Dr. Saif ALaa ALqaisy: 2015

Tuesday, 29 December 2015

Cytochrom p450 and drug detoxification is super in alcoholic

Cytochrome P450

The elimination of foreign compounds (xenobiotics) such as drugs and toxins from the body is an essential process designed to protect against potential toxicity from the foods we eat. The food broken down in the stomach is absorbed by the small intestine and then ferried directly to the liver via the portal vein (see figure below). This allows the liver time to detoxify compounds before they are distributed through the circulatory system. In the liver, there are two main types of metabolism that deal with xenobiotics, and a third that deals with their transport.

· Phase I metabolism results in small chemical changes that make a compound more hydrophilic, so it can be effectively eliminated by the kidneys. These reactions usually involve either adding or unmasking a hydroxyl group, or some other hydrophilic group such as an amine or sulphydryl group, and usually involve hydrolysis, oxidation or reduction mechanisms. Cytochrome P450 enzymes are responsible for most phase I reactions.

· Phase II metabolism takes place if phase I is insufficient to clear a compound from circulation, or if phase I generates a reactive metabolite. These reactions usually involve adding a large polar group (conjugation reaction), such as glucuronide, to further increase the compound’s solubility. Often, the functional groups generated in phase I reactions are required for attachment of the phase II polar groups (though in some cases phase II reactions can occur on their own). Transferase enzymes are responsible for most phase II reactions, e.g. uridine diphosphoglucuronosyl transferase (UGT), N-acetyl transferase (NAT), glutathione S-transferase (GST), and sulphotransferase (ST).

· Phase III involves drug transporters, which influence the effect, absorption, distribution and elimination of a drug. Drug transporters move drugs across cellular barriers, and as such can target sites of accumulation. They are located in epithelial and endothelial cells of the liver, gastrointestinal tract, kidney, blood-brain barrier and other organs.

Cytochrome P450 enzymes are the most important enzymes in Phase I metabolism in mammals, and are primarily responsible for the metabolism (degradation and elimination) of drugs.

Liver portal system: food is digested in the stomach and small intestine, then absorbed in the small intestine, where it is transported to the liver for detoxification before being distributed.

Cytochrome P450, Detox Enzymes

Cytochrome P450 (CYP) enzymes are a superfamily of mono-oxygenases that are found in all kingdoms of life, and which show extraordinary diversity in their reaction chemistry. In mammals, these enzymes are found primarily in the membranes of the endoplasmic reticulum (microsomes) within liver cells (hepatocytes), as well as many other cell types. These enzymes use haem iron to oxidise molecules, often making them more water-soluble for clearance. They achieve this by either adding or unmasking a polar group. In general, the reaction catalysed by these enzymes can be summarised as:

R-H + O2 + 2e- + 2H+ à R-OH + H2O

Where R-H is the substrate and R-OH is the oxygenated substrate. The oxygen is bound to the haem in the core of the CYP enzyme. Protons (H+) are usually delivered from the cofactor NADH or NADPH through specific amino acids in the CYP enzyme, which relay the protons to the active site, where they are essential for a reductive splitting of the oxygen so a single atom can be added to the substrate. CYP enzymes can receive electrons from a range of different redox partner enzymes.

Mammalian enzymes

Mammalian CYP enzymes can oxidise both xenobiotics and endogenous compounds, and are important for detoxification of foreign substances, as well as for controlling the level of endogenous compounds, such as hormone synthesis and breakdown, cholesterol synthesis and vitamin D metabolism. CYP enzymes are also involved in vascular autoregulation, especially in the brain, and are vital to the formation of cholesterol, steroids and arachidonic acid metabolites. They can also clear the body of metabolic products such as bilirubin, which arises from the breakdown of haemoglobin. There is a high concentration of CYP proteins in the liver, but these enzymes are also found throughout the body, where they often have specialised roles.

Plant enzymes

Plant CYP enzymes are important for the biosynthesis of several compounds, such as hormones, defensive compounds, and fatty acid conjugates.

Bacterial enzymes

Bacterial CYP enzymes are important for several metabolic processes, such as the camphor-hydroxylating catalytic cycle in P. putida, and for the biosynthesis of the antibiotic erythromycin in S. erythraea.

Saturday, 26 December 2015

My audition for Audi ..post it on loopia .. Loaded on my YouTube account , Facebook& twitter

http://youtu.be/QBAwu4CvtBM

Friday, 13 November 2015

Do not neglect follow up of SUBDURAL

A 24 old male, after road traffic accident , he had a head injury and loss of conciouseness 24 days ago.. Brain CT at the first day shows only small amount of sudural heamorrhage , not significant for surgical evacuation , after 7 days and till the day 24 of his ICU admission , he developed a sudden TONIC CLONIC generalized fit , we start carbamazepine tablet 200 mg once a day, we increased up to 400 mg twice aday, then no response , we added continues infusion pump sedation at the ICU and we start adding adjuvant therapy and we tried to decrease the sedation with the add of the adjuvants, we added revotril 4 mg twice aday, then we added speaking 500 mg twice aday,

Also we couldn't stop the continuous sedation ..we decided to do another brain CT SCAN

WE FOUND A BIGGER THAN HIS FIRST SUBDURAL heamorrhage , but today it was hemolysed blood collection also at the right parieto/temporal

Side...

Why brain CT delayed?

Is the brain secondary insult by pressure effect of the sudural is perminant damage snd the patient will be on that anti epileptic post surgical evacuation!??

Is this an urgent case to do burr hole evacuation under GA!??

Why the surgeon dose not follow up the midical situation and connect his new changes and investigate accordingly?

All these question I say it...

To improve our way of processing our patients

And to be honest that the surgeons defect in follow up is as much important as the surgery itself.

Respects.

Tuesday, 10 November 2015

Vaccination

Important to know

Vaccines Vaccines

• definition

• vaccine Vaccine is a microbe that causes the disease, or part of it, and after that weaken or kill him. And lead vaccine effect in the formation of antibodies after several months, but the effect lasts for a long time, may be lifelong. The process of giving the vaccine intent to acquire immunity against the disease, are called "vaccination" or "vaccination" Vaccination

• types of vaccines

a. Live vaccines

• are vaccines that contain microbes or viruses, live, but weakened and Oahnh so as not to cause any diseases to humans, but only stimulates the immune system. Examples include: measles vaccine for measles, and tuberculosis vaccine BCG, polio vaccine and Sabin, who may be given by mouth in the form of points.

• B. Non-living vaccines

• are vaccines that contain dead microbes, or parts of them, such as whooping cough vaccine, and the Salk polio vaccine children, and who may be given by intramuscular injection, rather than oral.

• c. Toxoid Toxoid

Are vaccines that contain the toxins the bacteria, converted to toxoid is harmless, such as diphtheria toxoid Diphtheria Toxoid, and tetanus toxoid Tetanus Tox

Vaccines are divided into several divisions, but the old division: basic, and non-core, is the most common

• a. Basic vaccines "compulsory"

• so named because most of the countries of the world made it compulsory for children, and is given free of charge, and criminalizes and punishes those who do not give her. They include the following:

• 1- tuberculosis BCG.

2. Children Poliomyelitis paralysis.

3. Tri-bacterial "Aldftiraa- Altetanos- whooping cough." D.P.T.

4. hepatitis b. Hepatitis B

5-measles Measles.

6. triple viral "Alhsbh- German-measles mumps" MMR

• vaccines non-core "additional"

• This group of vaccines not be given mandatory in all countries, but is given in accordance with specific vaccine to the circumstances; as well as by the economic conditions of different countries. Some vaccines have been moved from this group, turned into a compulsory vaccination, such as Alheimovils flu vaccine for Haemophilus Influenza B (HIB) in Almottagdmh.binma countries in the developing world is not compulsory, the high price.

