💉💊Medical informations📚📝

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الدكتور مؤيد قاسم الشمري /طبيب الباطنيه الصدريه السكري 🌹❤️

عظم الله اجورنا وأجوركم.. بذكرى عاشوراء ايام الامام الحسين المبادئ والقيم
.. بمناسبه هذه الايام طبيب حب يساهم ويساعد الفقراء والناس ال محتاجه وذوي الشهداء من خلال مبادرة الفحص المجاني للناس بأول ٤ايام بشهر عاشوراء ابتداءا من اليوم..
حاولوا توصلون هالاعلان الاكثر عدد من الناس الفقراء والمحتاجين..
اسم الطبيب/الدكتور مؤيد قاسم الشمري
طبيب(الباطنيه القلبيه الصدريه السكري)

العنوان /النجف حي الجمعيه /شارع الوائلي قرب المستشفى الالماني..
موبايل الحجز /٠٧٨١٢٢٦١١٤١
او ٠٧٦٠١٦٨٥٤٤٩

#شارك_الاعلان
لفائده اكثر عدد من الناس 💗

متلازمة واردينبيرغ أو متلازمة واردينبيرج (Waardenberg Syndrome)

متلازمة نادرة بسبب طفرة جينية تصيب ١ من كل ٤٠ الف شخص في العالم ، يعد المرض مرضا وراثيا ينتقل عبر الاجيال ويمثل نسبة ٢-٥ % من الاسباب الخلقية للصمم.

تتميز ببعض العيوب الخلقية الشكلية مثل:
◀️ درجات مختلفة من الصمم.
◀️تباين واختلاف في لون العينين وبهتانها ( غالبا ما تكون احدى العيون ذات بؤبؤ ازرق ).
◀️ تصبغات وبهاق على الجلد وخصل من شعر مقدمة الرأس قد يتطور لاحقا الى شيب مبكر ( قبل عمر ال ٣٠ عام ).
◀️ قد تترافق مع اعراض اختلاجات في الجهاز العصبي او اضطرابات خلقية في العمود الفقري والجهاز الهضمي او في الانف والعينين.

يتم تشخيصها بالاعتماد على العلامات والاعراض التي تظهر على المرضى ، والفحوصات الجينية المخصصة.

لا يوجد علاج محدد لها وفقط علاج الاعراض والتشوهات المرافقة مثل اجهزة السمع المساعدة او الجراحة التقويمية التجميلية للتشوهات الخلقية.

Cardio-selective Beta-Blocker (B1)
(MEN BABA)

Metoprolol
Esmolol
Nebivolol
Betaxolol
Atenolol
Bisoprolol
Acebutolol

عجز القلب بكل محاوره ،وبشكل مبسط جدا

Heart Failure
Definition: is a condition in which the heart is unable to pump sufficient amount of blood to maintain blood flow to meet the body's demand.
-Mild to moderate degree be symptomatic during exercise.
-Sever degree symptomatic even during test.
Some classifications of heart failure:
1-according to pathophysiology :High ,low (COP) heart failure.
2-according to clinical presentation (signs,symptoms):left,right,biventricular heart failure.
3-according to management or onset :acute ,chronic heart failure.

[According to pathophysiological classification:]
Notes:
COP=Stroke volume×Heart rate
SV=End diastolic volume -End systolic volume
EDV:called preload,the volume and pressure of blood in ventricles at the end of diastole (dilation),so is the capacity of stretching.
ESV:called afterload,the volume and pressure of blood in ventricles during systole.
So is the force of contraction .
According to starling law: Force of contraction related directly to Capacity of stretching,
So when there is increase in preload ,there is related increasing in afterload .
Contractility:is intrinsic ability of myocardium for forceful contraction at given fiber length.
SV depends on:
1-preload,
2-afterload, >>any defect in these mechanisms lead to heart failure.
3-contractility,
A-Low COP heart failure:causes,
1-increase of preload,chronic volume overload:
-aortic ,mitral valves regurgitation (Lt HF).
-VSD,ASD (Right HF).
2-decrease of preload(inflow obstruction) :mitral,tricuspid valves stenosis.
3-increase of afterload (outflow obstruction):
-hypertension, aortic valve stenosis (Lt HF).
-Pulmonary hypertension ,pulmonary valve stenosis (Rt HF).
-diastolic dysfunction:constrictive pericarditis,restrictive cardiomyopathy,cardiac lemonade.
4-decrease contractility :
-MI.
-Myocarditis.
-Cardiomyopathies
5-arrythmias:[Atrial fibrillation,CHB,tachycardia]
Mechanisms:
1-hypertrophy of smooth muscle lead to obstruct the flow of coronary arteries lead to ischemia and necrosis and increase of demand.
2-decrease the preload lead to decrease the afterload.
3-decrease the contractility .
4-tachycardia leads to fatigue of myocardium and decrease filling time,
bradycardia ,decrease the contractility leads to heart failure even SV is normal.

