Dr Mohamed Omar

15/08/2024

𝐃𝐇𝐈𝐃𝐈𝐃𝐊𝐀 𝐆𝐀𝐂𝐌𝐀𝐇𝐀👋

Dhididka badan ee qofka uu ku arko gacmihiisa ama lugahiisa waxaa caafimaad ahaan loo yaqaannaa " oo macnaheedu yahay cillada dhididka xad dhaafka ah.

Qofka markuu kululaado ama uu jimicsi sameeyo inuu dhidido waa arrin caadi ah oo eebbe ugu talagaly in jirka lagu qaboojiyo si loo yareeyo heerkulka.

Waxaa kaloo dabiici ah hadduu qofka xanaaqo ama naxo ama welwelo inuu dhidid ka yimaado.Laakiin cillada ku kooban sacabada iyo calaacalaha oo aad looga dhidido iyadoo aysan jirin wax kiciyo sida aan kor ku soo xusay waa cillad qanjirrada dhididka oo si xad dhaaf ah u shaqeeyo..

Qofka qabo cilladaan, waxaa kacsan qanjirrada dhididka u qaabilsan ee ku yaallo jirka ama meelo gooni ah sida sacabada iyo calaacalaha, qofka uu dhididka badan ka sii welwelo ama dhibsado waxay sii kordhinaysaa dhididka horay u badnaa.

Hadduu iyadoo cillada dhididka badan jirto, qofka uu sii welwelo ama naxo wuu ka sii daraa dhididka sida markii aad imtixaan ka shaqaynayso oo kale.

haddii calaacalaha aad ka dhidido waxaa loo yaqaanaa "Palmar Hyperhidrosis" kan cagahana "Plantar Hyperhidrosis".

Dhididka badan oo noocaan ahi, wuxuu noqon karaa mid dahxal ah oo aan la xiriirin xanuun kale.

Laakiin waxaa dhacdo xaalado caafimaad darro oo dhididka siyaadiyo waxaana ka mid ah cudurradaan soo socda:
1- Kacsanaanta dheecaanka korriinka jikra "Growth hormone"
2- Cilladaha niyad jabka iyo welwelka ee maskaxda ku dhaca.
3- Kansarka
4- Daawooyinka qaar oo si qaldan loo isticmaalo
5- Kacsanaanta qanjirka thyroid-ka.
6- Tiibishada sambabka ku dhacdo "Qaaxada"
7- Xanuunka Buruseelka
8- Dhaawac xangullaha lafdhabarta
9- Faalijka nooc ka mid ah.
10- Xanuunka xasuusta lumiya ee Parkinson.
11- Xilliga dhalmodeyska ama caadada istaagto.
12- Cillada sonkorta dhacdo.

Haddii qofku iskala noolaan karo wax dhib ah kuma yeelaneyso laakiin haddii ay saameyn ku yeelato nolol maalmeedkiisa waa inuu la xiriiraa takhtar si xal loogu helo.

Dadka ugu badan ee dhibaato ku qabo ayaa waxaa ugu horreeyo ardayda weliba xilliyada imtixaannada maadaama ay niyad kacsaniyihiin dhididkane uu saaid yahay taasoo keenta in ay warqadaha iska qooyaan imtixaankane ka shaqayntiisa dhib ku noqdo.

Hababka kontoroolidda dhidhidka xad dhaafka ah waxaa lagu yarayn karaa kareemyada leh deodorants-kaoo ay ku jirto maado loo yaqaanno "antiperspirants" oo dhididka yarayso.

Waxaa kaloo lagu joojiyaa iyadoo koronta lagu qabto qanjirrada dhididka siyaadada ah u soo daayo ama cirbad lagu duro ama qalliin lagu sameeyo neerfaha kontoroolo qanjirrada dhididka.