• include non-core vaccines, the following diseases:

• 1 Alheimovils flu Haemophilus Influenza B.

2. Hepatitis A Hepatitis A.

3. chickenpox Chicken Pox.

4. influenza virus Influenza Vaccine.

5. Typhoid Typhoid.

6. Meningitis Meningitis.

7. Cholera Cholera.

8. yellow fever Yellow Lever.

9. bacteria streptococcus pneumoniae Pneumocsccal Vaccine.

10. Anthrax Anthrax.

11. Plague Plague.

12. Dog Rabies disease.

13. rotavirus Rota virus.

•

BCG

Vaccine tuberculosis (TB)

Bacillus - Calmette - Guerin vaccine

• vaccine against tuberculosis (pulmonary and non-pulmonary)

• vaccine effectiveness 80%

• The vaccine consists of bacilli Kalimat Guerin BCG

Where it has to address these bacilli to become so weak that generate immunity in the human body without causing disease by the immune system identify these bacilli

• tuberculosis vaccine BCG containing the microbe debilitating dryer cooling. Before giving it, it must be diluted, mitigation solution, immediately before use. And the vaccine loses its effectiveness quickly after dilution, for the remaining executed him after 6 hours at most, or at the end of the session.

• possible to save the BCG vaccine at a temperature (2-8 m) safe (can be frozen for the purpose of storage for a long time)

• Do not freeze bottles of solvent (distilled water) at all

• vaccine saves at the top of the vertical temperature in the refrigerator (+ 2-8) ° C and vice versa in the refrigerator horizontal

• Omar deal

• given in the first week of birth, in most countries, or during the first three months of birth. It can not be given after year,

• Omar deal

• given in the first week of birth, in most countries, or during the first three months of birth. It can not be given after year,

• The purpose of the use of the vaccine is not to prevent the disease, but to prevent serious complications that can occur when a child injured during the first year of life of tuberculosis, which include:

• cerebral meningitis Altdrna

• lung inflammation miliary Altdrna

• When bypass the old first year, there is no benefit of BCG vaccination because the purpose of vaccination is to prevent serious complications of tuberculosis disease in the first year of life.

• dose and the way

• 0.05 milliliter (oo) in the skin, for newborn babies.

The vaccine is injected into the skin layers, above the shoulder muscle, because this place has less contact with the lymphatic system, and then does not cause any damage or serious complications. To ensure injection in the layers of the skin, not under the skin, should be available the following conditions:

• (1) should not exceed the age of the angle between the needle and the surface of the body, about 15 degrees.

(2) the existence of resistance during injection.

(3) the emergence of swelling after injection dose directly.

• interactions

• It has three types of interactions:

(1) natural interaction

• happens if the child gave the correct dose of the vaccine, within the layers of the skin, and the syringe was sterile, as the bacteria multiply tuberculosis vaccine BCG very slowly, and shows a small tumor appears after injection remains 30 minutes and then disappears

• two weeks after a small tumor mushy red color appears, a drop of about 10 Mellimitr (the head of a pencil as non-tapering) in the subject of vaccination; stay for two weeks and then disappear

• After a period of between two to three weeks, the tumor turns into a small abscess, and become a diameter ulcer about 1 cm, and then healed ulcers on their own, leaving a scar diameter of about 5 Mellimitr, and this scar useful because it is a sign that the child has received the vaccine.

• (2) strong interaction

• In some cases, severe inflammation topical happen, or abscess deeper. And sometimes swollen lymph nodes, located near the facility or in the armpit. This happens because the

• 1- entered injection under the skin, to too much by mistake,

• 2-or because of giving a greater dose than they should,

• 3-or because the syringe was not sterile.

If the reaction remained topically, you do not need any treatment only put dry gauze. If formed a large ulcer, or swollen lymph nodes, the child presented to the doctor because it may be in need of medicines for TB treatment just like tuberculosis patient, and for a period of up to 3 months.

• (3) Early interaction

• If the child has some immunity from previous infection with tuberculosis, the red swelling appears before two weeks, and this means that the child had received BCG vaccination before, or that he had injured himself tuberculosis disease for some time. In case of doubt in the child's infection with tuberculosis, are required to consult a doctor.

• verification of the presence of BCG scar

• must check for swelling, or sore, or scar, at the site of inoculation, when you visit the doctor, following the visit to give the child a vaccine BCG. I found the scar, it means that the vaccine has been successful. And if there is no scar, you must repeat the dose after at least three months, from the previous dose. And it can not be returned after the first year of life.

• Complications

• (1) inflation in the lymph nodes under the armpit.

(2) An abscess cool Cold Abscess, place of administration of the vaccine.

(3) occurrence of cutaneous fistula place to give the vaccine.

(4) wound abscess or fistula sometimes leads to a large scar, skin deformation view on the arm.

• 5-inflammation of the bone

6. General infections appear more rare (5 cases / 1 million), especially in children living with HIV or severe immune deficiency

The vaccine is not given to:

• People who have positive results for the tuberculin test.

-alochkas Who take immune drugs.

-almassabon With HIV.

Since there are no previous cases, there is no contraindications

Complications

• (1) inflation in the lymph nodes under the armpit.

(2) An abscess cool Cold Abscess, place of administration of the vaccine.

(3) occurrence of cutaneous fistula place to give the vaccine.

(4) wound abscess or fistula sometimes leads to a large scar, skin deformation view on the arm.

• 5-inflammation of the bone

• 6- General infections appear more rare (5 cases / 1 million), especially in children living with HIV or severe immune deficiency

DTP

The oral polio vaccine

oral polio vaccine

• disease of the nervous system and causes paralysis often lower sides

• disease disappeared from most states (except Afghanistan -backstan-South Sudan, Nigeria)

• transmission of the virus through the mouth

• Polio

• causes: the wild virus (squirrel) WILD 1-2-3 type

• disease on its way to eradication

• The only way to prevent disease is vaccine

• types of vaccine

• -IPV in 1955, making polio vaccine intramuscular (Salk).

• 2-OPV in 1960 to make oral polio vaccine (Sabin

• For oral polio vaccine (OPV) vaccine is more effective to use 95%

• (economic-over of immunity community-easy use-)

• has no side effects: less than 1% suffer from headache -ashal-sore muscles

• mollusk paralysis from the vaccine (VAPP) 2-4 / 1000000

• Children living with HIV are given a vaccine IPV

• vaccine saves at the top of the vertical temperature in the refrigerator

• (+2) - (+ 8) ° C and vice versa in the refrigerator any horizontal bottom of the refrigerator

• pollinate all the kids and there are no contraindications for vaccinations, for example, diarrhea, coughing, met, etc.)

