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كوريا الجنوبية والتعليم ..ه
لماذا نجحت كوريا في فرض نفسها بقوة في سنوات قليلة لا تتعدى ثلاثين عاما كدولة اقتصادها من أقوى اقتصاديات العالم وصنعت نهضة علمية أسهمت في تطور التقنية بمختلف مجالاتها؟
Samsung Galaxy S3 VS S4 مقارنه وحشيه !ه
هقدملكم انهارده مقارنه مابين افضل جهازين موجودين فى السوق .. الكل هيقول ان الاس 4 احسن وافضل .. طيب تعرف افضل واحسن فى ايه ؟ .. ان شاء الله معايا انهارده هقارنلكو مابين الأتنين
إظهار الرسائل ذات التسميات More. إظهار كافة الرسائل
إظهار الرسائل ذات التسميات More. إظهار كافة الرسائل
الجمعة، 24 مايو 2013
السبت، 11 مايو 2013
للشاعر القدير: عطا سليمان رموني
قلب العروبة
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قَـلْـبُ العُروبَةِ كُـلُّ العُـرْبِ تَـعْـشَقُها
أرضُ الكَنانةِ أرضُ الفَنِّ والطَّـرَبُ
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يـا مَـوْطِـنَ النِّـيـلِ والأهْـرامُ قاهِـرةً
يـا مَـنْبَع الشِّعْرِ مِصْرَ العِلْمُ والأدَبُ
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قد عزّكِ اللهُ في القرآنِ مكرمةً
مصر ادخلوها أمانٌ أيها العربُ
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عِــزَّاً لِـمِـصْـرَ وَرَغْدُ العَيْشِ أسْعَدُهُ
هَـبْـهـا بِـفَـضْلِكَ ربي الأمنَ منقلبُ
أنا بورسعيدي
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أنا بورسعيدي عاشق للبلد عشقين
عشق الطفوله عشقتك زي ضي العين
عشقتك بعد حج البيت وعمري تجاوز الستين
أبو رمضان بيهواكي بتجري بدمي بالشرايين
عشقناكي يا بور سعيد يا شامه من على الجبين
وهذا العشق ورثتو لاولادي كإرثٍ يحفظوه بالعين
قولولي مين ما يعشقها دي بورسعيد قولولي مين
يا مصر
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يا مَصْرِ عِيشي بِالهَنا
يا عَزَّنا .. يا أُمِّنا .. إنْتِ المُنا..
نِـعْـشِـقْها ونْـقُولْ كُـلِّـنا
يـا مَـصْـرِ أغـلى حُـبِّـنا
إنـتِ يـا مَـصْـرِ فَـخْـرِنا
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يا مَصْرِ آيَهْ فِـي الحَـلآ
في قْلُوبْنا دا إنْتِ الغَـلآ
مِنْ يِعْـشَقِكْ دايْـماً عَـلآ
حَنْقُولْها نِصْرَخْ عَالمَلآ
إنـتِ يـا مَـصْـرِ فَـخْـرِنا
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يـا مَصْرِ يا حِضْنِ الدَّفا
اللْ يِـعْـشَقِـكْ يِدِّي الوَفا
الـحِـقْـدِ مـا بِـينا اخْـتَـفا
يا ربِّ يدومْ بِينا الصَّفا
عَلشانْ ما يِحْصَلْشِ الجَفا
إنـتِ يـا مَـصْـرِ فَـخْـرِنا
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يـا مَـصْـرِ يـا كَيْدا العِدا
لِـيـكـي الـزَّعامَهْ مؤَكَّدا
اللْ كِـلْـمِـتِـكْ لِـيها صَدا
مِينْ اللي يِقْدَرْ يِنْسى جِيشِكْ مَرغوا أنْفَ العِدا
يُومْ سِتَّهْ أُكْتوبَرْ عَبَرْنا والتاريخ بيِشْهَدا
دا انْتِ الجَمالْ .. إنْتِ الدَّلالْ
إنْـتِ يـا مَـصْـرِ فَـخْرِنا
#منقول
الخميس، 9 مايو 2013
shedule of matches !
