(( لعلها المنجية )) 📚📔📝✍

Presentation of achalasia :- Dysphagia > the most common Regurgitation Chest pain Heartburn Loss of weight

Signs of achalasia on barium swallow :- Proximal diltation with distal narrowing like rat tail or bird beak appearence

Treatment of achalasia :- Young patient , early stage of achalasia > medical treatment :- Endoscopic botulinum toxin injection Ca channel blocker Nitroglycrine Patient not responding to medical treatment or patient with severe dysphagia > surgical treatment Name of operation is heller's cardiomyotomy ( division of longitudinal and circular muscles below the mucosa , leaving the mucosa intact ) + antireflux procedure ( nissen fundoplication ) 👍

Grading of achalasia according to the diameter of the oeophygus in the barium swallow :- Grade 1 : diameter less than 4 cm Grade 2 : 4 - 6 cm Grade 3 : more than 6 cm Grade 4 : segmoid oseophygus ( end stage achalasia ) esophygus sitting over the diaphragm Sigmoid esophygus is for esophygectomy

Takita's grading systeme of dysphagia :- Grade 1 : able to eat normally Grade 2 : requires liquides with meals Grade 3 : able to take only semi solid foods Grade 4 : able to take only liquides Grade 5 : able to swallow saliva but not liquides Grade 6 : complete dysphagia

نصيحة: إذا عندك مقدرة تساعد زول فما تتردد واعرف انك اذا سهلت على زول طريق ف ربنا بسهل ليك طرق كتيرة وبسخر ليك اللي ح يساعدك.. واتذكر أنك..... ستمضى قريباً بأمر القــــــــدر وتغـــــدو رفاتاً ويبقــــــى الاثر

https://youtu.be/gRWSyqatWQQ #medicine

Cardio examination

Abdomen examination

Neuro examination

Respiratory examination

Rheumatoid hands

History taking

Management of CP children 🌸growth and feeding (Nasogastric tube feeding/gastrostomy tube feeding/ dietician ) 🌸Neurological problems ... Epilepsy (antiepileptic drugs ). Intellectual impairment (Developmental assessment/IQ assessment..to guide type of special education) Behavioural disorders (autistic, aggressive/psychologists and social worker support) Sever spastictity(prevention by physiotherapy/management by muscle relaxant and tendon release by plastic surgeon) Movement(occupational therapy help the child daily living activity/orthosis or zipper frames or wheel chair) 🌸 Respiratory problems Recurrent chest infections due to recurrent aspiration (NG tube feeding/management of GORD to prevent aspiration) 🌸social and psychological support for the mother and the family in general. *From Dr.Omnia #paediatrics

Gower sign الشافع بسند نفسو عشان يقدر يقوم ع حيلو

Calf pseudohyperatrophy

#Duchenne_muscle_dystrophy

https://t.me/PediatricsNeeds #paediatrics