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Surgery 3rd batch ๐Ÿฉบ

Surgery 3rd batch ๐Ÿฉบ

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ู‚ู†ุงุฉ ุจู„ูˆูƒ ุงู„ุฌุฑุงุญุฉ ุงู„ู„ุฌู†ุฉ ุงู„ุนู„ู…ูŠุฉ ุงู„ุฏูุนุฉ ุงู„ุซุงู„ุซุฉ ูƒู„ูŠุฉ ุงู„ุทุจ ุงู„ุจุดุฑูŠ ุฌุงู…ุนุฉ 21 ุณุจุชู…ุจุฑ ู„ู„ุนู„ูˆู… ุงู„ุทุจูŠุฉ ูˆุงู„ุชุทุจูŠู‚ูŠุฉ ู„ุงุณุชู‚ุจุงู„ ุงุณุชูุณุงุฑุชูƒู… ูˆู…ุดุงุฑูƒุงุชูƒู… ุงู„ู…ู‡ู…ุฉ ูŠู…ูƒู†ูƒู… ุงู„ุชูˆุงุตู„ ู…ุนู†ุง ุนุจุฑ ุงู„ุจูˆุช : @Surgery3_bot

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Channel Posts
Surgery 3rd batch ๐Ÿฉบ
Repost from ุทุจ ุงู„ุฅู…ุชูŠุงุฒ ๐Ÿฉบ
40 yr old obese female with negative PMH presented with sudden onset severe RUQ pain since 1 hr, colicky in nature radiated to RT shoulder. She has  hx of similar attack 1 month ago. PMH :_ve PSH : _ve PDH :_ve Allergy :unknown Vitals Spo2 98 RA PR 96 regular Bp 120/80 sitting RR 25 Temp 37 C O/E Conciosous Oriented Soft abd with RUQ tenderness Negative murphy sign (if positive it goes with cholecystitis) Clear chest Investigation CBC, RBS, abd us RX 1.Nill per mouth 2.Parcetamol vial 1g 3.Buscopan amp ุนุถู„ูŠ 4-zofran You can add diclofenac with PPI cover if no response to intial meaasure. Also you can add opoids if no response (Some says opoids increases risk of stone impaction due to spasm of sphincter of oddi ) 5.G/S 500 ml ู‡ุฐุง ุงู„ูƒูŠุณ ุงุนุชุจุฑู†ุงู‡ุง biliary colic ู„ู†ูุชุฑุถ ุงู„ู…ุฑูŠุถู‡ ู‚ุฏ ู„ู‡ุง ุงูƒุซุฑ ู…ู† 5ุงูˆ 6  ุณุงุนุงุช ุจุงู„ุงู„ู… ุงูˆ ู…ุงุงุณุชุฌุงุจุช ู„ู„ analgesia ุงูˆ ุนู†ุฏู‡ุง fever  ู†ุชูˆู‚ุน ุงู†ู‡ ู…ู…ูƒู† ูˆุงุตู„ู‡ ู…ุฑุญู„ู‡ ุงู„ Choleycystitis ู„ุฐู„ูƒ ู…ู…ูƒู† ู†ุถูŠู Antibiotic ุฃูŠุถุง ู„ุง ุชู†ุณูˆุง ุจู‚ูŠู‡ ุงู„ ddx ู…ุซู„ ุงู„ cholngitis ุงูˆ ุงู„ pancreatitis ุงู„ us  ุจูŠุณุงุนุฏู†ุง ุจุดูƒู„ ูƒุจูŠุฑ ูˆูˆู…ูƒู† ู†ุณูˆูŠ investigations ุญุณุจ ุงู„ Clinical picture -ุงู„ุฑูˆุดุชุฉ ู„ู…ู† ุชุฎุฑุฌ ู„ู„ุจูŠุช  R/Rowachol cap or Bilichol cap 1*3*14 or 21 days ู‚ุจู„ ุงู„ุงูƒู„ ุจู†ุตู ุณุงุนุฉ R/Ursodeoxycholic acid 300mg tab - ursodiol 1*2*30 d ุจุนุฏ ุงู„ุงูƒู„ R/Nospa tab SOS R/  Cipro or Ciprofar 500 tab ู‚ุฑุต ูƒู„ ูกูข ุณุงุนุฉ ู‚ุจู„ ุงู„ุฃูƒู„ ุจุณุงุนุฉ ู„ู…ุฏุฉ ูฅ ุฃูŠุงู… R/ Flagyl 500 tab ู‚ุฑุต ูƒู„ ูจ ุณุงุนุงุช ู„ู…ุฏุฉ ุฃุณุจูˆุน ุชุนู„ูŠู…ุงุช ู„ู„ู…ุฑูŠุถ ุชู‚ู„ูŠู„ ุงู„ุฏู‡ูˆู† ููŠ ุงู„ุฃูƒู„ ุดุฑุจ ูƒู…ูŠุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ู…ูŠุงุฉ ุชู‚ู„ูŠู„ ุงู„ูˆุฒู† ูˆ ู…ู…ุงุฑุณุฉ ุงู„ุฑูŠุงุถุฉ

