Creative Doctors ๐Ÿ–ค
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is it important to ask a patient about travel history when he presented by dysphgia ุŸand why ?
ุงู„ุฌูˆุงุจ ุญูŠู†ุฒู„ ุจู„ู…ุญุงุถุฑู‡ ุงู„ู‚ุงุฏู…ู‡
ุงุฐุง ุชุญุจูˆู† ุชุดุงุฑูƒูˆู† ุงุฌูˆุจุชูƒู…
โค4
So any one here familiar with cardiac lusoria?
https://youtu.be/-hxxftx_09Y
is it important to ask a patient about travel history when he presented by dysphgia ุŸand why ?
ุงู„ุฌูˆุงุจ ุจู‡ุงูŠ ุงู„ู…ุญุงุถุฑู‡
https://youtu.be/PwO6zhHfyHo

ุณุงู…ุนูŠู† ุฐุจุญุฉ ุจู„ู…ุฑูŠุก๐Ÿ˜…
ู„ุง ฺ†ุฐุจ ุจุณ ู‡ุฐุง ุงู„ู…ูˆุถูˆุน ูƒู„ุด ูŠูˆู‡ู…ูƒ ุจูŠู†ู‡ ูˆุจูŠู† ุงู„ angina ูุฎู„ูŠ ุจุงู„ูƒ ูˆุงุนุฑู ุงู„ูุฑู‚ ุจู‡ุฐุง ุงู„ููŠุฏูŠูˆ
โค1
https://t.me/yas0ay

ุณูˆูŠุช ู‡ุงูŠ ุงู„ู‚ู†ุงุฉ ูˆุญูˆู„ุช ุจูŠู‡ุง ูƒู„ ุงู„ูุฏูŠูˆู‡ุงุช ูˆุงู„ู…ุญุงุถุฑุงุช ุญุชู‰ ูŠุณู‡ู„ ุนู„ูŠูƒู… ุงู„ูˆุตูˆู„ ุงู„ู‡ุง ูˆู…ุง ุชุชุฏุงุฎู„ ูˆูŠ ุงู„ูƒู„ุงู… ุจู„ูƒุฑูˆุจ
ุงู†ุถู…ูˆุง ุจูŠู‡ุง
โค13
ุงู„ูŠ ุดุงู ุงู„ุดุฑุญ ูŠุงุฑูŠุช ูŠู†ุทูŠู†ูŠ ููŠุฏ ุจุงูƒ ูˆุงู‡ู…ุดูŠ ุงุณุชู‚ุจู„ ุงู„ููŠุฏุจุงูƒ ุงู„ุณู„ุจูŠ ูˆูŠูƒูˆู† ุชู‚ูˆูŠู…ูŠ ุฃูŠุถุงู‹ ูˆุจูŠู‡ ุญู„ูˆู„ ูˆุงู„ูŠ ุนุฌุจู‡ ุงู„ุดุฑุญ ู‡ู… ูŠู†ุทูŠ ุฑุฃูŠู‡ ุญุชู‰ ุงุณุชูุงุฏ ู…ู† ุงุฎุทุงุฆูŠ ุงุฐุง ุงูƒูˆ ูˆุงุญุงูˆู„ ุงุญุณู†ู‡ุง ู…ู† ุจุงฺ†ุฑ ๐Ÿ˜…
ุงู„ูŠูˆู… ฺ†ุงู† ุทูˆูŠู„ ูˆู…ุชุนุจ ุจู„ุชุญุถูŠุฑ ูˆุงู„ุชุตูˆูŠุฑ ู„ูƒู† ุงู„ุญู…ุฏุงู„ู„ู‡ ุชู…ุช ุนู„ู‰ ุฎูŠุฑ ุงูˆู„ ู…ูˆุถูˆุน
โค24
In severe acute pancreatitis:
Do not give prophylactic antibiotics, including for patients with sterile necrosis (Strong recommendation).
โค4
extent of pancreatic and peripancreatic changes not directly proportional to severity of organ failure..
โค3
dipstick measurement of urinary trypsinogen-2 levels > 50 ng/mL (50 mcg/L) on admission may have moderate sensitivity but high specificity for diagnosing acute pancreatitis in patients presenting to emergency department with acute abdominal pain
โค3
lactated Ringer's solution may reduce systemic inflammatory response syndrome (SIRS) compared to normal saline in patients with acute pancreatitis
โค6๐Ÿ”ฅ1
treatments reported to be effective in hypertriglyceridemic pancreatitis include IV heparin, insulin, fibrates, and plasmapheresis
โค3
in patients with severe acute pancreatitis, use enteral nutrition rather than parenteral nutrition for prevention of infectious complications; avoid parenteral nutrition unless the enteral route is not available, not tolerated, or not meeting caloric requirements (ACG Strong recommendation, High-quality evidence)
โค3
early enteral nutrition may decrease infectious complications and mortality compared to late enteral nutrition or total parental nutrition in patients with acute pancreatitis
โค4
https://t.me/yas0ay