The vaccine is not given to: -

• HIV

• cancer and its treatment (chemical-ray)

• close contacts of those diseases

• eradication strategy

• 1-routine immunization with polio vaccine with 6 doses increase the coverage rate to 90%

• 2-days national immunization SIAs

• 3-monitoring cases of acute paralysis mollusk

• 4-scan and disinfect MOPPING UP

• national campaigns for vaccination

• spring and autumn round (each with two rounds of their one-month interval)

• All children under 5 years

• Regardless of the position Altgayha

• There is no risk of taking extra doses of polio vaccine

•

Hepatitis vaccine Alvairose pattern b

Hepatitis-B Vaccine

- Hepatitis B Alvairose Nmt-

Transmission

1-blood and blood products and other fluids,

2. from the mother to the fetus during delivery,

3. sexual contact

The vaccine: a (d n .. A). Recycled genetically (DND) (baker's yeast)

What is the vaccine

•: hazy liquid, when the recession for a long period precipitates is shown in the form of granules soft sand bottom of the bottle, so you should jolt before use to take shape Blur

• type of vaccine

• unilateral (MONOVALENT)

The quintet (PENTAVALENT

Saves the vaccine at the bottom of the vertical temperature in the refrigerator (2-8) ° C

And vice versa in the refrigerator any horizontal at the top of the refrigerator to avoid taking into account the horizontal and placed near the refrigerator condenser because it is sensitive to Congelation

• The vaccine must be given the first dose within 24 hours of birth and for the purpose of getting rid of hepatitis Alvairose signing the disease from an infected mother

• vaccine stores 2-8 degree temperature

• Balandjemad damage as well as damage the high temperature

• You must use the shaking test to see that the vaccine is exposed to damage or not

• side effects

• hepatitis B vaccine Alvairose almost more vaccine safe (does not cause side effects)

• Pain - hrqh-redness swelling in 5% of children vaccinated

• mild fever for a day or two days in 6% of children vaccinated

• rash, suffocation, rare shock 1 / 600,000

• Do not given the vaccine liver Alvairose pattern b in the same place for the triple vaccine (why ????)

• have their muscle

• vaccine liver senior

• given to private groups (medical and health personnel-some groups of patients such as those with kidney disease, blood and washing-barbers and midwives Almodhunat

• Mlamsin given to patients

• have their muscle in the upper arm

• date potions 0-1-6 month

Neonatal tetanus

Tetanus neonatorum

• severe illness and often fatal because of the toxins the bacteria (clostridia Titani) and the patient is characterized by hardening of the year and structural stiffening of the muscles of the body with a nervous convulsions (epileptic) seizures. Bacteria Claustaradia found in the soil, out of human gut, horses, chickens, dogs, cats, pigs, sheep and cows and the seriousness of these diseases as they enter the human body through wounds proliferate and secrete a poison that causes the symptoms of the disease, which often ends with death for someone who does not have immunity against the disease.

Tetanus toxoid vaccine for tetanus toxoid

The vaccine: a tetanus toxoid which is the result of the treatment of tetanus poison substance formaldehyde.

• saves the vaccine degree 2-8 °

• damage Balandjemad

• You must use the shaking test the vaccine in case of doubt

• Store in a refrigerator down the vertical and horizontal top of the refrigerator

• Prevention of neonatal tetanus disease: -

• 1.ttaam all women of childbearing age with at least three doses of the vaccine tetanus toxoid that does not exceed the period between pregnancy third dose of more than five years, therefore we emphasize the receipt of the women for five doses of tetanus toxoid, according to timings and thereby guarantee provide protection for more than five ten years.

• 2. vaccinate pregnant women with two doses during the first pregnancy if they were not fertilized before marriage where the first dose in the fourth month of pregnancy, the second dose a month later that complement the table after childbirth as the first dose does not provide protection for children newborn The second dose The availability protection for not more than three years from the date of the second dose and dose C after birth and give protection for a period of five years and a dose four in the years after the third dose is given protection for a period of ten years

• The dosage and fifth year of the fourth dose gives protection for more than fifteen years.

• 3. ensure security and clean the birth of the expectant mother in the hospital under the supervision of a medical angel coach with emphasis on: -

• a. Born to be clean and sterile lounge.

• B. All tools used during the examination of the pregnant or birth sterile.

• c. Cut the umbilical cord device which sterile.

• Dr. And attention to clean the umbilical cord of the baby through the umbilical scan and the skin around the navel medical alcohol only until the fall of the remnants of the umbilical cord care.

• e. Emphasis on the need for parents not to put any item on the navel of the child where she usually put some communities as a solution or substance Alzergiwn or henna or even animal feces on the child's family and therefore it significantly lead to contamination of the umbilical Bmkurat tetanus.

• Health 4.altthagev family the subject of vaccination during pregnancy, the mother continued to complete vaccinations tetanus vaccination schedule as well as the newborn child with all vaccines, especially the triple vaccine which contains tetanus toxoid.

• saves the vaccine at the bottom of the vertical temperature in the refrigerator (+ 2-8) ° C and vice versa in the refrigerator horizontal

• There are situations we face in dealing with pregnant women as if come pregnant for the second time or third and have already vaccinated in the previous pregnancy but did not complete the vaccination Bmeidha in that case series are dealt with as follows taking into account the general rule of vaccinations, a potions sequence and the interval between doses

• In the case of a card Tgayha the reviewing prove the number of potions are continuing from the last dose, for example, were given two doses of tetanus toxoid vaccine in the first pregnancy are giving it third dose be given a date after the age of four o'clock another dose, age dose the fifth session.

• In the absence of Tgayha card in pregnant are calculated potions the least number of potions and means in case of doubt between the pregnant woman was given in pregnancy former doses or three are treated as received two doses and dose is given three or that suspicion among it were given three or four doses are treated as received three doses.

• In the absence of Tgayha card and there is no confirm the number of potions Almseltmh there is no harm in re-vaccination any start of first dose note that the vaccine tetanus toxoid vaccines that the immune system is an excellent deal with any in the case of the first dose at any time and passed a year or more in a dose two o'clock, the immune system will respond well to dose two o'clock even if months ago on the schedule, but not forget the fact that the first dose are not given immunity and the second and third dose gives protection for a limited period of years

DTP

DPT

DPT includes:

• 1- Diphtheria Diphtheria

• 2-Tetanus Tetanus

• 3-whooping cough (pertussis) Pertussis

• Diphtheria: a disease of the respiratory tract (the membrane) -kulb- nervous system

• Tetanus: lead to convulsions and death of a child

• Whooping cough: cough -amadaafat-pneumonia and brain damage

• In 1923 making diphtheria vaccine

In 1926 making pertussis vaccine

• 1- Diphtheria Diphtheria toxoid (bacterial toxins)

• 2-Tetanus Tetanus toxoid (bacterial toxins)

• 3-Pertussis Pertussis whole cell murdered

• The vaccine is a liquid

• If a long period remained stagnate vaccine (vaccine isolated from the fluid in the form of soft sand bottom of the package) must therefore be shaking before use

Balandjemad damage the vaccine should therefore be a test men

The vaccine saves degree 2-8 ° C

Saves the vaccine at the bottom of the vertical temperature in the refrigerator (+ 2-8) ° C and vice versa in the refrigerator no higher horizontal refrigerator.

You must use the freezing index

You must know how to conduct a test men

• The vaccine is given 0.5 CC in the left thigh muscle from the front side brutal and deeply into the muscle to avoid the effects of a substance aluminum added to the vaccine to increase the immune effect of the vaccine as the vaccine superficially glaucoma will lead to a swelling of the vaccination area

• Side Effects

• slightly

• 1-mild fever in the evening (half of the children vaccinated) can give Barracatol, fever disappear within 24 hours but if that lasted more than 24 hours, it is not because of the last of the vaccine

• 2- pain -ahmrar-swelling in the place of glaucoma

• 3-cry more than 3 hours, often because of the pain (1%)

• 4-epilepsy 1/12500 dose because of a rare fever

• Contraindications vaccination triple vaccine.

• vascular shock (a severe reaction) to a previous dose of the triple vaccine.

• symptoms of encephalopathy, such as loss of consciousness or deterioration in the level of awareness with regurgitation or the emergence of other neurological symptoms such as convulsions are not the result of other causes.

• In some cases the doctor to decide when to give the DPT vaccine may cause neurological symptoms of the child, the complete table Altgayha be using the vaccine for young duo DT and which contains vaccines against tetanus and diphtheria only without the pertussis vaccine.

