#remember
✅ nosebleeds and menses generally are not a contraindication to anticoagulation
✅بالعربي نزيف الانف والدوره الشهريه ليس مانع لاستخدام مضادات التجلط في حال وجود حاجه ملحه لاستخدام هذه الادويه
#UPTODATE2025
✅ nosebleeds and menses generally are not a contraindication to anticoagulation
✅بالعربي نزيف الانف والدوره الشهريه ليس مانع لاستخدام مضادات التجلط في حال وجود حاجه ملحه لاستخدام هذه الادويه
#UPTODATE2025
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هل مضخات الإنسولين فعلاً أفضل للأطفال المصابين بالسكري من النوع الأول؟
في دراسة كانت
meta-analysis (2025)
لـ10 تجارب عشوائية شمل >700 طفل/مراهق أظهر أن
insulin pumps (automated insulin delivery)
خفّضت HbA1c بمقدار 0.41% وزادت Time-in-Range بنسبة +11.5% بشكل عام و+19.7% أثناء الليل.
كما قلّلت
hypoglycemia وhyperglycemia
وكان التحسّن أوضح overnight.
أما
severe hypoglycemia وDKA
فكانت نادرة لكنها حدثت بتكرار أكبر في مجموعة المضخة.
الخلاصة: من الآمن والفعال
offer insulin pump therapy
للأطفال المصابين بـT1DM عندما تتوفر التقنية ويمكن استخدامها بأمان.
#Clinical_Notes
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Chapter e21_ Skin Care and Minor Dermatologic Conditions.pdf
620.7 KB
نزل شابتر جديد في Dipiro's هذا الشابتر لم ينزل في النسخه السابقه
Skin Care & Minor Dermatologic Conditions
ماذا يحتوي بشكل عام؟
(General Overview)
هذا الشابتر يقدّم نظرة شاملة وسهلة عن كيفية العناية بالجلد والتعامل مع الحالات الجلدية البسيطة التي يمكن علاجها بـ العناية الذاتية Self-care والمنتجات المتاحة بدون وصفة (OTC).
يركّز الشابتر على:
فهم أساسيات الجلد (Skin anatomy & function) وكيف يؤثر العمر والبيئة على صحته.
كيفية تقييم المشكلة الجلدية باستخدام خطوات عملية مثل SCHOLAR-MAC لتحديد هل الحالة مناسبة لـ self-care أو تحتاج إحالة.
اختيار الشكل الدوائي المناسب (ointments, creams, gels, lotions) ومتى نستخدم كل واحد.
أشهر الحالات الجلدية البسيطة مثل:
جفاف الجلد (Dry skin / Xerosis)
التهابات التلامس (Contact dermatitis)
التهاب الحفاض (Diaper rash)
القشرة والتهابات الجلد الدهنية (Dandruff / Seborrheic dermatitis)
الحروق الشمسية (Sunburn)
الجروح والخدوش البسيطة (Minor wounds)
العلاج غير الوصفي (OTC): أهم المنتجات، متى تُستخدم، ومتى يجب التوقف.
متى يجب مراجعة الطبيب إذا لم تتحسن الحالة أو ظهرت علامات خطورة.
الفكرة الأساسية للشابتر:
تعليم القارئ كيف يقيّم مشاكل الجلد الخفيفة ويختار علاجًا آمنًا ومناسبًا، مع التأكيد على الوقاية والعناية اليومية.
