انضموا إلينا في لقاء مميز مع الدكتورة إيمان نبيل، أستاذة علم الأنسجة والخلايا بجامعة الإسكندرية، حيث نناقش مواضيع ملهمة تهم كل طالب طب وكل عاشق للعلم
والطموح.
رابط الحلقة كاملة :
https://youtu.be/wHN1cwLmISA
#فريق_مسند
#بودكاست_طبيب

🎙️ مفاجأة بودكاست طبيب! 🎉

نحن نبدأ رحلة جديدة مع ضيوف مميزين من خارج اليمن ومن أبرز الأطباء والخبراء في العالم العربي! 🌟

السؤال لكم: ⁉️

من برأيكم سيكون ضيفنا الأول ؟!
هل هو طبيب معروف ؟!
أم شخصية طبية لها أثر كبير في الوطن العربي ؟!

🔸 المفاجأة في ضيفنا القادم أنه شخصية طبية بارزة لها صدى واسع في العالم العربي!

شاركونا توقعاتكم في التعليقات 💬

⏳سيتم النشر قريباً ....!

🔔 تابعونا، لأن القادم يستحق الانتظار!

ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
📌تابعونا على منصة اليوتيوب
https://youtube.com/@mosnad_team?si=7DxMcZrw3u8hdVVh
📌للاشتراك في قناة #فريق_مسند على التليجرام
https://t.me/mosnad1

https://youtu.be/1f4O95RvUpQ?si=PSE81Gf31B8CxW4U
حلقة جديدة من#بودكاست #طبيب
وضيف جديد هذه المرة هي الدكتورة "أ.د علية شعيب" رئيسة قسم النساء والولادة في جامعة صنعاء ، الذي سيشرح اغلب المشاكل الذي تهم المرأة أثناء الحمل والولادة .

وتشرح لنا السبب وراء زيادة العمليات القيصرية بين نساء هذي الأيام 😁

حلقة متميزة ومهمٌة .. تابعوها الآن على منصة اليوتيوب لـ #فريق_مُسند | Mosnad Team

# Autoimmune Hepatitis
## Definition
- Chronic liver disease characterized by inflammation caused by the immune system attacking liver cells
- Can lead to liver damage, cirrhosis, and liver failure

## Types
- Type 1 Autoimmune Hepatitis
- Most common form
- Can affect individuals of any age, often women
- Type 2 Autoimmune Hepatitis
- Less common
- Primarily affects children and young adults
- Overlap Syndromes
- Co-occurrence with other liver diseases (e.g., primary biliary cholangitis)

## Causes
- Genetic Predisposition
- Family history of autoimmune diseases
- Environmental Triggers
- Viral infections (e.g., hepatitis viruses)
- Medications (e.g., certain antibiotics, anti-seizure drugs)
- Hormonal factors (more common in women)

## Symptoms
- General Symptoms
- Fatigue
- Weakness
- Fever
- Liver-Related Symptoms
- Jaundice (yellowing of skin and eyes)
- Dark urine
- Pale stools
- Abdominal discomfort
- Extrahepatic Symptoms
- Joint pain
- Skin rashes (e.g., psoriasis, eczema)
- Autoimmune disorders (e.g., thyroid disease)

## Diagnosis
- Clinical Assessment
- Patient history and physical examination
- Laboratory Tests
- Liver function tests (elevated ALT, AST)
- Autoantibody tests (e.g., ANA, SMA, LKM)
- Serum immunoglobulin levels (elevated IgG)
- Liver Biopsy
- To assess inflammation and fibrosis
- Imaging Studies
- Ultrasound or MRI to evaluate liver structure

## Treatment
- Medications
- Corticosteroids (e.g., prednisone)
- Immunosuppressants (e.g., azathioprine)
- Monitoring
- Regular follow-ups to assess liver function and treatment response
- Lifestyle Modifications
- Balanced diet
- Avoiding alcohol
- Liver Transplantation
- Considered in severe cases or liver failure

## Prognosis
- Varies based on early diagnosis and treatment
- With treatment, many patients achieve remission
- Untreated autoimmune hepatitis can lead to serious liver damage and complications

د.عقيل الشامي ..?
?CLD case senario..
A 40-year-old male pt. known case of CLD ,heavy Qat chewer presented to ER one week ago complaining of several attacks of vomiting of blood of large amount, bright red and black color, containing clots, preceded by nusea, followed by dizziness and palpitation,associated with melena ..