• vaccine effectiveness after three doses 90%

• booster is given first because of the vulnerability of the child and be more and more contact with play

• For the same reasons given anabolic second

• glaucoma way DPT (muscle) left thigh

•

Individual measles vaccine

Measles

• the causative agent of the disease

• Paramyxovirus measles virus

• Virus is variable has several types of genetic genotype

• single serotype

• with 23 genotypes

• The vaccine is against all the existing species

• Host: only human

Transmission of the disease through the respiratory tract and mucous Alafrazat

Incubation period: 10-12 days of exposure to the disease to the emergence of a fever and a period of 14 days from exposure until the appearance of the rash

• infection period: Highly infectious highly contagious four days before the onset of the rash to four days after the rash appears

- Ro for measles = 12.5 - 18.0 (transmission rate = 12.5-18 case

- Household attack rates 75 - 90% rate of transmission of the disease in the family = 75-90%

• But in the case of the vaccine virus is not transmitted

Immune disease

• Before the advent of the vaccine: all regions of the world become equally

• babies generally have immunity from the mother up to the age of 5-9 months (but the disease occurs and the proportion of high-gravity)

• immunity that comes after the disease is lifelong

• immunity that comes after the vaccine be for a period of 20 years and a lifetime for most people

• After the introduction of the vaccine proportion of the disease began to recede

• But outbreaks occur from time to time due to the cumulative increase for children at risk

• This increase is due to: -

• 1- the presence of non-vaccinated children

• 2- and having children vaccinated, but vaccination failure

• measles vaccine 12-month-old efficiency ratio of 95%

• measles vaccine 9 month old efficiency ratio of 85%

• measles vaccine the age of 6 months effective rate of 60%

• 70884 × 0.90 × 0.85 = 54226

• 70884 - 54226 = 16657 annually

• 16657 × 4 = 66 630 years the number of children non-immune

• the number of children has become a non-immune equal to the number of an entire generation in this case preferably work vaccine campaign (follow up) every four years, and when coverage to less than 60% prefer to work for a vaccine campaign ( follow up) every 2 years

Individual measles vaccine

• the first time enters the vaccine in 1963

• Moraten strain in America

• Schwartz strain in other countries

• perfect formation begins immunity after a period of 6-8 weeks from the disease or the vaccine

• vaccine schedule 9 months - 15 months - 4-6 years

• If given a nine month before the vaccine must be returned in the ninth month

Warning give the vaccine

• -Can give the vaccine in the case of a cold fever Alkhvevh- -ashal

• If severe illness and high fever vaccine should be delayed to improve the situation of children

• malnutrition diseases the vaccine should be given to them.

• The vaccine can be given in the case of egg allergy.

• Do not may be given the vaccine in the case of the sensitivity of the measles vaccine in the past or mixed measles.

• Do not may be given the vaccine in the event of a sensitivity to Naomaysn.

• Do not may be given the vaccine for AIDS patients and those suffering from HIV (the patients who take steroid treatment and cancer patients).

side effects

Food hormons and fat hormons ...!!

Hypothalamic part of the brain of humans

appetite regulation by ghrelin and leptin

The arcuate nucleus of the hypothalamus is the main target of ghrelin and leptin. Ghrelin is a peripheral orexigenic signal secreted from the stomach, whereas leptin is a peripheral anorexigenic signal secreted from adipose tissue. In the arcuate nucleus, ghrelin stimulates neurons expressing neuropeptide Y and agouti-related peptide, and leptin suppresses them. Neuropeptide Y released in response to ghrelin stimulates appetite and increases body weight. Appetite regulation in the hypothalamus is, therefore, controlled through the neuropeptide Y signaling pathway. The effects of leptin are opposite to those of ghrelin; leptin decreases neuropeptide Y release to suppress appetite and body weight.

Food hormons....!!!!

Hypothalamic part of the brain of humans

appetite regulation by ghrelin and leptin

Happiness hormon and how we can get it and increase its secretion

السعادة ..هرمونات السعادة وكيفية تفعيلها والتركيز عليها لضمان جسد صحي....

هرمونات. السعادة

هناك العديد من الهرمونات في جسم الإنسان ترتبط إرتباطاً مباشراً بشعوره بالسعادة و الحزن , بالقلق و الإطمئنان , بالإنتباه أو الخمول . لقد وهب الله أجسادنا هذه الهرمونات التي يفرزها الجسم في حالاته المختلفة بغرض الحفاظ على الإتزان النفسي و البدني و مواجهة الأخطار المهددة للحياة و لجعل استمرارنا في الحياة ممكن إذا ما تعرضنا لظروف سيئة

و مثلما ترتبط السعادة بالأحوال و الظروف المحيطة فإن هناك أيضاً كيمياء داخلية يمكننا أن نتحكم بها نسبياً لتخرجنا من حالات الحزن و الكآبة و الضيق في الأوقات الصعبة . لكن تذكرعلاج أصل المشكلة دائماً .

لا يفوتنا أن نؤكد الإكثار من بعض العادات الجيدة مثل ممارسة الرياضة و اليوجا و شرب الماء بكثرة و أخذ حمام يومي بارد هو أمر مفيد حتماً لإطلاق دفقة من هرمونات السعادة في جسدك بشكل منتظم لكن يجب عدم الإفراط في تناول الطعام أو الشيكولاته مثلاً لمكافحة التوتر أو الحصول على هرمونات السعادة فلا يجب أن نعالج مشكلة بمشكلة .

كيمياء السعادة

يفرز جسمك مواد كيميائية ليكافئك على كل سلوك يساعدك على النجاة و البقاء على قيد الحياة و تتم هذه العملية من خلال مكانين رئيسين بالمخ الجهاز الحوفي و قشرة المخ.

الجهاز الحوفي و هو المسئول عن الإنفعالات و المشاعر ينتج مواد كيميائية عصبية هامة تخبر جسمك ما هو جيد أو سيء بالنسبة لك إنها استراتيجية نجاة للحفاظ على حياتك.

في وجود شيء ما طيب فإن الجسم يفرز هرمونات السعادة : الأوكسيتوسين , الإندروفين , السيراتونين, الدوبامين

أما في حالة الخطر فإن الجسم يفرز هرمون المشاعر السيئة و الشعور بالخطر المعروف بالكورتيزول

حينما نواجه تجربة جيدة فإن كيمياء السعادة تنتشر أما حينما تغيب تلك الكيماويات تنتشر مكانها كيماويات الحزن و المشاعر السيئة و هنا علينا أن نبحث عن حل لإصلاح هذا الوضع , إذا أردنا السعادة فعلينا تعزيز الهرمونات الجيدة لإزالة الأثر السيء للهرمونات التي تجعلنا نشعر بالسوء .

تعالى نتعرف أكثر على هرمونات السعادة التي يطلقها الجسم و كيف يمكنك إطلاق سحر هرمونات السعادة في جسدك بمنتهى السهولة .

الأوكسيتوسين (هرمون الحب) Oxytocin

الأوكسيتوسين أو هرمون الحب هو الهرمون المسئول عن الروابط الإجتماعية و يسمى أيضاً هرمون ((. العناق. ,))إنه الهرمون الذي يعزز العلاقة بين الأم و رضيعها خلال الولادة و خلال الرضاعة ويعزز العلاقة الحميمة الرجل و زوجته و المسئول عن علاقات الصداقة و الشعور بالإنتماء و الترابط بين البشر بل و حتى الحيوانات .

