus Female + Dyspnea & Chest Pain +.
Loud S2 ( Pulmonary HTN “ Repeated Showering.
🔖🔖🔖🔖
18. )
Chest Pain + Cough + Dyspnea + Hemoptysis + tinge of jaundice ( Pulmonary Infarction).
🔖🔖🔖
19.)
Acute Shock + Cyanosis + Dyspnea + Low cop ( Massive Pulmonary Embolism).
🧩🧩🧩
20. )
Long Standing “ severe ” HTN + Disturbed Conscious Level Without Lateralization
( Hypertensive Encephalopathy).
✨✨✨
21. Anorexia , Nausea , Vomiting & Blurring of Vision in Patient with HF ( Digitalis toxicity).
#وزاري
AL-NUIASI SURGERY
11 Nov, 21:38
🚨 treatment of STEMI 🫀
1 Aspirin tab 300 mg bolus then 100mg الاسبرين لازم يكرطهن .
2-Ticagrelol tab 180 mg bolus then 90mg *2.
3-Metoprolol (5-15 )mg IV or (50-100 )mg PO ( bolus) then 50 mg 1*2 PO
4-(Actilyse) (100)mg total dose
- هنا نقسم الجرعه ثلاثة
١ _خلا دقيقتين ننطي (ملغ١٥)
٢_خلا نصف ساعه ننطي (ملغ٥٠)
٣_ ننطي اخر ساعه (ملغ٣٥)
هنا كملنه ال 100mg.
5-Enoxaparin 6000 iu 1*2 SC.
6-Atorvastatin 40-80 mg
7-intravenous Nitrates (glyceryl trinitrate 0.6–1.2 mg/hr
8-enalapril (10 mg twice daily).
1 Aspirin tab 300 mg bolus then 100mg الاسبرين لازم يكرطهن .
2-Ticagrelol tab 180 mg bolus then 90mg *2.
3-Metoprolol (5-15 )mg IV or (50-100 )mg PO ( bolus) then 50 mg 1*2 PO
4-(Actilyse) (100)mg total dose
- هنا نقسم الجرعه ثلاثة
١ _خلا دقيقتين ننطي (ملغ١٥)
٢_خلا نصف ساعه ننطي (ملغ٥٠)
٣_ ننطي اخر ساعه (ملغ٣٥)
هنا كملنه ال 100mg.
5-Enoxaparin 6000 iu 1*2 SC.
6-Atorvastatin 40-80 mg
7-intravenous Nitrates (glyceryl trinitrate 0.6–1.2 mg/hr
8-enalapril (10 mg twice daily).
AL-NUIASI SURGERY
11 Nov, 21:22
#_approach
🚨 STEMI ….
جداً مهم ‼️
1-For patients < 120 minutes away from a PCI-capable facility
مريضنا عنده ستمي ووقت الاحوله لل pci اقل من 120 دقيقه شتسوي؟⤵️
A-Immediate cardiology consult and evaluation for emergency revascularization
B-Start medical therapy (Antiplatelet and anticoagulants)
_________
2-For patients > 120 minutes away from a PCI-capable facility and symptom onset < 12 hours
مريضنا عنده ستمي ووقت الاحوله لل pci اكثر من 120 دقيقه شتسوي؟⤵️
A-Immediate cardiology consult, even if no PCI is available
B-Check for absolute and relative contraindications to fibrinolysis
C-If no absolute contraindications present: Administer fibrinolysis
D-Start medical therapy (Antiplatelet and antocoagulants)ا عنده ستمي ووقاحوله لل pci اكثر
3-For all patients with STEMI
A-Adjunctive medical therapy for ACS
B-Continuous telemetry, serial ECG, and serum troponins every 4–6 hours
C-ICU level of care
🚨 STEMI ….