2
Necrotizing Fasciitis ุทู„ุนุช ุงู„ู‚ุณู… ุนู„ู‰ ู‡ุฐูŠ ุงู„ุงุฏูˆูŠุฉ ๐Ÿ‘‡ 1-Tazact 4.5 g IV โ€” TDS 2-Vancomycin 1 g IV โ€” BD 3-Heparin 5000 IU IV 4-Pantoprazole 40 mg IV โ€” OD 5-Perfalgan 1 g IV โ€” SOS 6-Human Albumin 20% 50 ml IV โ€” BD 7-Tramax + Plazil IV โ€” SOS 8-Chest Physiotherapy 9-Check RBS โ€” QID 10-Full diet, high protein 11-Mofest 400 mcg IV โ€” OD 12-Atrolip 40 mg Tab โ€” OD 13-Plavix 75 mg Tab โ€” OD 14-Methylcobal 500 mcg Tab โ€” OD 15-Kanzar-H 50/12.5 mg Tab โ€” OD ----------- ๐Ÿ“ุญุงู„ุฉ Fournier gangrene ๐Ÿ‘‡ 1-Meropenem 1 g IV โ€” BD 2-Vancomycin 1 g IV โ€” BD 3-Clindamycin 600 mg IV โ€” TDS 4-N/S 500 ml IV 5-D/N/S 500 ml IV โ€” OD 6-Perfalgan 1 g IV โ€” TDS 7-Pantoprazole 40 mg IV โ€” OD 8-Tramadol + Plazil โ€” SOS 9-Insulin 8-8-8-6 S/C after check RBS โ€” QID 10-Aspirin 100 mg Tab โ€” OD 11-Atorlip 20 mg Tab โ€” OD 12-Amisulpride 200 mg Tab 13-Escitalopram 10 mg Tab 14-Plavix 75 mg Tab โ€” OD 15-Ami Kacin Cream โ€” BD
95
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๐Ÿ“Cholangitis: Infection of the bile duct with Charcotโ€™s triad:ย fever+rigors , jaundice, RUQ pain. Rx/ Augmentin 1.2g/8h IV. Abdo US & Surgical consultation for urgent ERCP -------------- ๐Ÿ“Choledocholithiasis: 4F (female, forty, fatty, fertile)ย  It's a Gallstone in common bile duct, causing obstructive jaundice. Rx/Maintain hydration(iv fluid) Rx/prophylactic antibiotics (eg Augmentin 1.2g/8h IV) Exclude pancreatitis and cholangitis, Surgical consultation for ERCP and cholecystectomy
61
4
Acute pancreatitis:acute abdomen: Constant severe Abd. Pain โฌ‡๏ธby leaning forward , Epigastric Abd distention, tenderness, N/V