Daaweyntaan waxay ku xiran tahay qofka xaaladiisa heerka ay gaarsiisan tahay iyo meesha dhididkiisu u badan yahay.

haddii cilladaadu aysan gaarsiisneyn heer daawo ama qalliin waxaa jiro tillaabooyin aad guriga ku samayn karto si aad dhididka iskaga yarayso:
1- Baradho inta aad xaliif ahaan u jarjartid, gacmaha ama meelaha aad uga dhidido ku xoqo.
2- Cusbo iyo liin dhanaan la isku daray marso meelaha aad uga dhidido waxay yareeyaan shaqada qanjirka dhididka

07/07/2024

DILAAGA QARSOON DEXAMETHASONE

( DAAWADA
) OO LOO YAQAN KINIINKA
BARIISKA

Isticmaalka ama cunista kaniiniyada loo isticmaalo
xasaasiyadda iyo sanboorka ee loo yaqaano kaniini
bariis ( ) waxaa soo batay
isticmaalka kaniinkaan oo bulshada qaarkeed si
khaldan ugu isticmaalaan waxyaabahan soo socda:
1. Cayilka: dadka qaar dumarka ubadan ayaa
kaniinkan u isticmaala inay isku cayiliyaan iyagoo ka faideysanaya cilladihiisa caafimaad ( effects).
2. Hargabka: qaar ka mid ganacsatada
daawooyinka ee farmasiyada jooga ayaa dadka
kaniinkan siiya waqtiyada ay cabur ama hargab
dareemayaan waana khalad weyn o caafimaad
darro ba'an keeni kara.
Daawadaan Dexamatheson waxay kamid tahay
daawooyinka loo yaqaan ( drugs ) ama
daawinka difaaca jirka hoos udhiga(
lowering agents ) waxayna leeyihiin isticmaal gaara
oo xaddidan iyo shuruudo lagu qaato kana mid ma
ahan daawooyinka la ogolyahay in warqad la,aan la
iibin karo ama la libsankaro( over the counter drugs)
waayo waxay leedahay waxyeelooyin tiro beel ah
haddii aan si sax ah ama qiyaas sax ah la isticmaalin

Dhibaatooyinka( Side effects ) kaniini

bariiska( )

1. Dhig kar ( ) haddi uu qofka ku
dhoco xanuunka loo yaqaan ( Cushing syndrome)
2. Sonkor ( steroid induced )
3. Cayil siyaado ah ( ) cayil aan jirka simayn
oo qofku ka ciyilayo dhexda,tunka iyo face ka ( face)
4. Isbaddal midabka ah sida caddaan
(depigmentation) gofka oo caddaan an dabiici
ahayn cadaada( waana sababta dad badan u
cunaan kaniinka)
5. Xanuunno iyo howlgab ku dhaca qanjirrada jirka
qarkood. ( adrenal insufficiency ) Iyo cillado iyo
jirrooyin kaloo badan.

soo jeedin

1. Waxaan kula talinaynaa bulshada inaysan
daawadaas isticmaalkeeda billaabin talo iyo
ogolaansho xirfadle caafimaad la,anteed.
2. Waa in qofkiï hadda isticmaala u iska daayo
isagoo la tashanaya dhakhtar si talo looga siiyo
joojinteeda maadama haddi hal mar lawada joojiyo
dhibaato keenayo

03/07/2024

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the p***s. In boys with hypospadias, the urethra forms abnormally during weeks 8–14 of pregnancy. The abnormal opening can form anywhere from just below the end of the p***s to the sc***um. There are different degrees of hypospadias; some can be minor and some more severe.

of Hypospadias
The type of hypospadias a boy has depends on the location of the opening of the urethra:

1. : The opening of the urethra is located somewhere near the head of the p***s.

2. : The opening of the urethra is located along the shaft of the p***s.

3. : The opening of the urethra is located where the p***s and sc***um meet.

Problems
Boys with hypospadias can sometimes have a curved p***s. They could have problems with abnormal spraying of urine and might have to sit to urinate. In some boys with hypospadias, the has not fully into the sc***um. If hypospadias is not treated it can lead to problems later in life, such as difficulty performing sexual in*******se or difficulty urinating while standing.


It is estimated that each year about 5 boys out of every 1,000 born in the United States have hypospadias,12 making it one of the most common birth defects.

and Risk Factors
The causes of hypospadias in most infants are unknown. In most cases, hypospadias is thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy.

Just like the many families affected by birth defects, CDC wants to find out what causes them. Understanding the risk factors that are more common among babies with birth defects will help us learn more about the causes. CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS; began with births in 2014), to understand the causes of and risks for birth defects, like hypospadias.

In recent years, CDC researchers have reported important findings about some factors that affect the risk of having a baby boy with hypospadias:

1. Age and weight: Mothers who were age 35 years or older and who were considered obese had a higher risk of having a baby with hypospadias.