جداً مهم ‼️
1-For patients < 120 minutes away from a PCI-capable facility
مريضنا عنده ستمي ووقت الاحوله لل pci اقل من 120 دقيقه شتسوي؟⤵️
A-Immediate cardiology consult and evaluation for emergency revascularization
B-Start medical therapy (Antiplatelet and anticoagulants)
_________
2-For patients > 120 minutes away from a PCI-capable facility and symptom onset < 12 hours
مريضنا عنده ستمي ووقت الاحوله لل pci اكثر من 120 دقيقه شتسوي؟⤵️
A-Immediate cardiology consult, even if no PCI is available
B-Check for absolute and relative contraindications to fibrinolysis
C-If no absolute contraindications present: Administer fibrinolysis
D-Start medical therapy (Antiplatelet and antocoagulants)ا عنده ستمي ووقاحوله لل pci اكثر
3-For all patients with STEMI
A-Adjunctive medical therapy for ACS
B-Continuous telemetry, serial ECG, and serum troponins every 4–6 hours
C-ICU level of care
AL-NUIASI SURGERY
10 Nov, 00:32
#_pulmonary_embolism
DDX: of deep venous thrombosis (DVT)
Remember as ABC:
-A musculoskeletal injury.
-Baker’s cyst rupture.
-Cellulitis.
DDX: of deep venous thrombosis (DVT)
Remember as ABC:
-Baker’s cyst rupture.
-Cellulitis.
AL-NUIASI SURGERY
10 Nov, 00:27
🏥#_pulmonary_embolism
عدنه clot سدت pulmonary artery, اهم سبب هو (DVT) +
Causes remember (FAT-BATخفاش)= (fat,air.E, thrombus- bacterial,amniotic fluid,tumor).
وخصوصاً ذولي اليكعدون هواي بالسيارات او ع bed .
——-
,، شلون راح يجيني للطوارى:
🚨signs and symptoms :
1- acute dyspnea من يرتاح زين، من يمشي تزداد
2- pleuritic chest pain+ hemoptysis 🩸 اذا صار عنده pulmonary infraction
3-common (tachycardia +tachypnea)
4-coughing ( dilation in PA)
———————————
📍dx:
1- CT-pulmonary angiogram(gold standard✅) +D-diamar+ + V/Q scan
2-ECg pattern (S1Q3T3)
3-ABG(hypoxemia)
4- thrompothilia screening (age<50)
—————————
🫁 treatment:
• Acute:
-Oxygen
-IV fluids
-Thrombolysis , e.g. alteplase if massive PE or haemodynamically unstable.
-Low molecular weight heparin.
• Long-term:
-Anticoagulation
-Inferior vena cava filter
———————-
‼️complications:
Remember (SAP4)
-Sudden death.
-Arrhythmia.
-Pulmonary infarction.
-Pleural effusion.
-Paradoxical embolism.
-Pulmonary hypertension
——————
عدنه clot سدت pulmonary artery, اهم سبب هو (DVT) +
Causes remember (FAT-BATخفاش)= (
وخصوصاً ذولي اليكعدون هواي بالسيارات او ع bed .
——-
,، شلون راح يجيني للطوارى:
🚨signs and symptoms :
1- acute dyspnea من يرتاح زين، من يمشي تزداد
2- pleuritic chest pain+ hemoptysis 🩸 اذا صار عنده pulmonary infraction
3-common (tachycardia +tachypnea)
4-coughing ( dilation in PA)
———————————
📍dx:
1- CT-pulmonary angiogram(gold standard✅) +D-diamar+ + V/Q scan
2-ECg pattern (S1Q3T3)
3-ABG(hypoxemia)
4- thrompothilia screening (age<50)
—————————
🫁 treatment:
• Acute:
-Oxygen
-IV fluids
-Thrombolysis , e.g. alteplase if massive PE or haemodynamically unstable.
-Low molecular weight heparin.
• Long-term:
-Anticoagulation
-Inferior vena cava filter
———————-
‼️complications:
Remember (SAP4)
-Sudden death.
-Arrhythmia.
-Pulmonary infarction.
-Pleural effusion.
-Paradoxical embolism.
-Pulmonary hypertension
——————
AL-NUIASI SURGERY
09 Nov, 23:54
🚨Life threatening causes chest pain?
Remember :(PET-MAC) ماك حيوان اليف 🐈
P: pulmonary.E
E:Oesophageal rupture
T: tension pneumothorax
M: MI
A: aortic dissection
C; cardiac temponad.
