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«٧ أكتوبر | ذكرى طوفان الأقصى. فلسطين حاضرة في الوجدان؛ نحيّي صمود أهلها وارتباطهم بأرضهم، ونتطلع إلى الحرية والكرامة والسلام. من زيتون فلسطين تبدأ الحكاية… وتبقى جذورها شاهدة.»
ما عُمَرُه كان الدكتور الذي يُصعّب المادة على الطلبة معيارًا للدكتور المثالي.
بل على العكس، الدكتور المثالي هو الذي يجعل الطالب يحب المادة، ويفهمها بطريقة بسيطة وواضحة، ويزرع فيه الفهم الحقيقي بدلًا من الحفظ المؤقت.
فالهدف من أي مادة دراسية ليس أن تكون عقبة أمام الطالب، وإنما أن تمنحه علمًا ينتفع به، ويخرج منها فاهمًا ومستفيدًا.
هذه هي ثمرة التدريس الحقيقي، وهذا هو الدكتور الذي يستحق أن يُوصف بالمثالي ..🤍✨.
Topics of the day
#Rickets@Clinicalpediatricround
#Vitamins_Defenciecy@Clinicalpediatricround
🔰Other Vitamins Deficiency
📍1. Vitamin C (Ascorbic Acid) ➡️ Infantile Scurvy▪︎Irritability/Bone Tenderness & Swelling/Legs PseudoParalysis ▪︎Bleeding Gums & SubPeriosteal Hemorrhage & Petechiae/Hair Follicles HyperKeratosis/Mental Changes/Anemia
📍2. RiboFlavin (B2)▪︎Angular Stomatitis/Cheilosis/Glossitis/Seborrheic Dermatitis/ ▪︎Reduced Eye Tearing With Photophobia/Corneal Vascularization & Cataracts
📍3. Niacin (B3/Pellagra) ➡️ Dermatitis/Diarrhea/Dementia/Vomiting & Dysphagia/Body Weakness
📍4. Pyridoxamine (B6) ➡️ Infantile Seizures/HypoChromic MicroCytic Anemia/Vomiting & Diarrhea/Failure To Thrive/Irritability▪︎Isoniazid & Penicillamine & Heat Exposure ➡️ Associated With B6 Deficiency
📍5. Folate (B9) ➡️ MacroCytic Anemia/HyperSegmented Neutrophils/Glossitis▪︎Risk Factors For B9 Deficiency ➡️ Phenytoin & Methotrexate Drugs/Chronic Hemolysis (Thalassemia/Sickle Anemia)/Heated Milk Formula (B9 Heat Liable)/Evaporated & Goat's Milk
📍6. B12 ➡️ MacroCytic Anemia/HyperSegmented Neutrophils/Neurological Changes (Depression/Peripheral Neuropathy/Dementia/Coma)▪︎Risk Factors For B12 Deficiency ➡️ Pernicious Anemia/Transcobalamine II Deficiency/Gastric Or Bowel Resection/Small Bowel Bacterial Overgrowth
📍7. Vitamin E ➡️ Sensory & Motor Neuropathy (Loss Deep Tendon Reflexes)/Increase Risk Of Hemolytic Anemia in PreTerms/Edema/Thrombocytosis
📍8. Vitamin K ➡️ Hemorrhagic Disease Of Newborn (More in BreastFed Infants At 1st Weeks) ➡️ Give 0.5-1mg IM Prophylactic Vitamin K After Birth
📍9. Vitamin D ➡️ Rickets (Children) & Osteomalacia (Adolescents)
📍10. Zinc ➡️ AcroDermatitis Enteropathica (Skin Rash/Alopecia/Poor Growth/Infection/HypoGeusia)
📍11. Iron ➡️ Iron Deficiency Anemia/Spoon Nails (Koilonychia)/Decrease Mental & Physical Activity
📍12. Copper ➡️ Hypochromic Anemia/Neutropenia/Osteoporosis/Hypotonia/Hypoalbuminaemia
📍13. Fluoride ➡️ Dental Caries تسوسhttps://t.me/Clinicalpediatricround
🔴Vitamins & Minerals Deficiency