#Clinical_Notes
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🛑Antiplatelet therapy according to cause and severity of ischemic stroke
✅Intracranial large artery atherosclerosis with stenosis 70 to 99%: 👉DAPT for up to 90 days, 👉followed by single-agent antiplatelet therapy
✅Small vessel disease, extracranial large artery atherosclerosis (no revascularization), intracranial large artery atherosclerosis with stenosis 50 to 69%, or cryptogenic:
✅NIHSS score ≤5 (minor ischemic stroke): DAPT for 21 days, followed by single-agent antiplatelet therapy
✅NIHSS score >5 (higher severity ischemic stroke): Single-agent antiplatelet therapy
#UPTODATE2025
✅Intracranial large artery atherosclerosis with stenosis 70 to 99%: 👉DAPT for up to 90 days, 👉followed by single-agent antiplatelet therapy
✅Small vessel disease, extracranial large artery atherosclerosis (no revascularization), intracranial large artery atherosclerosis with stenosis 50 to 69%, or cryptogenic:
✅NIHSS score ≤5 (minor ischemic stroke): DAPT for 21 days, followed by single-agent antiplatelet therapy
✅NIHSS score >5 (higher severity ischemic stroke): Single-agent antiplatelet therapy
#UPTODATE2025
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🛑diabetes mellitus and stroke
✅ Patients with diabetes mellitus have approximately twice the risk of ischemic stroke compared with those without diabetes
✅ the risk of stroke associated with diabetes is higher in women than in men
#UPTODATE2025
✅ Patients with diabetes mellitus have approximately twice the risk of ischemic stroke compared with those without diabetes
✅ the risk of stroke associated with diabetes is higher in women than in men
#UPTODATE2025
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اخيرا
حساب لكزيكمب الجديد
Lexicomp (Lexidrug)
Username
assalam25
Password
1nmWApLbc&
#Clinical_Notes
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🛑 anticoagulation and Thermbocytopenia
✅some individuals with Immune thrombocytopenic purpura
(ITP) and a platelet count in the range of 30,000 to 50,000 may tolerate anticoagulation if needed)
#Uptodate2025
✅some individuals with Immune thrombocytopenic purpura
(ITP) and a platelet count in the range of 30,000 to 50,000 may tolerate anticoagulation if needed)
#Uptodate2025
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🛑 atrial fibrillation and chronic kidney disease
✅High CHADS-VASc score → high stroke risk
✅High HAS-BLED → high bleeding risk
✅is reasonable to not anticoagulate the following groups of individuals with AF and eGFR <30 mL/min (stages 4 and 5) given our uncertainty of the benefit-to-risk ratio for antithrombotic therapy in these patients:
✅Patients with high frailty
✅Patients with prior life-threatening bleeding or recurrent bleeding
✅Patients with poorly controlled hypertension
#Uptodate2025
✅High CHADS-VASc score → high stroke risk
✅High HAS-BLED → high bleeding risk
✅is reasonable to not anticoagulate the following groups of individuals with AF and eGFR <30 mL/min (stages 4 and 5) given our uncertainty of the benefit-to-risk ratio for antithrombotic therapy in these patients:
✅Patients with high frailty
✅Patients with prior life-threatening bleeding or recurrent bleeding
✅Patients with poorly controlled hypertension
#Uptodate2025
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🛑 atropine and heart block
✅ 1St degree and 2nd degree (mobize1) 👉 effective
✅ 2nd degree (mobize2) and active ischemia 👉 paradoxical effect in HR👉 worsening degree of AV block
✅ 3rd degree 👉not effective
#Salah
✅ 1St degree and 2nd degree (mobize1) 👉 effective
✅ 2nd degree (mobize2) and active ischemia 👉 paradoxical effect in HR👉 worsening degree of AV block
✅ 3rd degree 👉not effective
#Salah
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Clinical Notes
🛑 atropine and heart block ✅ 1St degree and 2nd degree (mobize1) 👉 effective ✅ 2nd degree (mobize2) and active ischemia 👉 paradoxical effect in HR👉 worsening degree of AV block ✅ 3rd degree 👉not effective #Salah
✅بالعربي
طبعا كنت اقول انه atropine
فعال في جميع مراحل heart block 🤔 في حاله acute(unstable)
لكن قرات انه فعال
في Ist degree
وفي 2nd degree (Mobize1)
فقط
لكن في
2nd degree (Mobize2)
بالعكس له parodixal effect in HR
يعني ممكن يوطي HR🤔
اما في 3rd degree not effective in HR🥲
#salah
طبعا كنت اقول انه atropine
فعال في جميع مراحل heart block 🤔 في حاله acute(unstable)
لكن قرات انه فعال
في Ist degree
وفي 2nd degree (Mobize1)
فقط
لكن في
2nd degree (Mobize2)
بالعكس له parodixal effect in HR
يعني ممكن يوطي HR🤔
اما في 3rd degree not effective in HR🥲
#salah
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Clinical Notes
🛑 atropine and heart block ✅ 1St degree and 2nd degree (mobize1) 👉 effective ✅ 2nd degree (mobize2) and active ischemia 👉 paradoxical effect in HR👉 worsening degree of AV block ✅ 3rd degree 👉not effective #Salah
نقدر نختصرها
✅✅Atropine works only when the block is at the AV node.