Remember :(PET-MAC) ماك حيوان اليف 🐈
P: pulmonary.E
E:Oesophageal rupture
T: tension pneumothorax
M: MI
A: aortic dissection
C; cardiac temponad.
AL-NUIASI SURGERY
08 Nov, 14:25
🚨#_Asthma
🏥Acute asthma treatment:
هنا اكو تسلسل مهم لازم تبدي بيه
O2+saba+ipratrop+oral prednisone.
🫁Signs and symptoms
-Dyspnea , Chest Tightness , Cough , Clear Sputum , Triggered by Exercise
🚨( Bronchial Asthma).
-Dyspnea , Cough , Wheezes 1 Hour after Aspirin ( 🍓Aspirin Induced Asthma).
___________
📍How to distinguish bet astma and copd?
نفرق بينهن من خلال فحص DLCO⤵️
If (N or elevated)=asthma
If (decrease)= COPD
____
شغلات مهمه لازم تسأل البيشنت مالتك ب اسما!!
وهي:
اذا عنده (sinusitis +GERD+ OSA+Atopy)
شكد متنطيه علاج ميصير زين اذا متتخلص من ذني✅
+ سويله education قبل لتنطيه العلاجات
——-
Remember:
Side-effects of steroids:
. Weight gain.
• Thinning of the skin.
• Striae formation. Cataracts.
• Cushing’s syndrome
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
🏥Acute asthma treatment:
هنا اكو تسلسل مهم لازم تبدي بيه
🫁Signs and symptoms
-Dyspnea , Chest Tightness , Cough , Clear Sputum , Triggered by Exercise
🚨( Bronchial Asthma).
-Dyspnea , Cough , Wheezes 1 Hour after Aspirin ( 🍓Aspirin Induced Asthma).
___________
📍How to distinguish bet astma and copd?
نفرق بينهن من خلال فحص DLCO⤵️
If (N or elevated)=asthma
If (decrease)= COPD
____
شغلات مهمه لازم تسأل البيشنت مالتك ب اسما!!
وهي:
اذا عنده (sinusitis +GERD+ OSA+Atopy)
شكد متنطيه علاج ميصير زين اذا متتخلص من ذني✅
+ سويله education قبل لتنطيه العلاجات
——-
Remember:
Side-effects of steroids:
. Weight gain.
• Thinning of the skin.
• Striae formation. Cataracts.
• Cushing’s syndrome
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
AL-NUIASI SURGERY
08 Nov, 13:05
أعتمدواا عليه مرتبه الكيسات وكل السستمات🚨🔥
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
AL-NUIASI SURGERY
08 Nov, 11:38
🔮مفاتيح حل حالات الجهاز التنفسي Respiratory cases
#RESPIRATORY CASES
🩻🩻🩻🩻🩻🩻🩻🩻🩻
1. Dyspnea , Chest Tightness , Cough , Clear Sputum , Triggered by Exercise
( Bronchial Asthma).
🩻🩻🩻
2. Dyspnea , Cough , Wheezes 1 Hour after Aspirin ( Aspirin Induced Asthma).
🩻🩻
3. *Cough , Yellow Sputum , Dyspnea , Heavy Smoker , Hyper-Resonance of Lung ,
Expiratory Wheezes ( COPD).
🩻🩻🩻
4. Acute Dyspnea , Shortness of Breath , Sitting Too Much Time in Bed or Bus , Taking
( Pulmonary Embolism).
🩻🩻
5. Tall , Thin , Sudden Dyspnea , Smoker , Right Sided Chest Pain
( 1ry Spontaneous Pneumothorax).
🩻🩻🩻
6. Yellow Sputum , Dullness , XCR: Infiltration of Left Lower Lobe
( Community Acquired Pneumonia).
🩻🩻🩻
7. Hemoptysis , Chronic Bronchitis , Weight Loss , Heavy Smoker , Clubbing
( Bronchogenic Carcinoma).
🩻🩻🩻
8. History of Pneumonia , Dullness , Blunt Costophrenic Angles
( Exudative Pleural Effusion).
🩻🩻🩻
9. Dyspnea , Dry cough , Facial Congestion , Bluish Tinge
( Superior Mediastinal Syndrome).