يفرز في حالات الحب، الثقة، الهدوء. و لوحظ أنه عند ارتفاع نسبة هرمون الأوكسيتوسين في الدم لدى بعض الناس يزيد من قدرتهم على الثقة بالاخرين. كما أنه يزيد من فرص الحوار والتفاهم بين الزوجين على المواضيع الشائكة . و يدرس هذا الهرمون باهتمام من الناحية النفسية ومدى تأثيره على الاضطرابات النفسية.

الحصول على دفقة من هرمون الأوكسيتوسين ؟

عانق شخصاً ما : العناق سيعطيك دفقة مهمة من الأوكسيتوسين خلال الأوقات الصعبة !

كن محل ثقة : يميل الأشخاص الذين يثق بهم الناس للشعور بمزيد من الثقة بالآخرين

إقتني حيوان أليف : إذا كنت لا تثق بالآخرين ربما يساعدك اقتناء حيوان أليف على استعادة جزء من ثقتك بالآخرين

اقضي وقتاً مع من تحب مثل الزوجة أو الأبناء أو الأهل أو الأصدقاء

مساعد الآخرين في أوقات الأزمات سيساعدك على التخلص من التوتر الذي يعوق إفراز الأوكسيتوسين

صلة الرحم و المسح على رأس اليتيم و مساعدة المحتاجين أيضاً ربما تعطيك دفقة جيدة من الأوكسيتوسين

2. هرمون الإندورفين ( مسكن الآلام )

الإندروفين إنه مسكن الآلام و مكافح القلق و التوتر الذي يفرزه الجسم عند الشعور بالألم لتهدئة االآلام و إعطاءنا القدرة على تحملها

كيف تحصل على هرمون الإندروفين؟

التمارين الرياضية : تساعد التمارين الرياضية على إطلاق الإندروفين خاصة إذا كانت مرحة و ممتعة و بها تحدي أكثر من المعتاد

إضحك : ضحكة حقيقية قوية من القلب و ستجعل الجسم يفرز الإندروفين و تتحرر من الخوف !

أطلق العنان لدموعك : حينما تمنع دموعك فأنت تضيف الكثير من التوتر لجسدك لا تمنع دموعك فالدموع تخلصك من التوتر و تحميك من الضغوط .

الإطالات و اليوجا : تساعد الإطالات و اليوجا على الإسترخاء و تخليصك من التوتر و من ثم تساعدك على إفراز الإندروفين

الحمام البارد يساعد على إطلاق هرمون البيتا اندروفين

3- الدوبامين هرمون التحفيز

الدوبامين هرمون التحفيز و المكايساعدك على أن تكون يقظ و منتبه و نقص الدوبامين يجعلك تعاني من نقص الإنتباه و التركيز و يجعلك في مزاج سيء كما أنه يساعدنا على إطلاق طاقتنا لنحقق المزيد من النجاحات , في الحقيقة مدمني النجاح هم مدمني دوبامين, بالطبع أهم الدوافع هو الدافع الفطري للبقاء على قيد الحياة و هذا يعني عادة الحصول على الغذاء والماء، ولكن مع تطور الحياة صار هناك دوافع أخرى عديدة للبشر:

كيف نحصل على هرمون الدوبامين

تناول السكريات و الحلوى و السكاكر هو أحد أهم أسباب إنطلاق الدوبامين في الجسد (اقرأ : لماذا يعشق الأطفال السكريات مثل الحلوي و الشوكولاتة)

اكثر ما يطلق هرمون الدوبامين هو تحقيق المهمة أو سماع المديح من مديرك عند تأديتها و للحصول على دفقات من الدوبامين في جسدك عليك بالإكثار من النجاحات من خلال تحقيق أسباب النجاح :-

قسم المهمة لمهام صغيرة : إذا كانت لديك مهمة صعبة قسمها لمهام صغيرة بحيث تحصل على الدوبامين عن كل مهمة صغيرة تقوم بها مما يساعدك و يحفزك على الإستمرار في النجاح

رقصة النصر : عليك بتهنئة نفسك على أي إنجاز تقوم به فهذا يعطيك دفعة جيدة ربما ليست مثل التي يحصل عليها عداء في نهاية الماراثون لكنها ستمنحك ذلك الشعور الدافيء الذي تنتظره.

رتب حياتك : رتب مكتبك و نظم وقتك و ضع مدى زمني لتنفيذ كل مهمة من المهام الصغيرة التي قسمتها سابقاً.

4- سيروتونين (مضاد الإكتئاب) Serotonin

السيروتونين يلعب دوراً مهماً في تنظيم مزاج الإنسان ويعتقد أن نقص السيوتونين مسئول عن حدوث مرض الإكتئاب

مصادر الحصول على هرمون سيروتونين

السيروتونين يمكن الحصول عليه من التعرض لآشعة الشمس

السكريات و الكربوهيدرات تساعد على إفراز السيروتونين

ممارسة الرياضة و الجهد البدني اليومي أيضاً لها دور مهم في إفراز السيروتونين

من خلال تناول الأطعمة الغنية بالكربوهيدرات و كذلك تناول الجوز (عين الجمل) الذي يحتوي على سيروتونين بنسبة 300 ميكروجرام/جرام. كذلك يوجد في الأناناس و الموز و البرقوق و الطماطم و الكاكاو وفي كل ماينتج من الكاكاو مثل الشوكولاته، كل تلك النباتات تحتوي على نسبة من السيروتونين أكبر من 1 ميكروجرام/جرام .

من الأشياء المحفزة لإفراز السيراتونين أيضاً الترقيات و الشعور بالأهمية و التقدير:

استمتع بموقعك : ليس من الأفضل دائماً أن تكون أمام عجلة القيادة , احياناً كونك راكب عادي هو أفضل بكثير لحياتك

لاحظ نفوذك : دون تحكم أو غطرسة يمكنك أن ترى أن هناك من وضعوك في موضع قيادة لحياتهم قدر وضعك و كن ممتناً لكونك ذو تأثير جيد في حياة الآخرين

توقف عن الرغبة بالتحكم في جميع الأمور : في معظم الأحيان لا يمكننا التحكم فيما يحدث حولنا علينا ان نتقبل هذا بأن نحاول أن نغير أو نترك الأمور تسير كما هو مقدر لها إن كانت الأمور أكبر من قدرتنا

افخر بعملك : اجعل عقلك يقول 'انظروا الى ما قمت به' دون أن تكون مرتبط كثيراً برد الفعل و تقبل حقيقة أنه لا يمكنك الوصول للكمال

مركب GABA (مضاد القلق)

هو مركب كيميائي يمنع القلق و يعطي شعور بالأمان و الهدوء و يمكن إطلاقه من خلال ممارسة رياضة مثل رياضة اليوجا و الإسترخاء و التأمل و العبادة

هرمون الأدرينالين (هرمون مواجهة الخطر)

الأدرينالين هرمون الخطر كما يعرف الجميع , يعطيك هرمون الأدرينالين شعورا بالحياة و يتغلب على الملل و الرتابة إنه دواء الملل، والشعور بالضيق والركود. و يمكن الحصول على دفقة من الإدرينالين من خلال بعض الألعاب الخطرة بدءاً من ركوب قطار أفعواني في الملاهي و حتى و القفز الحر من الطائرات أو القفز بمظلة من حافة جرف . الحمام البارد أيضاً يساعدك على إطلاق حصة من الأدرينالين و سيجعلك بدوره تصبح أكثر إنتباهاً و يقظة كما يحارب الإكتئاب و يضبط ضغط الدم المنخفض .

هرمون الفينيل إيثامين

هو أحد هرمونات السعادة التي نحصل عليها في المراحل المبكرة من العلاقات , يحتوي الكاكاو على فينيل إيثامين كما أن الشيكولاته تساعد ايضاً على ذلك .