2. Fertility treatments: Women who used assisted reproductive technology to help with pregnancy had a higher risk of having a baby with hypospadias.

3. Certain hormones: Women who took certain hormones just before or during pregnancy were shown to have a higher risk of having a baby with hypospadias.

CDC continues to study birth defects like hypospadias and how to prevent them. If you are pregnant or thinking about becoming pregnant, talk with your doctor about ways to increase your chance of having a healthy baby.


Hypospadias is usually diagnosed during a physical examination after the baby is born.


Treatment for hypospadias depends on the type of defect the boy has. Most cases of hypospadias will need surgery to correct the defect.

If surgery is needed, it is usually done when the boy is between the ages of 3–18 months old. In some cases the surgery is done in stages. Some of the repairs done during the surgery might include placing the opening of the urethra in the right place, correcting the curve in the p***s, and repairing the skin around the opening of the urethra. Because the doctor might need to use the fo****in to make some of the repairs, a baby boy with hypospadias should not be circumcised.

20/06/2024

15/06/2024

30/05/2024

screening

Helps in building a healthy and trusting relationship: Premarital health screening educates couples with unbiased health information that is essential for their future. One's family medical history, hereditary factors, food and exercise patterns, weight, and addictions contribute to their health.

A premarital health checkup contains various screening tests that offer information about their genetic, infections and communicable diseases for preventing the risk of transmitting these diseases to each other or their future offsprings. Here are 5 ways a premarital checkup can make the future of married couples a healthy one.

1. in building a healthy and trusting relationship: Premarital health screening educates couples with unbiased health information that is essential for their future. One's family medical history, hereditary factors, food and exercise patterns, weight, and addictions contribute to their health.

2. sexually transmitted diseases (STDs): Health conditions like, HIV, hepatitis, syphilis, gonorrhea and herpes are lifelong and debilitating. If it goes undetected or unmanaged, it can adversely affect the married life of the couple. Not diagnosing and treating STDs early can result in health complications and infertility, fetal wastage, ectopic pregnancy, cancer and/or early death.

3. passing on hereditary diseases to offsprings: Conditions such as hemophilia, thalassemia, Marfan syndrome, Huntington’s disease and sickle cell are blood borne and can shorten lifespan. There are high chances of these conditions being passed on to the offsprings, that’s why these traits should be screened for.

4. in family planning and managing children’s health: Premarital screening gives ample information about fertility of each person. It also helps them understand their Rh factor. For a successful pregnancy, the Rh factor of the couple should be the same, otherwise it can be dangerous for the child. These issues should be addressed as early as possible and essential for family planning and health management.
Tests that should be included in a premarital health screening

24/05/2024

Peptic ulcer disease
GASTRECTOMY

of peptic ulcer disease
Is an erosion of the gastrointestinal tract mucosa common in the esophagus, stomach and the duodenum usually resulting from digestive action of hydrochloric acid.

OF PEPTIC ULCERS

1. Esophageal – lower part of esophagus.
2. Gastric – along lower curvature of the stomach.
3. Duodenal – in the duodenum.
4. Marginal – where the remaining stomach is connected to the intestines.

Predisposing factors of peptic ulcer disease
• stress
• excessive alcohol intake
• use of non steroidal antinflamatory drugs
• eractic meals
• smoking
• infection by helicobacter pylori (H. pylori)

AND SYMPTOMS

• Burning sensation (heartburn). Due to the reflux of stomach acid content into the oesophagus.
• Nausea and vomiting.
• Anorexia
• Weight loss
• Haemetemesis or vomiting blood .
• Malena due to ulceration .
• Abdominal pain

SITES FOR PEPTIC ULCER DISE

Peptic ulcer disease (PUD) is characterized by discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in the stomach and proximal duodenum.

BETWEEN GASTRIC AND DUODENAL ULCERS

• Gastric ulcers pain occurs 30 to 1 hr after food while duodenal pain occurs 2 to 3 hrs after food .
• Gastric ulcers vomiting is common while duodenal vomiting is uncommon .
• Gastric ulcers there is hematemesis while duodenal there is Malena .
• Gastric ulcers there is weight loss while duodenal ulcers there is weight gain.
• Gastric ulcers pain is aggregated after meal while duodenal pain is relieved after taking meals .
• Gastric ulcers no appetite while duodenal appetite increased or good .