🩻🩻🩻
10. COPD Patient Develops Sudden Stabbing Chest Pain ( Simple Pneumothorax).
🩻🩻🩻
11. Sputum-:
Smoker [ Chronic Bronchitis ] + Hemoptysis ( Bronchogenis Carcinoma).
🩻🩻🩻
12. Smoker [ Chronic Bronchitis ] + Dyspnea + May be Wheezes & Excessive Sputum
( COPD).
🩻🩻
13. Hemoptysis + Loss of body weight + Night sweating ( TB).
🩻🩻🩻
14. Purulent sputum = Suppurative ,, If After Operation ( 1ry Lung Abcess).
🩻🩻🩻
15. Wheezy Chest in Young Age ( Bronchail Asthma).
🩻🩻🩻
16. Chest troubles (cough, dyspnea...etc) With polyurea, polydypsea & normal blood glucose →SARCOIDOSIS PRESENTED BY DI
🩻🩻
17) Chest troubles with HSM,LN enlargement& erythema nodosum, weight loss, night sweating
In chest x ray bilateral lymphadenopathy
→ SARCOIDOSIS
🩻🩻🩻
18 ) Past history of TB then exertional dyspnea POST TB FIBROSIS
🩻🩻🩻
19) Past history of TB then dyspnea, orthopnea, ascites = CONSTRICTIVE PERICARDITIS
🩻🩻🩻
20) Past history of TB then hypotension & hyper-pigmentation= Addinosin disease
🩻🩻
21) Past history of TB. then headache & neck rigidity➡️ =TB MENINGITIS
🩻
22) Past history of TB... abdominal distension with unilateral shifting dullness ASCITES LOCULATED TB=
🩻
23) DVT congested neck veins, LL edema, enlarged tender liver➡️ COR-PULMONALE DUE TO THROMBO-EMBOLIC P**
🩻
24) Cough, chest pain, SVC obstruction, Associated with Myasthenia gravis or pure red cell aplasia. CXR: Mass in superior mediastinum →THYMOMA➡️
🩻
25.) Old Male heavy smoker, change in Cough. Hemoptysis pattern + Clubbing
→BRONCHIECTASIS OR BR. CARCINOMA
🩻
26) Cirrhosis + no viral & autoimmune markers + Emphysema, ➡️ANTITRYPSIN DEFICIENCY
🩻
27) Chest disease LL edema &puffiness of eye
lids heavy proteinuria Complicated by
AMYLOIDOSIS KIDNEY (NEPHROTIC)➡️
Ddx
. 📌chronic lung abscess Bronchiectasis
. 📌Chronic empyema
. 📌TB
🩻
28) Young adult + sudden chest pain after exertion (driving bicycle)→ RUPTURE BLEB
🩻
29) COPD patient presented with
sudden chest pain
→PNEUMOTHORAX (RUPTURE BULLAE)
🩻🩻🩻🩻🩻🩻
30) SUDDEN DYSPNEA & CHEST PAIN
Different diagnosis
. 📌Pneumothorax
. 📌Myocardial infarction
. 📌Pulmonary embolism
🩻🩻🩻🩻🩻🩻
31) ACUTE CHEST PAIN & SHOCK
Different diagnosis
📌Tension pneumothorax.
📌Extensive myocardial infarction.
📌Massive pulmonary embolism.
📌Dissecting aortic aneurysm.
🩻🩻🩻🩻🩻🩻🩻
32) pt. with peptic ulcer..upper endoscope was done..on the 2 day... severe retro-sternal chest pain, crunching sound with the heart
Freely you have received; freely give.
beats...CXR: air around the hear pneumo mediastinum &➡️ Acute mediastinitis
🩻🩻🩻🩻🩻🩻
33) fever , dyspnea, chest pain, cough &expectoration & rusty/blood stained Sputum= PNEUMONIA
🩻🩻🩻🩻🩻🩻🩻🩻
34) PNEUMONIA NOT RESPONDING TO treatment ,
Atypical pneumonia (Legionella, Mycoplasma) Resistant organism eg staph(MRSA) Underlying disease eg:
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
#RESPIRATORY CASES
🩻🩻🩻🩻🩻🩻🩻🩻🩻
1. Dyspnea , Chest Tightness , Cough , Clear Sputum , Triggered by Exercise
( Bronchial Asthma).