هرمون الغريلين

الغريلين هو هرمون تقليل التوتر و زيادة الإسترخاء , يفرز هذا الهرمون في حالة الجوع و هذا هو سبب إقبالنا على الطعام حينما نشعر بالتوتر بالرغم من كون الفكره لست بالجيدة , لذا تناول كميات كافية من الطعام دون أن تملأ معدتك للحفاظ على مستويات جيدة من هرمون الغريلين

Hormones. Excellency

There are many hormones in the human body are directly linked to your sense of happiness and sadness, concern and reassurance, attention or inactivity. God gave our bodies these hormones secreted by the body in different cases is for the purpose of maintaining the physical and psychological equilibrium and face life-threatening dangers, and we continue to make in life is possible if we were bad conditions

And happiness as linked to conditions and circumstances, there is also an internal chemistry we can control them relatively to get us out of situations of sadness and depression and distress in difficult times. But Tzkralaj root of the problem always.

We can not fail to emphasize a lot of some of the good habits such as exercise and yoga and drink water frequently and take a bath on a cold is beneficial inevitably to launch a splash of happiness hormones in your body on a regular basis but must not over-eat or chocolate, for example, to combat stress or get happiness hormones should not tackle the problem of the problem.

The alchemy of happiness

Your body produces chemicals that rewards you for all behavior that helps you survive and survive and this process is done through the main places in the brain limbic system and cerebral cortex.

Limbic system and is responsible for emotions and feelings produces important chemicals nervous tell your body what is good or bad for you that they escape strategy to keep your life.

In the presence of something good, the body produces happiness hormones: oxytocin, endorphins, serotonin, dopamine

In the case of danger, the body produces the hormone bad feelings and a sense of danger is known Balchortizul

When faced with a good experience, the chemistry of happiness spread either when those chemicals absent spread place Chemicals sadness and bad feelings, and here we have to look for a solution to fix this situation, if we are happy, we promote good hormones to remove the bad effect of the hormones that make us feel bad.

Almighty know more happiness hormones launched by the body and how you can launch a charm happiness hormones in your body very easily.

Oxytocin (love hormone) Oxytocin

Oxytocin or hormone of love is the hormone responsible for social ties and also called hugs hormone, it is the hormone that enhances the relationship between the mother and her baby during birth and during breast-feeding and enhances intimacy man and his wife and in charge of relations of friendship and a sense of belonging and interdependence between human beings and even even animals.

Secreted in cases of love, trust, calm. And it was noted that when the proportion of high hormone oxytocin in the blood of some people more than their ability to trust others. It also increases the chances of dialogue and understanding between the couple on difficult subjects. And studying the hormone attention from the psychological point of view and its impact on mental disorders.

Get a splash of the hormone oxytocin?

Hugged someone: hugs will give you a task splash of oxytocin during difficult times!

Be trustworthy: inclined people who trust their people to feel more confident to others

Buy a pet: If you do not trust others may help you acquire a pet to restore part of the trust of others

Spend time with the one you love, such as a wife or children or parents or friends

Assistant others in times of crisis will help you to get rid of the tension that hinders the secretion of oxytocin

Kinship and survey at the head of the orphan and help those in need may also give you a good splash of oxytocin

2. hormone endorphins (painkiller)

Endorphins analgesic pain and combat anxiety and tension that produced by the body when feeling pain to calm Aalalam and give us the ability to carry around

How do you get the hormone endorphins?

Exercise: Exercise helps to release endorphins especially if they are playful and fun and the challenge more than usual

Laugh: laugh a real strong of heart and will make the body produces endorphins and liberated from fear!

Unleash your tears: tears prevented when you add a lot of stress for your body does not prevent your tears Valdmua save you from the tension and protect you from stress.

Alatalat and Yoga: Yoga helps Alatalat and the relaxation of tension and Tkhalisk and then help you secretion of endorphins

Cold bath helps to release the hormone beta Androfen

3. dopamine hormone stimulation

Dopamine hormone stimulation and Almkaasaadk to be alert and attentive and the lack of dopamine makes you suffer from a lack of attention and focus and makes you in a bad mood as it helps us to launch our power to achieve more successes, in fact addicts success are addicted to dopamine, of course, the most important motivation is the motivation innate to stay alive and this usually means access to food and water, but with the evolution of life there became many other motives for humans:

How do we get the hormone dopamine

Eating sugars and sweets and candies is one of the main reasons for the launch of dopamine in the body (read: Why adores children sugars such as sweets and chocolates)

More so-called hormone dopamine is to achieve a task or hear praise from your boss when performed, and for bursts of dopamine in your body you with plenty of successes through the achievement of the reasons for success: -

A small section of the functions of the job: If you have a difficult task of dividing them small tasks so that you get all of dopamine small task carried out by helping you and motivates you to continue to success

Victory dance: you congratulate yourself on any achievement doing it gives you a good boost may not like that obtained at the end of a marathon runner but it will give you that warm feeling you waiting.

Order your life: Order your office and your time systems and place over a time frame for implementation of each task from the small tasks that formerly divided.

4. serotonin (antidepressants) Serotonin

Serotonin plays an important role in the organization of human mood and believes that the lack of Alsuotonin responsible for the occurrence of depression disease

Access to sources of serotonin

Serotonin can be obtained from sun exposure

Sugars and carbohydrates help the secretion of serotonin

Exercise and daily physical effort also has an important role in the secretion of serotonin

By eating foods rich in carbohydrates, as well as eating nuts (walnuts) that contains serotonin by 300 micrograms / gram. There is also the pineapple and bananas and plums and tomatoes, cocoa and every consequential of cocoa, such as chocolate, all these plants contain a ratio of greater than 1 microgram / gram of serotonin.

Of stimulating things to secrete serotonin promotions and also a sense of importance and appreciation:

Enjoy your location: It is not always best to be in front of the steering wheel, sometimes being a normal passenger is much better for your life

Note influence on: without control or arrogance you can see that there Daok and in the position of leadership to their lives as much as your situation and be grateful for being a good influence in the lives of others

Stop the desire to control all things: for the most part we can not control what happens around us, we have to accept this that we are trying to change or leave things go as destined to things it was greater than our ability

I am proud to your business: Make your mind says, 'Look what you've done' without being very much linked to reactive and accept the fact that you can not reach for perfection

GABA compound (anti-anxiety)

Is a chemical compound prevents anxiety and gives a sense of security and calm and can be launched through the practice of sports such as yoga and relaxation and meditation and worship

The hormone adrenaline (a hormone the face of danger)

Hormone adrenaline danger as everyone knows, the hormone adrenaline gives you a sense of life and overcome the boredom and monotony It medicine boredom, malaise and stagnation. And it can get a splash of adrenaline through some dangerous games starting from Serpentine train ride in the amusement park and even free and jumping out of airplanes or skydiver from the edge of the cliff. Cold bath also helps to launch a share of adrenaline will make you turn and become more attentive and vigilant as fights depression and controlling low blood pressure.

Vinyl hormone Aithaman

Happiness is one of the hormones that we get in the early stages of relationships, cocoa contains a vinyl Aithaman as that chocolate also helps to do so.

Hormone Ghrelin

Ghrelin is a hormone reduce stress and increase relaxation, secretes this hormone in the case of hunger, and this is Akabbalna reason the food when we feel nervous in spite of the fact that the idea I'm not as good, so eating sufficient amounts of food without that fills your stomach to maintain good levels of the hormone ghrelin

Dr saif alaa

Monday, 9 November 2015

Cervical spondylosis and neck+ shoulders and face pain is cervical cause and should be not called migraine...

neck pain

and upper back and shoulder pain is

a neck caused pain...some times eyes or ears and face skin pain

caused bby neck pain (( not brain migrin

What Is Cervical Spondylosis?

Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common, age-related condition that affects the joints and discs in your neck. It develops from wear and tear of the cartilage and bones found in your cervical spine, which is in your neck. While it’s largely due to age, it can be caused by other factors as well.

According to the Mayo Clinic, the condition is present in more than 85 percent of people over the age of 60, although some people who have it never experience symptoms.

For some, it can cause chronic, severe pain and stiffness. However, many people who have it are able to conduct normal daily activities.

Risk:

e greatest risk factor for cervical spondylosis is aging. Cervical spondylosis often develops as a result of changes in your neck joints as you age. Disk herniation, dehydration, and bone spurs are all results of aging.

Factors other than aging can increase your risk of cervical spondylosis. These include:

•neck injuries

•work-related activities that put extra strain on your neck from heavy lifting

•holding your neck in an uncomfortable position for prolonged periods of time or repeating the same neck movements throughout the day (repetitive stress)

•genetic factors (family history of cervical spondylosis)

•smoking

•being overweight and inactive

Symptoms:

Most people with cervical spondylosis don’t have significant symptoms. If symptoms do occur, they can range from mild to severe and may develop gradually or occur suddenly.

One common symptom is pain around the shoulder blade. Patients will complain of pain along the arm and in the fingers. The pain might increase when:

•standing

•sitting

•sneezing

•coughing

•tilting your neck backward

Another common symptom is muscle weakness. Muscle weakness makes it hard to lift the arms or grasp objects firmly.

Other common signs include:

•a stiff neck that becomes worse

•headaches that mostly occur in the back of the head

•tingling or numbness that mainly affects shoulders and arms, although it can also occur in the legs

Symptoms that occur less frequently often include a loss of balance and a loss of bladder or bowel control. These symptoms warrant immediate medical attention.

If you have the sudden onset of numbness or tingling in the shoulder, arms, or legs or if you lose bowel or bladder control, talk to your doctor and seek medical attention as soon as possible.

GO TO THE DOCTOR. IF:

If your pain and discomfort start to interfere with your daily activities, you may wish to make an appointment with your doctor. Although the condition is often the result of aging, there are treatments available that can reduce pain and stiffness.

check this excersize link to strenght your neck muscles very important and easy

http://youtu.be/prjxXR87Kaw

سوفان الفقرات. والام الرقبة. وأعلى الظهر والأكتاف:

(( والاشتباه بداء الشقيقة )):

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السوفان او ما يسمى ب (( داء الفقار الرقبية ))

Cervical spondylosis

داء الفقار الرقبية (Cervical spondylosis) هو عملية من التغيرات التنكسية في اقراص ومفاصل الفقار الرقبية، ومن الممكن ظهوره بعد سن الـ 30 عاما. تتجسد التغيرات التنكسية في بروز القرص (Protruded disk) التنكسي، تطور نابتات عظمية (Osteophyte)، تضيق مخارج الاعصاب واصابة في الغضروف المفصلي في الفقار. قد تؤدي هذه التغيرات الى تضيق القناة النخاعية، ضغط على العمود الفقري او الجذور.

أعراض (( السوفان )) داء الفقار الرقبية

يشكو المريض من الام في الرقبة، او الام مشعة الى الراس، الكتف، اعلى الظهر او الى الذراعين. تدل نتائج الفحص الجسدي على تقييد في حركة الرقبة، اعراض تنبيه جذري، واحيانا اعراض ضرر عصبي.

تشخيص (( السوفان )) داء الفقار الرقبية

يتم تحديد التشخيص بواسطة التصوير بالاشعة السينية (رنتجن – X - ray)، التصوير المقطعي المحوسب (Computed Tomography – CT) للفقار الرقبية من العمود الفقري او التصوير بالرنين المغناطيسي (Magnetic resonance imaging - MRI).

علاج (( السوفان )) داء الفقار الرقبية

تتم المعالجة بواسطة ادوية مضادة للالتهاب والاوجاع، العلاج الفيزيائي / الطبيعي (Physiotherapy)، العلاجات البديلة (Alternative medicine) واحيانا تكون هنالك حاجة الى المعالجة الجراحية لاستئصال قرص بارز، لتحرير مخرج العصب ولتثبيت الفقار المتضررة

هذا الرابط ادناه لمرضى سوفان الفقرات العنقية والام الفقرات العنقية نتيجة السوفان وليس الانزلاق وهي تمارين منزليه بسيطه ممكن اداءها اثناء الجلوس

http://youtu.be/prjxXR87Kaw

اما بالنسبة الصداع النصفي لداء الشقيقة وهو مرض بالاعصاب لسبب معين كما سنشرح ادناه وليس بسبب انضغاط عصب مجاور للفقرة كما في سوفان الفقرات العنقية المسمى بداء الفقار.

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داء الشقيقة:

صداع الراس،الشقيقة اوالصداع النصفي(Migraine)، يمكن ان تكون معوقة عوارضها شديدة جدا، تجعل من المصابين بها يفكرون، احيانا، فقط بايجاد مكان مظلم وهادئ للاستلقاء. تفيد المعطيات ان حتى 17% من النساء و 6% من الرجال عانوا في السابق من نوبة الصداع النصفي.

في بعض الحالات تظهر علامات تحذير (اورة – Aura) لصداع الراس الشديد هذا، او تكون مصحوبة بعلامات مثل ومض الضوء، تشوش في الرؤية (Blurred Vision) او الشعور بوخز في الذراع او الرجل. كثيرا ما تكون الشقيقة مصحوبة باعراض اضافية، مثل الغثيان، التقيؤ، والحساسية المفرطة للضوء والضجيج. قد تكون الشقيقة شديدة لدرجة شل حركة المريض لعدة ساعات او حتى ايام.

لحسن الحظ، لقد طرا في العقد الاخير تحسنا ملحوظا على اساليب التعامل مع الشقيقة. من المفضل ان يقوم المرضى الذين استشاروا الطبيب في الماضي ولم ينجحوا في السيطرة على عوارض الشقيقة، بمعاودة استشارة الطبيب.

حتى الان، لا يوجد علاج شاف للمرض، ولكن الادوية تساهم في تقليل معدل ظهور الشقيقة ووقف الصداع بمجرد ان يبدا. تناول الادوية المناسبة، الى جانب قيام المريض باجراءات وتغييرات بنمط الحياة ممكن ان تؤدي الى تحول هائل في مجرى مرض الشقيقة.

أعراض الشقيقة

قد تكون نوبات اعراض الشقيقة النموذجية مصحوبة بجزء من الاعراض التالية او جميعها:

الم بين معتدل وشديد، في احد شقي الراس او في الجانبين.

صداع يرافقه الشعور بنبض او ضربات في الراس.

ازدياد حدة الالم خلال القيام بجهد جسدي.

الام تشوش قدرة الشخص على القيام بعمله المعتاد.

الشعور بالغثيان، مع او بدون التقيوء.

حساسية للضوء (Photophobia) والضجيج (Phonophobia).

عادة ما تستمر نوبة الشقيقة ما بين 4 - 72 ساعة اذا لم يتم علاجها، اما تواتر النوبات فيختلف من شخص لاخر. قد تظهر الشقيقة عدة مرات في الشهر او مرة او مرتين فقط في السنة.