🔰Thiamine (B1) Deficiency (Beri Beri)🔹Causes Of Deficiency in Infants 1. Breast Feed Infants Of An Alcoholic Mother 2. Infant With Severe Malnutrition 3. Infant Received Hyperalimentation Fluid Not Supplemented With Vitamins 4. Milk Boiling (B1 Heat Labile) 5. Coffee/Tea/Fermented Fish/Diet Consists Largely Of Polished Rice التخلص من ماء التمن يعني التخلص من الثيامين 6. High Body Demands (Malignancy/Surgery) 7. Dialysis/Chronic Diarrhea/Diuretics
🔹Clinical Features📍1. Most Affected Infants At Age 1-4 Months 📍2. Wet Beri Beri (Infantile) ➡️ Present As Heart Failure ➡️ Anorexia/Apathy/Vomiting/Irritability/Pallor/Dyspnea/Cyanosis/Body Edema/Tachycardia/Cardiomegaly/Death 📍3. Dry Beri Beri ➡️ Present As Neuropathy ➡️ Aphonic Cry Or Dysphonia (Cry But No Sounds)/Feet & Toes Paresthesia/Ataxia/Ptosis/Loss Tendon Reflexes/Psychotic & Mental Changes/Optic Atrophy/Nystagmus/Increase ICP & Meningismus & Coma
🔹Dx1. Low Erythrocyte Transketolase Activity 2. High Thiamine Pyrophosphate 3. Lactic Acidosis 4. Symptomatic Improvement After Thiamine Administration
🔹Complications1. Death From Heart Failure 2. Wenicke's Encephalopathy & Korsakoff Syndrome (Dry Beri Beri) ➡️ Confusion & Ataxia & Opthalmophlegia/Amnesia & Confabulation يخترع قصص 3. Epilepsy/Mental Disability
🔹Mx1. 10mg/Daily IM Or IV Thiamine For 1 Week 2. Then Orall 3-5mg/Day Maintenance For 6 Weeks 3. Other B-Complex Supplements
🔰Vitamin A Deficiency
🔹Clinical Features (Xeropthalmia)📍1. Night Blindness/Photophobia/Bitot Spots in Eye 📍2. Xerosis Of Conjunctiva & Cornea (Dry Eye) ➡️ Then Ulceration & Necrosis & Keratomalacia Of Cornea 📍3. Recurrent infections Due To Immune Dysfunction (Measles) 📍4. Dry Scaly HyperKeratotic Skin (Toad's Skin) 📍5. Vitamin A Toxicity (Overdose 6000-15000µg) ➡️ Increase ICP (Headache/Vomiting/Bulging Fontanelles) With Hepatotoxicity & Teratogenicity
🔹Dx ➡️ Measure Plasma Retinol Level
🔹Mx1. No Eye Symptoms ➡️ 1500µg/Day Vitamin A Supplement 2. XeroThalmia (Eye Symptoms Present) ➡️ 1500µg/Kg/Day Orally For 5 Days Then IM 7500µg in Oil Until Recovery https://t.me/Clinicalpediatricround
‼️🔰D. Rickets الكساح‼️▪︎Weakening & Softening Of The Child Bones After Defective Mineralization Due To Ca & Phosphate Deficiency (Impaired Mineralization Of Growing Bones) ▪︎Affects Growing Bones Of Children Mostly At 6m-2Years (Before Epiphyseal Closure)
🔹Pathophysiology▪︎Vitamin D Roles ➡️ Absorption Of Ca & Phosphate From Git & Kidney Then Deposit Them in The Bone Matrix ▪︎Low Vitamin D ➡️ Low Ca & Phosphate ➡️ Rickets ▪︎PTH Roles ➡️ When Serum Ca Level Low ➡️ Increase PTH ➡️ Increase Bone OsteoClastic Activity ➡️ Increase Ca Release From Bone To Blood ➡️ Raise Serum Ca Level Again (But Can't Raise Phosphate Level) ▪︎Breast Milk ➡️ Low in Vitamin D ▪︎Formula Milk ➡️ Sufficient in Vitamin D ▪︎Transplacental Vitamin D ➡️ Enough Only For 1st 2m Of Infant's Life