🩻🩻🩻
2. Dyspnea , Cough , Wheezes 1 Hour after Aspirin ( Aspirin Induced Asthma).
🩻🩻
3. *Cough , Yellow Sputum , Dyspnea , Heavy Smoker , Hyper-Resonance of Lung ,
Expiratory Wheezes ( COPD).
🩻🩻🩻
4. Acute Dyspnea , Shortness of Breath , Sitting Too Much Time in Bed or Bus , Taking
( Pulmonary Embolism).
🩻🩻
5. Tall , Thin , Sudden Dyspnea , Smoker , Right Sided Chest Pain
( 1ry Spontaneous Pneumothorax).
🩻🩻🩻
6. Yellow Sputum , Dullness , XCR: Infiltration of Left Lower Lobe
( Community Acquired Pneumonia).
🩻🩻🩻
7. Hemoptysis , Chronic Bronchitis , Weight Loss , Heavy Smoker , Clubbing
( Bronchogenic Carcinoma).
🩻🩻🩻
8. History of Pneumonia , Dullness , Blunt Costophrenic Angles
( Exudative Pleural Effusion).
🩻🩻🩻
9. Dyspnea , Dry cough , Facial Congestion , Bluish Tinge
( Superior Mediastinal Syndrome).
🩻🩻🩻
10. COPD Patient Develops Sudden Stabbing Chest Pain ( Simple Pneumothorax).
🩻🩻🩻
11. Sputum-:
Smoker [ Chronic Bronchitis ] + Hemoptysis ( Bronchogenis Carcinoma).
🩻🩻🩻
12. Smoker [ Chronic Bronchitis ] + Dyspnea + May be Wheezes & Excessive Sputum
( COPD).
🩻🩻
13. Hemoptysis + Loss of body weight + Night sweating ( TB).
🩻🩻🩻
14. Purulent sputum = Suppurative ,, If After Operation ( 1ry Lung Abcess).
🩻🩻🩻
15. Wheezy Chest in Young Age ( Bronchail Asthma).
🩻🩻🩻
16. Chest troubles (cough, dyspnea...etc) With polyurea, polydypsea & normal blood glucose →SARCOIDOSIS PRESENTED BY DI
🩻🩻
17) Chest troubles with HSM,LN enlargement& erythema nodosum, weight loss, night sweating
In chest x ray bilateral lymphadenopathy
→ SARCOIDOSIS
🩻🩻🩻
18 ) Past history of TB then exertional dyspnea POST TB FIBROSIS
🩻🩻🩻
19) Past history of TB then dyspnea, orthopnea, ascites = CONSTRICTIVE PERICARDITIS
🩻🩻🩻
20) Past history of TB then hypotension & hyper-pigmentation= Addinosin disease
🩻🩻
21) Past history of TB. then headache & neck rigidity➡️ =TB MENINGITIS
🩻
22) Past history of TB... abdominal distension with unilateral shifting dullness ASCITES LOCULATED TB=
🩻
23) DVT congested neck veins, LL edema, enlarged tender liver➡️ COR-PULMONALE DUE TO THROMBO-EMBOLIC P**
🩻
24) Cough, chest pain, SVC obstruction, Associated with Myasthenia gravis or pure red cell aplasia. CXR: Mass in superior mediastinum →THYMOMA➡️
🩻
25.) Old Male heavy smoker, change in Cough. Hemoptysis pattern + Clubbing
→BRONCHIECTASIS OR BR. CARCINOMA
🩻
26) Cirrhosis + no viral & autoimmune markers + Emphysema, ➡️ANTITRYPSIN DEFICIENCY
🩻
27) Chest disease LL edema &puffiness of eye
lids heavy proteinuria Complicated by
AMYLOIDOSIS KIDNEY (NEPHROTIC)➡️
Ddx
. 📌chronic lung abscess Bronchiectasis
. 📌Chronic empyema
. 📌TB
🩻
28) Young adult + sudden chest pain after exertion (driving bicycle)→ RUPTURE BLEB
🩻
29) COPD patient presented with
sudden chest pain
→PNEUMOTHORAX (RUPTURE BULLAE)
🩻🩻🩻🩻🩻🩻
30) SUDDEN DYSPNEA & CHEST PAIN
Different diagnosis
. 📌Pneumothorax
. 📌Myocardial infarction
. 📌Pulmonary embolism
🩻🩻🩻🩻🩻🩻
31) ACUTE CHEST PAIN & SHOCK
Different diagnosis
📌Tension pneumothorax.