✅If the block is below the AV node → it may be ineffective or harmful.
✅✅Atropine works only when the block is at the AV node.
✅If the block is below the AV node → it may be ineffective or harmful.
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🛑 maintenance dose antiplatelet time in STEMI
✅ prasugrel 10mg daily beginning approximately 24 hours after the loading dose
✅ ticagrelor 90 mg twice daily beginning approximately 12 hours after the loading dose
✅ clopidogrel 75 mg daily and should begin approximately 24 hours after the loading dose
#Uptodate2025
✅ prasugrel 10mg daily beginning approximately 24 hours after the loading dose
✅ ticagrelor 90 mg twice daily beginning approximately 12 hours after the loading dose
✅ clopidogrel 75 mg daily and should begin approximately 24 hours after the loading dose
#Uptodate2025
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🛑Cangrelor in treatment STEMI
✅Cangrelor is an intravenous P2Y12 inhibitor that is an option for therapy in patients with STEMI in cardiogenic shock or when an oral P2Y12 inhibitor cannot be administered (eg, patients with nausea and emesis)
#Uptodate2025
✅Cangrelor is an intravenous P2Y12 inhibitor that is an option for therapy in patients with STEMI in cardiogenic shock or when an oral P2Y12 inhibitor cannot be administered (eg, patients with nausea and emesis)
#Uptodate2025
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🛑Switching ticagrelor to clopidogrel
✅For patients who have been receiving ticagrelor, we give the first dose of clopidogrel 12 hours after the last dose of ticagrelor
✅We give a 600 mg loading dose of clopidogrel to all such patients
🛑Switching prasugrel to clopidogrel
✅For patients who have been receiving prasugrel for five days or less, some of our experts load with clopidogrel 300 mg 24 hours after the last dose of prasugrel, while others do not load.
✅For patients taking prasugrel for >5 days, we do not give a loading dose and begin therapy with clopidogrel 75 mg daily.
#Uptodate2025
✅For patients who have been receiving ticagrelor, we give the first dose of clopidogrel 12 hours after the last dose of ticagrelor
✅We give a 600 mg loading dose of clopidogrel to all such patients
🛑Switching prasugrel to clopidogrel
✅For patients who have been receiving prasugrel for five days or less, some of our experts load with clopidogrel 300 mg 24 hours after the last dose of prasugrel, while others do not load.
✅For patients taking prasugrel for >5 days, we do not give a loading dose and begin therapy with clopidogrel 75 mg daily.
#Uptodate2025
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🛑Oral decongestants in pregnancy
✅Pseudoephedrine can be used in the second and third trimesters in females without hypertension.
✅Oral decongestants should generally be avoided during the first trimester
#Uptodate2025
✅Pseudoephedrine can be used in the second and third trimesters in females without hypertension.
✅Oral decongestants should generally be avoided during the first trimester
#Uptodate2025
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Clinical Notes
Dipiro's_pharmacotherapy_13ed_مسعود_رسام_126_.zip
كتاب ديبرو النسخه 13
Dipiro's Pharmacotherapy pathophysiology approach 13th Edition
اصبح شبه مكتمل من 168 شابتر
#Clinical_Notes
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Dipiro's pharmacotherapy 13ed. مسعود رسام.zip
67.8 MB
كتاب ديبرو النسخه 13
Dipiro's Pharmacotherapy pathophysiology approach 13th Edition
اصبح شبه مكتمل من 168 شابتر
#Clinical_Notes
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🛑NSAIDS and pregnancy
✅ acetaminophen (the preferred analgesic during pregnancy
✅For pregnant patients >20 but ≤28 weeks in whom NSAID use is deemed necessary, the shortest duration (ideally ≤48 hours) and lowest effective dose should be used.
✅For patients >28 weeks, we avoid NSAID use given their associations with adverse outcomes at these gestational ages.
#Uptodate2025
✅ acetaminophen (the preferred analgesic during pregnancy
✅For pregnant patients >20 but ≤28 weeks in whom NSAID use is deemed necessary, the shortest duration (ideally ≤48 hours) and lowest effective dose should be used.
✅For patients >28 weeks, we avoid NSAID use given their associations with adverse outcomes at these gestational ages.
#Uptodate2025
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