🔹Causes Of Rickets🔶A. Nutritional (Infantile Or Primary Rickets) ▪︎Most Common Cause ▪︎Mostly Affect Infants Due To : 📍1. Maternal Vitamin D Deficiency 📍2. Infants Diet Low in Vitamin D Or Ca Or Phosphate Due To ▪︎Exclusive Breast Feeding After 6m Age ▪︎Prolonged Parenteral Nutrition ▪︎Weaning Diet Not Rich in Vitamin D/Ca/Phosphate 📍3. Poor Infants Cutaneous Synthesis Of Vitamin D Due To ▪︎Dark Skin Pigmentation ▪︎Full Body Clothing ▪︎Winter & Spring/indoor Living 🔶B. Secondary Rickets Due To : 📍1. Malabsorption ▪︎Celiac Disease ▪︎Pancreatic Insufficiency (Cystic Fibrosis) ▪︎Cholestatic & Chronic Liver Disease ▪︎Diet High in Phytic Acid 📍2. Increase Vitamin D Metabolism ➡️ By Enzyme Induction (Anticonvulsants Phenobarbital) 📍3. Defective Production Of Vitamin D ▪︎Type I Vitamin D Dependent Rickets ▪︎Familial HypoPhosphoataemic Rickets ▪︎Chronic Renal Disease ▪︎Fanconi's Syndrome 📍4. Organs Resistant (Type II Vitamin D Dependent Rickets)
🔹Clinical Features Of Rickets📍1. Proximal Muscle Weakness & Delayed in Teeth Eruption & Crawling & Walking (Waddling Gait) 📍2. Irritability/Insomnia/Anorexia/Forehead Sweating 📍3. Head ➡️ ▪︎CranioTabes (1st Sign) (Thinning Of Inner Bones Of Skull) Detected By Pressing Over Occipital Or Parietal Bones ▪︎Large Box Shape Head With Frontal & Parietal Bossing & Large Depressed Anterior Fontanelles (Asymmetric Skull Shape) ▪︎CranioSynoStosis (Early Closure Of Skull Sutures) 📍4. Chest & Abdomen ➡️ ▪︎Rachitic Rosaries (No Ribs Ossification At Costochondral Junction) ▪︎Harrison Sulcus (Transverse Groove Near The Diaphragm) ▪︎Abdominal Protrusion & Umbilical Hernia 📍5. Extremities ➡️ ▪︎Broadening At Wrist & Ankle (Expansion Of Metaphysis) ▪︎Marfan Sign (Transverse Groove Felt Over Medial Malleolus Due To Two Unfused Parts Of Malleolus) ▪︎Deformity (Varus/Valgus/Kyphosis/Scoliosis/Lordosis)
🔹Dx Of Rickets1. Low Serum Vitamin D & Ca & Phosphate 2. High PTH & ALP 3. Wrist Xray ➡️ ▪︎Broadening & Widening The Distal End Of Metaphysis ▪︎Cupping (Concavity) The Distal End Of Metaphysis ▪︎Loss Sharp Line Of Metaphysis (Fraying) ▪︎Wide Joint Space ▪︎Green Stick Fractures At Shaft
🔹Complications1. Hypocalcemia Causing Tetany & Seizures & Laryngeal Spasms ➡️ Give Immediate IV 1-2ml/Kg 10% Ca Gluconate Over 5-10 Min Followed By Maintenance Oral Ca Over 2-6w 2. Skeletal Deformities & Bone Fractures ➡️ Avoid Walking & Crawling To Prevent Deformity 3. Short Stature & Failure To Thrive 4. Gastroenteritis & Chest infections Due To Hypotonia & Stasis (Decrease Intestinal Motility & Weak Cough Reflex)
🔹Mx Of Rickets1. Oral 2000-5000 IU/Day Vitamin D For 4-6w 2. Or Single IM 300k-600k IU For 2-4 Doses Over 1 Day (Shock Or Stoss Therapy) ➡️ Used If No Compliance 3. Then Daily Vitamin D Maintenance ▪︎400 IU/Day (Age <1 Year) ▪︎600 IU/Day (Age >1 Year)
🔹Improvement Criteria1. Zone Of Calcification Seen On Xray 2. ALP Back To Normal 3. Improved Muscle Tone #Rickets https://t.me/Clinicalpediatricround
برنامج افضل من الشات GPT