📌Extensive myocardial infarction.
📌Massive pulmonary embolism.
📌Dissecting aortic aneurysm.
🩻🩻🩻🩻🩻🩻🩻
32) pt. with peptic ulcer..upper endoscope was done..on the 2 day... severe retro-sternal chest pain, crunching sound with the heart
Freely you have received; freely give.
beats...CXR: air around the hear pneumo mediastinum &➡️ Acute mediastinitis
🩻🩻🩻🩻🩻🩻
33) fever , dyspnea, chest pain, cough &expectoration & rusty/blood stained Sputum= PNEUMONIA
🩻🩻🩻🩻🩻🩻🩻🩻
34) PNEUMONIA NOT RESPONDING TO treatment ,
Atypical pneumonia (Legionella, Mycoplasma) Resistant organism eg staph(MRSA) Underlying disease eg:
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
AL-NUIASI SURGERY
08 Nov, 11:23
Case Summary:
A 55-year-old male presents to the emergency department with a history of fever, productive cough with rust-colored sputum, and pleuritic chest pain for the past three days. The patient has a history of chronic smoking but no significant prior lung disease. Physical examination reveals decreased breath sounds and dullness to percussion over the right lower lung field.
Chest X-Ray Findings: your answer….⤵️
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
A 55-year-old male presents to the emergency department with a history of fever, productive cough with rust-colored sputum, and pleuritic chest pain for the past three days. The patient has a history of chronic smoking but no significant prior lung disease. Physical examination reveals decreased breath sounds and dullness to percussion over the right lower lung field.
Chest X-Ray Findings: your answer….⤵️
#_respiratory_system@AlNuaisi
Tel : @al_nuaisisurgery
#_لاتنسوا_امواتنا_بالدعاء.
AL-NUIASI SURGERY
29 Oct, 15:15
السلام عليكم
جبتلكم بيج اكسسوارات اجهزة كل الي تحتاجونه موجود
#قلم ايباد يدعم راحة اليد ضمان سنتين
#كفرات ايباد انواع من شركات اصلية
#هتفونات اصلية من شركة وكالة
#اقلام ابل وشاومي
#شاحن ابل وسامسونك وكالة
كل الي تاخذونه داخلة الضمان 3 سنوات ضمان حقيقي من الوصل
فقط التواصل ع حسابنا
https://www.instagram.com/drgam_store/profilecard/?igsh=NGJiNzNlYmk1ZXI5
جبتلكم بيج اكسسوارات اجهزة كل الي تحتاجونه موجود
#قلم ايباد يدعم راحة اليد ضمان سنتين
#كفرات ايباد انواع من شركات اصلية
#هتفونات اصلية من شركة وكالة
#اقلام ابل وشاومي
#شاحن ابل وسامسونك وكالة
كل الي تاخذونه داخلة الضمان 3 سنوات ضمان حقيقي من الوصل
فقط التواصل ع حسابنا
https://www.instagram.com/drgam_store/profilecard/?igsh=NGJiNzNlYmk1ZXI5
AL-NUIASI SURGERY
01 Sep, 23:24
https://vt.tiktok.com/ZS2FXJKyh/
ـــــــــ
عاجل❤️🔥❤️🔥❤️🔥
رواتب المجموعة الطبيه بعد تعديل سلم الرواتب😍😍😍
ـــــــــ
عاجل❤️🔥❤️🔥❤️🔥
رواتب المجموعة الطبيه بعد تعديل سلم الرواتب😍😍😍
AL-NUIASI SURGERY
18 Aug, 19:16
التعليم تعلن إطلاق استمارة التقديم إلى القبول المركزي
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
AL-NUIASI SURGERY
11 Aug, 22:41
AL-NUIASI SURGERY
03 Aug, 18:57
لماذا تعتبر ادوية ( اسبرين وفولتارين والبروفين: Nasid)
من contraindications
ب third trimester for pregnant 🤰?