✨Portal HTN occure at any age young or old "

?any liver disease has 3 to 4 patterns :-
▫️The first one is acute fulminant hepatitis :in this pattern the disease occures for the first time " in absence of pre-existing liver diseases" with high liver enzymes plus hepatic encephalopathy the pt here need liver transplant otherwise he will die especially  with high grade hepatic-encephalopathy

▫️The second pattern :-
acute hepatitis: in this pattern the pt come to you complaining of fatigue, jundice, but the brain is intact ex. HAV in child age or HBV in adults
HAV has life long immunity
HBV 5➠10% become chronic

▫️third pattern:- chronic hepatitis"at this condition enzymes of liver sometimes become high and other times come back to normal "flactuation"

?LIVER CIRRHOSIS:-
either compensated=> liver functions still good or decompensated =>deterioration of liver functions ( liver cell failure )

✨Functions of the liver :-
Synthetic function ➪proteins
Secretory and excretory finction⇒bile
Detoxification⇒ toxins and drugs
Metabolic function ⇒CHO ,FAT

▫️HBV, HCV, HDV➪cirrhosis

✨Causes of cirrhosis
▫️Autoimmune hepatitis which developed as a result of pesticids and insectisides that found in QAT ⭕️
▫️Infelterative diseases like :
Wilson
Hemochromatosis
alpha 1 anti trypsin deficency
▫️Alcoholic liver diseases
▫️Non alcoholic liver disease =>fatty liver disease this pattern which is most common in our country due to fast food, sedentry life style, obesity and carbohydrates predomenancy in chocolate and other things ➪fatty liver ➢fat deposite in liver cells ➪necrosis of cells ➪⇑liver enzymes => non alcoholic steato-hepatitis [NASH]

▫️schistosoma don't lead to  liver cirrhosis..!!just pre sinosoidal cirrhosis and the liver parnchyma is intact otherwise it lead to portal HTN.
If associated with other factors like toxins or HCV lead to liver  Cirrhosis

✨Wilson affect young age
Hemochromatosis is common b.t 20 and 30 years

?Causes of hematemesis:-
start from nose till ligamentum of Treitz
▫️nose bleeding when pt is sleepy he swallow some of it then vomit it  as well heamoptysis may present as vomiting blood at the same pattern of nose bleeding
▫️Ulcerogenic lesions of esophagous, stomach and doudenum➭hematemesis
▫️tumors 
▫️Varices of esophagous, stomach, doudenum
In doudenum they named ectopic varices " unexpected site of varices"
▫️AVM
▫️GERD
most common cause of esophageal bleeding is GERD
▫️Mallory weiss syndrome that affect people who vomite severly ex. alcholic persons and this condition may lead to ⇒perforation "boerhaave's syndrome" ...
▫️Fistulas➭hematemesis but they are rare

?A16- year- old female pt came to you with her relatives complaining of vomiting of blood!!!
ask her one Q just to know if she is really ill or acting !...
what is the color of stool? ??! If she said it is normal => hystrical " DONOT KNOW THE SOURCE OF BLEEDING " may she injured herself !!
Hystrical => conversional disorders

▫️keep in mind that 15% of CLD bleeding is due to ulcers not just varices but the amount differnciat b.t them

⚡️Vomiting of bright red colore suggest acute bleeding
black colour mean blood pass through stomach and digested ➭ turn to black "hematin" coffee ground appearance "

⚡️melena must be present in association with vomiting of blood if the amount is more than 200 ml