لأنه خاص لطلاب الطب في جميع الاقسام
حيث يتم الإجابة على سؤالك حسب مراجع وبحوث علميه
ولو اردت التأكد من ال reference يظهره لك
رابط تحميل البرنامج
https://play.google.com/store/apps/details?id=io.vera.app
محاضرة الدكتور حسن الدشال الثالثة المعدلة حق اليومCardiovascular System diseases
إن شاء الله تعالى نتكلم كل يوم عن موضوعين من القائمة فوق بالرغم من نشر بعضها في السابق لكن نستكمل بقية ال Topics
🔰Rheumatology1. Acute Rheumatic Fever (ARF) 2. Henoch Schonlein Purpura 3. SLE (Lupus) 4. Kawasaki Disease 5. Juvenile Idiopathic Arthritis (JIA)
🔰Cardiology 1. Congenital Heart Diseases▪︎VSD/ASD ▪︎Aortic Coarctation/TOF/TGA/PS ▪︎PDA 2. Arrhythmia (Only SVT In Pediatrics) 3. Cardiomyopathy
🔰Poisoning1. Basics 2. Paracetamol/Aspirin/Iron/Lead 3. Hydrocarbons/Organophosphorus/Caustics
🔰General 1. Vaccination
📌 Pediatric Content 📌
🔰Respiratory Diseases
1. Bronchiolitis
2. Stridor
3. Pneumonia
4. Asthma
5. Bronchiectasis
6. Pleural Effusion
🔰Infectious Diseases
1. Pertussis
2. Measles & Rubella & Roseola
3. Erythema Infectiosum & Scarlet & ChickenPox
4. Mumps
5. Diphtheria
6. TB Infection
7. Kala-Azar
8. Tetanus
9. Congenital Infections (TORCH)
▪︎Rubella
▪︎Toxoplasmosis
▪︎CMV
▪︎Chickenpox (Varicella)
▪︎Syphilis
▪︎Herpes
🔰GIT & General
1. Gastroenteritis
▪︎Dehydration Mx
▪︎Fluid Calculation Ex.
2. Malnutrition
▪︎Marasmus & Kwashiorkor
▪︎Refeeding Syndrome
▪︎Rickets
▪︎Vitamins & Minerals Deficiency
3. Feeding
▪︎Breast Feeding
▪︎Artificial Feeding
4. Malabsorption
▪︎Malabsorption Syndromes
▪︎Celiac Disease
▪︎Cystic Fibrosis
5. Congenital Anomalies
▪︎Esophageal Atresia
▪︎Bowel Atresia
▪︎Hypertrophic Pyloric Stenosis
▪︎HirschsPrung's Disease
6. Intussusception & Volvulus
🔰Hematology
1. Hemolytic Anemia
▪︎G6PD Deficiency
▪︎Thalassemia
▪︎Sickle Anemia
▪︎Spherocytosis
▪︎Hemolytic Disease Of NewBorn
2. Bleeding Disorders
▪︎Basics
▪︎ITP
▪︎Hemophilia
▪︎Von Willebrand Disease
▪︎Vitamin K Deficiency
▪︎DIC
3. Blood Malignancy
▪︎Aplastic Anemia (BM Failure)
▪︎Acute Leukaemia
▪︎Lymphoma
4. Most Common Anemia
▪︎Iron Deficiency Anemia
▪︎Megaloblastic Anemia
🔰Nephrology
1. Poststreptococcal GN
2. Nephrotic Syndrome
3. Hemolytic Uremic Syndrome (HUS)
4. Urinary Tract Infection (UTI)
5. Acute Renal Failure
6. VesicoUreteric Reflux (VUR)
🔰Neurology
1. Meningitis & Encephalitis
2. Poliomyelitis
3. Seizures
▪︎Febrile
▪︎Epilepsy
▪︎Status Epilepticus & Neonatal
▪︎Management
4. Cerebral Palsy (CP)
🔰Neonoatology
1. Sepsis
2. RDS
3. Hypoxic Ischemic Encephalopathy
4. Jaundice
5. Kernicterus
6. Infants Of Diabetic Mother
7. Neonatal Conjunctivitis
8. Hemolytic Disease Of NewBorn
9. Vitamin K Deficiency
🔰Endocrinology
1. DM
2. DKA
3. Congenital Hypothyroidism
4. Short Stature
5. Congenital Adrenal Hyperplasia
6. Growth Hormone Deficiency
🔰Genetics & IEM
1. Down Syndrome
2. Turner Syndrome
3. Klinefelter & Fragile X Syndromes
4. Trisomy 18 & 13 & Cri-Du-Chat