B-High COP heart failure:
In condition that the body gets a hyper dynamic circulation:
1-Thyrotoxicosis.
2-Chronic sever anemia.
3-Beri-beri syndrom.
4-Paget’s disease of bone.
5-AV fistula.
In high COP Hf the pulse rate may be wide >60mmgh.
Note:Compensatory mechanism of body to activate RAAS,SNS in low COP lead to increase load on myocardium end by hypertrophy and ischemia.

[According to clinical presentation:]
1-left side HF:
Causes:[systemic HTN, valvular heart diseases,MI,CAD,AF,drugs or alcohol,myocarditis,cardiomyopathy,immune disorder]
Presentation:
-pulmonary oedem(crackles).
-hypoxia(SaPo2<90%).
-tachypnea.
-SOB.
-displaced Apex beat.
*cardiac asthma may occurs.
2-Right side HF:
Causes:[chronic lung disease^corpulmonale^,pulmonary hypertension,pulmonary valve stenosis,ASD,VSD,myocarditis,cardiomyopathy].
Pesentation:
-peripheral odema.
-ascites.
-elevated JVP.
-hepatospleenomegaly.
-ventricular heaven.


Management :
1-Investigation.
2Treatment.
Investigation:
1-X-ray: features of HF in x-ray are,
-enlargement of cardiac silhouette.
-septal or kerly B line .
-reticular shadow of alveolar odema.
-prominent of blood vessels of upper lobe of lung.
-enlargement of hilar vessels.
-cardiac-thoracislc ratio>0.5
-absence of costophrenic angle.
-splaying of carina>90degree
-convex LA appendage
-double density sign with distant from carina >7cm

2-Echo,
For assessment of severity ,determines if there is valvular heart disease,and in follow up.
3-Blood test:
-CBC.
-serum urea,creatinine.
-Hemoglobin,to exclude anemia.
-Thyroid fuction test,to exclude thyrotoxicosis,
-LFT,RFT.
-c-reactive protein.
-cardia

c markers of MI is suspected .

-electrolytes.hyponatremia is common.
-BNP,sensitive 85%,specific 84%.
*Poor prognostic of heart failure is [hyponatremia, BNP].
2-Treametnt
A-acute pulmonary odema
B-congestive heart failure,
-diuretics(loop,thiazide,potassium sparing)
-ACEI.
-ARBs.
-Beta blocker.
-digoxin,amiodarone,lvabraine.
-nitrate.hydralazine.
-new drug(Neprelisin inhibitors):increase bioavailability of NP,bradykinin,substance p.
*There are non pharmacological treatment includes:
[ICD,CRT,VAD,transplantation.]

Wisam.

وَمَنْ أَحْيَاهَا فَكَأَنَّمَا أَحْيَا النَّاسَ جَمِيعًا

اذا كنت مشافى من كورونا ادخل هنا واتبرع لوجه الله
واذا كنت رايد بلازما لحالة ادخل هنا وان شاءالله تلگه اللي تريده
انشر الرابط شگد ما تكدر لانقاذ روح

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معلومات خاطئة تصححها منظمة الصحة العالمية

الكل معرض للخطر🚷
فيرجى منكم الحذر🚫
الوقاية هي السبيل الوحيد🦠

مرحبا ..رمضان كريم ع الجميع ❤️🌸
للفائده حبيت أفيدكم تتوفر كمامات فلتر داخلي ..ب 4 الوان مختلفه أسود و أحمر و ابيض ورصاصي ..
تستخدم لاكثر م̷ـــِْن 10ايام مع التعقيم ..
للاستفسار والطلب

د.ليث
@layo4

نصائح للعاملون الصحيون