Acute pancreatitis:acute abdomen: Constant severe Abd. Pain โฌ‡๏ธby leaning forward , Epigastric Abd distention, tenderness, N/V. ุงุณุฃู„ ุนู† ุญุตูˆุงุช ุงู„ู…ุฑุงุฑุฉ ู‡ู„ ุนู…ู„ ERCPุŸ ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ Rx/ O2 therapy SOS Rx/ NS infusion 500mgย  + dextrose 5% infusion BD(DNS) Rx/ Urine catheter Rx/ NPO + NGT Rx/ fentanyl ู„ุงูŠุนู…ู„ ู‡ุจูˆุท ุถุบุท( Fentanyl 1mg/kg) Rx/ fentanyl 50mcg iv bolus SOS. Rx/ pantoprazol 40mg iv OD Rx/ plasil or emeset if N/V TDS Rx/ send for CBC(leukocytosis), CRP, s. Amylase & lipase, LFT RFT,( s. Ca+, Na+, K+) Abd. US, abd. CTุบุงู„ุจุงุชูุทู„ุจ. ๐Ÿ”ต / Consider prophylactic antibiotics if severe (Ceftriaxone 1g iv AST bd + Flagyl infusion tds) ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ู€ ICU Admission if severe: Rx/clexane 60mg SC BDย  !?? Rx/send for daily CBC,CRP, RFT, LFT, s. Ca+Na+K+,
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Acute cholecystitis: acute abdomen: Rx/Klamoks 1.2g iv TDS Or Ceftriaxone 2g iv OD AST. Rx/ Flagyl 500mg iv vial TDS Rx/ Anal+1
Acute cholecystitis: acute abdomen: Rx/Klamoks 1.2g iv TDS Or Ceftriaxone 2g iv OD AST. Rx/ Flagyl 500mg iv vial TDS Rx/ Analgesics & antiemetics(Tramadol + plasil ุญุงูˆู„ ุชุชุฌู†ุจู‡ ู„ุงู†ู‡ ูŠุนู…ู„ spasm ููŠ ุงู„ Sphincter of oddi of gallbladder ) or fentanyl 50mcg, or pethedine 25mg iv bolus SOS Rx/ NPO Rx/ NS infusion 500mg BD + dextrose 5% infusion BD Rx/ pantoprazol 40mg iv Rx/ CBC(leukocytosis) , CRP, LFT, Abd. US(if negative >> erect abd x ray) . Rx/ correct electrolytes abnormalities. Rx/ surgical consultation
97
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ู…ูˆุถูˆุน ุจุญุซูŠ ู…ู‡ู…ู…ู…ู… ู„ูƒู„ ุงู„ุฒู…ู„ุงุก ุงู„ุงุทุจุงุก ูˆุงูŠ ุทุงู„ุจ ู…ู† ุฌู…ูŠุน ุงู„ู…ุณุชูˆูŠุงุช ูˆุงู„ุงู‚ุณุงู…๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿฉบ๐Ÿฉบ โœจโœจโœจโœจุชุญูŠุฉ ุทูŠุจุฉ โœจุŒโœจโœจโœจ โ€‹ุฃุชู…ู†ู‰ ุฃู† ุชูƒูˆู†ูˆุง ุจุฃูุถู„ ุญุงู„ ุงูŠู‡ุง ุงู„ุงุทุจุงุก๐Ÿ”ฅ. ุงู†ุง ุฒู…ูŠู„ูƒู… /ุฏ.ุนุจุฏุงู„ุนุฒูŠุฒ ุงู„ูƒุงู…ู„ ู…ุดุงุฑูƒ ููŠ ู‡ุฐู‡ ุงู„ูˆุฑู‚ู‡ ุงู„ุจุญุซูŠู‡ ูˆุงุทู„ุจ ูุถู„ุงู‹ ู…ู† ูƒู„ ุงู„ุฒู…ู„ุงุก ูˆุงู„ุฒู…ูŠู„ุงุช ู„ู„ู…ุดุงุฑูƒุฉ ููŠ ู‡ุฐู‡ ุงู„ุฏุฑุงุณุฉ ุงู„ุจุญุซูŠุฉ ุงู„ูˆุทู†ูŠุฉ ุงู„ู‡ุงู…ุฉ ุจุนู†ูˆุงู†: ๐Ÿ“Š "ุฌูˆุฏุฉ ุงู„ุญูŠุงุฉ ูˆุงู„ุนูˆุงู…ู„ ุงู„ุงู‚ุชุตุงุฏูŠุฉ ูˆุงู„ุงุฌุชู…ุงุนูŠุฉุŒ ูˆุงู„ู†ูุณูŠุฉุŒ ูˆุงู„ู…ุชุนู„ู‚ุฉ ุจุงู„ู†ุฒุงุน ุงู„ู…ุตุงุญุจุฉ ู„ู‡ุง ุจูŠู† ุทู„ุงุจ ุงู„ุฌุงู…ุนุงุช ุงู„ูŠู…ู†ูŠุฉ" ๐Ÿ‡พ๐Ÿ‡ช. Quality of Life and Its associated socioeconomic, conflict-related, and