5. GalactoSemia & Phenylketonuria
6. Gaucher & MucoPolySaccharidosis
🔻🔻تكملة الفهرس بالمنشور الثاني🔻🔻
🔰Refeeding Syndrome▪︎it's Acute Clinical Deterioration 24-48h After Initiation Of Rapid & High Energy Feeding Correction in Severe Malnourished Patients ▪︎High Risk Of Sudden Death Or HF
🔹Clinical Features & Dx1. Low Phosphate & K & Mg & Thiamine 2. High Na & Glucose 3. SOB/Tachycardia/Hypotension/Arrhythmia/Rapid Liver Enlargement/Watery Diarehea 4. Muscle Weakness & Rhabdomyolysis/Blood Cells Dysfunction/Seizures/Altered Mental State 🔹Mx ➡️ Slow Correction Of Thiamine (200-300 mg Daily Orally) & Phosphate & Other Disturbances #Refeeding_Syndrome
🔴Malnutrition in Pediatrics
‼️🔰A. Marasmus‼️▪︎Severe Muscle Wasting & Subcutaneous Fat Loss Due To Chronic Calories & Protein Deficiency (Chronic UnderNutrition) ▪︎Mostly Affect Infants <1 Years
🔹Causes مافي اكل يوصل للجسم1. Inadequate Food Intake مجاعة Or Inappropriate Weaning Or Diluted Formula 2. Feeding Difficulties (Cleft Lip & palate) 3. Chronic infection (TB/Pyeleonephritis) & Diarrhea (Lactose Intolerance) & Malignancy 4. Malabsorption (Celiac/Cystic Fibrosis) 5. Inborn Errors Of Metabolism (Galactosemia) & Congenital Anomalies (CHD/Pyloric Stenosis/GERD) 6. Maternal Neglect/Preterm & Twins
🔹Clinical Features & Dx1. Start As Failure To Gain Weight Then Progressive Weight Loss (Body Weight <60% Of Normal) 2. Muscle Wasting (Decrease MidArm Circumference <12cm) 3. Subcutaneous Fat Loss (Decrease Skin Fold Thickness) ➡️ Start At Abdomen (1°) Then Buttocks & Limbs (2°) Then Cheeks (3°) 4. Baby Become Hungry/Irritable Or Apathic/Crying & Little Sleep 5. Simian Face (Triangular)/Prominent Ribs/Large Head/Dry & Thin Skin/Thin Sparse Hair & Easily Pulled Out 6. Constipation Or Starvation Diarrhea (Greenish Scanty Offensive Diarrhea) 7. Hypothermia & Hypoglycemia
‼️🔰B. Kwashiorkor‼️▪︎Acute State Of inadequate Protein Intake With Normal Caloric (Carbs) Intake Results in Hypoalbuminaemia & Pitting Edema Of The Body ▪︎Mostly Affect Infants At 6m-3Years (Weaning Age)
🔹Causes ياكل غلط1. Sudden Inappropriate Weaning On Diet Rich In Carbs But Deficient in Proteins 2. Acute Infections/Toxins/Micronutrient Or Aminoacids Imbalance
🔹Clinical Features & Dx1. Bilateral Pitting Edema With Shining Skin ➡️ Start At Dorsum Of Feet & Hands Then Ascends 2. Near Normal Body Weight (60-80% From The Normal) 3. Mentality Changes ➡️ Apathic/Lethargic/Disinterest in Surroundings 4. Muscle Wasting (Decrease MidArm Circumference <12cm) 5. Preserved Subcutaneous Fat (Normal Skin Fold Thickness) 6. Skin Changes ➡️ Erythema (Pellagroid) Then Pigmentation Then Desqumation (Flaky Paint Rash Or Crazy Paving) Then Hypopigmentation Then Ulceration 7. Hair Changes ➡️ Brown To Gray Color/Flag Sign (Bands Of Altered Pigmentation Followed By Normal Pigmentation)/Sparse Easily Pulled Hair 8. Moon Face (Enlarged Parotid Glands & Facial Edema) 9. Distended Abdomen (Ascites & Fatty Liver Enlargement) 10. Angular Stomatitis & Cheilosis 11. Basal Crackles 12. Ix ▪︎Albumin <2.5 mg/dl ▪︎Total Proteins <4.5 mg/dl ▪︎Nonessential : Essential AA >3 ▪︎Urea Nitrogen : Creatinine <8
