تقيوء الدم يكون غالبا دم طازج احمر او متغير مائلا للسواد كنتيجة نزف للدم من اعلى الجهاز الهضمي (المرئ ,المعدة وبداية الاثنى عشر ) وله #اسباب_كثيرة من اشهرها الناتج عن :
1-نزف دوالي المرئ والمعدة
2-التهاب وقرحة المعدة والاثنى عشر
3-التهاب المرئ وارتجاع المرئ
4-وجود اورام سرطانية في المرئ او المعدة او الاثنى عشر
5-اعتلال الية تخثر الدم او التناول غير المنضبط لمثبطات تخثر الدم (الاسبرين)
6-الافراط في تناول مسكنات الالم
كيفية التصرف #في_المنزل
1- الحفاظ على الثبات الانفعالي للتركيز في الامر والتصرف بحكمة
2- عدم اعطاء المريض اي شئ عن طريق الفم
3- الحفاظ على وضع المريض شبه جالس
4- التوجه الى اقرب مستشفى به طوارئ في اسرع وقت
#في_المستشفى
1- تركيب مدخلين وريديين (كانيولا) وسحب عينة دم لعمل صورة دم وووظائف كبد وكلى وسيولة
2- تركيب انبوب معدة (رايل) لتقييم كمية النزف وغسل المعدة
3- متابعة الوظائف الحيوية كل 15 دقيقة ولمدة ساعتين على الاقل
4- اعطاء محاليل وريدية (ودم مكدس حسب الحاجة)
5- استدعاء طبيب جهاز هضمي متخصص في اسرع وقت
يتم تقييم حالة المريض من بسيطة الى متوسطة او حرجة ,ويتم متابعته لفترة من الوقت او حجزه بالعناية المركزة او القسم الداخلي ., وفي حالة الحجز يتم تحضير المريض لعمل منظار جهاز هضمي علوي في اسرع وقت (خلال 12 ساعة)بعد استقرار حالته اولا او عمل المنظار اذا استمر النزف رغم اعطاء المحاليل والدم المكدس والادوية المناسبة
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
اعداد
د/ سيد احمد حنظل
مدرس (م) واخصائي الجهاز الهضمي والكبد
كلية الطب ـ جامعة الفيوم
تقيوء الدم يكون غالبا دم طازج احمر او متغير مائلا للسواد كنتيجة نزف للدم من اعلى الجهاز الهضمي (المرئ ,المعدة وبداية الاثنى عشر ) وله #اسباب_كثيرة من اشهرها الناتج عن :
1-نزف دوالي المرئ والمعدة
2-التهاب وقرحة المعدة والاثنى عشر
3-التهاب المرئ وارتجاع المرئ
4-وجود اورام سرطانية في المرئ او المعدة او الاثنى عشر
5-اعتلال الية تخثر الدم او التناول غير المنضبط لمثبطات تخثر الدم (الاسبرين)
6-الافراط في تناول مسكنات الالم
كيفية التصرف #في_المنزل
1- الحفاظ على الثبات الانفعالي للتركيز في الامر والتصرف بحكمة
2- عدم اعطاء المريض اي شئ عن طريق الفم
3- الحفاظ على وضع المريض شبه جالس
4- التوجه الى اقرب مستشفى به طوارئ في اسرع وقت
#في_المستشفى
1- تركيب مدخلين وريديين (كانيولا) وسحب عينة دم لعمل صورة دم وووظائف كبد وكلى وسيولة
2- تركيب انبوب معدة (رايل) لتقييم كمية النزف وغسل المعدة
3- متابعة الوظائف الحيوية كل 15 دقيقة ولمدة ساعتين على الاقل
4- اعطاء محاليل وريدية (ودم مكدس حسب الحاجة)
5- استدعاء طبيب جهاز هضمي متخصص في اسرع وقت
يتم تقييم حالة المريض من بسيطة الى متوسطة او حرجة ,ويتم متابعته لفترة من الوقت او حجزه بالعناية المركزة او القسم الداخلي ., وفي حالة الحجز يتم تحضير المريض لعمل منظار جهاز هضمي علوي في اسرع وقت (خلال 12 ساعة)بعد استقرار حالته اولا او عمل المنظار اذا استمر النزف رغم اعطاء المحاليل والدم المكدس والادوية المناسبة
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
اعداد
د/ سيد احمد حنظل
مدرس (م) واخصائي الجهاز الهضمي والكبد
كلية الطب ـ جامعة الفيوم
" يتميز الدكتور علي الربيعي بإيصال المعلومات بأسلوب مميز"
دورة انعاش العقل علي الربيعي ,علي الربيعي ويكيبيديا,علي الربيعي انعاش العقل,علي الربيعي السيرة الذاتية,علي الربيعي فيس بوك,
الشيخ الدكتور علي الربيعي في عيون طلابه ومتدربيه في دورة انعاش العقل
https://www.youtube.com/watch?v=7ite7D_J73Y
دورة انعاش العقل ومضاعفة الحفظ والإستيعاب الدكتور علي الربيعي
للاشتراك والتسجيل في دورة انعاش العقل ومضاعفة الحفظ لـ 100ضعف انقر الرابط التالي : http://www.aqleeat.net
للتسجيل فى دورة انعاش العقل ومضاعفة الحفظ يمكنكم التواصل معنا عن طريق حساباتنا التالية
الموقع الرسمي لـ " التدريبات العقلية " : www.aqleeat.com
التدريبات العقلية علي تويتر : www.twitter.com/AQLEEAT
التدريبات العقلية علي فيس بوك : www.facebook.com/aqlyat
التدريبات العقلية علي الساوند كلاود : www.soundcloud.com/aqleeat
للاستفسارات راسلونا على aqleeaat@gmail.com
Neo4j is a powerful and expressive tool for storing, querying and manipulating data. However modeling data as graphs is quite different from modeling data under a relational database. In this talk, Michael Hunger will cover modeling business domains using graphs and show how they can be persisted and queried in Neo4j. We'll contrast this approach with the relational model, and discuss the impact on complexity, flexibility and performance.