mental health factors among *Yemeni* *university students* : a nationwide multicenter study - โ€‹ู‡ุฏู ุงู„ุฏุฑุงุณุฉ: ุชู‚ูŠูŠู… ู…ุณุชูˆู‰ ุฌูˆุฏุฉ ุงู„ุญูŠุงุฉ ู„ุฏู‰ ุทู„ุงุจู†ุง ูˆูู‡ู… ุงู„ุชุญุฏูŠุงุช ุงู„ู…ุนูŠุดูŠุฉ ูˆุงู„ุฃูƒุงุฏูŠู…ูŠุฉ ุงู„ุชูŠ ู†ูˆุงุฌู‡ู‡ุง ููŠ ุธู„ ุงู„ุธุฑูˆู ุงู„ุฑุงู‡ู†ุฉ ๐Ÿ—’๏ธ. - โ€‹ุงู„ุณุฑูŠุฉ: ู…ุดุงุฑูƒุชูƒู… ุทูˆุนูŠุฉ ุชู…ุงู…ุงู‹ุŒ ูˆู†ุคูƒุฏ ู„ูƒู… ุฃู† ุฌู…ูŠุน ุงู„ุจูŠุงู†ุงุช ุณุชูุญุงุท ุจุงู„ุณุฑูŠุฉ ุงู„ุชุงู…ุฉ ูˆุงู„ู…ุทู„ู‚ุฉ ูˆู„ู† ุชูุณุชุฎุฏู… ุฅู„ุง ู„ุฃุบุฑุงุถ ุงู„ุจุญุซ ุงู„ุนู„ู…ูŠ ๐Ÿ”’. - โ€‹ุงู„ูˆู‚ุช: ุชุนุจุฆุฉ ุงู„ุงุณุชุจูŠุงู† ู„ู† ุชุณุชุบุฑู‚ ู…ู† ูˆู‚ุชูƒู… ุงู„ุซู…ูŠู† ุณูˆู‰ (5 ุฏู‚ุงุฆู‚ ุจุณุณ๐Ÿ˜) โฑ๏ธ. โ€‹ู…ุดุงุฑูƒุชูƒู… ูˆุชูˆุตูŠู„ูƒู… ู„ุตูˆุช ุงู„ุทุงู„ุจ ุงู„ูŠู…ู†ูŠ ุณูŠุณุงู‡ู… ุจุดูƒู„ ูƒุจูŠุฑ ููŠ ุฅู†ุฌุงุญ ู‡ุฐุง ุงู„ู…ุดุฑูˆุน ุงู„ุนู„ู…ูŠ ุงู„ูˆุทู†ูŠ ๐ŸŽ“๐ŸŒธ. โ€‹๐Ÿ”— ุฑุงุจุท ุงู„ุงุณุชุจูŠุงู†: https://forms.gle/qs9CszPdqxsD3xCB6 ๐Ÿ”‘ ูƒูˆุฏ ุงู„ู…ุดุงุฑูƒุฉ: (3) ุงุชุฃูƒุฏูˆ ู…ู†ู‡ ุถุฑูˆุฑูŠ ุนุดุงู† ู‡ุฐุง ุญู‚ูŠ ุงู„ูƒูˆุฏโœ…โœ… _ โ€‹ุดุงูƒุฑูŠู† ู„ูƒู… ุฌุฒูŠู„ ุชุนุงูˆู†ูƒู… ูˆูˆู‚ุชูƒู… ูˆุชู…ู†ูŠุงุชู†ุง ู„ูƒู… ุจุงู„ุชูˆููŠู‚ ูˆุงู„ู†ุฌุงุญ ุงู„ุฏุงุฆู… ๐ŸŒŸ.
467
7
ุนู…ู„ูŠ ุฌุฑุงุญู‡ ู…ุฎุชุตุฑ ูˆุฌู…ูŠู„ ุฌุฏุง
523
8
ุงู„ูƒุงููŠู‡.....pdf
497
9
ุญุงู„ุฉ hx ุฌุงู‡ุฒ GBS+3
ุญุงู„ุฉ hx ุฌุงู‡ุฒ GBS
512
10
Colostomy ( Intestinal stoma ).pdf
424
11
ู…ู„ุฎุต General Ex.pdf
388
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โœจischemia sheet ๐Ÿ“‹ุดูŠุช ู„ุฃุฎุฐ ุญุงู„ุงุช ุงู„Ischemia ุŒ ุชู…ุช ุฅุนุงุฏุฉ ุตูŠุงุบุชู‡ ูˆุชุฑุชูŠุจู‡ ู…ู† ุงู„ู…ุตุงุฏุฑ ุงู„ุชุงู„ูŠุฉ๐Ÿ‘‡๐Ÿป ๐Ÿ“Œูƒุชุงุจ ุงู„ุฏูƒุชูˆุฑ ูˆุงุฆู„ ู…ุชูˆู„ูŠ ๐Ÿ“Œูƒุชุงุจ ุงู„ุฏูƒุชูˆุฑ ุงู„ู…ุทุฑูŠ ๐Ÿ“Œุงู„ุฏูƒุชูˆุฑ ุนู„ูŠ ุญุณูŠุจ ๐Ÿ“Œุงู„ุฏูƒุชูˆุฑ ูˆู‡ุฏุงู†
384
13
ู„ูˆู‚ ุจูˆูƒ ุฌุฑุงุญุฉ ู…ุน ุงู„ุญุงู„ุงุช .pdf
309
14
History part 2 Dr.fatima alshareef .pdf
299
15
History part 1 Dr.Fatima alshareef .pdf
323
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ู‡ูŠุณุชูˆุฑูŠ ุฌุฑุงุญุฉ ๐Ÿ‘
314
17
ุญุงู„ุฉ hx ุฌุงู‡ุฒ thyroid+5
ุญุงู„ุฉ hx ุฌุงู‡ุฒย  thyroid
306
18
โ€ŽโจูƒูŠุณุงุช ุฌุฑุงุญุฉโฉ.pdf
254
19
Appendicitis.pdf
253
20
Diabetic foot.pdf
247
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