▫️pseudojundice from far distance you see jundice

?Pre hepatic causes of liver cirrhosis due to stenosis, infection, eggs of bilharzia,
Causes of post sinosoidal cirrhosis oral contraceptives, chemotherapy and budd chiari

✨How to measure portal HTN?
By ballon catheter inserted using transjugular rout through IVC to hepatic venulos to measure wedge capillary pressure

# Hepatic Encephalopathy
## Definition
- A decline in brain function due to severe liver disease
- Impaired detoxification leading to the accumulation of toxins in the bloodstream

## Causes
- Liver Disease
- Cirrhosis
- Acute liver failure
- Infections
- Hepatitis
- Sepsis
- Metabolic Disturbances
- Electrolyte imbalances
- Hypoglycemia
- Gastrointestinal Bleeding
- Medications
- Diuretics
- Narcotics
- Dietary Factors
- High protein intake

## Symptoms
- Cognitive Dysfunction
- Confusion
- Memory loss
- Disorientation
- Behavioral Changes
- Apathy
- Agitation
- Personality changes
- Physical Symptoms
- Tremors
- Slurred speech
- Incoordination
- Coma (in severe cases)

## Diagnosis
- Clinical Assessment
- Patient history
- Neurological examination
- Laboratory Tests
- Liver function tests
- Serum ammonia levels
- Imaging Studies
- CT scan
- MRI
- Psychometric Tests
- Psychometric hepatic encephalopathy score (PHES)

## Treatment
- Medications
- Lactulose (to reduce ammonia levels)
- Rifaximin (antibiotic to decrease gut bacteria)
- Dietary Management
- Protein restriction (in acute cases)
- Balanced diet
- Management of Underlying Causes
- Treating liver disease
- Correcting metabolic imbalances
- Liver Transplantation (in severe cases)

## Prevention
- Regular Monitoring
- Follow-up for patients with liver disease
- Dietary Adjustments
- Controlled protein intake
- Avoiding Alcohol and Toxins
- Management of Comorbidities
- Diabetes, hypertension

## Prognosis
- Varies based on underlying liver disease and timely intervention
- Early diagnosis and treatment improve outcomes

السلام عليكم ورحمة الله وبركاته
في زميل لنا في جامعة عدن ، اتواصل معي اليوم على أساس أنه في كرس لدكتور مصري يشرح
Emergency and How you deal with patient in emergency department
سعر الكرس لنا كيمنيين ٢٣ دولار
لكن الطلاب في جامعة عدن أتفقوا معه وشرحوا له وضعنا كطلاب يمنيين وهو كثر الله خيرة تفهم الوضع وعلى أساس يكون في تخفيض بحسب العدد ، فاتفقوا معه يكون تخفيض الى ١٢ دولار بشرط يكون العدد ١٢٠ طالب ، طبعا الكرس بيكون تقريبا ٦٠ فديوا موجودات في تطبيق ننزله من جوجل بلي ، مدت الكرس سنة كاملة ،ولو تشتي تجدد بعد انتها المده تجدد بسعر أقل ،
فهو كلمني على أساس لو في شخص يشتي ينظم
معاهم من أجل يستوفي العدد ،

فا الذي يشتي ينظم يتواصل بي
هذا الرقم 775033651
وهذا المعرف @OsamaAl_banna
والله ولي التوفيق .

#Pediatric_history_2024

1-Basic of pediatric history
2-H/O fever
3-Respiratory history
4-GIT history
كما يشمل ايضا common discussion Q ال يمكن تواجهها في اي حالة تاخد منها history.
--
باقي اجزاء history ح ينزل تباعا ان شاء الله.
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ملاحظة ال بدأ الدراسة بالشيت السابق ال موضح بالعربي تمام وممتاز ويقدر يكمل بيه .
ربي يوفقكم جميعًا

Cases in ENT

Conductive hearing loss causes
• Wax impaction
• Otitis media with effusion (OME)
• Eustachian tube dysfunction
• Ear infections
• Perforations of the tympanic membranes
• Chronic Suppurative Otitis Media