@al_nuaisi : your answer!
من contraindications
ب third trimester for pregnant 🤰?
@al_nuaisi : your answer!
AL-NUIASI SURGERY
29 Jul, 22:56
Alnuaisi mnemonics 🇵🇸💜🇮🇶
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
AL-NUIASI SURGERY
26 Jun, 23:05
من بريد القناة :
_
السلام عليكم
عندنا دراسة عن عمليات القولون و محتاجين ممرض/ة في مستشفى الصدر التعليمي في النجف للانضمام الى الفريق
الي يشوف نفسه مهتم هذا الرابط https://docs.google.com/forms/d/e/1FAIpQLSeHyKivth2GMaYz95PP2tQhSLty___djvwS2S08tnCSqTxTtQ/viewform
_
السلام عليكم
عندنا دراسة عن عمليات القولون و محتاجين ممرض/ة في مستشفى الصدر التعليمي في النجف للانضمام الى الفريق
الي يشوف نفسه مهتم هذا الرابط https://docs.google.com/forms/d/e/1FAIpQLSeHyKivth2GMaYz95PP2tQhSLty___djvwS2S08tnCSqTxTtQ/viewform
AL-NUIASI SURGERY
26 Jun, 17:13
من بريد القناة:
السلام عليكم اني طالبة في جامعه الكفيل كلية طب م،ثالثة.
اريد بديل من جامعة العميد اذا ممكن
@Alnuaisi_surgerybot
السلام عليكم اني طالبة في جامعه الكفيل كلية طب م،ثالثة.
اريد بديل من جامعة العميد اذا ممكن
@Alnuaisi_surgerybot
AL-NUIASI SURGERY
15 Jun, 21:44
عيد مبارك 🎉
كل عام وأنتم إلى الله أقرب ولفعل الطاعات أسبق والى الجنة أرغب ✨
أدام الله السكينة في قلوبكم والمحبة في نفوسكم والابتسامة على وجوهكم 🫀
كل عام وأنتم إلى الله أقرب ولفعل الطاعات أسبق والى الجنة أرغب ✨
أدام الله السكينة في قلوبكم والمحبة في نفوسكم والابتسامة على وجوهكم 🫀
AL-NUIASI SURGERY
13 Jun, 22:54
برأيك منو اخطر اصابة ؟
Alnuaisi mnemonics 🇵🇸💜🇮🇶
Tel : @al_nuaisisurgery
Follow 🔻
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Alnuaisi mnemonics 🇵🇸💜🇮🇶
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AL-NUIASI SURGERY
11 Jun, 22:41
Alnuaisi mnemonics 🇵🇸💜🇮🇶
يستخدم التصوير بالرنين المغناطيسي (MRI): T1+T2
يسلط التصوير بالرنين المغناطيسي T1 الضوء على التشريح (anatomy)ويوفر صورًا واضحة ويظهر السوائل الداكنة(dark) ⚫️. من ناحية أخرى يركز التصوير بالرنين المغناطيسي T2 على علم الأمراض(pathology)، مما يجعل السوائل مشرقة (bright)⚪️، وهو مثالي لتصور الالتهاب والوذمة وبعض الإصابات.
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
يستخدم التصوير بالرنين المغناطيسي (MRI): T1+T2
يسلط التصوير بالرنين المغناطيسي T1 الضوء على التشريح (anatomy)ويوفر صورًا واضحة ويظهر السوائل الداكنة(dark) ⚫️. من ناحية أخرى يركز التصوير بالرنين المغناطيسي T2 على علم الأمراض(pathology)، مما يجعل السوائل مشرقة (bright)⚪️، وهو مثالي لتصور الالتهاب والوذمة وبعض الإصابات.
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
AL-NUIASI SURGERY
08 Jun, 23:11
Alnuaisi mnemonics 🇵🇸💜🇮🇶
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
Tel : @al_nuaisisurgery
Follow 🔻
Inst: https://www.instagram.com/med.nuaisi
#_لاتنسوا_امواتنا_بالدعاء
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