هناك تفاوت بحدة الشقيقة، لدى غالبية الاشخاص يظهر الصداع بدون علامات انذار سابقة. وقد سمي هذا النوع من الشقيقة في الماضي بالشقيقة الشائعة (Common Migraine).

بينما تظهر لدى جزء اخر من المرضى علامات انذار مبكرة (اورة – aura)، وقد سمي هذا النوع من الشقيقة في الماضي، بالشقيقة التقليدية (Classical Migraine

Dr saif alaa

Cerebellar atrophy... Our operation room cleaner..26 male

24 years old male.our hospital operation room .porter(( cleaner at the operation theater .. Neurosurgery

department , recently developed slurred speech and ataxic gait

Tremors , his memory , cognition are intact

diagnosed as :

DEGENERATIVE CEREBELLAR DISEASE .

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t is Cerebellar Degeneration?

Cerebellar degeneration is a process in which neurons in the cerebellum - the area of the brain that controls coordination and balance - deteriorate and die. Diseases that cause cerebellar degeneration can also involve other areas of the central nervous system,including the spinal cord, medulla oblongata, cerebral cortex, and brain stem. Cerebellar degeneration may be the result of inherited genetic mutations that alter the normal production of specific proteins that are necessary for the survival of neurons.

Associated diseases: Diseases that are specific to the brain, as well as diseases that occur in other parts of the body, can cause neurons to die in the cerebellum. Neurological diseases that feature cerebellar degeneration include:

ischemic or hemorrhagic stroke, when there is lack of blood flow or oxygen to the cerebellum
cerebellar cortical atrophy, multisystem atrophy, and olivopontocerebellar degeneration, progressive degenerative disorders in which cerebellar degeneration is a key feature
Friedreich’s ataxia, and other spinocerebellar ataxias, which are caused by inherited genetic mutations that result in ongoing loss of neurons in the cerebellum, brain stem, and spinal cord
transmissible spongiform encephalopathies (such as Creutzfeldt-Jakob disease) in which abnormal proteins cause inflammation in the brain, including the cerebellum
multiple sclerosis, in which damage to the insulating membrane (myelin) that wraps around and protects nerve cells can involve the cerebellum

Other diseases that can cause cerebellar degeneration include:
chronic alcohol abuse that leads to temporary or permanent cerebellar damage
paraneoplastic disorders, in which a malignancy (cancer) in other parts of the body produces substances that cause immune system cells to attack neurons in the cerebellum

Symptoms of cerebellar degeneration: The most characteristic symptom of cerebellar degeneration is a wide-based, unsteady, lurching walk, often accompanied by a back and forth tremor in the trunk of the body. Other symptoms may include slow, unsteady and jerky movement of the arms or legs, slowed and slurred speech, and nystagmus -- rapid, small movements of the eyes.

What research is being done?

The NINDS funds research to find the genes involved in diseases that cause cerebellar degeneration. Discovering these genes, identifying their mutations, and understanding how the abnormal proteins they produce cause cerebellar degeneration may eventually help scientists find ways to prevent, treat, and even cure the diseases that involve cerebellum

ضمور المخيخ. /و. /. أو/. والحبل الشوكي . تعريفه .أعراض الاصابة . طرق العلاج

السلام عليكم ورحمة الله وبركاتة
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في العقل البشري توجد هناك 14 مليون خلية عصبية ,عشرة أضعاف هذه الكمية من الخلايا موجودة لتتحكم بالأعصاب , هذه الخلايا مقسمة إلى خلايا طرفية ومركزية , والخلايا المركزية مقسمة إلى المخ , الدماغ الأوسط .المخيخ , العصب الدماغي والنخاع الشوكي .
من ضمنها مجموعة تعمل للتحكم بحركة الجسم وهي المخيخ , العصب الدماغي والحبل الشوكي.
المخيخ هو القسم الخلفي من الدماغ وهوأصغر من المخ ويقوم بتنظيم الأوامر التي يتلقاها من المخ وحفظ توازن
الجسم

تعريف ضمور المخيخ والحبل الشوكي:

مرض وراثي وهو إحدى أنواع الاضطرابات التي تصيب مناطق مختلفة من المخيخ وذالك بسبب خلل جيني مما يؤدي إلى ضمور المخيخ والحبل الشوكي.ويعرف بSCA2 وهواختصار للمصطلح الطبي Spinocerebellar ataxai type 2

ويوجد هذا المرض بنسبة واحد إلى اثنين في كل مئة ألف شخص.

أعراض الإصابة ..

أهم أعراض الإصابة اختلال التوازن عند المشي أو مايعرف بالترنح مما يؤدي إلى كثرة السقوط ومع تقدم المرض يحتاج المريض إلى استخدام الكرسي المتحرك ومن ثم فقد الحركة كليا ويصبح المريض طريح الفراش.
انعدام تناسق الحركات العضلية للذراعين مما يؤدي إلى صعوبة الكتابة ومن ثم فقدها كليا.
إصابة العينين ببطء الحركة ممايؤدي إلى عدم القدرة على تقدير المسافات.
بعض المرضى يصابون بالتشنج وتعتبر من الأعراض المبكرة للضمور.
وتزداد الأعراض سوءاً مع تقدم المرض مثل:
صعوبة الابتلاع.
التحدث بطريقة غير واضحة.
ضعف الذاكرة.
الشلل الرعاشي.
وهناك أمراض مصاحبة مثل : التصلب ،الاكتئاب واضطرابات النوم.

الفحوصات اللازمة:

يجب القيام بتحاليل وراثية للمريض وأسرته وذالك عن طريق أخذ عينة من الدم والكشف عن الخريطة الجينية
كما يجب معرفة مدى احتمالية إصابة فرد آخر من الأجيال القادمة بنفس المرض.

طرق العلاج :

حتى الآن لايوجد علاج لضمور المخيخ /. و. /. او/. الحبل الشوكي ولكن هناك علاجات لتخفيف الأعراض وليس لعلاج المرض نفسه مثل :
البوسبيرون (buspiron): يقوم بتهدئة الأعصاب وتحسين القدرة على المشي .
بريميدون(primidon):تقليل الحركات اللاإرادية .

وهناك مجموعة من الأجهزة التي تساعد المريض الاعتماد على نفسه في القيام بالمهمات اليومية،على سبيل المثال : العكاز, الكرسي المتحرك في حالة عدم القدرة على المشي، ،وهناك أجهزة تساعد على الكتابة وتناول الطعام والقيام بالعناية الشخصية في حالة عطوب اليد والذراع , وهناك أجهزة للتواصل مع الناس في حالة فقد القدرة على الكلام ، وكذلك العلاج البدني مما يساعد على تقوية العضلات.

معاناة فتاة مع المرض:

أنا فتاة أبلغ من العمر16 عاما ، علمت بإصابتي بهذا المرض قبل عامين وكانت أول أعراض إصابتي كثرة السقوط وكان لدي الصعوبة في مسك الأشياء , في البداية كنت أعتقد أن هذا بسبب عدم ارتدائي للنظارة الطبية , ولاحظت عدم اتزاني في المشي . في إحدى الأيام رأيت فتاة تتكلم بصعوبة جدا ويدها تتحرك بارتجاج , عندما رأيتها علمت بأنني في يوم من الأيام سوف أصبح مثلها , أحيانا يكون التفكير في مرضي صعبا علي وينتهي بي الحال إلى البكاء. أعتقد أن في يوم قريب سوف أحتاج إلى الكرسي المتحرك , وأنا أحرص على تناول دوائي بانتظام وأدعم نفسي في كل شيء أفعله . وأقول الى كل من يحمل هذا المرض أن لاتستسلم ولاتدع المرض يوقفك.

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الله يعافي كل مريض ومريضة ..