ุณูˆูŠุช ู‡ุงูŠ ุงู„ู‚ู†ุงุฉ ูˆุญูˆู„ุช ุจูŠู‡ุง ูƒู„ ุงู„ูุฏูŠูˆู‡ุงุช ูˆุงู„ู…ุญุงุถุฑุงุช ุญุชู‰ ูŠุณู‡ู„ ุนู„ูŠูƒู… ุงู„ูˆุตูˆู„ ุงู„ู‡ุง ูˆู…ุง ุชุชุฏุงุฎู„ ูˆูŠ ุงู„ูƒู„ุงู… ุจู„ูƒุฑูˆุจ
ุงู†ุถู…ูˆุง ุจูŠู‡ุง
ู†ุตูŠุญุฉ ุจุณูŠุทู‡ ู„ู„ูŠ ูŠุฑูŠุฏ ูŠู‚ุฑู‡ ุจู„ุนุทู„ุฉ
ู‚ุณู…ู‡ุง :
75% ุฑุงุฌุน ุงู„ูŠ ุงุฎุฐุชู‡ ุจู„ู…ุฑุญู„ุฉ ุงู„ุณุงุจู‚ุฉ
25% ุงู‚ุฑู‡ ุดูŠ ุฌุฏูŠุฏ

ุญุชู„ูˆ ุถุงุจุทู‡ู† ุงุฑุฌุน ุนู„ูŠู‡ู† ุฑุงุฌุน
ุญุชุดูˆู ูุฑู‚ ูƒู„ุด ุฌุจูŠุฑ
โค19๐Ÿ”ฅ4
ุฏูƒุชูˆุฑ/ู‡

ู‡ุงูŠ ูƒู„ู…ุฉ ู„ู„ุชุงุฑูŠุฎ ูˆุชุฑุฏูŠู†
ุชุณู…ุนูŠู‡ุง ุชุฑุฏูŠู† ู„ุง
ุฃุณุงุณ ุงู„ุทุจ ูƒู„ู‡ ู‡ูˆ ุงู„ุจูŠุฒูƒ
ู…ุงูƒูˆ ูˆุงุญุฏ ุฌุจูŠุฑ ุนู„ู‰ ุงู„ุจูŠุฒูƒ ูŠูˆู…ูŠู‡ ุงุฎู„ูŠ ู†ุต ุณุงุนู‡ ุงุฑุงุฌุน ุจูŠู‡ุง ุจูŠุฒูƒ ูˆุงูุชู‡ู… ุจูŠู‡ ุดุบู„ุงุช ุชุณุงุนุฏู†ูŠ ู„ูŠูƒุฏุงู… ู„ุฃู† ู‡ูˆ ุฃุณุงุณ ูˆู†ุธุงู… ุงูŠ ุฎู„ู„ ุจูŠู‡ ุญูŠุฃุซุฑ
โค3
ุงูƒูˆ ูƒุชุงุจ ุงุญุจ ุงู‚ุฑู‡ ุจูŠู‡ ุจูŠุฒูƒ ูƒู„ุด ู‡ูˆุงูŠู‡ ู‡ูˆ ูƒุชุงุจ Goljan pathology ุญุฑููŠุงู‹ ู…ูˆ ุจุณ ุจุงุซูˆ ูƒู„ุดูŠ ุจูŠู‡ ูŠูˆู…ูŠุฉ ู„ุงุฒู… ุงู‚ุฑู‡ ุจูŠู‡ ูˆู…ู…ุชุน ุงู„ู‰ ุฏุฑุฌุฉ ูˆุนุงูŠุฏู‡ ุงูƒุซุฑ ู…ู† ู…ุฑู‡ ู‡ุณู‡ ุงุฏุฒู‡ ุงู„ูƒู…
ูˆูŠููŠุฏ ุงู„ูŠ ูŠุญุถุฑูˆู† USMLE ุงูŠุถุงู‹ุŒ ุงู„ุจูŠุฒูƒ ุงู„ูŠ ุงุฎุฐู†ุงู‡ ุจู„ูƒู„ูŠุฉ ู…ุน ุงุญุชุฑุงู…ูŠ ู‡ุฐุง ู…ุถูŠุนุฉ ูˆู‚ุช ูˆูŠุนุชุจุฑ ู„ุงุดูŠุก
โค3