🔹Mx Of Both✖️A. Kwashiorkor ➡️ Increase Protein Intake (Start As 1g/Kg/Day Then 4-6g/Kg/Day) From Lactose Free Formula Or Food (Eggs/Chicken/Meat/Yogurt) ✖️B. Marasmus 📍1. Stabilization Phase (1st Week) ▪︎Correct Hypoglycemia & Hypothermia & Dehydration ➡️ Warming & Giving 10% Glucose & Frequent Feeding (Every 2h) & ORS Or IV Fluid Maintenance ▪︎Correct Anemia & HF ➡️ Blood Transfusion (Whole Blood) ▪︎Correct Minerals & Vitamins Deficiency ▪︎Give F75 Feeding Formula (75Kcal/Kg/Day Orally Or NG Tube) 📍2. Rehabilitation Phase (2nd Week To 6weeks) ▪︎Give F100 Formula (100Kcal/Kg/Day Orally Or NG Tube) ▪︎Or Give Ready-To Use-Therapeutic Food (Mixture Of Powdered Milk/Peanuts/Sugar/Vitamins/Minerals) 📍3. Follow Up Phase (7th Week Till Recovery) ➡️ Continue Feeding With Diet Rich in Carbs & Proteins (50% Carbs/35% Fat/15% Proteins)
🔹Complications Of Both1. Dehydration & Shock 2. Infection (Gastroenteritis/Pneumonia/Sepsis) 3. Hypothermia & Hypoglycemia & Bradycardia (Marasmus) 4. Bleeding (Due To Vitamin K Or C Deficiency Or DIC) 5. Heart Failure (Due To Severe Anemia/Fluid Overload) 6. Electrolytes & Vitamins Deficiency (Vitamin A & Zinc) 7. Permanent Growth Stunting & Delayed Development 8. Refeeding Syndrome
‼️🔰C. Marasmus Kwashiorkor‼️▪︎Body Weight <60% From The Normal (Marasmus) + Body Edema (Kwashiorkor) ▪︎Occurs in Severe Malnourished Patients (Marasmus) Fed Only On Carbs Diet ...... Loss Muscle & S.C Fat/Simian Face/Prominent Ribs/Weight <60% ➡️ Marasmus #KwashiorKor #Marasmus
Repost from Act as Internalist 👨🏻⚕️🫀🩺
Progeria 🤖
✔️Progeria, medically known as
Hutchinson Gilford Progeria Syndrome (HGPS)
⬅is a rare genetic disorder
characterized by dramatically accelerated aging in children.
🔹 What is Progeria :❔⬅It is a condition in which children appear normal at birth, but within the first year of life, they begin to show signs of premature aging.
⚙ Cause (Pathophysiology):🛑It is caused by a mutation in the LMNA gene, which encodes the Lamin A protein. ▫️This mutation produces an abnormal protein called Progerin. ✔️The accumulation of progerin leads to: 💙Structural defects in the cell nucleus 💙Accelerated cellular aging 💙 Tissue damage, especially in blood vessels
🔹 Signs and Symptoms :🤩💡Usually appear within the first year of life: ▫️Growth failure and short stature ▫️Hair loss (alopecia) ▫️Thin, wrinkled skin 🎯 Characteristic facial features: ▫️Small jaw ▫️Prominent nose ▫️Loss of subcutaneous fat ▫️Joint stiffness ▫️Early cardiovascular disease (most serious complication) 📍 note : Intelligence is typically normal.