Pre- operative management

Psychological care
1. Explain condition and procedure to the patient and relatives.
2. Explain risks and benefits e.g. risk of peritonitis and need for arresting hemorrhage due to perforation.
3. Reassure patient about treatment modalities.

Informed consent
• Make sure that the patient and relative understands reasons for operations
• Make patient or next of kin sign consent form
• Witness the consent form

Assessment
• Take history and conduct physical examination to assess client’s condition

Check the following:

• The presence of pain
• Nutritional status
• Hydration status
• Vomiting
• Signs of shock e.g. If shock is present , elevate foot end of bed, give intravenous infusion

Ensure the following laboratory tests are done:
• Full blood count
• Haemoglobin level
• Partial prothrombin or bleeding time to identify coagulation deficiencies
• Grouping and cross match in case of need for transfusion of blood
Observations
Check and record the following
• Temperature, Pulse Respirations and Blood Pressure every 15 – 30 minutes until patient is stable
• vomitus for blood and amount
• urine output and amount
• intake and output chart
• abdominal distention
• stool for blood and amount
• level of consciousness using the Glasgow coma scale

Pain control
Do measures to relieve pain e.g.
• diversional therapy
• imagery
• putting patient in a comfortable position
• giving analgesics such as pethdine

Nutrition
 Patient is kept nil per oral
 Total Parentral Nutrition is maintained using intravenous infusion e.g. dextrose saline
 Nasogastric tube is inserted to compress the stomach

Hygiene /Skin preparation
 wipe if stable before being taken to theatre to reduce the presence of microorganisms on the body.
 Do mouth swabbing with wet swabs to keep the mouth moist
 Shaving is not done unless if preferred by surgeon
Elimination
• Insert urinary catheter to prevent injury to the bladder during operation
• Provide emesis bowl for vomiting

Immediate pre- operative care
• Put identification band
• Gown the patient
• Put patient items in safe hands e.g. with the in-charge
• Take and record Temperature, Pulse Respirations and Blood Pressure to act as baseline data
• Remove jewellery to prevent injury during surgery
• Remove all prosthesis e.g. dentures, eye glasses to prevent airway blockage or dislodging.
• Es**rt patient to the theater
• Carry all unnecessary documents and equipments e.g. patient’s notes, laboratory results, x-rays etc
• Handover to theater nurse

3 complications of Peptic ulcer disease

iii.

A: bleeding from the ulcers due to severe ulceration of the stomach wall
B: Can be life threatening and requires immediate measures to stop the bleeeding & replace lost blood
C: signs and symptoms include heamoptisis and malena stool

iv. stenosis

A: narrowing of the pyloric sphincter
B: results from build up of fibrous tissue by healing ulcers
C: symptoms include;feeling of fullness after meals, anorexia and vomiting

v.

A: a break in the wall of the stomach or duodenum due an eroded ulcer
B: symptoms include severe epigastric pain, haemoptisis,later abdominal pains becomes generalised and abdominal tenderness occurs
C: secretions may leak into the peritoneum causing peritonitis.

21/05/2024

Urolithiasis

commonly referred to as kidney stones, is a condition that affects millions of people worldwide. It is characterized by the formation of hard, crystalline mineral deposits in the urinary tract, primarily in the kidneys.

The journey of a kidney stone begins in the renal pelvis, where urine accumulates before being passed into the ureter. When the concentration of certain substances such as calcium, oxalate, or uric acid increases in the urine, they can crystallize and form stones. These stones can range in size from tiny specks to large masses, akin to small pebbles.

The manifestation of urolithiasis can be silent, with stones quietly residing in the kidneys. However, when these stones begin their descent into the narrow confines of the ureter, they can cause excruciating pain, often described as one of the most intense forms of discomfort a person can experience. This pain, known as renal colic, is the body’s alarm bell, signaling the presence of these unwelcome intruders.

The risk factors for developing kidney stones are multifaceted, encompassing both genetic and environmental influences. Certain dietary habits, such as high intake of animal protein, sodium, and sugar, have been associated with an increased risk of stone formation.

21/04/2024

Spectrum of clinical features associated with distal renal tubular acidosis

15/03/2024

Seizure disorders