إيه المقصود بـ
Resistant Hypertension?

💡 Definition
Resistant hypertension is high blood pressure that remains uncontrolled despite the use of at least three antihypertensive medications at optimal doses.
One of these medications should be a diuretic.

🔍 Causes
Primary causes can include poor medication adherence, suboptimal treatment, or secondary causes like obstructive sleep apnea.
Lifestyle factors like excessive salt intake or obesity can also contribute.

📊 Diagnosis
To diagnose resistant hypertension, healthcare providers must rule out pseudoresistance.
This involves checking for white coat hypertension, incorrect blood pressure measurements, or poor medication adherence.

💊 Treatment
Treatment includes optimizing the current medication regimen.
Adding a mineralocorticoid receptor antagonist (like spironolactone) may help.
Lifestyle changes such as weight loss, reduced salt intake, and regular physical activity are essential.

⚠️ Secondary Hypertension
Common causes of secondary hypertension include chronic kidney disease, primary aldosteronism, and thyroid disorders.
Addressing the underlying cause is crucial in managing resistant hypertension.

📅 Monitoring
Frequent blood pressure monitoring is necessary to evaluate the effectiveness of treatment.
Ambulatory or home blood pressure monitoring can provide a more accurate assessment than clinic readings.

🧠 Complications
If left untreated, resistant hypertension can lead to serious complications such as stroke, heart attack, and kidney failure.
Early and effective management is vital to prevent these outcomes.

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كل ما تريد معرفته عن حقن ®️Prolia

? What is Prolia?
Prolia (denosumab) is a medication used to treat osteoporosis in postmenopausal women and men at high risk of fractures.
It is a monoclonal antibody that works by inhibiting a protein involved in bone resorption.

? How is it administered?
Prolia is given as a subcutaneous injection every six months.
This biannual administration helps maintain consistent levels of the medication in the body.

?️ Mechanism of Action:
Prolia targets and binds to RANKL (Receptor Activator of Nuclear factor Kappa-B Ligand), a protein that signals bone removal.
By inhibiting RANKL, Prolia reduces bone breakdown and increases bone density.

⚠️ Side Effects:
Common side effects of Prolia include back pain, pain in extremities, musculoskeletal pain, high cholesterol, and urinary bladder infections.
Severe side effects can include hypocalcemia (low calcium levels), serious infections, and osteonecrosis of the jaw.

? Clinical Studies:
Clinical trials have shown that Prolia significantly reduces the risk of vertebral, nonvertebral, and hip fractures in individuals with osteoporosis.
It has been proven effective in increasing bone mass and strength.

? Considerations and Contraindications:
Prolia is not recommended for individuals with hypocalcemia, and calcium levels should be corrected before starting treatment. Patients should ensure adequate intake of calcium and vitamin D during therapy.

? Reference ➡️ EMA

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تفريغ د عبد المتعال فودة Blood

Lecture:3
Immunomodulatory agents

By Dr Maymounah
"من إستفاد فلا ينسى الشهيد أبو آية بدعوة صادقة"

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21_ circulating Ab against coagulation factors :
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22_ Coagulation inside the body versus natural anticoagulant :
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23_ Liver disease and PT :
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24_ thrombocytosis :
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25_ essential thrombocythemia :
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26_ Antithrombin defeciency :
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27_ difference between FDPs and D Dimer:
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28_ Vit K
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29_ Hemorrhagic disease of the newborn
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30_ كلام مهم للجراحين
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_ difference between PTT and lupus
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_ Process of coagulation Dr osama :
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وده رابط فيديوا لشرح
Normal hemostasis :

https://youtu.be/FmGf0goNYxs?feature=shared

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