🔹 Complications :🤩📌 The main cause of death is: Atherosclerosis (premature hardening of the arteries) This may lead to:⬇ ▫️Heart attacks ▫️Strokes
⏳️ Life Expectancy:🤔✔️Usually between 13–15 years ✔️Some patients may survive into their early 20
🔬 Diagnosis :🤩🤩 Clinical examination: ▫️Confirmed by genetic testing of the LMNA gene
🔹 Treatment:🤩▫️There's no cure yet ❕, but treatments can help slow the disease such as: 🏹 Lonafarnib which leads to: ▫️Improves survival ▫️Reduces cardiovascular complications 🎯Supportive care: ▫️Cardiac medications ▫️Physical therapy ▫️Proper nutrition https://t.me/Clinicalinternalmedicine
🤍🤍🤍
📌 Reye Syndrome▫️
▫️ Definition :is a rare but serious pediatric condition characterized by: 🔖Acute noninflammatory encephalopathy 🔖Hepatic dysfunction with microvesicular fatty change 🖊It classically occurs in children following a viral infection (especially influenza or varicella) who receive aspirin (salicylates).💊
⚙ Pathophysiology :The core problem is mitochondrial dysfunction in hepatocytes. 🔖Aspirin + viral illness → → Impaired mitochondrial β-oxidation of fatty acids → Accumulation of microvesicular fat in liver cells → Decreased ATP production 💭Consequences: 🔖↑ Ammonia (hyperammonemia) 🔖Cerebral edema 🔖Hypoglycemia (due to impaired gluconeogenesis) 🔖Elevated AST/ALT
❓ Clinical Features :Usually affects children 4–12 years old. 💭Typical scenario: Child recovering from viral infection → given aspirin → develops: ✔️Persistent vomiting ✔️Lethargy ✔️Confusion ✔️Seizures ✔️Rapid progression to coma 🌟Labs show: ↑ AST/ALT ↑ Ammonia Hypoglycemia Normal bilirubin (often)
💡 Diagnosis :🤍Clinical suspicion + history of salicylate exposure. 🤍Liver biopsy (if performed) shows: Microvesicular fatty change No inflammation
🚀 Management :🎉Supportive ICU care 🎉Control intracranial pressure 🎉Correct hypoglycemia 🎉Avoid aspirin in children✖️ #𝑺𝒚𝒏𝒅𝒓𝒐𝒎𝒆 🤍🤍🤍
🔖 Mumps (النكاف)🪶المعروف شعبيًا بـ أبو كعيب أو (الرطين ) بالصنعاني 😬أيضا قال لنا بعض الزملاء يسموها عندهم في البلاد (علي قفز )🤨 المهم نرجع لموضوعنا الأساسي
✔️. تعريف النكاف :⬅️هو عدوى فيروسية معدية تصيب الغدد اللعابية النكافية الموجودة تحت وأمام الأذنين، مما يؤدي إلى تورمها.
🔸 أهم الأعراض ⚠️:تظهر الأعراض عادة بعد 16–18 يومًا من التقاط العدوى وتشمل ⬇️: ▫️تورم الوجنتين: العرض الأبرز هو انتفاخ مؤلم في إحدى الغدد النكافية أو كلتيهما. ▫️أعراض تشبه الإنفلونزا: تشمل الحمى، الصداع، آلام العضلات، التعب، وفقدان الشهية. ▫️ألم عند المضغ أو البلع: خاصة عند تناول الأطعمة الحمضية التي تحفز إنتاج اللعاب.
🔸 كيفية الانتقال ✈:ينتشر الفيروس بسهولة عبر⬇️: 1⃣الرذاذ التنفسي: الناتج عن السعال أو العطس. 2⃣ الاتصال المباشر: مثل التقبيل أو مشاركة أدوات الطعام وزجاجات الماء. 3⃣ الأسطح الملوثة: لمس الأسطح التي سقط عليها رذاذ الشخص المصاب.
🔸 العلاج والتعامل المنزلي 📝:⬅️ بما أنه مرض فيروسي، لا توجد مضادات حيوية لعلاجه، والهدف من الرعاية هو تخفيف الأعراض حتى يشفى الجسم تلقائيًا: ▫️ الراحة التامة: لمساعدة الجهاز المناعي على المقاومة. ▫️ السوائل: الإكثار من شرب الماء وتجنب العصائر الحمضية مثل البرتقال لأنها تزيد الألم. ▫️ الأطعمة اللينة: مثل الشوربات والبطاطس المهروسة لتجنب الألم أثناء المضغ. ▫️الكمادات: استخدام كمادات دافئة أو باردة على الغدد المتورمة لتخفيف الألم. ▫️المسكنات: يمكن استخدام Paracetamol أو Ibuprofen لخفض الحرارة، مع ضرورة تجنب الأسبرين للأطفال تمامًا.
🔸 الوقاية: 🤩💡تُعد جرعتا لقاح MMR vaccine الوسيلة الأكثر فعالية للوقاية من المرض 💉 🪶 نسأل الله السلامة والعافية للجميع 😊 #MedMoon🌟