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
As an intern house officer, I prepared this presentation after I came across a rare case of dengue fever complicated by hemophagocytic lymphohistiocytosis (HLH). Dengue fever itself is a rare disease entity in the UAE, as a developed country; and the presence of such a complication merely added to the complexity of the diagnosis. Therefore, I am delighted to share this lively PowerPoint Presentation about dengue, which was initially supplemented with an interesting case presentation but was removed for confidentiality purposes when sharing the document. I hope you enjoy it!
PS: Use the slideshow button in Microsoft PowerPoint for the best experience.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
2. This presentation includes:
What is Dengue
Fever?
How does it
occur?
Epidemiology
of DENGUE
Fever.
Types of
Dengue fever.
Clinical
presentation of
Dengue fever.
Investigations
Treatment of
Dengue Fever.
9. Definition of DENGUE FEVER:
Dengue fever is a mosquito-borne tropical disease caused by the
dengue virus.
10. Epidemiology:
40% of the world’s
population are at risk of
Dengue.
Dengue is endemic in at
least 100 countries in
Asia, the Pacific, the
Americas, Africa, and
the Caribbean.
WHO estimates that 50 to
100 million infections
occur yearly, including
500,000 DHF cases.
22,000 deaths yearly,
mostly children.
11. Some Informations about DENGUE FEVER:
First outbreak: 1779
Became global problem : 1945
Causative agent : Dengue Virus
Vector: Aedes Mosquito
First case in Bangladesh : 2000
Affected this year : 1900
Fatality this year: 4
12. Dengue Fever at a glance :
Complications/ Cure
Fever last for averagely 4-5 days
Sings symptoms of Dengue
Within 14 days
Aedes Mosquito bite
13. Mechanism of Dengue Fever:
if not corrected , death
Hemorrhagic manifestation
Decreased Platelet count
Infection to stromal tissue of Bone marrow
Low BP
Fluid leakage
Increased permeability of capillaries
Fever and Flu like symptoms, myalgia
Release of Cytokines and interferons
Engulf by macrophase
Dengue Virus enters into body
Biting of Aedes Mosquito
14. Classification of Dengue fever:
It is classified according to degree of severity:
1. Dengue fever
2. DHF, Grade 1
3. DHF, Grade 2
4. DHF, Grade 3
5. DHF, Grade 4
Lab. Feature in
DF:
Leukopenia,
Thrombocytopenia,
no change in HCT
Lab. Features in
DHF & DSS:
Thrombocytopenia,
HCT raises ≥ 20%
15. Clinical Features of Dengue:
Symptoms:
Fever
Malaise
Vertigo
Weakness
Rash
Retro-orbital pain
Joint pain
Bodyache
Bleeding in any form
18. Helpful Investigations:
For Diagnosis ( Confirm):
Upto 4 days: NS1 Antigen ( Non-Structural)
5th day onward: Anti-dengue antibody IgG and IgM
For Management purpose:
CBC
Chest x-ray
Serum albumin: may be reduced
Prothombin time: may be elevated
Serum electrolyte: may be altered
For Exclusion:
MP test
To see the prognosis:
1. Platelet
2. Leukocytes
3. Hematocrit
19. Management of Dengue Fever:
1. Counselling
2. for Dengue fever:
Supportive management at home:
Rest
Antipyretic: only paracetamol
Fluids: more, including ORS
Food: Family diet
Referral knowledge to parents
When to take hospital:
Abdominal pain
Passage of black tarry stool
Bleeding in skin/nose/gums
Excessive sweating
Cold skin
20. 3. For Dengue hemorrhagic Fever and Dengue Shock Syndrome:
Major Objectives of Management:
Circulatory volume and hemodynamic status
Blood Osmolality
Fluid and Electrolyte balance
Prevention and treatment of complications
Treatment options:
Fluid replacement
Blood transfusion
21. Choice of fluids:
Crystalloids:
5% dextrose in isotonic normal saline
5% dextrose in half strength normal saline
5% dextrose in Ringer’s lactate solution
Colloids:
Dextran 40
Plasma expander e.g. haemaccel
Plasma
22. Fluid Replacement Algorithm:
DHF Grades 1 and 2:
Initial IV crystalloid 6ml/kg/hr- 2 hour
Improvement No improvement
Reduce IV, 3ml/kg/hr- 6 to 12 hr Crystalloid 10ml/kg/hr-2hr
Further improvement Improvement No improvement
Discontinue IV after 24 hr Reduce IV 6ml,3ml/kg/hr
HCT Raise: Colloid
H falls: Blood
23. DHF Grades 3 and 4
IV crystalloid 10-20 ml/kg/hr
Improvement no improvement
IV therapy reduce to 3 ml/kg/hr give oxygen
Further improvement HCT raise: give colloid
Discontinue IV after 24-48 hr HCT falls: Blood
24. DON’Ts in Dengue: Give aspirin or
NSAID
Give antibiotic
Give steroid
Change the rate
of infusion
Give transfusion
unless indicated
28. Prevention:
1. using
mosquito net
during sleeping
specially at
evening and
morning time.
2. Destroying
the habitant of
Aedes
mosquito
3. vaccination
against Dengue
4. Using
repellent
5. Using anti
mosquito
cream.
29. So, Keep the Aedes mosquito away,
be safe from Dengue !!!