اللهم إني أسألك الهدى والتّقى والعفاف والغنى. اللهمّ إنّي أسألك خير المسألة، وخير الدعاء، وخير النجاح، وخير العمل، وخير الثواب، وخير الحياة، وخير الممات، وثبِّتني، وثقِّل موازيني، وحقق إيماني، وارفع درجاتي، وتقبَّل صلاتي، واغفر خطيئتي، وأسألك الدرجات العُلى من الجنة.

☆ Discussion case of Seizure (Child or Newborn):

•Management of Seizure: ‼️

1) Call for help

2) Airways (Open airways, put patients in lateral position..
ولو أنا في المستشفى ندير:
Suction any fluid to avoid aspiration.

Breathing (Give Oxygen by mask + Pulse oximeter)

Circulation (take blood sample for Glucose and Calcium level)

ولو كانت:
-Hypoglycemia (<45 mg/dl)
نعطوا Dextrose 10%.
ولو كانت:
-Hypocalcemia
نعطوا Ca gluconate.

لو درنا level of glucose and calcium، وكانوا Normal نبدو في إعطاء أدوية الصرع.

Antiepileptic drugs

(Phenobarbitone or Phenytoin)
If not respond give benzodiazepines of not respond put patient on General anaesthesia and mechanical ventilation.)

☆Diagnosis by:

-CBC and CRP if suspected infection.
-Lumbar puncture (Glucose, protein and WBCs) in case of Meningitis.

-If case of birth asphyxia => Brain CT scan.

Discussion of case Newborn with poor feeding and vomiting: ‼️

D.D:

1- Neonatal sepsis ( UTI or Meningitis).
2- Neonatal jaundice.
3- Inborn errors metabolism.

☆Diagnosis of neonatal sepsis: ‼️

1) CBC (Hb, platelet, WBCs lymphocytosis "viral cause ", PMN" bacterial cause".

2) CRP.

3) Septic screen (Urine C/S, CSF C/S, Blood C/S, Chest x-ray, Surface swap).

Treatment: ‼️

First step incubator care, then Supportive and specific Rx.

-Supportive Rx:
IVF and Monitoring.

-Specific Rx:
IV antibiotic.
Ampicillin (for GBS and listeria) and Gentamycen (for E.coli).
For 2 weeks, if case of meningitis for 21 days.

★ Therapeutic dose of iron supplement used to treatment Iron deficiency anemia:
3-6 mg/kg/day for 3-6 months. ‼️

-Daily requirements of nutrients: ‼️****

☆ Fluid = 150 ml/kg/day

☆ Calorie = 110 k calori/kg/day.

☆ Protein = 2mg/kg/day

☆ Vit D = Term (400-600 IU/day)
Pre term (800-1000 IU/day)

☆ Iron = Term baby 1mg/kg/day.
Pre term 2-3 mg/kg/day.

☆ Constitutional short suture:

- Length at birth Normal +/- 50 cm.

- Negative family Hx of short suture.

- Positive family Hx of Delay puberty.

- Height velocity is normal.

- Bone age = Height age > Chronological age.

☆ يعني عُمره من تاريخ الميلاد 9 سنوات، وعمر وعظامه 7 وعمره الطّولي 7 سنوات. 👀

- Adult height (Final height) is Normal length (Catch up).

- More in Male ‼️

هذا مُلخص للـImmune ⤴️ كامل بإذن الله، ومعش تستحقوا تقروه مرّة ثانية..

موفّقين مُسدّدين جميعًا. 🩵

✧Types of B cell defect:

1) Selective IgA deficiency.
2) X linked agama globulinameia (Bruton disease).
3) Neutrophile defect.
4) Hyper IgH syndrome.

•الأول والثاني أهم أنواع B cell defect وهاذو اللي بنركزوا عليهم. ‼️****

✧Types of T cell defect:

1) Sever combined immune deficiency.
2) Wiskott-Aldrich syndrome.
3) DiGeorge syndrome.
4) Ataxia Telangectesia.

•هاذو مُهمات كلهم الحقيقة، بس كل نوع كلمة وقُص! 👀*‼️***

✧Types of Phagocyte defect:
هلبا أنواع منهم، بس أهم واحد هذا:
Leukoctye adhesion deficiency
ذكره د.الجعكي في شيت الـNeonate، نحفظوا عليه بإنّ البيبي يجي بـ:
Delayed separation of umbilical cord, delayed wound healing. 👀‼️

✧Types of complement defect:
حتى هذا كذا نوع لكن نحفظوا الحاجات هاذو بس:
- Deficiency C1, C2, C4 → SLE.

- Deficiency C5, C6, C7, C8 → Nesseria mengiditis.

• Immunology:

Immune system component from:

-Innate immunity & Adaptive immunity.

✧ Innate immunity: [Phagocyte, complement] which the first line, non specific, no memory immunity.

✧ Adaptive immunity: [T-cell →T-helper, cytotoxic, B-cell. →produce Antibodies →Immunoglobulin]

♢ Thier are 5 types of Ig:
1) IgG most common (75%), small in size, can cross placenta and Ab of 2ry response.

2) IgM large size not cross placenta (MCQ‼️) and Ab of 1ry response.

3) IgA secretory foun in Breast milk.

4) IgD found in B cell membrane, but unknown function.

5) IgE mainly in Hypersensitivity type 1 and parasitic infestation.