18:00 Ringside
19:00 Barclays Premier League World
19:45 Live Football Leicester City vs Watford
15:00 Live Romania - Liga I CFR Cluj vs CSS Drobeta Turnu Severin
19:15 Live IIHF World Championships 2013 Sweden vs Canada
17:00 Live Euroleague Basketball Olympiacos Piraeus v CSKA Moscow
20:00 Live Euroleague Basketball Barcelona v Real Madrid
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Problem Solving In Pediatrics
Problem Solving In Pediatrics
Case 1
A 12 months old boy presents to the emergency department with a 6 hour history of vomiting, colicky abdominal pain, and irritability. On physical examination a sausage like mass is palpable in the right upper quadrant of the abdomen What is the most appropriate next step in management?
A. Order a CT scan of the abdomen
B. Order a barium swallow
C. Obtain a surgical consultation
D. Follow up examination after 4 hours
Choice A : a. Points against: time and money wasting + not method of choice, ultrasound is better.
Choice B: a. Points against: shows till duodenum while obstruction is in upper Rt quadrant + baby suffers
from vomiting b. If we were to use this method, we'd use barium enema
Choice C: (the right choice) a. Points with: 1. Age of boy, intussuception usually occurs between 6 months
to 3 y.o. (usually after gastroenteritis) 2. Sausage like mass ( CANT possibly be liver) 3. Since known intussuception, early management is very easy [reduction by pressure] using air Choice D: a. Points against: sausage like mass suggests intussuception, if the last sentence was not in the case this would have been the right choice [hospital admission with regular check up every hour]
b. If a case of intuss. Is left without ttt, it proceeds to gangrene and death, with management necessitating surgical intervention, which would not have been required if managed early (reduction by pressure using air)
Paediatric appendicitis
Pathophysiology
Obstruction is a fundamental factor in the development of
acute appendicitis. Obstruction increases intraluminal
pressure leading to ischaemia, bacterial invasion, bacterial
overgrowth, necrosis, and perforation.
In the early phases, activation of receptors in the
intestinal wall leads to perception of pain in the
periumbilical region. In later phases, when the purulent
secretion from the appendiceal wall contacts the parietal
peritoneum, somatic pain fibres are triggered and the pain
localizes near the appendiceal site, McBurney’s point. The
characteristic organisms responsible of appendiceal
inflammation are predominantly anaerobic, including
Escherichia coli, Enterococcus, Bacterioides fragilis,
Pseudomonas, Klebsiella, and Clostridium5.
Many terms have been used to describe the pathologic
stages of appendicitis, from the normal state to perforation.
Only the clinically relevant distinctions of simple
appendicitis (15.4) and complicated appendicitis should be
made.
Clinical presentation
The classic sequence (persistent abdominal pain, fever, and
localized pain on palpation at McBurney’s point) starts with
periumbilical pain, preceded by appetite loss in about
50–60% of children. The main symptom is abdominal pain,
usually beginning as a vague periumbilical pain or mild
gastrointestinal discomfort. After several hours, this pain
gradually migrates to the right iliac fossa. Characteristically
the pain is implacable and is exacerbated by movements and
pressure, making ambulation painful and difficult. A child
with acute appendicitis typically walks bent over and slowly.
Anorexia is a helpful sign. Nausea and vomiting appear after
the onset of pain. If vomiting precedes abdominal pain,
other diagnoses should be considered.
The last symptom in the clinical evolution is fever, which
appears after pain and vomiting, and no more than 1ºC
above normal. Fever higher than 39ºC is usually associated
with complicated appendicitis (gangrenous and perforated).
Symptoms may be influenced by the anatomical location of
the appendix. Pain of a retrocaecal appendix may be in the
flank or back. A pelvic appendix resting near the ureter or
testicular vessels can cause urinary frequency, inguinal or
testicular pain, or ureteral compression with hydro -
nephrosis. Young patients aged 1–4 years, typically show
vomiting and irritability, and draw up their legs to reduce
pain. Other common manifestations include abdominal
distension, diarrhoea, lethargy, and anorexia, together with
fever. In 50% of cases an abdominal mass is detectable on
palpation. The key point in this group of patients is
vomiting.
